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The Coverup of Laetrile (Amygdalin) at Sloan-Kettering Institute

I began my job as a science writer at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City, in June 1974. My boss, T. Gerald (Jerry) Delaney took me on an introductory tour to meet my coworkers. I was then assigned a tall, windowless space, more like a storage room than an office. It would be a year before I could exchange it for a nice office on the 20th floor of the new hospital.

Jerry handed me a manila folder bulging with letters from the public that were long overdue in answering. On the front, in block letters, someone had written the word “PSHAW.” I assumed that “PSHAW” was a genteel exclamation of contempt, impatience, or disgust. But it turned out to be the first initial and last name of my predecessor, Phyllis Shaw.

Pre-Internet Era

In that pre-Internet era, these letters—painstakingly typed or handwritten—were the public’s way of connecting with the war on cancer, as well as a way of sharing personal problems. There were inquiries about specific therapies, suggestions concerning possible treatments, and, occasionally, the ramblings of a paranoid schizophrenic. For example, one elderly lady in Maine believed that the cure for cancer could be found in the subterranean waters that flowed under the evergreen trees on her property. I naively called around to see if anyone was willing to test this water, but nobody was. Most scientists seemed bemused by the request.

This was the backlog of Phyllis’s job, which nobody else in the department wanted to deal with. So, naturally, the job fell to the new guy. Many of the “PSHAW letters’ ‘ concerned a substance called amygdalin, or, more popularly, laetrile. This was a treatment derived from the kernel of the apricot pit, which to judge from these letters had wonderful qualities against cancer.

I had heard of this once before: on Sunday, March 31, 1974, with 20 million other Americans, I had listened as Mike Wallace (on 60 Minutes) described how Americans were traveling to Mexico to get this unapproved cancer treatment. There was even a brief mention of experiments at Sloan-Kettering, but at that moment I became distracted by some minor family emergency and didn’t pay any special attention to the TV. The takeaway message, I gathered, was that desperate people would do just about anything to find a cure. It was surely just another example of the madness and delusion of crowds.

People Were Angry

As I read through the PSHAW letters, I realized that some people were angry, very angry that MSKCC wasn’t properly testing laetrile or refused to use this apricot pit “cure.” To answer them, Jerry gave me a carefully worded statement that he had drawn up a year before. It said that the testing of laetrile at Sloan-Kettering Institute was ongoing but that, to date, it had been found to have no effect in treating or preventing cancer. People should not abandon their proven, conventional treatments. The prevailing attitude in our office towards laetrile was one of mild amusement or skeptical disbelief.

My duties as MSKCC’s science writer were hardly onerous. I had to contribute a three-page news article to Center News every month, plus an occasional longer feature piece. I periodically wrote press releases and contributed to the research section of MSKCC’s Annual Report. But I was free to interview whichever scientists I chose, in their laboratories. Nothing could have been more fascinating. I felt as if I were getting a top-notch introduction to science and was getting paid for it, to boot! Sloan-Kettering was my “Yale College and my Harvard” (to quote Melville on the topic of whaling ships).

My boss, Jerry Delaney, had a boyish appetite for science, the more “gee whiz” the better. So, in addition to my written job description, I became his interpreter of new research (although I hardly knew more than he did). By doing this, I got good practice in talking about complicated scientific subjects in a way that was intelligible to the general public. I had an endless supply of fascinating people to talk to and learn from. In short, I couldn’t have been happier with my new job.

Meeting Kanematsu Sugiura, DSc

I first met Kanematsu Sugiura in the summer of 1974. New to the job, I was looking for promising topics to write about for our monthly publication, Center News. (It still exists as a bimonthly online magazine.) Jerry suggested that I go to the Walker Laboratory in Rye, N.Y., to troll for story ideas. The Walker Lab had opened in 1959 on the grounds of a large estate on the Boston Post Road. Its construction was part of a $12 million gift from the stockbroker Donald Stone Walker and was dedicated to studyin chemotherapy in test tubes, fertilized eggs, and animals. At the time of its dedication, the director of NCI’s chemotherapy service described the Walker facility as “the finest in the world.”

