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(New page: {{SI}} '''Editor-In-Chief:''' Michel C. Samson, M.D., FRCSC, FACS [mailto:SAMSONM1@ccf.org] {{EJ}} ==Overview== The '''Hoxsey Therapy''' or '''Hoxsey Method''' is a [[alterna...)
 
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{{SI}}
{{SI}}
'''Editor-In-Chief:''' [[User:Mcs|Michel C. Samson, M.D., FRCSC, FACS]] [mailto:SAMSONM1@ccf.org]


{{EJ}}
 
==Overview==
==Overview==
The '''Hoxsey Therapy''' or '''Hoxsey Method''' is a [[alternative medicine|alternative medical treatment]] promoted as a cure for [[cancer]]. The [[alternative cancer treatment]] consists of a caustic herbal paste for external cancers or an herbal mixture for "internal" cancers, combined with laxatives, douches, [[dietary supplement|vitamin supplements]], and dietary changes. Reviews by major medical bodies, including the [[U.S. Food and Drug Administration]] (FDA), the [[National Cancer Institute]], the [[American Cancer Society]],<ref name="acs">[http://documents.cancer.org/6516.00/ Hoxsey Herbal Treatment], from the [[American Cancer Society]]. Accessed [[March 11]] [[2008]].</ref> [[M. D. Anderson Cancer Center]],<ref name="mdanderson"/> and [[Memorial Sloan-Kettering Cancer Center]],<ref name="mskcc"/> have found no evidence that the Hoxsey Therapy is an effective treatment for cancer. The sale or marketing of the Hoxsey Method was banned in the [[United States]] by the FDA on [[September 21]] [[1960]] as a "worthless and discredited" remedy.<ref>{{cite web|url=http://www.fda.gov/centennial/this_week/38_sept_17_sept_23.html|title=This Week in FDA History|publisher=USFDA|accessdate=2008-08-27}}</ref> Currently, the Hoxsey Method is primarily marketed and practiced by the Bio-Medical Center in [[Tijuana, Mexico]]. The Hoxsey Therapy is also marketed over the [[Internet]]; in June 2008, the FDA National Health Fraud Coordinator noted that "There is no scientific evidence that it has any value to treat cancer, yet consumers can go online right now and find all sorts of false claims that Hoxsey treatment is effective against the disease."<ref name="fda-june-2008">[http://www.fda.gov/consumer/updates/cancerfraud061708.html Beware of Online Cancer Fraud]: from the [[U.S. Food and Drug Administration]], released [[June 17]] [[2008]]. Accessed [[August 27]] [[2008]].</ref>
The '''Hoxsey Therapy''' or '''Hoxsey Method''' is a [[alternative medicine|alternative medical treatment]] promoted as a cure for [[cancer]]. The [[alternative cancer treatment]] consists of a caustic herbal paste for external cancers or an herbal mixture for "internal" cancers, combined with laxatives, douches, [[dietary supplement|vitamin supplements]], and dietary changes. Reviews by major medical bodies, including the [[U.S. Food and Drug Administration]] (FDA), the [[National Cancer Institute]], the [[American Cancer Society]],<ref name="acs">[http://documents.cancer.org/6516.00/ Hoxsey Herbal Treatment], from the [[American Cancer Society]]. Accessed [[March 11]] [[2008]].</ref> [[M. D. Anderson Cancer Center]],<ref name="mdanderson"/> and [[Memorial Sloan-Kettering Cancer Center]],<ref name="mskcc"/> have found no evidence that the Hoxsey Therapy is an effective treatment for cancer. The sale or marketing of the Hoxsey Method was banned in the United States by the FDA on September 21, 1960 as a "worthless and discredited" remedy.<ref>{{cite web|url=http://www.fda.gov/centennial/this_week/38_sept_17_sept_23.html|title=This Week in FDA History|publisher=USFDA|accessdate=2008-08-27}}</ref> Currently, the Hoxsey Method is primarily marketed and practiced by the Bio-Medical Center in Tijuana, Mexico. The Hoxsey Therapy is also marketed over the Internet; in June 2008, the FDA National Health Fraud Coordinator noted that "There is no scientific evidence that it has any value to treat cancer, yet consumers can go online right now and find all sorts of false claims that Hoxsey treatment is effective against the disease."<ref name="fda-june-2008">[http://www.fda.gov/consumer/updates/cancerfraud061708.html Beware of Online Cancer Fraud]: from the [[U.S. Food and Drug Administration]], released [[June 17]] [[2008]]. Accessed [[August 27]] [[2008]].</ref>


==History==
==History==
[[Image:FDAHoxsey.JPG|thumb|right|400px|[[Food and Drug Administration]] warning regarding use of the Hoxsey method, released April 1956]]
[[Image:FDAHoxsey.JPG|thumb|left|400px|[[Food and Drug Administration]] warning regarding use of the Hoxsey method, released April 1956]]
The Hoxsey Therapy, a mixture of herbs, was first marketed as a purported cure for cancer in the 1920s by Harry Hoxsey, a former [[coal miner]] and [[insurance]] salesman,<ref name="cantor"/> and Norman Baker, a radio personality. Hoxsey himself traced the treatment to his great-grandfather, who observed a horse with a tumor on its leg cure itself by grazing upon wild plants growing in the meadow. John Hoxsey gathered these herbs and mixed them with old home remedies used for cancer.<ref name="fink">Fink JM. Third opinion: an international directory to alternative therapy centers for the treatment and prevention of cancer and other degenerative diseases. 3rd ed. Garden City Park, New York: Avery Publishing Group Inc., 1997:41-42.</ref><ref name="janssen">{{cite journal |author=Janssen WF |title=Cancer quackery--the past in the present |journal=Semin. Oncol. |volume=6 |issue=4 |pages=526–36 |year=1979 |pmid=394334 |doi=}}</ref> In common with many advocates of unconventional therapies, Hoxsey considered cancer a systemic disease, however localized its manifestations might appear to be. Among the claims made in his book, he purports his therapy aims to restore "physiological normalcy" to a disturbed metabolism throughout the body, with emphasis on purgation, to help carry away wastes from the tumors he believed his herbal mixtures caused to necrotize.<ref>Hoxsey, Harry M. You Dont Have to Die. New York: Milestone Books, Inc. 1956 pg 60. </ref>  
The Hoxsey Therapy, a mixture of herbs, was first marketed as a purported cure for cancer in the 1920s by Harry Hoxsey, a former coal miner and [[insurance]] salesman,<ref name="cantor"/> and Norman Baker, a radio personality. Hoxsey himself traced the treatment to his great-grandfather, who observed a horse with a tumor on its leg cure itself by grazing upon wild plants growing in the meadow. John Hoxsey gathered these herbs and mixed them with old home remedies used for cancer.<ref name="fink">Fink JM. Third opinion: an international directory to alternative therapy centers for the treatment and prevention of cancer and other degenerative diseases. 3rd ed. Garden City Park, New York: Avery Publishing Group Inc., 1997:41-42.</ref><ref name="janssen">{{cite journal |author=Janssen WF |title=Cancer quackery--the past in the present |journal=Semin. Oncol. |volume=6 |issue=4 |pages=526–36 |year=1979 |pmid=394334 |doi=}}</ref> In common with many advocates of unconventional therapies, Hoxsey considered cancer a systemic disease, however localized its manifestations might appear to be. Among the claims made in his book, he purports his therapy aims to restore "physiological normalcy" to a disturbed metabolism throughout the body, with emphasis on purgation, to help carry away wastes from the tumors he believed his herbal mixtures caused to necrotize.<ref>Hoxsey, Harry M. You Dont Have to Die. New York: Milestone Books, Inc. 1956 pg 60. </ref>  


