THE TREATMENT OF CANCER WITH PHENERGAN

The basic therapy is the result of a long investigation standing fully in the tradition of academic research. It has been known for centuries that on rare occasions Nature herself destroys malignant growth, as for example, during an attack of erysipelas. Precisely the same principle of destruction, namely, the selective disruption of energy metabolism, is exploited here. On the other hand most conventional treatments seek to impose an artificial form of death upon tumours. Because cancerous cells obstinately refuse to die in the preconceived manner laid down for them, the failure rate is unacceptably high. There may also be horrendous side effects and sharply increased risks (see Toxicological Considerations, below).

Unlike many standard treatments the procedures are highly selective. The active principle triggers a cytotoxic mechanism (necrosis) within the malignant cell; energy metabolism in mitochondria, the power houses of the cell (see Scientific Basis, below), provides the chemotherapeutic target. The schedules set out here aim to destroy both primary and secondary growths in two stages; first, by bringing about extensive tumour destruction over a period of a few hours, and second, by a process of attrition. These are early pioneering days; not all cancers have been found to be sensitive.

History of the Project: The work began with the arrival of a bright idea in the spring of 1974, but it was not until March 1996 that the first draft of this protocol was posted on four web noticeboards. Since then various refinements, notably the introduction of oral calcium, have been introduced. In none of the successive versions was any mention ever made of the personal struggles and sacrifices made over the years. The key advance would be to hold a limited clinical trial (see Clinical Trials, below), but this will probably never take place.

Now the time has come to add a personal note. Thirty years ago it became clear that whatever the ultimate outcome of this ambitious project might be, there was a story to tell. Writing began in October 1996, and the first edition of a book, In the Darker Shadow of Science: the Subjugation of Cancer, appeared in 2007 in a private limited edition. A revised and extended version is now available through booksellers in hard copy and E-book form. Details, together with a synopsis, are available on the web. The text is recommended to anyone with an interest in cancer and scientific biography; patients, their relatives, doctors, clinicians, scientists, administrators and students of the history of science.

Phenergan, one of the safest of all medicines, forms a central part of the story. Within two months of the appearance of the revised edition of the book HealthGrades Inc., an American company based in Colorado, issued an URL entitled Promethazine - Teratogenic Agent. The document is readily called up by entering promethazine and cancer into Google and other search engines. On each of the seventy-odd occasions that the word Promethazine is mentioned, it is always qualified by the phrase -Teratogenic Agent. But promethazine is not teratogenic. Search the document as you may; nowhere will you find any documentary evidence to support this astonishing statement.

Morning sickness can be a dreadful problem in pregnancy. Entering the words into Google will call up numerous sites. Several give advice to the effect that the best plan is to grin and bear it (that can only have been written by men), but if the condition becomes insufferable Phenergan is advanced as the anti-nausea medication of choice. So much for its alleged teratogenicity. One of the sites provides three references to its safety in pregnancy. What HealthGrades Inc. does not tell you is that the great majority of conventional anti-cancer drugs are highly poisonous. Inspection of their chemical structures suggests a good proportion are themselves likely to be teratogenic agents.

What lies behind the action of HealthGrades Inc.? Why have they done it? The safety record of Phenergan compares brilliantly with the great majority of anti-cancer drugs in common use. A majority of doctors will instantly perceive that HealthGrades Inc. has endangered its reputation. Certainly any cancer patient whose curiosity leads them to venture beyond this text may be persuaded not to follow the protocol. That no guarantee of success can be given is stated often enough; but for the cancer patient who might perhaps derive help from Phenergan treatment the consequences of dissuasion are likely to be serious. And that is something which must lie on the conscience of HealthGrades Inc.

HealthGrades Inc. is not alone. Millions of parents are grateful for the safety and effectiveness of Phenergan when given as instructed to children over two years of age. An assiduous search of the literature has traced only two fatalities from oral administration, both in infants and both caused by overdosing. This year a legal firm, Resource4ThePeople, and also American, began to offer to take legal action against manufacturers of Phenergan on behalf of parents who believe they have a child suffering injury from the sedative. The invitation will attract litigious parents on the make. These two developments illustrate the extent to which drug companies are prepared to go in order to deny unconventional benefit to cancer patients.

