用灌腸治療癌癥的另類療法

　　When Dr. Nicholas Gonzalez died in July, there wasnot much notice. He did not get an obituary in The New York Times or in most other majormedia outlets.

　　去年7月，尼古拉斯·岡薩雷斯(Nicholas Gonzalez)博士去世，沒有引起多少矚目?！都~約時(shí)報(bào)》雜志(TheNew York Times)和其他大多數(shù)主流媒體都沒有為他發(fā)布訃告。

　　Yet Dr. Gonzalez, whom I interviewed in 2003, was a fascinating figure in the world ofcancer, walking a tenuous boundary between orthodox oncology and alternative medicine— or what is now called complementary medicine. Though his beliefs and treatments havefierce critics, his insights shed light on the mysteries of cancer.

　　然而岡薩雷斯博士在癌癥界卻因其游走于正統(tǒng)腫瘤學(xué)和替代醫(yī)學(xué)(alternative medicine，現(xiàn)在稱為補(bǔ)充醫(yī)學(xué)[complementary medicine])之間的微妙邊界上而十分引人注目。我曾在2003年采訪過他。盡管他的觀念和治療方法飽受批評(píng)，但他的見解從一定程度上揭開了癌癥的一角神秘面紗。

　　Beginning in 1980 as a medical student, Dr. Gonzalez reviewed more than 1,000 medical chartsfrom a dentist named William Kelley. Dr. Kelley claimed to have cured his own liver andpancreatic cancer in the 1960s by rejecting surgery, radiation and chemotherapy in favor ofnutritional therapy, consisting of pancreatic enzymes, minerals, vitamins and coffee enemas.

　　從1980年開始成為醫(yī)學(xué)生起，岡薩雷斯博士審查了牙醫(yī)威廉·凱利(William Kelley)的1000多份病歷。凱利博士聲稱，在20世紀(jì)60年代，他拒絕了手術(shù)、放療和化療，采用營養(yǎng)療法(胰酶、礦物質(zhì)、維生素和咖啡灌腸法等)治愈了自己的肝癌和胰腺癌。

　　The pancreatic enzymes were critical because, Dr. Kelley believed, they digested cancer cells.But his treatment relied on two other theories. First, he claimed that the regimen alsodetoxified the body, allowing patients’ immune systems to destroy cancer. Second, he believedthat all cancers differed from patient to patient, so each patient should receive individualizedtreatment.

　　凱利博士認(rèn)為胰酶至關(guān)重要，因?yàn)樗鼈兛梢韵[瘤細(xì)胞。不過，他的治療方法依賴于另外兩個(gè)理論。首先，他聲稱自己的治療方案也可以為身體排毒，從而使患者的免疫系統(tǒng)自己去消滅癌癥。其次，他認(rèn)為，不同癌癥患者的病各有區(qū)別，因此每一位患者都應(yīng)接受個(gè)體化治療。

　　Once Dr. Kelley — working with a group of like-minded physicians — began treating patients,he ran afoul of the American Cancer Society (who claimed he was a quack) and variousprofessional societies. Eventually, his dental license was suspended; patients interested inhis regimen had to travel to Mexico to be treated by him.

　　于是凱利博士與一群持類似觀念的醫(yī)生開始治療患者，這觸發(fā)了美國癌癥學(xué)會(huì)(該組織聲稱凱利是個(gè)江湖郎中)和數(shù)個(gè)專業(yè)學(xué)會(huì)的眾怒。最終，凱利博士的牙醫(yī)執(zhí)照被吊銷，對(duì)他的治療方案感興趣的患者不得不去墨西哥接受治療。

　　After Dr. Gonzalez finished his chart review and interviewed more than 400 of Dr. Kelley’spatients, he concluded that the regimen worked. Hundreds of people who supposedly hadterminal metastatic cancer had lived for five, 10 or more years.

　　待岡薩雷斯博士審查完病例后，他又訪問了凱利博士的400多位患者，然后他得出了結(jié)論：那個(gè)治療方案是有效的。數(shù)以百計(jì)原本被認(rèn)定癌癥已到了終末轉(zhuǎn)移階段的患者活過了5年、10年乃至更長時(shí)間。

　　Dr. Gonzalez later completed a fellowship in immunology and began practicing in New YorkCity, treating a wide range of ailments, including chronic fatigue and multiple sclerosis. Butit was the treatment of cancer — especially end-stage cancer — that brought him both fameand controversy.

