THE TREATMENT OF CANCER WITH PHENERGAN

Robert Jones MA PhD

The successful treatment of cancer requires the total elimination of malignant cells in the body. The aim of the therapy on offer is to procure necrosis by disrupting energy metabolism in both primary and secondary (metastatic) growths. In marked contrast with conventional treatments, the procedure is highly selective; both side effects and associated risks are negligible. Patients are asked to be realistic; it is impossible to provide any guarantee of the desired outcome. Careful adherence to the advice provided is necessary.

Certain drugs acting on the central nervous system possess the additional property of causing injury to tumours by interfering with energy production. Some belong to the large group of drugs known as phenothiazines, many of which have been in use for half a century. Their diverse uses include the treatment of schizophrenia, nausea and pain. The active drug in this form of cancer treatment is the phenothiazine Phenergan (promethazine), currently used as an anti-histamine, as a paediatric sedative, and to quell travel sickness. Introduced in 1947, its effects on the central nervous system are much less marked than those of most other phenothiazines. In most countries Phenergan can be freely purchased in the form of l0mg and 25mg tablets; other phenothiazines are available only on prescription. Formulations in which the drug is provided in conjunction with other drugs are not recommended.

This novel and unconventional therapy has several unusual features. First, a new chemotherapeutic target is selected within the cancer cell. The majority of anticancer drugs currently in use are supposed to react with DNA located mostly in the nuclei. In marked contrast phenothiazines active against cancer trigger a cytotoxic mechanism within the cancer cell itself. The production of chemical energy in its power-houses (mitochondria) is disrupted initially by intensifying their natural state of partial disablement, and then by destroying them.

Second, in order to produce its anti-cancer action Phenergan has to be taken according to a specific schedule. The maintenance of continuous destructive pressure against malignant growths constitutes an essential feature of the treatment.

Third, the treatment is the result of a long investigation standing fully in the tradition of applied medical research. Despite the impressive weight of supportive scientific evidence (see below) and in spite of several requests, no cancer charity or pharmaceutical firm has agreed to conduct any kind of clinical trial. Patent cover for Phenergan has long run out. In consequence the costs of treatment are too modest to attract commercial interest.

The treatment is in four parts:

1. First, the white cells of the blood need to be protected against rare side-effects (blood dyscrasias) by taking certain micro-nutrients. A multi-vitamin/mineral preparation is necessary containing the recommended dietary allowance (RDA) of copper (2.5mg), manganese (4mg), zinc (l5mg) and selenium (50mcg, or 0.05mg). Minor deviations from these amounts, which should be taken daily, are unimportant. Vitamin supplements in excess of RDA values, especially vitamins C (RDA 60mg) and E (RDA 8-l0mg), should be avoided as far as possible.

2. Second, a quantity of polyunsaturated fatty acids (the so-called omega-3 fatty acids) of fish origin is needed. Flax oil may also be taken. Patients should aim at a minimum of a gram daily; more is advisable, but the intake can be cut back if bowel looseness is experienced.

3. Third, the purpose of the polyunsaturated fatty acid supplement is to allow cancerous cells to synthesise substances that bring about their self-destruction. To encourage the process still further, patients are recommended to take between 1 and 2 grams each of inositol and choline daily. These are naturally-occurring substances normally available from health stores. Some authorities recommend inositol hexaphosphate (1P6), which contains only 23% inositol and may form insoluble precipitates with calcium within the bowel. It may also be more expensive than inositol itself.

4. Fourth, treatment is initiated by taking Phenergan as a 50mg dose one evening at retiring. It is necessary to continue eight hours later on the following day with 25mg. Phenergan must be taken every eight hours until an adequate period of time has elapsed after the last traces of disease have disappeared. At present that period is arbitrarily put at six months, but should be extended if any doubt exists over the elimination of disease. The duration of treatment is further discussed below.

If possible patients should begin to take nutritional supplements, especially polyunsaturated fatty acids, several days before starting with Phenergan, and should continue during therapy. Success depends on maintaining continuous pharmacological pressure against the cancer throughout the entire period of treatment.

A general improvement in terms of improved sleep, normal appetite and general wellbeing should be perceptible at least by the end of the first week. In time pain can be expected to dissipate. A record of body weight should be kept. 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 pleasant surprise.

Contraindications and eligibility - Cancer patients are unlikely to benefit from this treatment if:

  1. Steroids are being administered in high doses. Any blockage of anti-cancer activity is, however, unstable, and therapy with Phenergan could be commenced three days after cessation of steroids.
  2. There has been brief or intermittent exposure to phenothiazines or to certain chemically-related drugs after the onset of disease; this, it might be added, would be unusual.
  3. Analgesics classified as non-steroid anti-inflammatory drugs (aspirin, Nurofen, etc) are being taken. These particular analgesics should be avoided. Paracetamol in moderation is suitable for pain relief.
  4. There is dietary supplementation with vitamin E.
    The question of vitamin E calls for special mention. Most diets already contain amounts adequate for a healthy life style. Recent work has shown that for individuals free from cancer dietary supplementation (50-100 international units [iu] daily) is highly beneficial, offering protection not only against the development of malignancy but also against coronary heart disease. Unfortunately the same beneficial properties are exploited by cancerous growths, which accumulate vitamin E to protect themselves against successful therapy. Several patients on vitamin E supplements (400mg-l200mg daily) failed to respond. Current advice is therefore to stop supplementation immediately and, if possible, to wait 7-10 days before starting with Phenergan. Likewise, selenium supplementation above the RDA is not recommended.
  5. Patients should be warned that extensive radiotherapy or treatment with certain cytotoxic drugs can lead to a mutation resulting in a partial or complete disablement of the cytotoxic mechanism. Clones of these mutant cells grow rapidly and are generally insensitive to therapy.