Situation of the Patient: Individuals struck down with the disease understandably respond with resentment, sometimes anger, at the injustice of their dreadful predicaments. As if the initial diagnosis is not bad enough, to be told, perhaps abruptly, that a treatment has been unsuccessful is a worse experience that may be lurking in store. Cancer patients deserve respect and dignity; the intentions are to spare further anguish, to extend survival, to improve quality of life, and to provide a chance of physical healing.

Very reasonably, patients want to know if their particular form of malignancy is likely to respond to the procedures described here. Forms of the disease which have displayed sensitivity to Procedure I include non-Hodgkin's lymphoma, cancer of the oesophagus, lung cancer and a chordoma; instances of breast cancer and colorectal cancer, all with secondary spread, also responded. Less experience has been gained with Procedure II, but apart from greater effectiveness no substantial differences are anticipated. Malignancies found to be insensitive are listed under [7], below.

A small minority, about 2-3%, of patients, find the treatment insupportable. There may be a positive response; there may not. No guarantee of a successful outcome can be given. Sincere apologies are made to those who cannot be helped. On several occasions relapse has followed tumour regression. Patients should be alert to this scenario and be prepared for the worst. In these instances only a single cancer cell needs to have undergone transformation (genetic mutation) into a drug resistant state. Such an event can happen at any time (see [6], below). The tumour will then consist of both sensitive and insensitive cells; after the therapy has killed the sensitive cells off, the insensitive cells gain the upper hand. The best hope then is surgery, but if resistant cells have already spread the outlook is poor.

Although certain drugs not classified as anti-cancer agents can cause limited injury to tumours by interfering with energy production (see website below for details), only very few are suitable for cancer treatment. Some belong to the group known as phenothiazines, a number of which have been in use for over sixty years. Their diverse uses include the treatment of psychoses, nausea, allergy, enhancement of analgesia and as muscle relaxants.

Phenergan, the active principle in this form of cancer therapy, is currently used as a paediatric sedative, as an anti-histaminic, and to quell morning or travel sickness. The agent has also been used as an anti-emetic in patients undergoing conventional chemotherapy, but, unlike chlorpromazine (Largactil) whose effectiveness in cancer patients has been anecdotally described in the medical literature (see website below), it is not used for chronic administration. The effects of Phenergan on the central nervous system are less marked than those of most other phenothiazines, which is considered an advantage. The fact that its anti-cancer potential has managed to escape detection in hospitals and clinics is attributed to two factors. First, tumour injury caused by brief adventitious medication with the phenothiazine will naturally be ascribed to simultaneous anti-neoplastic treatment. Second, any benefit will only be transient. Resistance develops when Phenergan is given on an intermittent basis (see Duration of Treatment and Outcome, below). Unpublished experiments revealed that the glucose content of mouse tumours with diffuse necrosis resulting from an attack on oxidative metabolism was significantly higher than in untreated controls, enabling surviving cells to grow more quickly.

The first doctor - in fact, the only doctor - to administer Phenergan to cancer patients was an Egyptian diabetologist, the late Dr Riad Mahmud. He gave Phenergan, calcium and papaverine in sequence by intravenous injection with the intention of relieving pain. Phenergan was continued orally at 8hr intervals. To his surprise all three patients with pancreatic cancer survived. The procedures described here rely heavily on his experience. Cancer is a serious disease, and its treatment needs to be considered in earnest. The apparently innocuous nature of the protocol should not encourage a flippant attitude. Rigid adherence to the advice is essential. The selectivity of the procedure allows a patient to go about his or her business almost entirely as normal while sustaining the full force of the therapy. Almost; patients need to adapt to the new situation. Mental strain and over-exertion should be avoided.

The original self-medication protocol (Procedure I) was posted on the web in February 1996. It is included in the book How We Controlled our Cancers (Wesprint Holdings. Subiaco, 2001) which the author, Jill Royce, generously made available in every lending library in Australasia. Details are also to be found in Conventional Cancer Cures: What's the Alternative? (ed. Chris Woollams. Health Issues Ltd, Bath Press, Bath, 2005). Over the years several organisations interested in providing patients with sensible non-orthodox help began to include the methodology on their websites. Patients no longer take the trouble to report back with their experiences, which suggests that the therapy has had a beneficial effect. It follows that no estimate of the number of beneficiaries can be made.