Harry initially opened a clinic in [[Taylorville, Illinois]] for the sale and use of his treatment, one of 17 that he would eventually open. Dogged in many states by legal trouble for practicing medicine without a license, Hoxsey frequently shut down and reopened the clinics in new locations. In 1936, Hoxsey opened a clinic in [[Dallas, Texas]] which became one of the largest privately owned cancer centers in the world. At one point in the 1950s, Hoxsey's gross annual income reached $1.5 million from the treatment of 8,000 patients.<ref name="cantor">{{cite journal |author=Cantor D |title=Cancer, quackery and the vernacular meanings of hope in 1950s America |journal=J Hist Med Allied Sci |volume=61 |issue=3 |pages=324–68 |year=2006 |pmid=16565262 |doi=10.1093/jhmas/jrj048}}</ref> Hoxsey published several books advertising his methods and clinics, and received support from prominent [[right-wing politics|right-wing]] [[conservatism in the United States|conservatives]] and [[Evangelicalism|fundamentalist Christians]] such as [[Gerald Winrod]] and [[H. L. Hunt]].<ref name="cantor"/>
Harry initially opened a clinic in Taylorville, Illinois for the sale and use of his treatment, one of 17 that he would eventually open. Dogged in many states by legal trouble for practicing medicine without a license, Hoxsey frequently shut down and reopened the clinics in new locations. In 1936, Hoxsey opened a clinic in Dallas, Texas which became one of the largest privately owned cancer centers in the world. At one point in the 1950s, Hoxsey's gross annual income reached $1.5 million from the treatment of 8,000 patients.<ref name="cantor">{{cite journal |author=Cantor D |title=Cancer, quackery and the vernacular meanings of hope in 1950s America |journal=J Hist Med Allied Sci |volume=61 |issue=3 |pages=324–68 |year=2006 |pmid=16565262 |doi=10.1093/jhmas/jrj048}}</ref> Hoxsey published several books advertising his methods and clinics, and received support from prominent right-wing conservatives and fundamentalist Christians such as Gerald Winrod and H. L. Hunt.<ref name="cantor"/>


The United States [[National Cancer Institute]] (NCI) and [[Food and Drug Administration]] (FDA), as well as the [[American Medical Association]] (AMA), began a series of efforts to restrict Hoxsey's clinic operations, viewing them as providing "false hope". Regarding the rationale for this campaign, John Heller, director of the NCI, wrote in 1953:
The United States [[National Cancer Institute]] (NCI) and [[Food and Drug Administration]] (FDA), as well as the [[American Medical Association]] (AMA), began a series of efforts to restrict Hoxsey's clinic operations, viewing them as providing "false hope". Regarding the rationale for this campaign, John Heller, director of the NCI, wrote in 1953:
<blockquote>Our efforts in cancer control are directed toward reduction of the intervals between onset and diagnosis of cancer, and between diagnosis and the application of effective treatment. People who fall victims to quacks are diverted from this narrow course for the best clinical management of cancer.<ref name="cantor"/></blockquote>
<blockquote>Our efforts in cancer control are directed toward reduction of the intervals between onset and diagnosis of cancer, and between diagnosis and the application of effective treatment. People who fall victims to quacks are diverted from this narrow course for the best clinical management of cancer.<ref name="cantor"/></blockquote>


The American Medical Association condemned Hoxsey's "caustic pastes" and tonics as fraudulent. In 1949, Hoxsey sued the ''[[Journal of the American Medical Association]]'' (JAMA) and its editors for [[libel]] and [[slander]]. Hoxsey won the case, but was awarded only $2; the judge concluded that since Hoxsey's promotion of his treatment depended largely upon claims that the AMA was persecuting him, he had suffered little or no damage from the ''JAMA'' articles.<ref name="mm">''The Medical Messiahs: A Social History of Health Quackery in Twentieth-Century America'', by James Harvey Young, [http://www.quackwatch.org/13Hx/MM/17.html Chapter 17].</ref> A review of 400 patients treated by Hoxsey found no verifiable cures.<ref name="guzley">{{cite journal |author=Guzley GJ |title=Alternative cancer treatments: impact of unorthodox therapy on the patient with cancer |journal=South. Med. J. |volume=85 |issue=5 |pages=519–23 |year=1992 |pmid=1585205 |doi=10.1097/00007611-199205000-00012}}</ref>
The American Medical Association condemned Hoxsey's "caustic pastes" and tonics as fraudulent. In 1949, Hoxsey sued the ''[[Journal of the American Medical Association]]'' (JAMA) and its editors for libel and slander. Hoxsey won the case, but was awarded only $2; the judge concluded that since Hoxsey's promotion of his treatment depended largely upon claims that the AMA was persecuting him, he had suffered little or no damage from the ''JAMA'' articles.<ref name="mm">''The Medical Messiahs: A Social History of Health Quackery in Twentieth-Century America'', by James Harvey Young, [http://www.quackwatch.org/13Hx/MM/17.html Chapter 17].</ref> A review of 400 patients treated by Hoxsey found no verifiable cures.<ref name="guzley">{{cite journal |author=Guzley GJ |title=Alternative cancer treatments: impact of unorthodox therapy on the patient with cancer |journal=South. Med. J. |volume=85 |issue=5 |pages=519–23 |year=1992 |pmid=1585205 |doi=10.1097/00007611-199205000-00012}}</ref>


