Nicholas Gonzalez (doctor)
Encyclopedia
Dr. Nicholas James Gonzalez, M.D., is a New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...

-based physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

. Dr. Gonzalez has received significant attention for his controversial therapies that target cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

. His practice is currently based in New York City
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...

. He developed the Gonzalez protocol, a treatment of cancer based on the belief that cancer is caused by toxins and physiological imbalances. Gonzalez's treatment methods have been rejected by the medical community, and Gonzalez has been characterized as a quack
Quack
A quack is a person who pretends, professionally or publicly, to have skill, knowledge, or qualifications he or she does not possess.Quack may also refer to:* Quack , an independent-comics series published by Star Reach in the 1970s...

 and fraud by other doctors and health fraud watchdog groups. In 1994 he was reprimanded and placed on two years' probation by the New York state medical board for "departing from accepted practice," although he never explicitly rejected more orthodox treatments and practices. In 1999 Dr. Gonzalez published an article describing prolonged life in a small group of patients with pancreatic cancer in the peer-reviewed journal Nutrition and Cancer
Nutrition and Cancer
Nutrition and Cancer is a peer-reviewed medical journal covering research on the role of nutritional factors in causing or preventing cancer. It is published eight times a year by Routledge. According to the Journal Citation Reports, the journal has a 2010 impact factor of 2.553....

; subsequently others concluded that the longer survival time reported by Gonzalez was due to selection bias
Selection bias
Selection bias is a statistical bias in which there is an error in choosing the individuals or groups to take part in a scientific study. It is sometimes referred to as the selection effect. The term "selection bias" most often refers to the distortion of a statistical analysis, resulting from the...

 and other confounds
Confounding
In statistics, a confounding variable is an extraneous variable in a statistical model that correlates with both the dependent variable and the independent variable...

.

A test of his protocol, published in 2009, found that Gonzalez's patients died faster than those treated with conventional chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

, and had significantly worse quality of life
Quality of life
The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and politics. Quality of life should not be confused with the concept of standard of...

.

Biography

Gonzalez graduated Phi Beta Kappa & magna cum laude from Brown University
Brown University
Brown University is a private, Ivy League university located in Providence, Rhode Island, United States. Founded in 1764 prior to American independence from the British Empire as the College in the English Colony of Rhode Island and Providence Plantations early in the reign of King George III ,...

, with a degree in English literature
English literature
English literature is the literature written in the English language, including literature composed in English by writers not necessarily from England; for example, Robert Burns was Scottish, James Joyce was Irish, Joseph Conrad was Polish, Dylan Thomas was Welsh, Edgar Allan Poe was American, J....

. From 1970-1977, Gonzalez worked as a journalist for Time Inc.
Time Inc.
Time Inc. is a subsidiary of the media conglomerate Time Warner, the company formed by the 1990 merger of the original Time Inc. and Warner Communications. It publishes 130 magazines, most notably its namesake, Time...

 and as a freelance writer, covering a variety of health-related topics, including a July 1972 cover story
Sands Point Country Day School
Sands Point Country Day School was an elementary and high school located in Sands Point, New York, from 1954 to 1974. The school was started by Marie L...

 in New York Magazine, a 1976 cover story for Family Health Magazine
Family Health Magazine
Family Health was an American health magazine founded by Maxwell M Geffen in the 1968. It was later renamed Health....

, and an article for Prevention Magazine. Gonzalez became interested in medical research, cancer research in particular, while covering these topics.

Gonzalez completed postgraduate premedical work at Columbia University
Columbia University
Columbia University in the City of New York is a private, Ivy League university in Manhattan, New York City. Columbia is the oldest institution of higher learning in the state of New York, the fifth oldest in the United States, and one of the country's nine Colonial Colleges founded before the...

 and received his medical degree
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

 from Cornell University
Cornell University
Cornell University is an Ivy League university located in Ithaca, New York, United States. It is a private land-grant university, receiving annual funding from the State of New York for certain educational missions...

 in 1983. Gonzalez worked with Dr. Robert A. Good
Robert A. Good
-External links:** can be found at The Center for the History of Medicine at the Countway Library, Harvard Medical School....

 at Memorial Sloan-Kettering Cancer Center
Memorial Sloan-Kettering Cancer Center
Memorial Sloan–Kettering Cancer Center is a cancer treatment and research institution founded in 1884 as the New York Cancer Hospital...

 while in medical school. After receiving his medical degree, Gonzalez completed an internship in internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...

 at Vanderbilt University
Vanderbilt University
Vanderbilt University is a private research university located in Nashville, Tennessee, United States. Founded in 1873, the university is named for shipping and rail magnate "Commodore" Cornelius Vanderbilt, who provided Vanderbilt its initial $1 million endowment despite having never been to the...

