Max Gerson

Overview
Max Gerson (18 October, 1881–8 March, 1959) was a German physician who developed the Gerson Therapy, an alternative dietary therapy which he claimed could cure cancer and most chronic, degenerative diseases. Gerson described his approach in the book A Cancer Therapy: Results of 50 Cases. However, when Gerson's claims were independently evaluated by the National Cancer Institute, it was found that Gerson's records lacked the basic information necessary to systematically evaluate his claims, and the patients who were "cured" by his treatment were also receiving standard, effective medical treatment simultaneously. The therapy is considered scientifically unsupported and potentially hazardous, and has been blamed for the deaths of patients who substituted it for standard medical care.

Life
Gerson was born in 1881 to a Jewish family in Wongrowitz, in the German province of Posen. According to Gerson's grandson and biographer, his choice of career in medicine was influenced by the general anti-Semitism of German science at the time, as science was closed to Jews, but medicine was open.

Gerson's biographer states that Gerson, as a resident physician, suffered from migraine headaches. Gerson altered his diet, eliminating many staples of German cuisine, and eventually claimed that he no longer had headaches. Entering private practice in Bielefeld, Germany, Gerson prescribed his migraine diet to patients.

When a migraine patient reported that his lupus vulgaris, or skin tuberculosis, had cleared up on Gerson's diet, Gerson treated other patients and claimed success. Pulmonary surgeon Ferdinand Sauerbruch heard about Gerson's success with lupus and invited him to conduct a clinical trial of his therapy at Sauerbruch's tuberculosis ward in Munich. 450 tuberculosis patients were placed on Gerson's diet, and Gerson claimed that 446 patients completely recovered. With Sauerbruch's backing, Gerson's diet became a popular therapy. Current advocates of the therapy claim that many Swiss tuberculosis sanatoria were put out of business by Gerson's discoveries, and are now ski resorts, including Davos and Gstaad.

During Gerson's career in Europe, he supervised tuberculosis sanatoria in Germany (Bielefeld, Kassel, Berlin, Munich), Austria (Vienna) and France (Ville d'Avray, near Paris). He published in European medical journals and lectured to university and medical society audiences, but Gerson's peers were not convinced of his successes with tuberculosis, alleging that he had faked x-rays and treated patients who never had TB, among other unethical behavior.

According to Gerson, he agreed in 1928 to treat a woman who was told she had incurable bile duct cancer. Gerson said that she recovered, along with two of her friends who also had cancer. Gerson posited that artificial fertilizers and pesticides were fuelling what he called an epidemic of degenerative diseases, and began to advise his regional government on agricultural practices. Gerson stated that he had collected evidence for his therapy and was on the verge of presenting his results, but that he lost his study as a result of the Nazi rise to power in Europe. Gerson left Germany when the government began arresting Jews, saying that he was forced to leave behind the results of his study.

In the United States
As a German Jew, Gerson fled Germany with his family in 1933, first to Vienna, then to Ville d'Avray (near Paris), then to London. He settled in New York City in 1936.

In 1946, Senator Claude Pepper (D-FL) summoned Gerson to testify about his cancer therapy before a Congressional Subcommittee hearing to appropriate $100 million for a cancer research center in which Gerson was expected to play a major part. Gerson presented to the US Congress what he claimed were five healed terminal cancer patients who testified to recovering from incurable disease, but he got little media attention and the appropriations bill died in the Senate.

In the U.S., Gerson applied his dietary therapy to several cancer patients, claiming good results, but colleagues found his methodology and claims unconvincing. Proponents of the Gerson Therapy now claim that medical authorities conspired to keep him from publishing in the peer-reviewed literature in the United States. In 1958, Gerson published a book in which he claimed to have cured 50 terminal cancer patients: A Cancer Therapy: Results of 50 Cases.

Gerson Therapy
Gerson's therapy required the patient to consume raw vegan food and to drink an 8-ounce glass of fresh organic juices every waking hour. Coffee and castor oil enemas were among several types of prescribed enemas, and some patients were given hydrogen peroxide orally and rectally. Rectal ozone was also applied. Dietary supplements include vitamin C and iodine. The diet prohibited the drinking of water and consumption of berries and nuts, as well as use of aluminium vessels or utensils.

Initially, patients were required to drink several glasses of raw calf liver extract daily. Following an outbreak of Campylobacter infection linked to the Gerson clinic's extract, which sickened and killed several of the clinic's patients, carrot juice was substituted.

Animal products and fats and oils were excluded (except for the raw calf liver extract and flax-seed oil), as were supposed sources of toxicity, including tobacco, salt, alcohol, fluorides, pesticides, food additives, and pharmaceuticals. Foods were to be fresh, organically grown and unprocessed. The therapy claimed to reverse any ill effects of exposure to environmental toxins over the course of 6–18 months, and Gerson believed it would be effective against most chronic diseases including tuberculosis, fibromyalgia, most forms of advanced cancer, arthritis (both osteoarthritis and rheumatoid arthritis), and diabetes.

Gerson's claims of success attracted some high-profile patients, as well as other alternative medicine practitioners. Gerson's daughter, Charlotte Gerson, continued to promote the therapy, founding the "Gerson Institute" in 1977.

Evidence
Gerson's therapy has not been independently tested or subjected to randomized controlled trials, and thus is illegal to market in the United States. The Gerson Institute claims that Gerson's observational studies and case reports are anecdotal evidence of the efficacy of the treatment. In his book, Gerson cites the "Results of 50 Cases"; however, the U.S. National Cancer Institute reviewed these 50 cases and was unable to find any evidence that Gerson's claims were accurate. Gerson Institute staff published a case series in the alternative medical literature; however, the series have suffered from significant methodological flaws, and no independent entity has been able to reproduce the Gerson Institute's claims.

Independent anecdotal evidence suggests that the Gerson Therapy is not effective against cancer. When a group of 13 patients sickened by elements of the Gerson Therapy were evaluated in hospitals in San Diego in the early 1980s, all of them were found to still have active cancer. The Gerson Institute's claimed "cure rates" have been questioned; an investigation by Quackwatch found that the Institute's claims were based not on actual documentation of survival, but on "a combination of the doctor’s estimate that the departing patient has a 'reasonable chance of surviving,' plus feelings that the Institute staff have about the status of people who call in." In 1994, a study published in the alternative medical literature described 18 patients treated for cancer with the Gerson Therapy. Their median survival from treatment was 9 months; at 5 years out, 17 of the 18 patients had died of their cancer, while one was alive but with active non-Hodgkin lymphoma.

The American Cancer Society reports that "[t]here is no reliable scientific evidence that Gerson therapy is effective in treating cancer, and the principles behind it are not widely accepted by the medical community. It is not approved for use in the United States." In 1947, the National Cancer Institute reviewed 10 "cures" submitted by Gerson; however, all of the patients were receiving standard anticancer treatment simultaneously, making it impossible to determine what effect, if any, was due to Gerson's therapy. A review of the Gerson Therapy by Memorial Sloan-Kettering Cancer Center concluded: "If proponents of such therapies wish them to be evaluated scientifically and considered valid adjuvant treatments, they must provide extensive records (more than simple survival rates) and conduct controlled, prospective studies as evidence."

Safety concerns
Coffee enemas have contributed to the deaths of at least three people in the United States. Coffee enemas "can cause colitis (inflammation of the bowel), fluid and electrolyte imbalances, and in some cases septicaemia." The recommended diet may not be nutritionally adequate.