In 1950, Hoxsey submitted case histories of 77 patients to the National Cancer Institute (NCI), claiming that they were "fully documented with clinical records and pathological reports" and that they would demonstrate his treatment's effectiveness. However, the NCI found that of these 77 reports, only 6 included actual [[biopsy|tissue biopsies]]. Of the 2 biopsies from patients described by Hoxsey as having "internal cancer", neither showed any evidence of actual malignancy. The NCI concluded that Hoxsey's records did not contain sufficient information to evaluate his treatment. Hoxsey argued that it was the NCI's responsibility to seek out the information necessary to verify his case reports, and attributed the failure to do so to a conspiracy on the part of the NCI and AMA.<ref name="ota-report"/>
In 1950, Hoxsey submitted case histories of 77 patients to the National Cancer Institute (NCI), claiming that they were "fully documented with clinical records and pathological reports" and that they would demonstrate his treatment's effectiveness. However, the NCI found that of these 77 reports, only 6 included actual [[biopsy|tissue biopsies]]. Of the 2 biopsies from patients described by Hoxsey as having "internal cancer", neither showed any evidence of actual malignancy. The NCI concluded that Hoxsey's records did not contain sufficient information to evaluate his treatment. Hoxsey argued that it was the NCI's responsibility to seek out the information necessary to verify his case reports, and attributed the failure to do so to a conspiracy on the part of the NCI and AMA.<ref name="ota-report"/>


In 1956, the FDA sent an investigator to Hoxsey's clinic posing as a patient. The investigator was told by Hoxsey's clinic that he had cancer (he did not), and that it would take a "long time" to cure him.<ref>[http://select.nytimes.com/gst/abstract.html?res=F20C17FF3455177B93C0A8178BD95F428585F9 Cancer "Care" Described; U.S. Agent Tells of Visits as Hoxsey Clinic "Patient"]. Published in the ''[[New York Times]]'' on October 12, 1956; accessed September 5, 2008.</ref> The U.S. government banned the sale of the Hoxsey herbal treatment in 1960.<ref name="guzley"/> Hoxsey was also forced to close all of his U.S. clinics. In 1963, Mildred Nelson, a [[nurse]] who had worked closely with Hoxsey, established the Bio Medical Clinic in [[Tijuana, Mexico]] with Hoxsey's approval. Hoxsey himself chose this site in 1963, when his last operation in the US was shut down.<ref>New York Times, Last Hoxsey Source Shut Off, New York Times, p. 27 (col. 2), Sept. 22, 1960</ref> Just before Nelson's death in 1999, the clinic was taken over by her sister, Liz Jonas.<ref name="nafta">{{cite journal |author=Moss RW |title=Patient perspectives: Tijuana cancer clinics in the post-NAFTA era |journal=Integr Cancer Ther |volume=4 |issue=1 |pages=65–86 |year=2005 |pmid=15695477 |doi=10.1177/1534735404273918}}</ref>
In 1956, the FDA sent an investigator to Hoxsey's clinic posing as a patient. The investigator was told by Hoxsey's clinic that he had cancer (he did not), and that it would take a "long time" to cure him.<ref>[http://select.nytimes.com/gst/abstract.html?res=F20C17FF3455177B93C0A8178BD95F428585F9 Cancer "Care" Described; U.S. Agent Tells of Visits as Hoxsey Clinic "Patient"]. Published in the ''[[New York Times]]'' on October 12, 1956; accessed September 5, 2008.</ref> The U.S. government banned the sale of the Hoxsey herbal treatment in 1960.<ref name="guzley"/> Hoxsey was also forced to close all of his U.S. clinics. In 1963, Mildred Nelson, a [[nurse]] who had worked closely with Hoxsey, established the Bio Medical Clinic in Tijuana, Mexico with Hoxsey's approval. Hoxsey himself chose this site in 1963, when his last operation in the US was shut down.<ref>New York Times, Last Hoxsey Source Shut Off, New York Times, p. 27 (col. 2), Sept. 22, 1960</ref> Just before Nelson's death in 1999, the clinic was taken over by her sister, Liz Jonas.<ref name="nafta">{{cite journal |author=Moss RW |title=Patient perspectives: Tijuana cancer clinics in the post-NAFTA era |journal=Integr Cancer Ther |volume=4 |issue=1 |pages=65–86 |year=2005 |pmid=15695477 |doi=10.1177/1534735404273918}}</ref>


In 1967, Hoxsey developed [[prostate cancer]], and his own treatment failed to cure it.  Because he failed to respond to his eponymous therapy, Hoxsey underwent surgery and standard medical treatment.<ref name="hafner">Hafner AW, editor. Reader's guide to alternative health methods. Milwaukee, Wisconsin: American Medical Association, 1993:128-130.</ref> He died seven years later, in 1974.
In 1967, Hoxsey developed [[prostate cancer]], and his own treatment failed to cure it.  Because he failed to respond to his eponymous therapy, Hoxsey underwent surgery and standard medical treatment.<ref name="hafner">Hafner AW, editor. Reader's guide to alternative health methods. Milwaukee, Wisconsin: American Medical Association, 1993:128-130.</ref> He died seven years later, in 1974.


==Treatment==
==Treatment==
Hoxsey herbal treatments include a topical paste of [[antimony]], [[zinc]] and [[bloodroot]], [[arsenic]], [[sulfur]], and [[talc]] for external treatments, and a liquid tonic of [[licorice]], [[red clover]], [[burdock]] root, [[Stillingia]] root, [[barberry]], [[Cascara]], [[prickly ash]] bark, [[buckthorn]] bark, and [[potassium iodide]] for internal consumption.<ref>Spencer JW, Jacobs JJ. Complementary/alternative medicine: an evidence based approach. Toronto: Mosby, 1999:142.</ref>
Hoxsey herbal treatments include a topical paste of [[antimony]], [[zinc]] and [[bloodroot]], [[arsenic]], [[sulfur]], and [[talc]] for external treatments, and a liquid tonic of [[licorice]], red clover, [[burdock]] root, Stillingia root, barberry, Cascara, prickly ash bark, [[buckthorn]] bark, and [[potassium iodide]] for internal consumption.<ref>Spencer JW, Jacobs JJ. Complementary/alternative medicine: an evidence based approach. Toronto: Mosby, 1999:142.</ref>


In addition to the herbs, the Hoxsey treatment now also includes [[antiseptic]] douches and washes, [[laxative]] tablets, and [[dietary supplement|nutritional supplements]]. A mixture of [[procaine hydrochloride]] and vitamins, along with liver and cactus, is prescribed. During treatment, patients are asked to avoid consumption of [[tomatoes]], [[vinegar]], [[pork]], [[alcohol]], [[salt]], [[sugar]], and [[white flour]] products.<ref name="fink"/>
In addition to the herbs, the Hoxsey treatment now also includes [[antiseptic]] douches and washes, [[laxative]] tablets, and [[dietary supplement|nutritional supplements]]. A mixture of procaine hydrochloride and vitamins, along with liver and cactus, is prescribed. During treatment, patients are asked to avoid consumption of tomatoes, [[vinegar]], [[pork]], [[alcohol]], [[salt]], [[sugar]], and white flour products.<ref name="fink"/>