. From 1984-1986, Gonzalez worked with Good again, completing a fellowship
Fellowship (medicine)
A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program . During this time , the physician is known as a fellow...

 in immunology
Immunology
Immunology is a broad branch of biomedical science that covers the study of all aspects of the immune system in all organisms. It deals with the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders ; the...

 while at University of Oklahoma
University of Oklahoma
The University of Oklahoma is a coeducational public research university located in Norman, Oklahoma. Founded in 1890, it existed in Oklahoma Territory near Indian Territory for 17 years before the two became the state of Oklahoma. the university had 29,931 students enrolled, most located at its...

 and All Children's Hospital
All Children's Hospital
All Children's Hospital is a Pediatric hospital located in St. Petersburg, FloridaIt is the only freestanding children’s hospital on the state's Gulf coast. It has consistently ranked among America’s top 25 children’s hospitals in comparative studies done by Child Magazine, which rated All...

 in St. Petersburg, Florida
St. Petersburg, Florida
St. Petersburg is a city in Pinellas County, Florida, United States. It is known as a vacation destination for both American and foreign tourists. As of 2008, the population estimate by the U.S. Census Bureau is 245,314, making St...

.

Cancer treatment and research

Gonzalez's treatment methods, which he's been using since 1987, are developed from previous work by the orthodontist William Donald Kelley. Gonzalez believes that cancer is caused by poor diet, a problem compounded when one does not eat a diet that corresponds with one's metabolic type; environmental pollution
Pollution
Pollution is the introduction of contaminants into a natural environment that causes instability, disorder, harm or discomfort to the ecosystem i.e. physical systems or living organisms. Pollution can take the form of chemical substances or energy, such as noise, heat or light...

 and daily stress contribute to health problems. According to the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...

, which co-sponsored with the National Center for Complementary and Alternative Medicine a clinical trial on Gonzalez's treatments produced "limited and inconclusive" results regarding the efficacy of the Gonzalez Regimen as a treatment for cancer.

Gonzalez protocol

The Gonzalez protocol is based on the belief that cancer is caused by toxins and physiological imbalances, and proposes as a treatment the use of oral pancreatic enzyme
Enzyme
Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical reactions in a biological cell need enzymes in order to occur at rates...

s, large numbers of dietary supplement
Dietary supplement
A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...

s (up to 150 pills per day) and twice daily coffee enema
Coffee enema
Coffee enemas are the enema-related procedure of inserting coffee into the anus to cleanse the rectum and large intestines. This procedure, although well documented, is considered by most medical authorities to be unproven, rash and potentially dangerous....

s.

In August 2009 the regimen was reported to be ineffective compared to chemotherapy; in fact, patients receiving the Gonzalez protocol did worse than patients on conventional chemotherapy, dying three times faster than those receiving conventional chemotherapy and reporting significantly worse quality of life
Quality of life
The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and politics. Quality of life should not be confused with the concept of standard of...

.

Rejection by mainstream medicine

Like his mentor, William Donald Kelley, Gonzalez's treatment method has been "rejected" by the "medical establishment". Gonzalez has been characterized as a quack
Quack
A quack is a person who pretends, professionally or publicly, to have skill, knowledge, or qualifications he or she does not possess.Quack may also refer to:* Quack , an independent-comics series published by Star Reach in the 1970s...

 and fraud by other doctors and health fraud watchdog groups, and in 1994 was reprimanded and placed on two years' probation by the New York state medical board for "departing from accepted practice". Forced to submit to psychological examinations and undergo retraining, Gonzalez was given two years of probation with a stipulation that he undergo retraining and do 200 hours of community service, which he completed satisfactorily. He is currently fully licensed to practice in New York.