But by 1974, Walker employees felt neglected by their “downtown” SKI counterparts. The sudden ascendancy of the immunology program put the systematic search for chemical treatments (their specialty) in doubt. Walker scientists felt insecure and under-appreciated. Because of their geographic isolation, their work was inadequately recognized in Center News. As it turned out, they had good reason to be concerned, because a few years later SKI sold off the facility for its 44 acres of precious Westchester real estate.

The Walker Facility

A station wagon left the Kettering Laboratory on East 68th Street every workday morning for the half-hour trip to Rye; it returned every afternoon at 3 pm. One fine summer day in 1974 I rode up to Rye with Chester Stock, head of the Walker facility, who had arranged for us to have lunch with some of the leading figures there. Among these was an elderly Japanese-American scientist, Kanematsu Sugiura, who sat upright throughout, dressed rather formally in a white lab coat over a shirt and tie. He had a pleasant but almost mask-like demeanor and seemed polite, modest, and self-contained.

Although he wrote English elegantly—as evidenced by hundreds of scientific papers—he spoke with a Japanese accent, and I sometimes had to strain to understand him. Like many older people, he was also slightly hard of hearing. Stock and others at the Walker Lab seemed to have a genuine affection for their older colleague.

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Kanematsu Sugiura, D.Sc. (1890-1979), photo circa 1975

Stock and Sugiura shared something else. They had appeared together (along with the late SKI Director Cornelius P. “Dusty” Rhoads) a year before ( June 1973) on the cover of Cancer Research. This was a keystone achievement, arguably more prestigious for a scientist than being on the cover of Time magazine (as three past MSKCC directors, Ewing, Rhoads, and Good, had been).

A Biographical Portrait

On the shuttle back to New York City, Stock agreed (although I sensed some hesitation) that a biographical portrait of Sugiura for Center News would be a good idea. I, therefore, made an appointment to return in a few weeks to interview Sugiura again. On this return visit, I found him in the second-floor office that he shared with the scientist Isabel Morgan Mountain, Ph.D., daughter of the Nobel laureate T. H. Morgan. Sugiura officially retired in 1962 at age 70, yet he continued to work steadily. Every day, Monday to Friday, and when required on Saturdays and Sundays as well, Sugiura arrived at the three-story suburban building at 8:00 am. Every day at precisely 5:00 pm he left for his home in nearby Harrison, NY in the company of his son-in-law and fellow SKI employee, Franz Schmid, DVM (who was married to Sugiura’s daughter, Miyono).

As an example of his legendary patience, one of the laetrile experiments we are about to discuss required him to inject and observe mice every day, seven days a week. Sugiura kept up this regimen, never missing a single day or wavering in his duty, for two-and-a-half years! To me, Sugiura embodied the best of the Japanese character. He was like one of those Japanese persons deemed a “Living National Treasure.” These are outstanding individuals, mainly in the craft or performing arts, who have attained an unusually high degree of mastery in their chosen field. Sugiura was that type of individual, although his medium was of course not paper folding, but laboratory science, specifically the experimental chemotherapy of cancer.

Sugiura was born in the small town of Tsushima (west of Nagoya, in Aichi Prefecture) on June 5, 1892. In 1906, after Japan won the Russo-Japanese War, the American railroad tycoon E.H. Harriman arrived to purchase the captured trans-Manchurian railway. Kanematsu’s older brother, Kamasaburo, was appointed the official interpreter and guide for Mr. Harriman.

The railroad transaction fell through, but Harriman was intrigued by an exhibition that Kamasaburo had arranged of the traditional arts of ken-jitsu (swordsmanship) and jiu-jitsu (martial arts). Considering the performers a novel form of amusement, Harriman decided to bring half a dozen of them from the Kodokan Judo Institute of Kyoto to the US for a six-month visit.