Recent anecdotal evidence suggests that cancer cells regressing under the influence of Phenergan may also be vulnerable to the mutagenic effects of certain anti-cancer drugs. For this reason it is recommended that offers to treat the disease additionally by conventional means with drugs currently used against cancer should be politely but firmly refused. Even if the treatment fails to halt the progress of disease, Phenergan will enhance the quality of life and extend survival. In other words, the therapy places the patient in a no-lose situation.

Tumours of the brain: Existing anti-cancer drugs are unable to cross the blood-brain barrier, and some brain tumours are usually difficult to treat. Experience indicates that for these patients clomipramine (Anafranil) is more effective than Phenergan. Clomipramine is a prescription drug; treatment therefore requires a participating doctor. At the time of writing details of the treatment have not been published, but its use is expected to be described shortly. Meanwhile readers are referred to the website www.sdrt.co.uk for more information. Alternatively enquiries may be addressed to the Samantha Dickson Research Trust, Chatter Alley, Dogmersfield, Hampshire RG27 8SS, United Kingdom; E-mail, sdrt1996@aol.com Telephone, + +44 (0)1252 727 433 for patient support.

Side effects: Drowsiness in the first few days after commencing Phenergan may be experienced, and normally lasts no more than a week or two. If not, l0mg tablets can be substituted, with two (20mg) taken at night. Sedation is the principal side effect; on the whole patients do not find the experience unpleasant, but driving a car and using machinery or sharp tools are not recommended, at least for the first fortnight.

Very few patients have experienced any difficulty with Phenergan therapy. One patient has maintained herself on the full schedule for over three years, to be on the safe side. Her only problem has been a modest gain in weight. Only one other patient found the therapy insupportable, but he responded to every medication in the same manner. There is a very small chance that jaundice may develop within a few days, or that the white cell count may fall (leucopenia or agranulocytosis) after 4-6 weeks. The former can be recognised by a yellowing of the features, the latter by sore throat. Thrombocytopenia (a fall in platelet count) is again highly unlikely, and may be recognised by unexplained bruising or cuts bleeding for longer than usual; in these instances specialist medical attention should be sought immediately. It might be added that none of these conditions has arisen to date among cancer patients taking Phenergan.

Patients with breast cancer who are suffering from radiation-induced peripheral neuritis may find that Phenergan will clear the condition up.

Duration of treatment: The therapy works slowly; just how long it will be necessary to keep taking Phenergan will depend, among other factors, on the extent of disease when treatment is started and on the state of nutrition. Patience is called for. It may be necessary to stay with Phenergan for as long as two years, especially where there are secondary deposits in the bone.

Precautions: It is necessary to give up alcohol completely. Exposure to ultraviolet light and sunlight, especially sunbathing, are to be avoided as far as possible. A leaflet is provided with the Phenergan packet; the advice given should be read and, apart from discontinuation, carefully adhered to. The group of drugs known as monoamine oxidase inhibitors must not be taken in conjunction with Phenergan.

The doctor and cancer specialist: The help and support of medical advisers must at all costs be enlisted and retained. Accurate reports of progress need to be requested. Being secretive is discourteous; keeping your oncologist fully informed is essential, and may stimulate genuine interest and additional sympathy. Your doctor is unlikely to have heard of this means of treating cancer, and may be sceptical. In these circumstances the only question one can reasonably expect to have answered is whether or not harm is likely to ensue.

If attempts are made to talk you out of therapy with Phenergan, ask what the dangers of the treatment are perceived to be, reassurance will very likely be given that the risks are negligible. If necessary reference can be made to a paper entitled "Successful Cancer Therapy with Promethazine: the Rationale,” published in Medical Hypotheses 46, 25-29 (1996). More supportive scientific evidence can be found in Notes on the Treatment of Cancer with Low-Dose Phenothiazines, with Special Reference to Promethazine, available on the Spotlight section of the Cancer Support Association of Western Australia. The site address is www.cancersupportwa.org.au It is necessary to click on the Figure in the text to ensure that the document prints out completely.

General advice: The success of this treatment depends on various factors, of which one is the state of advancement of the disease. Under no circumstances should Phenergan treatment be discontinued prematurely; if treatment is interrupted before the growth is wholly eliminated, 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 means of resensitisation is known at the present time. The maxim is: if in doubt, don't quit out.

What is certain is that the sooner the treatment begins, or, put another way, the smaller the tumour burden is, the quicker the patient may become cancer-free. If other treatments are being followed, there is absolutely no virtue in waiting to see what the outcome may be. Delay confers no advantage whatsoever. The big error that cancer patients commonly make is to believe that time is on their side, and to adopt a wait-and-see attitude. Nothing could be more mistaken. The overriding aim must be to begin to get the patient well again as soon as possible as a matter of pressing urgency.

If, after reading the above, uncertainty persists, the question remains: what is there to lose?