Procedure I has been modified (Procedure II) with a view to increasing cell kill and shortening the period of treatment. The latter is recommended as the option of choice. The advice should be read through several times before commencing, and read again frequently so as to avoid mistakes. Both protocols may be regarded as simple prototypes in the same light as the earliest primitive cameras, motor cars or aeroplanes. There is a need to be realistic and not to allow hopes to rise too high. Patients are expected to meet the modest costs (currently about £4-£5 a week in the UK) of their treatment. There are no hidden expenses.

Caution: To date the question of safety has not been an issue, but Phenergan treatment with calcium can cause slight tumour enlargement which may initially cause problems, especially if the disease has reached an advanced stage. For example, in a patient with obstructive carcinoma of the oesophagus swallowing became more difficult on the next day, but gradually returned to normal over the next few weeks. Patients need to decide which procedure to adopt. Difficulty may be encountered in instances where growths obstruct natural functions. In these circumstances Procedure I would be preferable.

Contra-Indications: The list below is as comprehensive as possible. Cancer patients are unlikely to benefit if:

[1] Steroids are being administered in high doses. This form of interference with anti-cancer activity is unstable. Therapy with Phenergan can be commenced three days after cessation of steroid medication.

[2] Analgesics classified as non-steroid anti-inflammatory drugs (aspirin, ibuprofen, diclofenac, etc) are being taken. Here the advice is to wait for a week before commencing. Serious pain calls for professional attention. Paracetamol, temporarily and in moderation, is suitable; so are opiates (for example, morphine given on prescription). A TENS (transcutaneous electrical nerve stimulation) device can provide limited measures of relief.

[3] Polyunsaturated (essential) fatty acids are micro-nutrients. They are required for normal health, and some participate in the process of tumour destruction. Scaly skin, especially on the backs of the hands, can indicate that the patient has a deficiency.

[4] There is dietary supplementation with vitamin E, a matter calling for special mention. Most diets already contain amounts adequate for a healthy life style. For individuals free from cancer supplementation (50-100iu daily) is beneficial, offering protection against coronary heart disease. Unfortunately the same beneficial properties are exploited by cancerous growths, which accumulate vitamin E as protection against pharmacological attack.

Some dietary schedules drawn up for cancer patients include substantial amounts of vitamin E. The wisdom of these recommendations is questioned. While it is known that vitamin E protects against the development of cancer, there is nothing to suggest benefit is to be gained once malignant disease is established. Indeed, several patients receiving supplements (400-1200iu daily) failed to respond to Phenergan. Current advice is therefore to stop supplementation immediately and to wait ten days. Likewise, selenium supplementation above the recommended dietary allowance (RDA) is not recommended.

[5] There has been brief or intermittent exposure after the onset of disease to phenothiazines or to certain chemically-related drugs possessing similar anti-cancer properties. In contrast with the situations in [1]-[4], this form of resistance is relatively stable.

[6] Although the cellular division rate for many cancers is between 3-5 days, such is the extent of attrition that many tumours take around two months to double in volume. Multi-drug resistance may arise spontaneously, from radiotherapy, or from treatment with cytotoxic drugs. A mutation in a cancerous cell resulting in partial or complete disablement of the cytotoxic mechanism will influence the growth rate by variable extents depending on its site within the genes. Clones of mutant cells may in consequence show varying degrees of sensitivity to therapy. For example, in one patient with metastatic ovarian disease two calcified cancers remained static over a four-month period. Another grew in volume by 20%; a fourth, by 50%; yet another, considered to be of different origin, doubled twice. Preliminary unpublished data suggest that patients who have not been exposed to radiotherapy have a better chance both of responding positively and also of avoiding relapse.

[7] The disease is prostatic cancer, melanoma or mesothelioma. At the present time it is not known if these early findings reflect the presence of an intrinsic resistance mechanism. The question is discussed below (Scientific Basis).

[8] Two patients with brain tumours (astrocytomas) enjoyed longer survival than expected as a result of Phenergan treatment, but the chances of full recovery would appear to be remote. Anafranil (clomipramine) may be a more suitable drug in such instances, but is available only on prescription. Patients are advised to search the web for advice (Google; enter the words: brain cancer clomipramine).

