I had always wondered what my blog first post would be, I never thought this would be it. I’m sad that this is it, but I feel as though this is urgent enough.
As a very quick background: The dubious clinic in Istanbul, Turkey, called the ChemoThermia Oncology Center, uses “metabolically supported chemotherapy”, which is also combined with a ketogenic diet, fasting, hyperthermia, and hyperbaric oxygen. Natural supplements, Mistletoe, Amygdalin/ Laetrile and vitamin infusions are also included. The fraudulence behind these unproven or disproven therapies are beyond the scope of this article. What will be focused on is the patients that have gone to the clinic and simply, what happens during and after they go.
This is also not an attempt to shame the patients for choosing these therapy options. Detailed corrections or scientific evidence about the therapies or treatments will not be included here as this is not exactly the point, the point is that there are things that are not being said. Details the public doesn’t know about. Deaths that future patients don’t know about. Deaths that advocates don’t talk about.
Pay attention to how these patients are looking for a cure, are looking for survival, an integrative “natural” way to “beat” the cancer. Pay attention to this because many of those who support and promote the clinic and their “results” tend to use some reiteration of this language. I believe this is a major reason as to why some patients come to the clinic and speak highly of it, they are usually told that not much else can be done for their final stages of disease and they are looking for anything to give them hope. This clinic, and the rhetoric under which it is written about online, taps into that false hope and desperate cancer patients are easily exploited and mislead. They are looking for the survival this clinic implies, some do not find it.
Life
This patient went to ChemoThermia and was an advocate for the clinic. However, her tone towards the clinic has change slightly over time – this has been interesting. This patient continued to use unproven Complementary and Alternative (CAM) therapies though, despite writing discouragingly about the clinic at times.
To preserve her privacy as much as possible, her name will not be given and the links to which she writes these semi-private blog entries on her Patreon page will not be included.
- Please see the update at the bottom of this section – I no longer think the title of this section is as hopeful as it sounds.
The patient’s story begins when she was diagnosed with Stage 4 Breast Cancer in August of 2016. She strongly believed that she could heal her body naturally. 13 months later (September 2017) a PET scan showed no evidence of disease.
Almost exactly 5 months (Feb 2018 to July 2018), after this amazing event of being disease-free, she made the decision not to go to the clinic in Turkey anymore. Though back home, she tried to replicate the alternative therapies she was getting.
In November 2018, her doctor in Turkey called and frantically told her she needed to go back to Turkey.
She went to Turkey and got the scan. Those results are unreported. She did post her CT scan results – “No definite residual metastases. Lung nodules are almost certainly benign. Bone metastases show therapeutic response.” Another update was not posted until 2019, I do not believe she ever posted those scan results from Turkey.
It is interesting that alternative therapies and those who advocate for them usually create a narrative and use words against surgery and conventional treatment. However, her doctor in Turkey recommended surgery and her doctor back at home disagreed with this idea.
At the end of May 2019, she gave some important health updates. She no longer does specific diets. She drove herself crazy dieting. She no longer does Keto. She did think Keto was beneficial, but she wasn’t sure it was as important as emphasized in the Turkey clinic. Doing the diet while having cancer and being on Chemo was incredibly difficult. Also, her body apparently responded to the treatment without the use of Keto.
On June 19th, she got news of cancer recurrence.
Understandably, she writes in a slightly frustrated tone after this. She thought and was led to believe that she was doing everything right. She followed the plan to “find the root cause and eliminate it.” But despite this, her cancer came back.
She seems to explain that her reason for choosing to go to Turkey was almost out of desperation. She was told she was going to die and she didn’t want to accept the palliative option. She weighed her options at the time and she was led to believe that this clinic was a promising one. She was now back home for treatment, trying to find an oncologist that was suitable for her.
On July 17th, she admits that she has had to try and open up to conventional treatment. The claim of No Evidence of Disease that the Turkey clinic showed is no longer that exciting to her. She thinks she can get there again though, perhaps she can. My only question would be, was she ever truly there in the first place? My speculations may be correct.