In 2005, the cost of initial evaluation and treatment with Hoxsey Therapy at the Bio-Medical Center in Tijuana, Mexico was reported to be between $3,900 and $5,100, though this price did not include the recommended purchase of an unspecified number of [[dietary supplement]]s and 3 years of return visits.<ref name="nafta"/>
In 2005, the cost of initial evaluation and treatment with Hoxsey Therapy at the Bio-Medical Center in Tijuana, Mexico was reported to be between $3,900 and $5,100, though this price did not include the recommended purchase of an unspecified number of [[dietary supplement]]s and 3 years of return visits.<ref name="nafta"/>
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:*[[heart block]]
:*[[heart block]]
*[[Pokeweed]] has caused deaths in children.  
*[[Pokeweed]] has caused deaths in children.  
*[[Red clover]] may increase the risk of bleeding for people who take [[anticoagulants]]. It also mimics the behavior of the hormone [[estrogen]], and thus is unsuitable for women with estrogen-responsive [[breast cancer|breast tumors]].
*Red clover may increase the risk of bleeding for people who take [[anticoagulants]]. It also mimics the behavior of the hormone [[estrogen]], and thus is unsuitable for women with estrogen-responsive [[breast cancer|breast tumors]].


==Effectiveness==
==Effectiveness==
No [[peer-review]]ed medical or scientific research has been published which would allow any conclusions about the effectiveness of the Hoxsey Therapy.<ref name="mdanderson">[http://www.mdanderson.org/departments/CIMER/display.cfm?id=A0AAFDBB-ECA2-11D4-810100508B603A14&method=displayFull&pn=6EB86A59-EBD9-11D4-810100508B603A14 Herbal / Plant Therapies: Hoxsey], from the Department of Complementary and Integrative Medicine of [[M. D. Anderson Cancer Center]]. Last updated [[July 31]] [[2006]]; accessed [[March 11]] [[2008]].</ref> The Bio-Medical Center in Tijuana, Mexico claims a success rate of 50&ndash;85%, though these figures have not been independently evaluated and the parameters of "treatment success" are undefined.<ref name="ota-report"/><ref name="nafta"/> Mildred Nelson, director of the Bio-Medical Center, has claimed an 80% success rate, and attributed treatment failures to a "bad attitude" on the part of the patient.<ref name="ota-report"/>
No peer-reviewed medical or scientific research has been published which would allow any conclusions about the effectiveness of the Hoxsey Therapy.<ref name="mdanderson">[http://www.mdanderson.org/departments/CIMER/display.cfm?id=A0AAFDBB-ECA2-11D4-810100508B603A14&method=displayFull&pn=6EB86A59-EBD9-11D4-810100508B603A14 Herbal / Plant Therapies: Hoxsey], from the Department of Complementary and Integrative Medicine of [[M. D. Anderson Cancer Center]]. Last updated [[July 31]] [[2006]]; accessed [[March 11]] [[2008]].</ref> The Bio-Medical Center in Tijuana, Mexico claims a success rate of 50&ndash;85%, though these figures have not been independently evaluated and the parameters of "treatment success" are undefined.<ref name="ota-report"/><ref name="nafta"/> Mildred Nelson, director of the Bio-Medical Center, has claimed an 80% success rate, and attributed treatment failures to a "bad attitude" on the part of the patient.<ref name="ota-report"/>


=== Studies by major medical bodies ===
=== Studies by major medical bodies ===
The [[American Cancer Society]] and the [[National Cancer Institute]] do not advise the use of the Hoxsey Therapy, as neither have found any objective evidence that the treatment provides tangible benefit to people with cancer.<ref name="acs" /> Reviews by the [[Memorial Sloan-Kettering Cancer Center]] and [[M. D. Anderson Cancer Center]] found no evidence that the Hoxsey Therapy is effective as a treatment for cancer.<ref name="mdanderson"/><ref name="mskcc">[http://www.mskcc.org/mskcc/html/69258.cfm Hoxsey Herbal Therapy], from the [[Memorial Sloan-Kettering Cancer Center]]. Accessed [[March 11]] [[2008]].</ref> A controlled experiment in lab mice did not find any difference in tumor growth between untreated mice and those given the Hoxsey tonic.<ref name="ca">{{cite journal |author= |title=Hoxsey Method/Bio-Medical Center |journal=CA Cancer J Clin |volume=40 |issue=1 |pages=51–5 |year=1990 |pmid=2104568 |doi=10.3322/canjclin.40.1.51}}</ref> An FDA review of 400 people claiming to have been cured by the Hoxsey method found that many of the patients never in fact had cancer, or had received successful medical treatment elsewhere before being treated with the Hoxsey Therapy. Those who had cancer at the time of the Hoxsey Therapy were uniformly either deceased or alive with active cancer. There were no cases of actual cures among those promoted as such by the Hoxsey clinic.<ref>{{cite web|url=http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Hoxsey_Herbal_Treatment.asp|title=Hoxsley Herbal Treatment|publisher=American Cancer Society|accessdate=2008-08-27}}</ref>
The [[American Cancer Society]] and the [[National Cancer Institute]] do not advise the use of the Hoxsey Therapy, as neither have found any objective evidence that the treatment provides tangible benefit to people with cancer.<ref name="acs" /> Reviews by the [[Memorial Sloan-Kettering Cancer Center]] and [[M. D. Anderson Cancer Center]] found no evidence that the Hoxsey Therapy is effective as a treatment for cancer.<ref name="mdanderson"/><ref name="mskcc">[http://www.mskcc.org/mskcc/html/69258.cfm Hoxsey Herbal Therapy], from the [[Memorial Sloan-Kettering Cancer Center]]. Accessed [[March 11]] [[2008]].</ref> A controlled experiment in lab mice did not find any difference in tumor growth between untreated mice and those given the Hoxsey tonic.<ref name="ca">{{cite journal |author= |title=Hoxsey Method/Bio-Medical Center |journal=CA Cancer J Clin |volume=40 |issue=1 |pages=51–5 |year=1990 |pmid=2104568 |doi=10.3322/canjclin.40.1.51}}</ref> An FDA review of 400 people claiming to have been cured by the Hoxsey method found that many of the patients never in fact had cancer, or had received successful medical treatment elsewhere before being treated with the Hoxsey Therapy. Those who had cancer at the time of the Hoxsey Therapy were uniformly either deceased or alive with active cancer. There were no cases of actual cures among those promoted as such by the Hoxsey clinic.<ref>{{cite web|url=http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Hoxsey_Herbal_Treatment.asp|title=Hoxsley Herbal Treatment|publisher=American Cancer Society|accessdate=2008-08-27}}</ref>