Toxicological Considerations: The safety record of Phenergan is phenomenal. Introduced in 1947, the phenothiazine has found application worldwide. The situation in orthodox cancer treatment is dramatically different. For example, in November 2008 the National Chemotherapy Advisory Group in the UK issued a report (National Confidential Enquiry into Patient Outcome and Death) on the role of permitted drugs in the causation of death in cancer patients. Over six hundred who had died within thirty days of receiving chemotherapy were included in the survey. The conclusion was that for a quarter of the patients it was the toxicity of the chemotherapy and not the course of disease that had either caused or hastened death. Moreover, over 40% suffered significant toxic effects from their treatments. The relevance of the findings to the protocol is not to be underestimated.

Self-Medication Procedures: Pre-Treatment: These supportive recommendations are intended to optimise the outcome. Where circumstances are pressing there may be no time for pretreatment, and Phenergan therapy, together with the supplements, should be inaugurated immediately.

1. Before commencing, patients should preferably consume at least 3g of omega-3 polyunsaturated fatty acids daily together with the recommended supplements for at least three days. Flax oil may also be taken. The intake can be cut back if bowel looseness is experienced. Should it be noticed during the course of treatment that bleeding from a cut or other injury lasts for longer than usual, the supplement may need to be stopped for a few days and the amount reduced on resumption. Medical assistance should be sought.

2. Patients are advised to take 250mg each of inositol and choline daily, and to cut back to once every three days after a month. These naturally-occurring substances are available from health stores. Inositol hexaphosphate (also known as IP₆), which contains only 23% inositol and has the disadvantage of forming insoluble precipitates with calcium within the bowel, is not recommended.

3. Certain trace elements are recommended with the intention of protecting the white cells of the blood against rare side effects (dyscrasias). A multi-vitamin/mineral preparation containing the RDAs of copper (2.5mg), manganese (4mg), zinc (15mg) and selenium (50mcg, or 0.05mg) is advised. Minor deviations from these amounts, which should be taken daily, are unimportant. Because the intention is selectively to induce peroxidation within cancerous cells, supplements of vitamin C (RDA 60mg) and vitamin E (RDA 10-15 international units) in excess of RDA values should be avoided as far as possible. Anti-oxidant preparations, especially those of Chinese origin, should also be avoided. The multi-vitamin/mineral preparation needs to be continued for the entire duration of the therapy.

Procedure I. Phenergan alone (original protocol): Treatment is initiated by taking Phenergan as a 50mg dose one evening at retiring. On the next day a total of 3x25mg needs to be taken every eight hours in divided doses of 25mg (7am, 3pm, 11pm are suitable times) and thereafter for as long as necessary (see Continuity of Action, below).

Procedure II. Phenergan with Calcium: The first day of therapy should be designated free of activity. Most of the side effects will be experienced within hours of commencement. Two further days of rest should be planned. Patients must not attempt to follow the instructions by themselves. When Phenergan is combined with calcium, subjects usually fall asleep after an hour or so. For this reason it is essential to have a reliable partner or close friend present throughout the first day to ensure the instructions are closely followed. Other responses are described under Side Effects.

The first day of treatment is unique. Meals should be light and carbohydrate-free. Omelettes, vegetables, bran preparations, fruit, and any foodstuffs low in sugar are all suitable. Apart from alcohol there are no fluid restrictions; drinking is encouraged. Tea, coffee and fruit juices should be sugar-free. For convenience treatment may be commenced at 9am. The schedule is as follows:

0hr: 50mg Phenergan.

1hr: 800-1200mg soluble calcium in 100-150ml (4-6fl.oz.) water.

2hr: 400-600mg soluble calcium in 100-150ml water.

4hr, 7hr and 10hr: as for 2hr.

12-14hr (the exact time is not important): 25mg Phenergan. (See Warning, below).

Soluble calcium is generally available as tablets in a variety of preparations, many of which are pleasantly effervescent; for example, 250mg, 400mg (UK; Sandocal), 600mg (Caltrate), 1000mg (Sandocal) or 1200mg (Calsource). Tablets of 1000-1200mg require to be snapped in two. To ensure solution, water (100-150ml) should be added 15-20 minutes beforehand. The total amount of calcium is 2.4-3.6g over a period of 9hr. The precise amount is not considered critical.