She makes it clear that avoiding conventional treatment in the hope that “natural” treatments and cures may work almost cost her her life.
She does keep the Turkey clinic in mind as an option, however, the clinic is not sustainable as it is too expensive and traveling is too taxing. This has been common in other patients too.
She documents her first days of Chemo back at home in September. The more conventional approach there is “more gentle and compassionate than in Turkey.” She is placed on one type of Chemo, in Turkey she was on four kinds. Food wasn’t provided in Turkey – they had to prepare and bring ALL their own food?! In Turkey, Chemo was delivered with a glucose solution…I am not sure if that is a part of regular practice? Also in Turkey, you were placed in a 60 degree (Celsius) hot box while still hooked up to Chemo and by the sounds of it, you weren’t supposed to get out until they told you to and you didn’t have control over the temperature. She describes it as being a “horrible treatment” and is “still traumatized from it”. Of course, Vitamin C infusions and other antioxidant supplements were also apart of the “Turkey protocol”. (Of note, antioxidant supplements have been associated with worse survival and poorer outcomes in patients receiving chemotherapy, this point continually needs to be reminded.)
Her first few weeks of Chemo in September have been better than she was expecting. Traveling to Turkey and the long hours were hard on her energy levels, the Chemo in Turkey also was very hard on her.
Of note, she does continue to use various unproven therapies.
In October, she had talked to somebody about the clinic in Turkey:
..I don’t know how I did it and I don’t think I could do it again. I decided that at the time, I was in survival mode, and I just did it. I just got through it as best I could.
I also truly believe she is happier and better off being at home and spending time with family, this is at least the impression I get as the months have gone by.
I get to go home tomorrow and start the magic of Christmas with a 5 year old, it’s what I’ve been missing most.
Come December she is having her ups and downs. Her cancer has progressed in her liver and bones, but she seems to be doing alright most days – that is all I will say as it is not my story to tell.
She does seem to joke about drinking a sugary beverage. 7UP gave her a boost. Perhaps she didn’t think of the drink when she was originally diagnosed because of the anti-sugar narrative propagated in the clinic in Turkey? They joked that 7UP was now the cure to everything, this allowed her to crack a smile. I am happy for her.
Leaving the hospital was great … I’ve had good and bad days since I came home, energy levels have been up and down. Here’s hoping I get to stay at home for the rest of the holidays and by some Christmas miracle, a slot opens up in the day [chemo] unit.
– December 19th, 2019.
Update
It is with a heavy heart that I have to update this blog. On January 12th, 2020, she passed away.
Death
It is with great sadness that I have found out that some of those who have received treatment for the clinic in Turkey have actually had disease progression and have passed away. The website does not disclose this at all and some of the testimonials are still on the website. This has been a major issue in the past as well. This sad, sad reality should be addressed since there are advocates who still promote the clinic and tout their “results”.
- Please take careful note of when the patients started treatment and when they passed away.
Ahava, who was diagnosed with Stage 4 Ovarian Cancer in 2012, is still featured on the testimonials page. Reading her Facebook posts, in the beginning, the cancer was getting worse. Despite receiving experimental treatment overseas, it was “out of control.” After running out of options and being told that the doctors couldn’t do anything more, she discovered ChemoThermia in August of 2018 and thought the results were a miracle. She said she felt better and that she looked “alive” again. Treatment was incredibly expensive though, which was stressful on her and her family. She described the hyperthermia treatment as “torture.” But in an optimistic YouTube video that the clinic posted in March, she said that after only 3 rounds of the treatment, her PET CT scan looked better and she had tremendous hope. She said that she’d continue to go to the clinic until her cancer was gone, she believed that it would happen. Over the months of treatment, she promoted the clinic and the Ketogenic Diet and metabolic therapy to “kill” or “starve” cancer cells. She praised Thomas Seyfried and Dr. Slocum’s work, which is easy to do since their presentations can be quite convincing. Various case studies were also praised, so this gives evidence to the fact that the misleading case studies are indeed having an impact on patients. She hoped that she wouldn’t do chemotherapy again, which we’ve seen certain people allude to by hinting that patients should “intelligently delay” chemotherapy for alternative treatments. Multiple times her posts indicated that the alternative treatments were saving her life, I so wish this had been the case. She got home on February 3rd after her 8th treatment of “metabolic therapy” at the clinic. She continued to raise money so she could afford the treatments. Her cancer continued to progress. An update in July indicated that the treatments were not working well enough for her to continue to travel to Turkey. Her last treatment at the clinic was in February, she passed away 6 months later in August 2019.