　　再后來，岡薩雷斯博士完成了免疫學(xué)?？漆t(yī)學(xué)培訓(xùn)，開始在紐約市行醫(yī)，治療各種疾病，包括慢性疲勞和多發(fā)性硬化癥等。他對(duì)癌癥，尤其是終末期癌癥的治療既為他贏得了名望，也給他帶來了爭(zhēng)議。

　　Working with another physician, Dr. Linda Isaacs, who at one point was his wife, Dr. Gonzalezadvocated a nutritional regimen similar to that of Dr. Kelley, including vitamins, minerals andantioxidants. He prescribed coffee enemas, which Dr. Gonzalez believed improved liverfunction and the excretion of waste. Finally, he gave cancer patients up to 45 grams ofpancreatic enzymes. According to Dr. Gonzalez’s website, his cancer patients took 130 to 175capsules daily, and his noncancer patients took 80 to 100 each day.

　　岡薩雷斯博士與另一位醫(yī)生，他曾經(jīng)的妻子琳達(dá)·伊薩克斯(Linda Isaacs)博士合作，倡導(dǎo)與凱利博士類似的，使用維生素、礦物質(zhì)和抗氧化劑等的營養(yǎng)療法。岡薩雷斯博士向患者處方咖啡灌腸劑，因?yàn)樗J(rèn)為這樣可以改善肝功能并促進(jìn)廢物的排泄。最后，他還給癌癥患者使用高達(dá)45克的胰酶。根據(jù)岡薩雷斯博士網(wǎng)站上的資料，其癌癥患者每天要服用130至175粒膠囊，而非癌癥患者每天要服用80至100粒。

　　In 1994, Dr. Gonzalez conducted a pilot study of his program for 11 patients with inoperablepancreatic cancer. Five lived longer than two years, and two lived longer than four years. Nopatients in a comparison group treated with standard chemotherapy survived more than 19months. This led the National Institutes of Health to fund a controlled trial at ColumbiaUniversity that formally compared Dr. Gonzalez’s regimen with chemotherapy for 55 patientswho had advanced pancreatic cancer. The results, published in the Journal of Clinical Oncologyin 2010, showed that on average, the patients getting the chemotherapy lived three times aslong than those getting the enzymes.

　　1994年，岡薩雷斯博士就他的治療方案進(jìn)行了一項(xiàng)實(shí)驗(yàn)性研究。該研究納入了11名無法手術(shù)的晚期胰腺癌患者：其中五人活了兩年以上，兩人活了四年以上;而在接受標(biāo)準(zhǔn)化療治療的對(duì)照組中，沒有患者活過19個(gè)月。這一研究結(jié)果促使美國國立衛(wèi)生研究院(National Institutes of Health, N.I.H.)出資在哥倫比亞大學(xué)(Columbia University)進(jìn)行了一項(xiàng)正式的對(duì)照試驗(yàn)，在55名晚期胰腺癌患者中對(duì)岡薩雷斯博士的方案與化療進(jìn)行了比較。該試驗(yàn)的結(jié)果于2010年發(fā)表在《臨床腫瘤學(xué)雜志》(The Journal of Clinical Oncology)上，它表明，接受化療的患者的平均存活時(shí)間是接受酶治療者的三倍。

　　I interviewed Dr. Gonzalez while researching a book on famous patients, which included thestory of the actor Steve McQueen, who traveled to Mexico in 1980 to try Dr. Kelley’s regimenfor his terminal mesothelioma. (Mr. McQueen ultimately died of his disease.) If I arrivedexpecting to find a shady character who manipulated vulnerable patients, I did not find one.Dr. Gonzalez was highly affable and professional. He assured me that he neverrecommended his treatment over cancer therapies with proven value. He was available, hesaid, for those with progressive disease or those who rejected standard chemotherapy.

　　我曾經(jīng)研究過一本關(guān)于著名患者的書，那書中講述了演員史蒂夫·麥奎因(Steve McQueen)的故事，他在1980年前往墨西哥，嘗試使用凱利博士的方案來治療自己的終末期間皮瘤(麥奎因最終死于這種疾病。)在此期間，我采訪了岡薩雷斯博士。如果說我此行的目的是想揪出操縱脆弱患者的幕后黑手，那么應(yīng)該說我失敗了。岡薩雷斯博士既和藹可親又非常專業(yè)。他向我保證，他從未聲稱自己的治療方法優(yōu)于那些療效已經(jīng)過實(shí)證的癌癥治療方法，或?qū)⑵鋬?yōu)先推薦給患者們。他說，他只是向疾病發(fā)生了進(jìn)展或者拒絕接受標(biāo)準(zhǔn)化療的患者敞開了大門而已。

　　But more affecting than Dr. Gonzalez were his patients. He introduced me to one woman whohad been diagnosed with metastatic ovarian cancer more than 10 years earlier but was aliveand well on his protocol. To underscore his point, Dr. Gonzalez showed me her pathologyreport, which confirmed what he had said. I met several other patients whose lives, theybelieved, had been saved by the hundreds of capsules they ingested each day.