During the first day it is anticipated that products of tumour destruction will be excreted in the urine. Patients with close hospital connections might be able to commission analyses of urinary metabolite excretion, especially of nitrogenous components.

On the next day it is vital to continue thereafter as in Procedure I, with 25mg every eight hours. In addition calcium, 200-300mg, may also be taken daily 30 min. after the last dose of Phenergan. Apart from the first few days only a minority of patients feel sleepy. If sedation persists after a week, the regime may be altered to 10mg at 7am, 10mg at 3pm, and 25mg at 11pm.

Side Effects: Not long after commencing Procedure II the patient may fall asleep. Restlessness of arms or legs or both, described by one patient as `twitching', are very likely to occur. This is a good sign and indicates destruction of malignant tissue. Identical effects are seen in brain tumour patients undergoing treatment with clomipramine (Pilkington, personal communication). On the whole patients do not find the experience unpleasant. Sensations of nausea are uncommon, and can be suppressed by (non-alcoholic) drinking. Fatigue and soreness can occur and may persist for a day or two. Driving a car or using machinery or sharp tools are not recommended, at least for a fortnight.

In contrast the response of a subject who was free from cancer was totally different; only a mild transient sleepiness was experienced at 8-10hr, and there was no twitching. Similarly, no significant response was observed in a terminally-ill patient who failed to respond to Phenergan and who died two weeks later. In all probability the entire tumour was insensitive to Phenergan. No instances of pain resulting from the therapy have been reported, but paracetamol would be a suitable analgesic.

Few patients experience difficulty with Phenergan therapy, but there has been an instance of dry mouth. Chronic treatment is tolerated well. One patient maintained herself on the full schedule for over four years; another, who kept on for nine years (1998-2007), experienced a modest gain in weight. The only patient who found the therapy insupportable responded to every other medication in a similar manner. The very small chances that jaundice may develop within a few days, or that the white cell count may fall (leucopenia or agranulocytosis) after 4-6 weeks, cannot be ruled out. The former may be indicated by a yellowing of the features, the latter by sore throat. Thrombocytopenia (fall in platelet count) is again highly unlikely, and may be indicated when minor cuts bleed for longer than usual, or by bruising. Alternatively the condition may be caused by an excessive intake of polyunsaturated fatty acids, as mentioned above. As far as the author is aware, so far none of these effects has been encountered.

Diary: Patients are advised to keep detailed and accurate records of their progress. The information should include dates of consultations, diagnosis, commencement of treatment and scans. Body weight, medications (drug identities and doses, frequency of medication), sessions of radiotherapy and chemotherapy, measurements of scans and relevant blood components, response to therapy, sleeping pattern, general outlook and observations of well-being. Anything else relevant to alterations in condition should also be noted.

Effects on the disease can be monitored by any means available. Even a dressmaker's tape measure and a little native wit can provide useful information. The results from marker levels and scans should be interpreted with care. If therapy is commenced between measurements, it should be borne in mind that shrinkage due to Phenergan may be offset by tumour growth prior to commencement. A similar argument applies to tumour markers, where a decrease may be partly cancelled out by a previous increase. The temptation to delay in order to make comparisons between the effects of different treatments may appear attractive but should be resisted.

Warning: In most countries Phenergan can be freely purchased in the form of 10mg and 25mg tablets; other phenothiazines are available only on prescription. The availability of Phenergan varies from country to country; for example, in Canada the product has been withdrawn. Patients should be extremely cautious and make absolutely sure it is promethazine they are receiving. The use of adulterated or counterfeit products obtained from the internet has led to failure. Formulations in which Phenergan is provided in conjunction with other drugs should be avoided. In view of the serious consequences of premature discontinuation, if a marked improvement is maintained after a few weeks patients would be well advised to purchase sufficient Phenergan to last for two or three months in case procurement becomes difficult.

Some patients inadvisably take matters into their own hands and modify the procedures. This has occasionally led to disaster. For example, an elderly patient with cervical cancer decided to reduce the Phenergan dose to 10mg every evening, with catastrophic effect.