Dan is also still featured on the clinic’s testimonials page. Dan was diagnosed with Glioblastoma in the early months of 2015. After surgery and 2 years of on and off treatment/recovery, 2 new tumors had developed. Dan had Stage 4 . He received debulking surgery on June 21st, 2017 as well as combined radiotherapy and chemotherapy. After finally raising enough money online, he was able to make the trip to ChemoThermia on November 27th, 2017. After just 6 weeks, Dan had an MRI and the tumors had apparently started to regress. Shortly after, he posted another update. He said: “I am cancer-free! I beat stage 4 brain cancer!” The treatment was claimed to be groundbreaking and ultimately life-saving – “it is curing some of the rarest and brutal cancers”. (This was after his 3rd scan, he would go for his 4th treatment and scan in the months to come. He was also not seizure-free unfortunately.) Due to the aggressiveness of GBM, it was recommended that he have 4 more treatments. After 6 months of treatment though, they had completely run out of money because it was so expensive – “our costs have escalated out of control.” About 3 months later, in August, he went for his 4th scan in Turkey. This is very very sad because he was so excited and so sure that the scan would be clear. After this 4th scan, it was reported that he’d start treatment just hours later, no update was given about these scan results. Things were quiet so I assume the scan results were not good. Another update was posted on his fundraising page: “Unfortunately, the tumors became resistant to the treatment and Dan had fast progression in a short amount of time.” Dan passed away 2 months later in October of 2018.
Sarah is another patient still on the testimonial page. Sarah had Stage 4 Triple Negative Breast Cancer. Fundraising efforts seemed to be a struggle for her. Not much is posted but it seems that she first came to ChemoThermia in October 2017. She continued to get treatment throughout 2018, but again, the high price of the clinic made things very difficult. She wanted to go there after hearing about the success stories from the clinic, thus, the testimonials continue to make an impression on vulnerable cancer patients fighting for their lives. Of note, she also bought the book How to Starve Cancer, which has been heavily marketed towards cancer patients. Despite these optimistic efforts, as we have seen, alternative treatments and diet books can only do so much. Sarah passed away in January of 2019.
Michael is still on the testimonial page. He had Stage 4 Pancreatic Cancer. The cancer spread to his liver in November 2017, he had been given close to a year to live – which is pretty much what happened. He heard about the clinic from social media. In June 2018 it was reported that he had completed the first and nearly second round of treatment in Turkey. It is estimated that he started at the clinic in May. Expenses were an issue once again and they had to set up donations and fundraising events. His optimistic testimonial was posted in August 2018. Sadly, Michael passed away late December of 2018.
Kathryn is still on the testimonial page. She was diagnosed in March 2014 with Triple Negative Breast Cancer. She “had a left mastectomy and lymph node clearance, followed by chemotherapy and radiotherapy.” After a tough recurrence 3 years later in January 2017 (spread to her lungs and spine, a lymph node in her neck, and encased the main artery in her arm) she started out by fundraising to receive mistletoe treatment. Her next goal was ChemoThermia. Her fundraising for the clinic took place in March 2018. She started treatment at the clinic sometime between then and April. After her third course of treatment at the clinic, the improvement was apparently “unbelievable”, her scan results showed that she was clear too. Her optimistic and encouraging testimonial was posted on YouTube in August 2018. After starting treatment around March-April 2018, news headlines read that she hoped it would “cure her cancer”. Kate passed away late January of 2019.