Philosophical Principles

Jiu-jitsu was of course more than an “entertainment novelty,” as Harriman called it. There were, and are, profound philosophical principles at its root, such as “defeating strength through flexibility” and “maximum efficient use of physical and mental energy.” These qualities were to serve Sugiura well in the course of his long life, including in his late-in-life struggles.

In October 1905, a team of six jiu-jitsu performers sailed with the Harriman family aboard the luxurious Siberia Maru, bound for San Francisco. These were the first Japanese martial artists to reach North American shores and among them was a 13-year-old prodigy named Kanematsu Sugiura. The other performers lodged at a Japanese inn in New York City, but Sugiura, being underage, lived with Harriman’s physician, William G. Lyle, MD. In 1906 these judokas (judo practitioners) performed at the White House for Teddy Roosevelt, who was America’s first brown belt, as well to enthusiastic crowds at Columbia University and elsewhere.

Six Clever Wrestlers and Swordsmen

The New York Times described this team as “E.H. Harriman’s troupe of six clever wrestlers and swordsmen.” The paper commented:

  • “Mr. Harriman during his late visit to Japan was so much interested in the art of jiu-jitsu as practiced by the most experienced members of that science that he brought to America a troupe of six of the most skillful Japanese performers…They are all skillful acrobats, and the rapidity with which they handle the short swords makes the customary fencing seen by our amateur foils men appear very tame.”

The Times described Kanematsu as “a lad of about 13 years of age.” Although by far the smallest, he amazed American audiences with his ability to “tumble a man twice his size and strength in a matter of seconds without bodily injury to either.” Harriman planned to educate all of the Japanese performers, American style. The New York Times reported:

  • “Besides giving exhibitions of their skill, the Japs [sic!] are going to be educated here, and in the near future will probably enter one of our colleges, as soon as their command of the English language becomes sufficiently perfect to read.”

Kanematsu Remained

But after six months, the entire team was affected by homesickness and went home, except Kanematsu, who stayed on as a houseguest of Lyle. On my first visit to him in 1974, he proudly showed me pictures of himself as a handsome, athletic young man, standing barefoot in the snow in his kendo (Japanese fencing) uniform. Although Kanematsu also was homesick, he knew this was the only way he would be able to get an education. The youngest of seven children, he was left fatherless when the elder Sugiura, a dye maker, succumbed to stomach cancer. Although a bright student, his family could not afford to continue his schooling and had apprenticed him to a hardware business. Harriman’s largesse offered him a better future.

In New York City, Sugiura attended Public School No. 69 and Townsend Harris High School. The latter was a legendary incubator of talented youngsters whose parents could not afford to send them to elite private schools. Its alums were to include famous scientists (Jonas Salk), jurists (Felix Frankfurter), musicians (Richard Rodgers), and politicians (Adam Clayton Powell).

Sugiura’s Interest in Science

Sugiura’s interest in science began early. After school hours, he worked at Roosevelt Hospital, where he washed instruments, scrubbed containers, and generally helped doctors with their experiments. In 1909 Harriman himself died of stomach cancer and left $1 million to establish a cancer research laboratory at Roosevelt Hospital. Lyle, who had attended Harriman on his deathbed, became its first director, and that is how, in 1911, young Kanematsu was hired as an assistant chemist at the Harriman Research Laboratory.

In 1912, he began his first experiments in the chemotherapy of cancer under Richard Weil, MD, chairman of Experimental Medicine at Cornell University Medical College. With scholarship funds provided by the Harriman family, Kanematsu attended evening classes at the Polytechnic Institute of Brooklyn, receiving his Bachelor of Science degree in chemistry there in 1915. Through summer classes at Columbia University he then completed the requirements for a Master of Arts degree in Chemistry in 1917.79 By this time, he had already authored 14 scientific papers.

Pre-World War I

In the pre-World War I days, when there were no animal supply houses, Sugiura would find animals with spontaneous tumors by scouring pet stores in New York City. He told me that he would also catch rats by hunting in the basement of Roosevelt Hospital. He began by testing various inorganic compounds on cancerous animals and was able to demonstrate that such chemicals had a small, but real, anticancer effect. Such findings helped overcome widespread skepticism about chemotherapy and spurred interest in finding more active chemicals yet.