Duration of Treatment and Outcome: Success depends on sustaining destructive pharmacological pressure against the cancer over an appropriate period of time. It is vital, therefore, that every effort be made to keep closely to the timings. An hour or so either way is not critical, but if a dose happens to have been missed, it should be taken immediately. In providing advice note has been taken of patient input. The therapy takes time; just how long it will be necessary to keep taking Phenergan will depend, among other factors, on tumour type, the extent of disease at the commencement of treatment, and on the state of nutrition.

The question of when best to discontinue is not as simple as was once thought. The protocols need to be continued well beyond the apparent elimination of disease. This period has been arbitrarily put at six months, but should be extended if anxiety exists. With Procedure I it may be necessary to stay with Phenergan for two years or more, especially where there are secondary deposits in the bone. Even if the treatment fails to halt the progress of disease, Phenergan can enhance quality of life and extend survival (see Introduction). In other words, the therapy places the patient in a no-lose situation. As a general point, although this treatment is not advanced as a substitute for surgical debulking, Phenergan reaches those parts which the scalpel cannot.

The earlier the presentation, the better. Whether a favourable outcome ensues or not depends in part on the medical history of the patient. Other factors influencing the outcome have been discussed above. No matter how hopeless the situation may appear, some positive outcome from Phenergan is not necessarily out of the question. On the basis of current experience with more than sixty patients the chances of remission are a little less than half; of improvement in the quality of life and extension of survival, about two-thirds. What is certain is that unless the therapy is started, the chances of success will remain unaffected.

Phenergan treatment should not be prematurely discontinued without good reason. Poor compliance has been responsible for failure. Of those who decided to abandon the therapy prematurely, none survived. If treatment is interrupted before the growth is wholly eradicated, residual tumour cells acquire resistance and Phenergan will be found to have no anti-tumour effect second time round. No reason is known for this peculiar behaviour, and no reliable means of resensitisation is known at the present time. However, in one or two cases sensitivity has returned spontaneously after a year or so, and for no apparent reason. One patient believed sensitivity returned as a result of switching to a diet free from gluten and dairy products, but her benefit was temporary. If it is decided to try once more, it will be necessary to recommence either one of the procedures as though starting from scratch. Advantage can only be taken if the disease is slow-growing; it is unusual for survival to last sufficiently long for resensitisation to take place. The maxim is: if in doubt, don't drop out.

It might be added that it is not considered likely that there will ever be a `cure' for cancer in a journalistic sense. What is sure is that until the principle of destroying cancer by disrupting energy metabolism within malignant cells is accepted by the medical and scientific establishments, the merciless toll will continue. Properly directed research is vitally necessary, and will only come about when the cancer establishment agrees (see Clinical Trials, below).

Response to Therapy: A general improvement in terms of weight gain, sounder sleep, restored appetite and general well-being should be noticeable at least by the end of the first week. Lessening of pain is an encouraging sign, but where there is involvement of bone several weeks may pass before relief is noticed. The advice on offer is gentle and humane; for those with experience of the fiercer forms of chemotherapy and radiotherapy the difference will come as a welcome surprise. Patients suffering from radiation-induced injury may find that Phenergan provides some measure of relief. Peripheral neuritis in a single case of post-mastectomy radiation cleared up after a number of weeks.

Precautions: A leaflet is provided with the Phenergan packet; the instructions should be read and, apart from discontinuation, followed. Alcohol appears not to interfere with the anti-cancer action, but abstinence is advised by the manufacturer. Exposure to ultraviolet light and sunlight, especially sunbathing, are to be avoided as far as possible. The group of drugs known as monoamine oxidase inhibitors must not be taken in conjunction with Phenergan.

The following example illustrates a potential danger from viral infection. At the time of commencing therapy with Phenergan there were thirteen `hotspots' in the bones of a patient with metastatic breast cancer. After two years none was active, but later an attack of influenza was followed by drug-resistant resurgence at new sites; the patient survived for another seventeen months. This single case would suggest that contact with viruses should be strenuously avoided.

