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Livingston-Wheeler Therapy

Common Name

Livingston therapy

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Clinical Summary

Metabolic treatment available at the Livingston-Wheeler Clinic in San Diego, CA. This therapy involves a strict vegetarian diet, BCG vaccine, coffee enemas, autogenous vaccine, vitamins, antibiotics, antioxidants, nutritional counseling, and support groups/counseling. Patients use it to treat cancer, arthritis, allergies, and AIDS. The regimen is based on the theory that cancer is caused by the bacterium Progenitor cryptocides, which Virginia Livingston-Wheeler, the developer, claims to have isolated in a wide variety of cancer tissues (3) (4). A weakened immune system supposedly allows the bacterium to grow, and consequently the therapy's focus is immune-stimulation.

A self-selected, matched-cohort, prospective comparison of patients at Livingston-Wheeler Clinic and a conventional cancer center found no difference in survival times between groups, but consistently lower quality of life in the Livingston-Wheeler cohort (6). Although clinic activities are illegal under California's 1959 Cancer Act, no legal action has been taken by the state. Metabolic diets may result in nutrient deficiencies (5). Repeated use of coffee enemas is linked to several deaths from serious infection and electrolyte imbalance (2).

The American Cancer Society strongly urges cancer patients not to seek treatment at the Livingston-Wheeler Clinic (1).

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Purported Uses
  • Allergies
  • Arthritis
  • Cancer treatment
  • HIV and AIDS
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Constituents
  • Diet
  • BCG vaccine
  • Autogenous vaccine
  • Nonspecific vaccines
  • Antibiotics (penicillin, erythromycin, cephalexin, tetracycline, furazolidone, methenamine)
  • Injections: gamma globulin (1/week), sheep spleen extract (1-2/week), crude liver extract (1+/week), vitamin B12 (1+/week).
  • Adjuvant therapy: Levamisole (50 mg 3/day, alternate weeks); fresh whole blood transfusions; enemas with coffee, lemon juice, or hot water; lactic acid bacillus; digestive enzymes to help maintain an acidic blood and urine pH (to kill Progenitor cryptocides); megadoses of vitamins; abscisic acid (or Dormin), a derivative of vitamin A and carotene from plants.
    (1)
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Mechanism of Action

Dr. Livingston-Wheeler claims that the bacterium Progenitor cryptocides is ubiquitous, but a weakened immune system allows it to become pathogenic and cause cancer; that the bacterium induces neoplastic changes when injected into animals and produces large amounts of hCG, which accounts for the rapid growth of cancer cells and cancer-related cachexia (4). Livingston-Wheeler and her husband also claimed to consistently find P. cryptocides in the fresh and cultured blood of cancer patients visualized by dark- and light field microscopy, but failed to specify the criteria by which they distinguished P. cryptocides from other bodies present in the bloodstream (3). Presence of the bacterium in healthy subjects is explained by claims that the bacterium is “ubiquitous” and “latent.” Independent analyses of cultures provided by Wheeler identified the bacteria as Staph epidermis, Strep faecalis, Staph faecalis, and other unrelated bacteria, and found that many of them produced hCG (1).

While the Livingston-Wheeler diet has similarities to the recommendations made by the American Cancer Society, its nutrient deficits (calcium, iron, vitamins D and B12, and protein) are unsuitable for some cancer patients.

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Pharmacokinetics

No formal pharmacokinetics studies have been performed.

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Warnings

The American Cancer Society strongly urges cancer patients not to seek treatment at the Livingston-Wheeler Clinic, as no evidence has supported the efficacy of the treatments offered there (1).

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Adverse Reactions

Common (metabolic diet): Nutrient deficiencies (calcium, vit B12, protein), anemia, and malabsorption may result from metabolic diets (1).
Reported (Autogenous vaccine): Malaise, aching, slight fever, and tenderness at injection site (1).
Case Reports (Coffee enemas):
Multiple seizures and hypokalemia leading to cardiorespiratory arrest, coma, and death were reported after excessive use of coffee enemas (1-4 per hour) for a number of days.
Death attributable to fluid and electrolyte imbalance causing pleural and pericardial effusions after use of coffee enemas, 4 per day for 8 weeks (2).

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Herb-Drug Interactions

None known

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Literature Summary and Critique

Cassileth BR, et al. Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. N Engl J Med 1991;324:1180-5.
A matched-cohort study comparing surivival of end-stage cancer patients receiving care at the Livingston-Wheeler Medical Clinic in San Diego, CA (treatment group, n=78) and at the University of Pennsylvania Cancer Center (control group, n=78). Patients were matched by sex, race, age, diagnosis, and date of metastatic or recurrent disease. Follow-up phone calls assessing ECOG performance status and quality of life occurred every 2 months until death or the end of the study. For both groups, median survival was 15 months. Quality of life deteriorated at an equal rate for both cohorts, although patients reported significantly better quality of life at all times, including enrollment (P=0.002). More Livingston-Wheeler patients reported adverse effects. Patient self-selection and lack of investigator blinding are admitted design flaws of this study. A no-treatment arm should be used in future clinical trials.