In 1917, the Harriman family lost interest in cancer and turned its attention to politics. The Harriman Research Laboratory closed its doors, and staff members were told to seek positions elsewhere. E. H. Harriman’s son, William Averell Harriman, later became the Democratic governor of New York.

Expanding the Hospital

In November 1917, Memorial Hospital’s director, James Ewing, MD (1866-1943), decided to expand the hospital’s tumor transplantation program and hired Sugiura. This was an unprecedented opportunity for Sugiura to study cancer under a microscope. Although surgical pathology had its roots in 19th-century Germany, it has a long and distinguished history in the U.S. as well. “The Chief,” as Ewing was called, was the first professor of Pathology at Cornell University, one of the founders of the American Association for Cancer Research (AACR), and gave his name to Ewing’s sarcoma, a type of bone cancer. Sugiura progressed to studies of radiation, nutrition, enzyme therapy, tumor transplantation, experimental chemotherapy, and carcinogenesis. A close colleague, Dorris Hutchison, Ph.D., later wrote:

  • “His test results in experimental chemotherapy encompass every type of chemical and biological agent received at the Sloan-Kettering Institute…. Sugiura did as Ewing asked and more. He became a ‘ jack of all trades,’ biochemist, radiologist, pharmacist, photographer, and ‘evening’ pathologist at Dr. Ewing’s side.”

Cornelius P. “Dusty” Rhoads, MD

Later, Sugiura worked closely with Cornelius P. “Dusty” Rhoads, MD, who would become the first president of Sloan-Kettering Institute. Before laetrile, his one brush with fame had been experiments showing that a synthetic dye known as “butter yellow” could cause cancer but that the B vitamin riboflavin could partially prevent cancer formation. But throughout his long life, Sugiura proved himself disinterested in publicity. He was a laboratory scientist par excellence, content if he were left alone to do his work.

Then came World War II. Even though he had lived productively in his adopted country for decades, and had a daughter born in the U.S., Sugiura, as a Japanese living in a U.S. coastal area, was threatened with internment in a camp. Intervention by Rhoads at the “highest levels of government” prevented this and Sugiura was “only” placed under house arrest. Nothing could keep him from his work, however, and, at great risk to himself, he would “wander away” from his apartment on the Grand Concourse in the Bronx to do research at the old Memorial Hospital on Central Park West and West 105th St.

After the War

After the war, the research structure at Memorial Hospital changed. Whereas previously the scientific, as well as clinical work, had been done at Memorial Hospital, laboratory research was transferred to the newly formed Sloan-Kettering Institute (SKI). In 1953, he became a naturalized American citizen. Sugiura was made an associate member of SKI in 1947 and a full member (equivalent to a full professor) in 1959.

Sugiura’s official title was head of the Solid Tumor Section of Sloan-Kettering’s Division of Experimental Chemotherapy. He also served as the Institute’s official liaison with Japanese scientists, including those visiting the US. Japan was then an essential source of new anticancer drugs, and he worked on a new antibiotic/anticancer agent from Japan, mitomycin C

Throughout his long life, Sugiura received many honors. In 1925, Kyoto Imperial University awarded him an honorary Doctorate of Science (D.Sc.) degree. That same year, he received the Leonard Prize from the Roentgen Society for his work on radiation biology. In 1960 the Japanese government honored him for his cultural services and in the same year Emperor Hirohito awarded him membership in the Order of the Sacred Treasure, Third Class.

60 Years of Research

The Japan Medical Association presented him with its highest award in 1965 for outstanding contributions to cancer research and “for his services, an inspiration to so many Japanese physicians and surgeons.” New York City Mayor John V. Lindsay and the New York County Medical Society recognized him for his cultural services and his dedication to the field of medicine in 1966. The first of his 250 PubMed-indexed papers and book chapters appeared in 1922 (other non-PubMed papers had appeared earlier). He wrote his last paper for the Japanese cancer journal, Gann, in 1978. His work thus spanned 60 years of chemotherapy research and touched on all the chief areas of progress. He was particularly interested, said his long-time colleague Dorris Hutchison, Ph.D., in “the development of new animal tumor models,” the very topic that would come to the fore in the laetrile debate.