Gonzalez has lost two malpractice
Malpractice
In law, malpractice is a type of negligence in, which the professional under a duty to act, fails to follow generally accepted professional standards, and that breach of duty is the proximate cause of injury to a plaintiff who suffers harm...

 lawsuits. In 1997, a New York court found Gonzalez "negligent" for his cancer treatment; according to news reports, Gonzalez "had to pay $2.5 million in damages to a patient he wrongly claimed to have cured" of cancer. The former patient had been diagnosed with uterine cancer
Uterine cancer
The term uterine cancer may refer to any of several different types of cancer which occur in the uterus, namely:*Uterine sarcomas: sarcomas of the myometrium, or muscular layer of the uterus, are most commonly leiomyosarcomas.*Endometrial cancer:...

 but "Gonzalez discouraged her from following through on her cancer specialist's advice, instead recommending dietary supplements and frequent coffee enemas". The patient had refused both standard treatment and an experimental protocol, but after the cancer spread to her spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...

, she discontinued Gonzalez's treatment and received chemotherapy and external beam radiation. Sometime in this period, she began having problems with her eyesight, back and hip, and she eventually became blind. In 2000, Gonzalez was found partly liable (49%) in the death of a patient with Hodgkin's disease and ordered to pay $282,000 in damages, due to his use of an unproven cancer screening method instead of standard cancer testing.

The American Cancer Society
American Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...

 notes that there is "no convincing scientific evidence that [the Gonzalez treatment] is effective in treating cancer" and that some portions of the treatment may be harmful. A review article from the Journal of Clinical Gastroenterology
Journal of Clinical Gastroenterology
Journal of Clinical Gastroenterology, first published in March 1979, is a peer reviewed, medical journal, published by Lippincott Williams & Wilkins. The Editor in Chief is Martin H. Floch, MD .-Aims and scope:...

is cited that notes the clinical efficacy of coffee enema
Coffee enema
Coffee enemas are the enema-related procedure of inserting coffee into the anus to cleanse the rectum and large intestines. This procedure, although well documented, is considered by most medical authorities to be unproven, rash and potentially dangerous....

s has not been proven and the therapy is associated with severe adverse effects previously described in a few case reports. Gonzalez's study published in Nutrition and Cancer
Nutrition and Cancer
Nutrition and Cancer is a peer-reviewed medical journal covering research on the role of nutritional factors in causing or preventing cancer. It is published eight times a year by Routledge. According to the Journal Citation Reports, the journal has a 2010 impact factor of 2.553....

in 1999 was criticized by an expert in integrative oncology research methods for its small sample size, selection bias
Selection bias
Selection bias is a statistical bias in which there is an error in choosing the individuals or groups to take part in a scientific study. It is sometimes referred to as the selection effect. The term "selection bias" most often refers to the distortion of a statistical analysis, resulting from the...

, and failure to account for confounding variables
Confounding
In statistics, a confounding variable is an extraneous variable in a statistical model that correlates with both the dependent variable and the independent variable...

.

Gonzalez was featured in Suzanne Somers
Suzanne Somers
Suzanne Somers is an American actress, author, singer and businesswoman, known for her television roles as Chrissy Snow on Three's Company and as Carol Lambert on Step by Step....

' book Knockout.

Support for research efforts

Gonzalez "has never explicitly rejected the more orthodox precepts of his profession", insisting that he wants his research evaluated by independent scientists.

Research supporting Gonzalez's treatment methods—performed with the help of Dr. Ernst Wynder
Ernst Wynder
Ernst Ludwig Wynder was an American epidemiology and public health researcher who studied the risk factors of smoking tobacco. His 1950 coauthored publication of "Tobacco Smoking as a Possible Etiologic Factor in Bronchiogenic Carcinoma: A Study of 684 Proved Cases" appeared in the Journal of the...

, funded by Nestle
Nestlé
Nestlé S.A. is the world's largest food and nutrition company. Founded and headquartered in Vevey, Switzerland, Nestlé originated in a 1905 merger of the Anglo-Swiss Milk Company, established in 1867 by brothers George Page and Charles Page, and Farine Lactée Henri Nestlé, founded in 1866 by Henri...

, and supported by Procter & Gamble
Procter & Gamble
Procter & Gamble is a Fortune 500 American multinational corporation headquartered in downtown Cincinnati, Ohio and manufactures a wide range of consumer goods....