In 1957, a group from the [[University of British Columbia]] visited Hoxsey's Mexican clinic and obtained records for 71 Canadian patients treated by Hoxsey. The University panel found that:
In 1957, a group from the University of British Columbia visited Hoxsey's Mexican clinic and obtained records for 71 Canadian patients treated by Hoxsey. The University panel found that:
<blockquote>For over one-half of the [cancer] patients from British Columbia, the result [of treatment with the Hoxsey method] has been either death or progression of the disease. In nearly one-quarter there was no proof that the patient ever had cancer. Nearly one in ten of the patients had curative treatment before going to the Hoxsey Clinic. In only one case, an external cancer, was there any evidence at all that the Hoxsey treatment had an effect on the disease; in that case, better results could have been obtained by orthodox means.<ref name="ota-report">[http://www.quackwatch.org/01QuackeryRelatedTopics/OTA/ota04.html Unconventional Cancer Treatments, Chapter 4: Herbal Treatments]. From a report by the U.S. [[Office of Technology Assessment]]. Accessed [[September 2]] [[2008]].</ref></blockquote>
<blockquote>For over one-half of the [cancer] patients from British Columbia, the result [of treatment with the Hoxsey method] has been either death or progression of the disease. In nearly one-quarter there was no proof that the patient ever had cancer. Nearly one in ten of the patients had curative treatment before going to the Hoxsey Clinic. In only one case, an external cancer, was there any evidence at all that the Hoxsey treatment had an effect on the disease; in that case, better results could have been obtained by orthodox means.<ref name="ota-report">[http://www.quackwatch.org/01QuackeryRelatedTopics/OTA/ota04.html Unconventional Cancer Treatments, Chapter 4: Herbal Treatments]. From a report by the U.S. [[Office of Technology Assessment]]. Accessed [[September 2]] [[2008]].</ref></blockquote>
The panel reported that in the one case of demonstrable cure, a patient with a skin cancer of the ear, Hoxsey's treatment had resulted in disfigurement which could have been avoided with standard surgical excision.<ref name="ota-report"/>
The panel reported that in the one case of demonstrable cure, a patient with a skin cancer of the ear, Hoxsey's treatment had resulted in disfigurement which could have been avoided with standard surgical excision.<ref name="ota-report"/>


In 1998, the [[Office of Technology Assessment]] issued a report on herbal cancer treatments. This group found that while many elements of the Hoxsey Therapy had antitumor activity ''[[in vitro]]'', the complete Hoxsey tonic had never been tested in animal models or in human clinical trials.<ref name="ota-report"/>
In 1998, the Office of Technology Assessment issued a report on herbal cancer treatments. This group found that while many elements of the Hoxsey Therapy had antitumor activity ''[[in vitro]]'', the complete Hoxsey tonic had never been tested in animal models or in human clinical trials.<ref name="ota-report"/>


=== Alternative medicine literature ===
=== Alternative medicine literature ===
Several books on herbalism have claimed that some of the herbs in the therapy have anti-tumor effects ''[[in vitro]]''.<ref>Diamond WJ, et al. An alternative medicine definitive guide to cancer. Tiburon: Future Medicine Publishing, Inc., 1997:829.</ref><ref>Tyler VE, Foster S. Tyler's honest herbal. New York: Haworth Herbal Press, 1999:316,72.</ref> According to botanist [[James A. Duke]] of the [[United States Department of Agriculture]], eight of the nine Hoxsey-tonic herbs have some anti-tumor activity in animal models, five have antioxidant effects, and all nine have antimicrobial activity that may be linked to cancer-fighting effects. Duke's assessment was that the Hoxsey tonic ingredients showed very significant chemical and biological anticancer activity.<ref>Duke, James. "The Herbal Shotgun Shell," American Botanical Council's HerbalGram, No. 18/19, Fall 1988/Winter 1989, pp. 12-13</ref>  
Several books on herbalism have claimed that some of the herbs in the therapy have anti-tumor effects ''[[in vitro]]''.<ref>Diamond WJ, et al. An alternative medicine definitive guide to cancer. Tiburon: Future Medicine Publishing, Inc., 1997:829.</ref><ref>Tyler VE, Foster S. Tyler's honest herbal. New York: Haworth Herbal Press, 1999:316,72.</ref> According to botanist James A. Duke of the [[United States Department of Agriculture]], eight of the nine Hoxsey-tonic herbs have some anti-tumor activity in animal models, five have antioxidant effects, and all nine have antimicrobial activity that may be linked to cancer-fighting effects. Duke's assessment was that the Hoxsey tonic ingredients showed very significant chemical and biological anticancer activity.<ref>Duke, James. "The Herbal Shotgun Shell," American Botanical Council's HerbalGram, No. 18/19, Fall 1988/Winter 1989, pp. 12-13</ref>  


A 1994 article in the ''Journal of Naturopathic Medicine'' followed 39 patients treated with the Hoxsey Therapy in Tijuana. Patient interviews were used to confirm the existence and stage of cancer; most patients were unaware of the stage of their tumor and medical records were not available. Most patients were lost to follow-up; of the patients successfully followed, 10 died and 6 were alive at their last follow-up.<ref>Austin, Dale, DeKadt. Long term follow-up of cancer patients using Contreras, Hoxsey and Gerson therapies. Journal of Naturopathic Medicine. 1994;5:74-76</ref> Review of this study pointed out its "obvious flaws", including "the majority of patients lost to follow-up, lack of access to detailed medical records, and reliance upon patients for disease stage information"; the authors themselves regarded the results as unclear.<ref name="mskcc"/>
A 1994 article in the ''Journal of Naturopathic Medicine'' followed 39 patients treated with the Hoxsey Therapy in Tijuana. Patient interviews were used to confirm the existence and stage of cancer; most patients were unaware of the stage of their tumor and medical records were not available. Most patients were lost to follow-up; of the patients successfully followed, 10 died and 6 were alive at their last follow-up.<ref>Austin, Dale, DeKadt. Long term follow-up of cancer patients using Contreras, Hoxsey and Gerson therapies. Journal of Naturopathic Medicine. 1994;5:74-76</ref> Review of this study pointed out its "obvious flaws", including "the majority of patients lost to follow-up, lack of access to detailed medical records, and reliance upon patients for disease stage information"; the authors themselves regarded the results as unclear.<ref name="mskcc"/>
Line 64: Line 63:
== Notable cases ==
== Notable cases ==