Consummate Teacher

He was also a consummate teacher of young experimentalists. It was in recognition of this activity that a photograph of him teaching graduate students was featured on the cover of Bristol-Myers Squibb’s A Century of Oncology, A Photographic History of Cancer Research.

In 1962 he formally retired and became Member Emeritus. Three years later, Stock helped gather Sugiura’s papers into a four-volume Collected Works. In words that would come back to haunt him, Stock summarized the scientific world’s opinion:

  • “Few, if any, names in cancer research are as widely known as Kanematsu Sugiura…. Possibly the high regard in which his work is held is best characterized by a comment made to me by a visiting investigator in cancer research from Russia. He said, ‘When Dr. Sugiura publishes, we know we don’t have to repeat the study, for we would obtain the same results he has reported.”
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Sugiura Teaching Mouse Examination Techniques, circa 1950

A Furious Controversy

Sugiura had lived a long and full life, been honored by his peers, and was respected in both his adopted and native land. By every indication, he would end his life as peacefully as he had lived it, content with his half-page niche in Contrary to Nature, the official National Cancer Institute-sponsored history of cancer research. Yet at age 80, Sugiura found himself at the center of a furious controversy. Because he had done what he was told and recorded what he saw, he lived to see old friends desert him, a close relative fail to support him, and former colleagues question his sanity and competence.

What Sugiura did was agree, in the summer of 1972, to test laetrile in spontaneously occurring tumors in mice. In assessing Sugiura’s role in the laetrile controversy one must answer the question of whether a person who had faithfully served his profession, institution, and adopted country for 60 years, who had retired honorably with a good pension, and whose entire social circle consisted of members of that Institute, would suddenly seek to embarrass all his friends, relatives and colleagues by radically misrepresenting his findings?

A Careful and Scrupulous Scientist

This was of course absurd. He would have to have been flaky, inconsistent, or erratic and he was the exact opposite of those things, the very picture of a careful and scrupulous scientist. Even his harshest critics ascribed his positive results with laetrile to some vaguely conceived “unconscious bias” rather than any conscious inclination towards malice aforethought. As we seek for any possible source of pro-laetrile bias, we should remember that it was SKI officials (particularly Drs. Lloyd J. Old and Chester Stock) who asked him to conduct the laetrile experiments in question…he did not volunteer, having shown no prior interest in the topic. Sugiura undertook this job with the same craftsman-like diligence that he undertook any task to which he was assigned. And had the topic not been later it is doubtful that his findings would have generated the slightest controversy.

As the controversy progressed, however, Sloan-Kettering’s leaders repeatedly underestimated Sugiura’s tenacious belief in the inviolability of scientific findings.

  • “Throughout his life, Dr. Sugiura held fast to his convictions,” said Dorris Hutchison, with a nod toward the laetrile controversy. By upholding the accuracy of his meticulous observations, in the face of furious opposition, Sugiura alienated many people, including some of his main supporters at SKI. But he held to his fundamental principle, which he summarized in five brief words: “I write what I see.”

Loyalty

A person in Sugiura’s position typically shows a powerful “bias” toward the urgent demands of his employers, family, and friends. One thinks of Upton Sinclair’s dictum, “It is impossible to get a man to understand something if his livelihood depends on his not understanding.” In other words, we typically do not bite the hand that feeds us. This would have been compounded by his national origin. A British ambassador to Japan once said that in Japanese society “loyalty is the supreme virtue.” He continued:

  • “Loyalty to Japan and the emperor was inculcated into every child in prewar Japan. The emphasis now seems to be on loyalty to the company employing you, loyalty to your section in the company, and loyalty to your immediate colleagues.”