Asma is still on the testimonial page. She had Stage 4 Ovarian Cancer. She went to ChemoThermia on November 27th, 2017. She said the treatments were “grueling”. After 5 treatments, she had a clear scan. Since the scan wouldn’t pick up tumors smaller than 3.8mm, she’d go back to Turkey in June 2018 for another 5 treatments. The cost quickly became very expensive. In July, there were apparently “positive results”, though they were still waiting for a scan. September 11th she was going to have a scan “to show how well she is responding to the amazing treatment she is receiving.” Just 16 days passed. On September 27th, 2018, Asma peacefully passed away.
Becky is still on the testimonial page. She had Stage 4 Breast Cancer since January 2017, which became chemoresistant. She heard about the clinic from her Naturopath. She came to the clinic sometime in the beginning of July 2018. There are not a lot of updates posted, however, her optimistic testimonial at ChemoThermia was posted August 13th, 2018. Becky passed away on December 13th, 2018.
Gary is still on the testimonial page. He had Stage III anal cancer in September of 2016, and after 3 months of chemotherapy and radiotherapy, it turned into Stage IV with liver metastasis. The cancer continued to worsen and he was given a palliative diagnosis. After this, they contacted the ChemoThermia clinic and he started treatment there in March of 2017. After the first 12 weeks of treatment, his PET scan was clear of disease; however, the state of his condition after this is unknown. It is likely that his disease progressed after this. Gary passed away in February of 2019.
Sinead is not on the testimonial page but she also received treatment in Turkey around November 2017 for Triple Negative Breast Cancer. After 3 “grueling” rounds of treatment, her cancer continued to progress. This was disappointing to hear, however, the upside was that since the treatment was not working and she got an early scan, she was able to move on and pursue a different line of treatment. Her friends and family say that she continued to fight right until the very end. She passed away in February of 2018.
Jocelyn is not on the testimonial page, but she did receive treatment at ChemoThermia. She is featured on the Prime Time investigative segment that is about the clinic. She had a rare and aggressive form of ovarian cancer. Her first treatment was in October 2017. In her first few months, things seemed quite promising. In early June 2018, it was reported that her scan at the clinic was “encouragingly positive” and she and her medical team decided to stick with the treatment in Turkey for another 3 months. That same month, her quality of life was not good at all and she was in so much pain and feeling awful. Efforts to raise more money increased. 2 months later she went for another scan, she was doing good and feeling good at the time. The next month her scan from Turkey was clear, which was great news, however, it was emphasized that a clear scan does not mean that she was in the all-clear. She continued maintenance treatment in Turkey. 1 month later (October 2018), her scan results from Ireland came back with large signs that the disease had reappeared. She decided to no longer go to ChemoThermia since she wanted more time at home with her daughter. Jocelyn passed away in November of 2018.
Nicola is not on the testimonial page, but she also received treatment at ChemoThermia. She had Stage 4 Cervical Cancer that was said to be untreatable. Fundraising events were very important to them – her and her family spent a huge amount of money on the clinic which resulted in her family’s funds running low. The treatment was once again described as “life-saving”. She began treatment at ChemoThermia on July 23rd, 2017, her results sounded promising. It sounded like it was working, that she was beating the disease. Unfortunately, her cancer was not getting any better. She had been back and forth to the clinic in the beginning months of 2018. Nicola passed away at home in March 2018.
The back and forth travel is quite discouraging. The clinic only keeps patients during the day and patients need to find their own accommodations during the night. It is very expensive and patients end up being away from home when they should be spending their precious days with friends and family. One woman, Colette, who had Stage 4 Triple Negative Breast Cancer, missed her son’s first birthday because she was in Istanbul at the ChemoThermia clinic. Fundraisers were also created so she could afford the clinic. She started going to the clinic in mid-March 2017. In a YouTube video she created she explains how exhausted she was during the treatment. Other videos show that she was back and forth traveling, trying to spend as much time with her son as she could when she was home. The March 2017 news headlines say that she flew to Turkey for a “life-saving cancer treatment.” In her final months, her condition became much worse. She passed away in February 2018 in the airport in Turkey before she could make it home.