The treatment gained wide press coverage in 2006 due to a court dispute between the family of [[Starchild Abraham Cherrix]] and Social Services of the State of [[Virginia]].  Cherrix has requested to undergo Hoxsey Therapy to treat a recurrence of [[Hodgkin disease]].  Because at the age of 16 he was still a minor, Social Services considered the parents to be negligent and sought to have Cherrix undergo conventional [[chemotherapy]] and [[radiotherapy]].  On [[August 16]] [[2006]], Circuit Judge Glen A. Tyler announced that both sides had reached an agreement that the parents did not act in a way that was medically neglectful.  In addition, it stipulated that Starchild would be treated by an [[oncologist]] of his choice who was both [[board certification|board-certified]] in [[radiation oncology|radiation therapy]] as well as interested in alternative methods to treat Hodgkin disease.<ref>{{cite news |author= Associated Press |title= Teen, court reach agreement over cancer care|url= http://www.msnbc.msn.com/id/14371567/|publisher= MSNBC.com|location= |date= 2006-09-05|accessdate=2008-03-21}}</ref>
The treatment gained wide press coverage in 2006 due to a court dispute between the family of Starchild Abraham Cherrix and Social Services of the State of Virginia.  Cherrix has requested to undergo Hoxsey Therapy to treat a recurrence of [[Hodgkin disease]].  Because at the age of 16 he was still a minor, Social Services considered the parents to be negligent and sought to have Cherrix undergo conventional [[chemotherapy]] and [[radiotherapy]].  On August 16 2006, Circuit Judge Glen A. Tyler announced that both sides had reached an agreement that the parents did not act in a way that was medically neglectful.  In addition, it stipulated that Starchild would be treated by an [[oncologist]] of his choice who was both [[board certification|board-certified]] in [[radiation oncology|radiation therapy]] as well as interested in alternative methods to treat Hodgkin disease.<ref>{{cite news |author= Associated Press |title= Teen, court reach agreement over cancer care|url= http://www.msnbc.msn.com/id/14371567/|publisher= MSNBC.com|location= |date= 2006-09-05|accessdate=2008-03-21}}</ref>


==Notes==
==Notes==
{{reflist}}
{{reflist|2}}


==External links==
==External links==
Line 80: Line 79:


===Narratives===
===Narratives===
*{{cite book |title= When Healing Becomes a Crime|last= Ausubel|first= Kenny|year=2000|publisher=Healing Arts Press|location=[[Rochester, Vermont]]|isbn=978-0892819256|page=480 pages}}  
*{{cite book |title= When Healing Becomes a Crime|last= Ausubel|first= Kenny|year=2000|publisher=Healing Arts Press|location=Rochester, Vermont|isbn=978-0892819256|page=480 pages}}  
*[http://imdb.com/title/tt0175753/ Hoxsey: How Healing Becomes a Crime (1987)], 1987 documentary film written and directed by Ausubel
*[http://imdb.com/title/tt0175753/ Hoxsey: How Healing Becomes a Crime (1987)], 1987 documentary film written and directed by Ausubel
*[http://www.quackwatch.org/13Hx/MM/17.html The Medical Messiahs: A Social History of Health Quackery in Twentieth-Century America], by James Harvey Young
*[http://www.quackwatch.org/13Hx/MM/17.html The Medical Messiahs: A Social History of Health Quackery in Twentieth-Century America], by James Harvey Young


{{Plastic surgery}}
 
{{Cleft lip and palate}}
{{SIB}}


[[Category:Patent medicines]]
[[Category:Patent medicines]]
[[Category:Alternative cancer treatments]]
[[Category:Alternative cancer treatments]]
{{WH}}
{{WS}}

Latest revision as of 18:20, 4 September 2012

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Overview

The Hoxsey Therapy or Hoxsey Method is a alternative medical treatment promoted as a cure for cancer. The alternative cancer treatment consists of a caustic herbal paste for external cancers or an herbal mixture for "internal" cancers, combined with laxatives, douches, vitamin supplements, and dietary changes. Reviews by major medical bodies, including the U.S. Food and Drug Administration (FDA), the National Cancer Institute, the American Cancer Society,[1] M. D. Anderson Cancer Center,[2] and Memorial Sloan-Kettering Cancer Center,[3] have found no evidence that the Hoxsey Therapy is an effective treatment for cancer. The sale or marketing of the Hoxsey Method was banned in the United States by the FDA on September 21, 1960 as a "worthless and discredited" remedy.[4] Currently, the Hoxsey Method is primarily marketed and practiced by the Bio-Medical Center in Tijuana, Mexico. The Hoxsey Therapy is also marketed over the Internet; in June 2008, the FDA National Health Fraud Coordinator noted that "There is no scientific evidence that it has any value to treat cancer, yet consumers can go online right now and find all sorts of false claims that Hoxsey treatment is effective against the disease."[5]

History

Food and Drug Administration warning regarding use of the Hoxsey method, released April 1956

The Hoxsey Therapy, a mixture of herbs, was first marketed as a purported cure for cancer in the 1920s by Harry Hoxsey, a former coal miner and insurance salesman,[6] and Norman Baker, a radio personality. Hoxsey himself traced the treatment to his great-grandfather, who observed a horse with a tumor on its leg cure itself by grazing upon wild plants growing in the meadow. John Hoxsey gathered these herbs and mixed them with old home remedies used for cancer.[7][8] In common with many advocates of unconventional therapies, Hoxsey considered cancer a systemic disease, however localized its manifestations might appear to be. Among the claims made in his book, he purports his therapy aims to restore "physiological normalcy" to a disturbed metabolism throughout the body, with emphasis on purgation, to help carry away wastes from the tumors he believed his herbal mixtures caused to necrotize.[9]

Harry initially opened a clinic in Taylorville, Illinois for the sale and use of his treatment, one of 17 that he would eventually open. Dogged in many states by legal trouble for practicing medicine without a license, Hoxsey frequently shut down and reopened the clinics in new locations. In 1936, Hoxsey opened a clinic in Dallas, Texas which became one of the largest privately owned cancer centers in the world. At one point in the 1950s, Hoxsey's gross annual income reached $1.5 million from the treatment of 8,000 patients.[6] Hoxsey published several books advertising his methods and clinics, and received support from prominent right-wing conservatives and fundamentalist Christians such as Gerald Winrod and H. L. Hunt.[6]