Therefore, everything in Sugiura’s background cried out for him to obey the wishes of his “superiors.” This would have been reinforced by his training in jiu-jitsu. Its principles include bowing to one’s teachers, never questioning the instructor’s decisions, respecting and obeying all orders, and always answering your teacher with a crisp, “Yes, sensei!”

The fact that Sugiura defied authority, in this case, speaks volumes about the strength with which he held to his belief in his findings concerning laetrile. Any personal consideration was overridden by his steadfast commitment to the truth. I repeatedly saw proof of this dedication. He would not tell even a white lie to save a friend from embarrassment. I took to calling him “compulsively” or even “pathologically honest,” because of this unbending dedication to the truth.

Forming Second Opinion

When I learned about Sugiura’s positive results with laetrile and the apparent coverup of his results, I tried a variety of ways to get the news out about this. Eventually, in 1976, the laetrile subcommittee of an organization called Science for the People broke away and formed its own group, which we called Second Opinion. We intended to issue our own mimeographed newsletter. In the course of my experiences as a student activist, I participated in creating many handmade flyers and newsletters. Even at Abraham Lincoln High School in Brooklyn, my wife Martha and I had co-edited a current events magazine called Vanguard, which was sold not just in the school but at local newsstands. At Stanford University and the University of California at Irvine, Martha and I participated in producing various underground anti-Vietnam war publications. So the idea of writing, editing, laying out, and distributing newsletters was neither novel nor strange to us.

Second Opinion functioned for the next three years and eventually published a 12-page printed newspaper, which we distributed to the 4,600 employees of MSKCC as well as to many interested outsiders. Each quarterly edition was a big event at MSKCC. People would grab handfuls for themselves and their office mates. We were not afraid to say what was on the minds of many of the employees, who often performed difficult jobs with little recognition and insufficient pay. We found that there was more pent-up frustration at the Center than we imagined, and we became a vehicle for that discontent. Of course, we also kept the staff current on the ongoing status of laetrile testing at Sloan-Kettering. In November 1976, Second Opinion made its first public appearance at MSKCC.

Alec Pruchnicki, MD, PhD

Together with Alec Pruchnicki, MD, Ph.D., then a graduate student at the City University of New York, and now a geriatrician, Martha and I laid out the first issue of Second Opinion on the kitchen table of our cramped apartment in Sheepshead Bay. Later we got an office on East 3rd Street in Manhattan, between First and Second Avenues. This was an eclectic block: our near neighbors included the Catholic Worker magazine and the New York chapter of the Hell’s Angels motorcycle club!

From the start we wanted Second Opinion to have mass appeal. We deliberately did not feature a story on laetrile on the first page, figuring that this might have less general interest than more locally relevant stories. Our lead articles were “SKI Student Expelled by Racist Dean,” and “Cutbacks Hit MSKCC Workers.” These were meant to appeal to large segments of the MSKCC community and were in fact partially written by workers and students.

On the Inside

Only on the inside was there a story on the laetrile controversy: “New Positive Results at SKI Squelched. Cover-Up Continues.” This first laetrile article began with a concise history of the controversy: “Laetrile (amygdalin) is an illegal anti-cancer substance that has been in the news quite a lot lately. The people who are in favor of its use claim that it is a non-toxic vitamin, which gives pain relief in cancer, and generally stops the disease from getting worse. Those who are against it—including most of the top doctors and government health authorities—claim that is ‘quackery.’ A number of people who have brought laetrile into the US from Mexico, where it is made from apricot pits, have been arrested for smuggling and will soon stand trial in California.”

After acknowledging Sugiura’s positive results as well as the fact that others at SKI “have questioned these results,” the article continued: “But the SKI Administration has refused to release any of the data, favorable or unfavorable. Instead, it has conducted a four-year public relations campaign, specially designed to cover up and discredit Sugiura’s results. All the real information about SKI’s laetrile tests has been obtained through ‘leaks’ from the Institute itself.” The article commented on the so-called “blind” test that had recently been conducted between SKI and Catholic Medical Center personnel. The article said this test ended in a “fiasco.”