Note:
This clinic was investigated for a Prime Time documentary segment. This covered two patients and went into more detail about the clinic. One patient was covered in this blog, the other was not. They also talked about a patient who used to be on the testimonial page, the video has been removed since, and it was revealed by the documentary that patient had died. So technically, there have been confirmed 14 deaths. I have not watched the entire video segment yet from start to finish. There are definitely many additional insights that this documentary brings. One important consideration is that when each patient mentions that they got a scan at the Istanbul clinic, the scans might not be clear or accurate enough to make a proper diagnosis of No Evidence of Disease. Several conflicts of interest also exist within all this mess.
It has also been confirmed that the patient in one the clinics claim to fame case studies, “Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer” has also died. It is unclear if this case study was done on one of the patients described above.
Much is still to be discussed.
Results and Discussion
While this is a small sample size of testimonials with several confounding factors as well as missing data from other patients, there is much doubt about the quality of life, efficacy and survival claims from ChemoThermia and the advocates that tout their apparent results and methods. From these 11 patients that have passed away, we can get an idea about the rate at which the treatment can prolong survival. Survival rates were roughly calculated based on the month of starting the treatment at ChemoThermia to the month of death. While each cancer is specific and heterogeneous, the maximum survival (a case of TNBC) was ~15 months. Minimum survival (general breast cancer) was only 5 months. Of note, these additional alternative therapies and ketogenic diets are often focused on in Glioblastoma. After standard treatment, GBM survival still tends to be around only 12–15 months. Within the medical literature, ketogenic diet therapy literature, and low carb/keto blogs and posts, this survival rate of GBM with standard treatment as been called a failure. However, the only GBM patient documented to receive treatment at ChemoThermia survived 11 months since the start of his treatment at the clinic. This is within the range and even a tiny bit lower than the average survival. This patient’s survival echos the various lackluster ketogenic diet therapy GBM case studies and trials that exist within the literature. This weak as well as lack of evidence for survival, adherence, and quality of life heavily conflict with the often-touted claims about the therapy.
Taking into consideration the one patient who we talked about before and their difficulty with the diet and treatment, the very expensive cost (something shared among all patients), possible inaccurate scans, and lack of progression-free results, these are all serious factors that prospective patients and advocates need to think about.
Survival.
For now, for simplicity sake, if we take the month that each patient started treatment at ChemoThermia as well as the month that they died and round that date to the first of each month, the mean survival time out of these 11 patients was ~10 months. Although this wouldn’t be very accurate since we cannot lump different cancer types all into one group.
The means of each cancer type can be seen below. Breast cancers were separated based on their description, i.e. confirmed cases of “Triple Negative” and just “Breast Cancer”.
A quick preliminary Survival Plot can also be made.
Furthermore, the survival data becomes even less staggering when we look at median survival rates using standard treatments. Some of the ChemoThermia patient’s survival no better or even less than the typical median survival rates. ChemoThermia patient survival in months is compared to typical median survival below for Ovarian, Triple Negative Breast and Cervical cancers.
Conclusion
In conclusion, the weak, as well as lack of, evidence for survival, adherence and quality of life, heavily conflict with the often-touted claims about the therapy. Many of the patient’s testimonials that are still currently on the website and used to show that the therapy works have died. From this, there is almost no reason to believe the survival claims associated with this clinic. The grueling nature of the therapy has been thought to contribute to worse deterioration and survival, not improved. Given that this organization and clinic has been criticized, on more than one occasion, as highly deceptive and irresponsible for being “purveyors of false hope”, its support should not go unscrutinized. This blog article has not gone into the details of the literature on the topic, however, much of the evidence is also disappointing.
It continues to be a sad, depressing mystery as to why many Low Carb/Keto proponents fail to mention all these deaths. The world keeps spinning, lies keep spreading.
Updates and corrections will be posted as needed.
– Last update: May 20th, 2020.
Sincerely, Science 