Weird medical history, ripped from the archives of Doonesbury

My introduction to Gary Trudeau's Doonesbury happened around the age of 8, when I discovered my father's anthology collections. (I was extraordinarily up on early 1970s pop culture for a late 1980s grade schooler.) Reading the new strip and the daily archives is still part of my morning routine. But, given that I was born in 1981, I don't always get all the references. Sometimes, that leads me to discover weird bits pop history.

For instance, the strip above ran on July 19, 1977. My first response this morning, "What the hell is Laetrile?" I mean, it's Duke, so I assumed it was a drug. But I wasn't expecting it to turn out to be a quack cancer treatment, the promotion of which led to a strange bedfellows situation where alt-med proponents joined forces with the John Birch Society to fight the federal government for the right to sell desperate cancer patients a potentially dangerous treatment that had never been tested for effectiveness or safety.

Laetrile is basically the brand name of amygdalin, a compound derived from bitter almonds, or from the pits of apricots and black cherries. It's sometimes called "Vitamin B17", although it's not a vitamin. Beginning in the 1950s, the father-son team of Dr. Ernst T. Krebs and Ernst T. Krebs, Jr. (The latter's only claim to a medical license was a "doctor of science" degree bestowed on him honorarily by an unaccredited Bible college) began marketing Laetrile as a treatment for cancer.

The downside to Laetrile is that it can break down and turn into cyanide in the presence of stomach chemicals. Also, it doesn't actually seem to do anything to cure or slow the progress of cancer. The upside to Laetrile is that selling it was extremely lucrative.

John Richardson was a general practitioner who began practice in the San Francisco Bay area in 1954. In 1971, after discussions with Krebs, Jr., he decided to become a cancer specialist. He had not encountered overwhelming success as a general practitioner. His 1972 income tax return revealed that he had grossed $88,000 in his medical practice, leaving a net of only $10,400 taxable income.

Richardson's practice boomed as a result of his newly found status as a cancer "expert." He states that "Our office soon was filled with faces we had never seen before—hopeful faces of men and women who had been abandoned by orthodox medicine as hopeless or "terminal" cases." In 1974, he reported that his medical practice had grossed $783,000, with a net income of $172,981. By charging patients $2,000 for a course of Laetrile, Richardson managed to increase his net income 17-fold in just two years. According to his income tax returns, Richardson grossed $2.8 million dollars from his Laetrile practice between January 1973 and March 1976. The actual amount of money he received may have even been higher. In Laetrile Case Histories, he claimed to have treated 4,000 patients, with an average charge of $2,500 per patient. Culbert states that by 1976 Richardson had treated 6,000 patients. If these figures are correct, Richardson would have grossed between $10 and $15 million dollars during this time.

Richardson's practice changed significantly after he began treating cancer patients with Laetrile. He also began treating what he termed "pre-clinical syndrome" patients with Laetrile. These were patients with no identifiable tumor or lesion who complained of feelings of "impending doom, malaise, unexplained or vague pains, headaches, bowel changes, loss of appetite, loss of energy, and depression." According to Richardson, cancer patients reported a reduction in pain, an improved appetite, return of strength, and an improved mental outlook. In addition, high blood pressure returned to normal.

In spite of these "dramatic improvements," Richardson admitted that most of his cancer patients died.

Cases like this one led to raids and prosecutions, as state and federal government authorities started cracking down on doctors for selling the bogus treatment. Richardson, for instance, was indicted in 1976.

Proponents fought back. Laetrile ended up in the Supreme Court in 1979—where justices rejected the idea that treatments given to terminally ill patients should be exempt from FDA regulation. And in 1977, when this Doonesbury comic came out, Laetrile was the subject of a Congressional hearing.

The full history is pretty amazing. Public interest in Laetrile petered off in the 1980s, after a National Cancer Institute study found no evidence that it worked (and did find evidence of cyanide poisoning in patients using it), and after actor Steve McQueen infamously used Laetrile to treat his cancer … and then died. But there are still people pushing it. Because of that, it's worth noting that meta-reviews of research into Laetrile treatments for cancer, conducted in 2006 and again in 2011, still say the stuff doesn't work and that it's potentially dangerous.

Read the Quackwatch history of Laetrile, which is quoted above.

Read Wikipedia's entry on Laetrile, which refers to it as "a canonical example of quackery" in the medical literature.

Read the abstract for the 2011 review of research into Laetrile as a treatment for cancer.

Read The American Cancer Society's summary of the history and evidence (or, rather, lack thereof) behind Laetrile