Richardson MA, et al. Assessment of outcomes at alternative medicine cancer clinics: a feasibility study. J Altern Complement Med 2001;7:19-32.
Prospective study assessing the feasibility of obtaining data and records from complementary and alternative medicine clinics and comparing 5-year survival to that of conventional therapies. Records were available for all 167 new American patients at the Livingston Foundation Medical Center in San Diego, CA. Five-year survival from the time of treatment at the clinic (not diagnosis) was found to be 18.9% for all cancer types, 12% for breast (3 of 25), 25% for prostate (2 of 9), 1 of 18 for lung, and 0 of 12 for colon cancer. Evaluation was incomplete because the clinic does not assess stage of disease at arrival or keep records of conventional therapies the patients may have had after leaving the clinic. Meaningful statistical analysis and comparison to historical control could not be performed due to the small number of patients in each stage- and site-specific group. The authors call for improvements in record-keeping at such clinics, so that evidence-based evaluation of their methods may occur.

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References
  1. American Cancer Society. Livingston-Wheeler therapy. Ca: Cancer J Clin 1990;40:103-8.
  2. Eisele JW, Reay DT. Deaths related to coffee enemas. JAMA 1980;244:1608-9.
  3. Livingston VW, Livingston AM. Demonstration of progenitor cryptocides in the blood of patients with collagen and neoplastic diseases. Trans N Y Acad Sci 1972;34:433-53.
  4. Livingston VW, Livingston AM. Some cultural, immunological, and biochemical properties of Progenitor cryptocides. Trans N Y Acad Sci 1974;36:569-82.
  5. Dwyer JT. Unproven nutritional remedies and cancer. Nutr Rev 1992;50:106-9.
  6. Cassileth BR, et al. Survival and quality of life among patients receiving unproven as compared with conventional cancer therapy. N Engl J Med 1991;324:1180-5.
  7. Richardson MA, et al. Assessment of outcomes at alternative medicine cancer clinics: a feasibility study. J Altern Complement Med 2001;7:19-32.
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How It Works

Bottom Line: Livingston-Wheeler therapy has not been shown to treat cancer.

Livingston-Wheeler therapy is classified as a “metabolic therapy.” It involves several treatments that supposedly stimulate the immune system (BCG vaccine and a vaccine made from the individual's own urine), a strict vegetarian diet, antioxidants, and detoxification via coffee enemas. It is available at the Livingston-Wheeler Clinic in San Diego, California. Virginia Livingston-Wheeler was a doctor in the early 20th century who believed that cancer is caused by a bacterium called Progenitor cryptocides, which she claimed to have isolated from cancer tissues.

Experts have studied the strict vegetarian diets required by metabolic therapies like Livingston-Wheeler, and have concluded that they are deficient in important nutrients such as calcium, iron, vitamins D, vitamin B12, and protein. Such diets may be unsuitable for cancer patients.

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Purported Uses
  • To treat allergies
    No scientific evidence supports this use.
  • To treat arthritis
    There are no data to back this claim.
  • To treat cancer
    One study found similar survival rates between patients treated with the Livingston-Wheeler therapy and with conventional cancer therapies at a major hospital, but the patients using the Livingston-Wheeler therapy had more side effects and lower quality of life. No other studies support this use.
  • To treat HIV and AIDS
    There are no studies to support this claim.
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Research Evidence

Cancer treatment
In order to get an idea as to whether the Livingston-Wheeler therapy is effective in treating cancer, researchers compared the average survival of 78 end-stage cancer patients treated at the Livingston-Wheeler Clinic in San Diego, CA with similar patients at the University of Pennsylvania Cancer Center. Patients treated at the Livingston-Wheeler Clinic were matched to patients at UPenn by sex, race, age, diagnosis, and date of metastatic or recurrent disease. The researchers followed up with patients by telephone calls every two months. The average survival and decline in quality of life was no different between the groups. However, the patients at the Livingston-Wheeler Clinic reported more side effects. These results do not support the use of the Livingston-Wheeler therapy for treating cancer.

A group of researchers tried to obtain medical records from the Livingston-Wheeler Clinic in order to compare the 5-year survival of patients using this therapy to patients using conventional cancer therapy. The medical records at this clinic did not contain important information such as stage of disease upon arrival at the clinic or other therapies the patients may have used in the past. For these reasons, the researchers were not able to make a complete comparison.

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Patient Warnings
  • The American Cancer Society strongly urges cancer patients not to seek treatment at the Livingston-Wheeler Clinic, as no evidence has supported the safety or effectiveness of the treatments offered there.
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Side Effects
  • Nutrient deficiencies (calcium, vitamin B12, protein), anemia, and malabsorption may result from metabolic diets.
  • The autogenous vaccine given at the Livingston-Wheeler Clinic can cause malaise, aching, slight fever, and tenderness at the injection site.
  • There have been a number of deaths associated with prolonged use of coffee enemas (on the order of four per day for days or weeks).
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Dosage (Inside MSKCC Only)
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Last updated: May 9, 2011
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