—was published in 1999 in the peer-reviewed journal Nutrition and Cancer
Nutrition and Cancer
Nutrition and Cancer is a peer-reviewed medical journal covering research on the role of nutritional factors in causing or preventing cancer. It is published eight times a year by Routledge. According to the Journal Citation Reports, the journal has a 2010 impact factor of 2.553....

. The study measured survival rates for 11 patients with pancreatic cancer
Pancreatic cancer
Pancreatic cancer refers to a malignant neoplasm of the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors is adenocarcinoma, which arises within the exocrine component of the pancreas. A minority arises from the islet cells and is classified as a...

. In the study, patients on the Gonzalez's regimen lived an average of 17.5 months, approximately three times longer than patients treated with chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

. The study was too small for definitive conclusions to be drawn, but was of enough interest to the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...

 that they provided funds for a larger study. A 2004 study using pancreatic enzymes in a mouse model of pancreatic cancer showed positive results. Gonzalez claims that this treatment was the first therapy that ever yielded positive results in the model used.

A randomized phase III clinical trial
Clinical trial
Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...

 for the possible treatment of pancreatic cancer
Pancreatic cancer
Pancreatic cancer refers to a malignant neoplasm of the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors is adenocarcinoma, which arises within the exocrine component of the pancreas. A minority arises from the islet cells and is classified as a...

 with the Gonzalez Regimen was funded by a $1.4 million grant from the National Center for Complementary and Alternative Medicine, and co-sponsored by the National Cancer Institute, awarded in 1999 to Columbia University
Columbia University
Columbia University in the City of New York is a private, Ivy League university in Manhattan, New York City. Columbia is the oldest institution of higher learning in the state of New York, the fifth oldest in the United States, and one of the country's nine Colonial Colleges founded before the...

's Rosenthal Center for Alternative Medicine. The trial was designed to compare the efficacy of pancreatic enzyme therapy plus specialized diet with gemcitabine for stage II, stage III, or stage IV pancreatic cancer. However, the study had difficulty attracting patients, and most eligible patients refused random assignment, so the trial was changed in 2001 to a controlled, observational study. The study closed early to new enrollment in October 2005. The results of the study showed that patients undergoing conventional gemcitabine-based chemotherapy lived three times longer and had better quality of life
Quality of life
The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and politics. Quality of life should not be confused with the concept of standard of...

 scores and lower pain scores than those undergoing the Gonzalez Regimen and those receiving the pancreatic enzyme therapy had a shorter median survival than patients with similarly staged pancreatic cancer. The results demonstrated that the Gonzalez Regimen was significantly worse for cancer patients than conventional treatment. An accompanying editorial criticizes the trial design, stating: "Can it be concluded that their study proves that enzyme therapy is markedly inferior? On the basis of the study design, my answer is no. It is not possible to make a silk purse out of a sow's ear. Given the scarcity of resources for cancer research, there are many more important questions to address."

This trial had been criticized for its implausible and unsupported theoretical model of cancer development which bears no resemblance to the scientific understanding of neoplasia
Neoplasia
Neoplasm is an abnormal mass of tissue as a result of neoplasia. Neoplasia is the abnormal proliferation of cells. The growth of neoplastic cells exceeds and is not coordinated with that of the normal tissues around it. The growth persists in the same excessive manner even after cessation of the...

, and because of Dr. Gonzalez's history of malpractice.

Publications

  • One Man Alone: An Investigation of Nutrition, Cancer, and William Donald Kelley (2010, New Spring Press; ISBN 978-0-9821965-1-9)
  • Foreword to: Beard, J. The Enzyme Treatment of Cancer and Its Scientific Basis. (2010, New Spring Press; ISBN 978-0-9821965-2-0)
  • Gonzalez NJ, Isaacs LL. The Trophoblast and the Origins of Cancer: One solution to the medical enigma of our time. (2009, New Spring Press; ISBN 978-0-9821965-0-2)
  • Fuhrman MP, Payne C, Eiden K, Steinle N, Gonzalez NJ. Nutrition and the Pancreas. In: Marian MJ, Williams PA, Bowers JM, eds. Integrating Therapeutic and Complementary Nutrition. (2007, CRC Press; ISBN 978-0-8493-1612-8)

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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