　　不過，比起岡薩雷斯博士，他的患者們更令我震動(dòng)。他向我介紹了一名女患者，雖然她10年前就被確診為轉(zhuǎn)移性卵巢癌，但經(jīng)過他的治療，她至今仍然活得好好的。岡薩雷斯博士還向我展示了她的病理報(bào)告，證實(shí)他所言非虛。我還會(huì)見了其他幾位堅(jiān)信自己的生命被每天攝入的數(shù)百粒膠囊所拯救的患者。

　　This sentiment is reflected in dozens of online comments recorded after Dr. Gonzalez diedunexpectedly at age 67 on July 21. Jen H. from Washington wrote: “The hope he provided tohis patients when all hope had been removed was and is invaluable.” Another person wrotethat Dr. Gonzalez had sent him a hand-written note explaining why he would not be able totreat the writer’s dying father.

　　這種觀點(diǎn)在去年7月21日，67歲的岡薩雷斯博士意外去世之后網(wǎng)上的數(shù)十條評(píng)論留言當(dāng)中都有流露。來自華盛頓的珍·H(Jen H)寫道：“在患者已經(jīng)萬念俱灰的時(shí)候，他帶來的一線希望是無價(jià)之寶。”還有人稱，岡薩雷斯博士曾親筆寫信給他，解釋他為何無法治療他即將死去的父親。

　　As someone trained to practice scientific medicine, I found my encounter with Dr. Gonzalez tobe a challenge. Not only was there no good data showing his regimen to be effective, butmuch of what he prescribed did not really make medical sense. Wasn’t it more likely that mostof his patients had been misdiagnosed or that their cancers had stopped growing for otherreasons? Dr. John Chabot, the Columbia professor who ran the N.I.H. trial, admired Dr.Gonzalez’s devotion to his patients but felt he was “misguided due to his zealotry.” Also,because insurance companies rarely pay for unconventional treatments, Dr. Gonzalez’sregimen often cost his patients tens of thousands of dollars.

　　作為一個(gè)接受過正統(tǒng)科學(xué)醫(yī)學(xué)培訓(xùn)的人，岡薩雷斯博士讓我感到充滿挑戰(zhàn)。并無良好的數(shù)據(jù)能證明他的治療方案的效力，而且，他所處方的大部分東西在醫(yī)學(xué)上都說不通。說起來，他的大部分患者只是被誤診了，又或者他們的癌癥停止生長是出于別的原因，可能性不是更大些么?N.I.H.試驗(yàn)的領(lǐng)導(dǎo)者，哥倫比亞大學(xué)的教授約翰·沙博(John Chabot)表示自己欽佩岡薩雷斯博士對(duì)患者們的奉獻(xiàn)精神，但他覺得他“被自己的狂熱給誤導(dǎo)了。”此外，由于保險(xiǎn)公司幾乎不報(bào)銷非常規(guī)治療的費(fèi)用，岡薩雷斯博士的治療方案往往要花掉患者數(shù)萬美元。

　　Still, shortly after my visit with Dr. Gonzalez, when an acquaintance was dying of cancer andhad exhausted all treatment options, I gingerly mentioned his work and the supposedly curedpatients I had met in his office. She was not receptive. She told me that she would never tryanything so unscientific, no matter how desperate she was.

　　不過，在我拜訪岡薩雷斯博士之后不久，當(dāng)一個(gè)熟人用盡了所有的治療方案，仍然行將被癌癥奪去生命之時(shí)，我還是小心翼翼地向他提起了岡薩雷斯博士的工作，以及我曾在他的辦公室里見過的那些所謂的“被治愈”的患者。她表示堅(jiān)決不能接受。她還說，不管多么絕望，她都永遠(yuǎn)不會(huì)嘗試如此不科學(xué)的東西。

　　Despite the lack of evidence of the treatment’s efficacy, Dr. Isaacs continues to use theGonzalez protocol for patients who see a connection between cancer and nutrition. And Dr.Gonzalez’s work lives on in other ways. New immunotherapy treatments seek to harness thebody’s immune system to fight cancer. And recent studies suggest that cancer is a differentdisease in different people and that treatments need to be personalized.

　　盡管缺乏療效證據(jù)，伊薩克斯博士仍然繼續(xù)向堅(jiān)信癌癥與營養(yǎng)有關(guān)的患者提供岡薩雷斯的治療方案。此外，岡薩雷斯博士的成果還在以其他方式展示著其生命力。新的免疫療法試圖借助人體的免疫系統(tǒng)來對(duì)抗癌癥。而且，最近有研究提出，不同患者的癌癥各有差異，因此需要進(jìn)行個(gè)性化治療。