Clinical Trials: As mentioned above, the next logical step would be to put the therapy through a clinical trial. Despite the impressive weight of supportive scientific evidence (eg, see Notes on the Treatment of Cancer with Low-Dose Phenothiazines with Special Reference to Promethazine on the website of the Cancer Support Association of Western Australia. Research section: www.cancersupportwa.org.au/research2.php Username, robert1: password, australia References to the use of chlorpromazine and to other drugs which affect cancers adversely in the same manner are included) and numerous appeals over a number of years, quite apart from the evident urgency of the situation, no cancer charity, research council or pharmaceutical company has agreed to run a trial.

In sharp contrast with the great majority of trials, where the differences in response are so minimal that large groups are required, the effectiveness of the regimes would entail small numbers of participants. Once success is established, informed research could quickly bring about such improvements as shortening the period of treatment and extending the range of sensitive tumours.

Patent cover for Phenergan, which was introduced in 1947, has long since run out. When an approach was made to the UK manufacturer, the reply was that the costs of development and of protecting new use application were anticipated to be too great and the returns too small to justify action.

Scientific Basis: Chemical energy is produced within cells by subcellular organelles known as mitochondria. In normal cells these structures produce some 95% of the energy required for cellular maintenance, but in cancer cells they function inefficiently in a continual state of partial disablement. This weakness, the Achilles heel of malignant growth, is characteristic of all tumours investigated to date, and is thought to account for the wide range of sensitivity to Phenergan. A proportion of the energy produced is dissipated as heat, which explains why, as has been known from the time of Hippocrates, many tumours are hot to the touch.

In theory, then, all cancers should be amenable to this form of therapy, but in fact a small proportion (see [7]) is not. The tentative reason is thought to be an unusually high glucose content. Glucose facilitates recovery from injury; prolonged exposure to calcium is anticipated to deplete the sugar in the tumour mass, thereby further endangering tumour viability. Unpublished experimental findings indicated that pharmacological attempts to lower the blood glucose may not necessarily augment cellular damage, and that insulin promotes recovery of malignant cells from injury.

The disruption of energy metabolism within malignant cells caused by Phenergan is believed to weaken defences sufficiently to allow calcium to enter the cells and wreak serious damage. Documentation can be found in Notes on the Treatment of Cancer... On the first day of Procedure II calcium carries the major burden of tumour destruction. Calcium has the same overall effect as Phenergan, but with these differences; the damaging action is more direct, more effective, and cannot be blocked.

Relationship of the Patient with the Doctor and Cancer Specialist: The help and support of medical advisers is valuable and must at all costs be enlisted, retained, and respected. Being secretive is discourteous; keeping your oncologist fully informed is essential. Your doctor is most unlikely to have heard of the therapy; cynicism can therefore be expected. In this situation the only question that can reasonably be expected to be answered is whether or not harm is likely to ensue. Accurate reports of progress need to be requested. Tumour regression is always welcome, but even if the news is not good, abandoning the therapy should be considered most carefully.

A diagnosis of cancer calls for an unusual measure of bravery. Those who manage best are sufficiently courageous to face the future with equanimity. The prognosis with conventional treatment should be requested. Doctors are sometimes reluctant to spell out the gravity of a situation. In providing a false sense of optimism patients may be left with an option that disguises a poorer chance of survival.

If attempts are made to dissuade, it may be asked what the dangers of the treatment with Phenergan are perceived to be. Reassurance is likely to be given that the risks are small. Uniquely for an alternative treatment, this is a procedure with a firm scientific base. Reference can be made to "Successful Cancer Therapy with Promethazine: the Rationale," published in Medical Hypotheses 46, 25-29 (1996). Further evidence and references to the literature can be found in Notes on the Treatment of Cancer... (see website). The site also includes a list of the author's publications from 1976 onward on the theme of cancer destruction through interference with energy metabolism.

Orthodox Treatment and Self-Medication: In England doctors go to much trouble to sustain hopes of remission, and are the beneficiaries of measures of deep faith from their patients. Optimism is seen as a useful adjunct to recovery. An understandable reluctance exists to tell a patient that a condition is incurable, a shattering experience for which few are prepared. A dangerous sense of false security may be engendered by a favourable report of tumour shrinkage; difficulty can be experienced in accepting the reality of subsequent relapse.