The United States National Cancer Institute (NCI) and Food and Drug Administration (FDA), as well as the American Medical Association (AMA), began a series of efforts to restrict Hoxsey's clinic operations, viewing them as providing "false hope". Regarding the rationale for this campaign, John Heller, director of the NCI, wrote in 1953:

Our efforts in cancer control are directed toward reduction of the intervals between onset and diagnosis of cancer, and between diagnosis and the application of effective treatment. People who fall victims to quacks are diverted from this narrow course for the best clinical management of cancer.[6]

The American Medical Association condemned Hoxsey's "caustic pastes" and tonics as fraudulent. In 1949, Hoxsey sued the Journal of the American Medical Association (JAMA) and its editors for libel and slander. Hoxsey won the case, but was awarded only $2; the judge concluded that since Hoxsey's promotion of his treatment depended largely upon claims that the AMA was persecuting him, he had suffered little or no damage from the JAMA articles.[10] A review of 400 patients treated by Hoxsey found no verifiable cures.[11]

In 1950, Hoxsey submitted case histories of 77 patients to the National Cancer Institute (NCI), claiming that they were "fully documented with clinical records and pathological reports" and that they would demonstrate his treatment's effectiveness. However, the NCI found that of these 77 reports, only 6 included actual tissue biopsies. Of the 2 biopsies from patients described by Hoxsey as having "internal cancer", neither showed any evidence of actual malignancy. The NCI concluded that Hoxsey's records did not contain sufficient information to evaluate his treatment. Hoxsey argued that it was the NCI's responsibility to seek out the information necessary to verify his case reports, and attributed the failure to do so to a conspiracy on the part of the NCI and AMA.[12]

In 1956, the FDA sent an investigator to Hoxsey's clinic posing as a patient. The investigator was told by Hoxsey's clinic that he had cancer (he did not), and that it would take a "long time" to cure him.[13] The U.S. government banned the sale of the Hoxsey herbal treatment in 1960.[11] Hoxsey was also forced to close all of his U.S. clinics. In 1963, Mildred Nelson, a nurse who had worked closely with Hoxsey, established the Bio Medical Clinic in Tijuana, Mexico with Hoxsey's approval. Hoxsey himself chose this site in 1963, when his last operation in the US was shut down.[14] Just before Nelson's death in 1999, the clinic was taken over by her sister, Liz Jonas.[15]

In 1967, Hoxsey developed prostate cancer, and his own treatment failed to cure it. Because he failed to respond to his eponymous therapy, Hoxsey underwent surgery and standard medical treatment.[16] He died seven years later, in 1974.

Treatment

Hoxsey herbal treatments include a topical paste of antimony, zinc and bloodroot, arsenic, sulfur, and talc for external treatments, and a liquid tonic of licorice, red clover, burdock root, Stillingia root, barberry, Cascara, prickly ash bark, buckthorn bark, and potassium iodide for internal consumption.[17]

In addition to the herbs, the Hoxsey treatment now also includes antiseptic douches and washes, laxative tablets, and nutritional supplements. A mixture of procaine hydrochloride and vitamins, along with liver and cactus, is prescribed. During treatment, patients are asked to avoid consumption of tomatoes, vinegar, pork, alcohol, salt, sugar, and white flour products.[7]

In 2005, the cost of initial evaluation and treatment with Hoxsey Therapy at the Bio-Medical Center in Tijuana, Mexico was reported to be between $3,900 and $5,100, though this price did not include the recommended purchase of an unspecified number of dietary supplements and 3 years of return visits.[15]

Side-effects

  • The topical paste is highly caustic, and can burn or scar the skin.
  • The oral treatment can cause:
  • Pokeweed has caused deaths in children.
  • Red clover may increase the risk of bleeding for people who take anticoagulants. It also mimics the behavior of the hormone estrogen, and thus is unsuitable for women with estrogen-responsive breast tumors.

Effectiveness

No peer-reviewed medical or scientific research has been published which would allow any conclusions about the effectiveness of the Hoxsey Therapy.[2] The Bio-Medical Center in Tijuana, Mexico claims a success rate of 50–85%, though these figures have not been independently evaluated and the parameters of "treatment success" are undefined.[12][15] Mildred Nelson, director of the Bio-Medical Center, has claimed an 80% success rate, and attributed treatment failures to a "bad attitude" on the part of the patient.[12]

Studies by major medical bodies

The American Cancer Society and the National Cancer Institute do not advise the use of the Hoxsey Therapy, as neither have found any objective evidence that the treatment provides tangible benefit to people with cancer.[1] Reviews by the Memorial Sloan-Kettering Cancer Center and M. D. Anderson Cancer Center found no evidence that the Hoxsey Therapy is effective as a treatment for cancer.[2][3] A controlled experiment in lab mice did not find any difference in tumor growth between untreated mice and those given the Hoxsey tonic.[18] An FDA review of 400 people claiming to have been cured by the Hoxsey method found that many of the patients never in fact had cancer, or had received successful medical treatment elsewhere before being treated with the Hoxsey Therapy. Those who had cancer at the time of the Hoxsey Therapy were uniformly either deceased or alive with active cancer. There were no cases of actual cures among those promoted as such by the Hoxsey clinic.[19]

In 1957, a group from the University of British Columbia visited Hoxsey's Mexican clinic and obtained records for 71 Canadian patients treated by Hoxsey. The University panel found that:

For over one-half of the [cancer] patients from British Columbia, the result [of treatment with the Hoxsey method] has been either death or progression of the disease. In nearly one-quarter there was no proof that the patient ever had cancer. Nearly one in ten of the patients had curative treatment before going to the Hoxsey Clinic. In only one case, an external cancer, was there any evidence at all that the Hoxsey treatment had an effect on the disease; in that case, better results could have been obtained by orthodox means.[12]

The panel reported that in the one case of demonstrable cure, a patient with a skin cancer of the ear, Hoxsey's treatment had resulted in disfigurement which could have been avoided with standard surgical excision.[12]

In 1998, the Office of Technology Assessment issued a report on herbal cancer treatments. This group found that while many elements of the Hoxsey Therapy had antitumor activity in vitro, the complete Hoxsey tonic had never been tested in animal models or in human clinical trials.[12]

Alternative medicine literature

Several books on herbalism have claimed that some of the herbs in the therapy have anti-tumor effects in vitro.[20][21] According to botanist James A. Duke of the United States Department of Agriculture, eight of the nine Hoxsey-tonic herbs have some anti-tumor activity in animal models, five have antioxidant effects, and all nine have antimicrobial activity that may be linked to cancer-fighting effects. Duke's assessment was that the Hoxsey tonic ingredients showed very significant chemical and biological anticancer activity.[22]

A 1994 article in the Journal of Naturopathic Medicine followed 39 patients treated with the Hoxsey Therapy in Tijuana. Patient interviews were used to confirm the existence and stage of cancer; most patients were unaware of the stage of their tumor and medical records were not available. Most patients were lost to follow-up; of the patients successfully followed, 10 died and 6 were alive at their last follow-up.[23] Review of this study pointed out its "obvious flaws", including "the majority of patients lost to follow-up, lack of access to detailed medical records, and reliance upon patients for disease stage information"; the authors themselves regarded the results as unclear.[3]

A 2001 analysis published in the alternative-medicine literature explored the feasibility of using the Bio Medical Center's records in Tijuana as the basis for outcomes research on the Hoxsey Therapy. Of 149 patients treated for cancer at the Bio Medical Center in 1992, the authors found that less than half of these patient records contained pathology reports verifying a cancer diagnosis. Additionally, 60%–90% had already received "conventional" treatment such as surgery, chemotherapy, or radiation therapy with a possible curative effect.[3] The authors were able to verify survival status in only 57% of the treated patients, due to lack of documentation, follow-up, and identifying information in the Bio Medical Center charts. Of the cohort of 149 patients, 11% were still alive 5 years after treatment with the Hoxsey Therapy; 46% had died; and 43% could not be located and their status could not be determined. The authors concluded that it was not possible to reliably assess the Bio Medical Center's outcomes because of the lack of documentation, limited follow-up, and failure to confirm in many cases the existence or stage of cancer.[24]

Notable cases

The treatment gained wide press coverage in 2006 due to a court dispute between the family of Starchild Abraham Cherrix and Social Services of the State of Virginia. Cherrix has requested to undergo Hoxsey Therapy to treat a recurrence of Hodgkin disease. Because at the age of 16 he was still a minor, Social Services considered the parents to be negligent and sought to have Cherrix undergo conventional chemotherapy and radiotherapy. On August 16 2006, Circuit Judge Glen A. Tyler announced that both sides had reached an agreement that the parents did not act in a way that was medically neglectful. In addition, it stipulated that Starchild would be treated by an oncologist of his choice who was both board-certified in radiation therapy as well as interested in alternative methods to treat Hodgkin disease.[25]

Notes

  1. 1.0 1.1 Hoxsey Herbal Treatment, from the American Cancer Society. Accessed March 11 2008.
  2. 2.0 2.1 2.2 Herbal / Plant Therapies: Hoxsey, from the Department of Complementary and Integrative Medicine of M. D. Anderson Cancer Center. Last updated July 31 2006; accessed March 11 2008.
  3. 3.0 3.1 3.2 3.3 Hoxsey Herbal Therapy, from the Memorial Sloan-Kettering Cancer Center. Accessed March 11 2008.
  4. "This Week in FDA History". USFDA. Retrieved 2008-08-27.
  5. Beware of Online Cancer Fraud: from the U.S. Food and Drug Administration, released June 17 2008. Accessed August 27 2008.
  6. 6.0 6.1 6.2 6.3 Cantor D (2006). "Cancer, quackery and the vernacular meanings of hope in 1950s America". J Hist Med Allied Sci. 61 (3): 324–68. doi:10.1093/jhmas/jrj048. PMID 16565262.
  7. 7.0 7.1 Fink JM. Third opinion: an international directory to alternative therapy centers for the treatment and prevention of cancer and other degenerative diseases. 3rd ed. Garden City Park, New York: Avery Publishing Group Inc., 1997:41-42.
  8. Janssen WF (1979). "Cancer quackery--the past in the present". Semin. Oncol. 6 (4): 526–36. PMID 394334.
  9. Hoxsey, Harry M. You Dont Have to Die. New York: Milestone Books, Inc. 1956 pg 60.
  10. The Medical Messiahs: A Social History of Health Quackery in Twentieth-Century America, by James Harvey Young, Chapter 17.
  11. 11.0 11.1 Guzley GJ (1992). "Alternative cancer treatments: impact of unorthodox therapy on the patient with cancer". South. Med. J. 85 (5): 519–23. doi:10.1097/00007611-199205000-00012. PMID 1585205.
  12. 12.0 12.1 12.2 12.3 12.4 12.5 Unconventional Cancer Treatments, Chapter 4: Herbal Treatments. From a report by the U.S. Office of Technology Assessment. Accessed September 2 2008.
  13. Cancer "Care" Described; U.S. Agent Tells of Visits as Hoxsey Clinic "Patient". Published in the New York Times on October 12, 1956; accessed September 5, 2008.
  14. New York Times, Last Hoxsey Source Shut Off, New York Times, p. 27 (col. 2), Sept. 22, 1960
  15. 15.0 15.1 15.2 Moss RW (2005). "Patient perspectives: Tijuana cancer clinics in the post-NAFTA era". Integr Cancer Ther. 4 (1): 65–86. doi:10.1177/1534735404273918. PMID 15695477.
  16. Hafner AW, editor. Reader's guide to alternative health methods. Milwaukee, Wisconsin: American Medical Association, 1993:128-130.
  17. Spencer JW, Jacobs JJ. Complementary/alternative medicine: an evidence based approach. Toronto: Mosby, 1999:142.
  18. "Hoxsey Method/Bio-Medical Center". CA Cancer J Clin. 40 (1): 51–5. 1990. doi:10.3322/canjclin.40.1.51. PMID 2104568.
  19. "Hoxsley Herbal Treatment". American Cancer Society. Retrieved 2008-08-27.
  20. Diamond WJ, et al. An alternative medicine definitive guide to cancer. Tiburon: Future Medicine Publishing, Inc., 1997:829.
  21. Tyler VE, Foster S. Tyler's honest herbal. New York: Haworth Herbal Press, 1999:316,72.
  22. Duke, James. "The Herbal Shotgun Shell," American Botanical Council's HerbalGram, No. 18/19, Fall 1988/Winter 1989, pp. 12-13
  23. Austin, Dale, DeKadt. Long term follow-up of cancer patients using Contreras, Hoxsey and Gerson therapies. Journal of Naturopathic Medicine. 1994;5:74-76
  24. Richardson MA, Russell NC, Sanders T, Barrett R, Salveson C (2001). "Assessment of outcomes at alternative medicine cancer clinics: a feasibility study". J Altern Complement Med. 7 (1): 19–32. doi:10.1089/107555301300004501. PMID 11246933. Unknown parameter |month= ignored (help)
  25. Associated Press (2006-09-05). "Teen, court reach agreement over cancer care". MSNBC.com. Retrieved 2008-03-21.

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