In some instances there may be less time for deceptive sympathy, and the message appears blunt and uncompromising. In Australia when, as often happens, patients are sometimes told that there is no hope of recovery, the Phenergan option may be accepted with alacrity. It is not generally understood that remissions from conventional treatment are not always permanent, nor that once secondary growths become established the chances of recovery with orthodox treatment are by no means good. On the other hand, if a cancerous cell sensitive to Phenergan migrates and establishes itself elsewhere in the body as a secondary growth, there is no reason why its genetically-determined properties should undergo change as a consequence of the move. Available experience supports the idea that, subject to mutation, when a primary growth is sensitive to Phenergan its secondaries can be expected to respond.

Alternative Approaches: Modern medicine is often miraculous. Antibiotics, transplants, open-heart surgery, joint replacements come to mind. Unhappily the conventional treatment of cancer has not kept pace with other advances in health care. The failure of orthodoxy opens the door to the glib operator or heartless quack not above cynically bankrupting the poor and the desperate. Critics of alternative treatments are right to point out that methodology is rarely divulged and that claims of success are never substantiated. Here the situation is totally different. Scientific evidence in support of the use of Phenergan in cancer is in the public domain (for references, see Relationship of the Patient...). A brief account of a pilot study of Phenergan treatment in man has been published (see In the Darker Shadow..., pp.518-19, 2010).

There is a belief that the treatment of cancer with phenothiazines amounts to alternative medicine, fringe medicine. Nothing could be farther from the truth. One can sympathise with the opposition of doctors to complementary practices, especially when patients and their families are charged formidable sums for worthless advice and/or nostrums. The more expensive a treatment or preparation is, the greater is the need for scepticism. Some complementarists are honest enough to admit that all they can offer is palliation, but understandably patients and their families expect more and are often unwilling, unable even, to accept reality. In this materialistic age there is a general feeling that everything must have its price. Unlike private clinics and a majority of purveyors of alternatives, no fee has ever been charged. Some have mistakenly concluded that advice for which no payment is asked must by definition be worthless. They have later found themselves to have taken an expensive stance.

Some patients have expressed a wish to conduct different alternative treatments in tandem with Phenergan. This has on occasion led to disaster. Because their impact on the anti-cancer action of Phenergan is unpredictable, other alternatives should emphatically not be run simultaneously.

Publicity: A high priority in this project has been to attempt to publish details of experience with Phenergan in cancer treatment. Efforts have been hampered by consistent refusals by oncologists to provide information or to enter into correspondence. Patients' memories tend to be inaccurate and unreliable. It has not proved possible to present data for publication in a format acceptable to an editor of a journal. Peer review, that much-vaunted criterion of excellence, has been repeatedly used by referees and editors of medical journals to block publication. The pilot study mentioned above is all that there is.

The continuing failure of the cancer establishment to recognise and pursue the line of attack described here has been intensely disappointing. Patients who derive benefit are urgently requested to pass the advice on, and not just to fellow sufferers, by all manner of means: word of mouth, especially within support groups, letters to newspapers and medical correspondents, calls to radio and television stations. A measure of the opposition to the project can be gauged from the URLs put out by HealthGrades Inc. and Resource4ThePeople. It will take energy and effort before the concept is adopted and the practical details applied. If you have been lucky, is there not an obligation to help others? And why not let me know too?

Action: If, after reading the above, uncertainty persists, the question remains: is this a chance worth taking? With all moribund patients the situation becomes hopeless when a point of no return is reached. The virtue of therapy with Phenergan can lie in moving that point farther away into the future. This is particularly true where metastatic spread is well established. However, even if tumour growth is not stemmed, some measure of benefit is not necessarily out of the question.

What is certain is that the sooner the treatment begins, or, put another way, the smaller the tumour burden, the quicker the patient may become cancer-free. Delay confers no advantage whatsoever. Patients unaware of the seriousness of their conditions commonly believe that time is on their side, and adopt a wait-and-see attitude. Nothing could be more mistaken. Time is never on the side of the cancer patient. The overriding aim must be, as a matter of pressing urgency, to begin to get well as soon as possible. Now is the time to decide whether or not to go ahead, and if so, to make plans this very minute.

Once more, then: what is there to lose?

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