The Inaugural Issue of Second Opinion

This inaugural issue of Second Opinion also contained an analysis of the power structure of MSKCC. This sort of research was something I had learned in my student-activist days at Stanford. The idea was to figure out who owned, or controlled, what. My “Bible” in those days was G. William Domhoff’s classic, Who Rules America? Domhoff, Distinguished Professor Emeritus of sociology at the University of California, Santa Cruz, had long argued that the owners and top-level managers of large companies and foundations were the dominant figures not just in the U.S. economy but in politics as well.

I applied Domhoff’s methodology to the situation at MSKCC and to the “war on cancer” in general. My rather astonishing finding was that many of the MSKCC Overseers were board members of major pharmaceutical companies, especially Bristol-Myers Squibb. This included MSKCC’s president, Lewis Thomas. At the same time, we tried to disavow any connection to the “narrow conspiracy theories” (as we called them) of the far right, as typified by G. Edward Griffin’s 1974 book on laetrile, World Without Cancer: The Story of Vitamin B17.

Cover Up!

Because of our statements about the economics of cancer, Good in 1976 accused Second Opinion of being “Marxists.” But Second Opinion had no official ideology and no connections to any other political group or party. Good (unable to refute our arguments) was desperately reaching for a handy debating tool. In any case, one certainly did not have to be a Marxist to believe that giant corporations increasingly dominate American medicine. But this proposition is far less controversial today than it was in 1976. Never ones to pull punches, Second Opinion boldly stated:

  • “We believe there is a cover-up of laetrile at SKI and will continue to expose it, as long as valuable data remains locked in the filing cabinets of SKI, and not published openly in scientific journals.”

Our Interest in Laetrile

At the same time, I am very proud of the fact that Second Opinion avoided advocating or endorsing laetrile, much less getting involved in its promotion or sale:

  • “Our interest in laetrile has always been to have it be adequately tested and to have all those research results released. If it is indeed a useful agent (whether as preventive, palliative, or cure) all patients should have access to it, including the poor. If it is useless, as determined by fair and extensive tests, we would oppose its use.”

Needless to say, this put us at odds with the “freedom of choice” movement, then the driving force in laetrile legalization efforts, which believed that people should be allowed to “choose their poison,” regardless of scientific findings on safety and efficacy. Here is what we wrote in our November 1976 issue:

  • “Does laetrile work? We do not know. It may turn out to be a hoax or an illusion. We are not advocating its use. But, on the other hand, we strongly urge SKI to release all of its data on laetrile, including both the positive and negative results. This will allow outside scientists to make their own judgments on this work and possibly attempt to reproduce the experiments themselves. Not to release the data, or to release it selectively, or lump positive and negative results together, constitutes the suppression or misrepresentation of scientific work, which is intolerable.”

The Intolerable Was About to Happen

The appearance of Second Opinion caused a sensation at MSKCC. The first issue was greeted with a sense of absolute incredulity. We had the “inside dirt” on many topics, which was no surprise since we were made up predominantly of insiders. But the fact that its authorship was anonymous, other than the mysterious frontman Alec Pruchnicki of the Bronx, was maddening to Institute officials. Dr. Good commented on this at the laetrile press conference in June 1977, saying rather ominously that he’d like to know who was behind Second Opinion. Who were these spies, infiltrators, and leakers? This was, of course, particularly troubling to me, since I knew that eventually, the trail would lead back to me.

We distributed the paper in the wee hours of the morning when the night shift got off and the morning workers, including the day nurses, arrived. The distributors were all “outside agitators,” colleagues from our group (some of whom, like Alec, came from Science for the People) as well as Martha and members of our family, such as our son, Benjamin, and our daughter, Melissa. The entire hospital seemed quiet on distribution days, as many people, including top administrators, pored over the latest issue.

But, even in those pre-Internet days, I believe that my connection to Second Opinion would ultimately have been traced. Sugiura had already told Stock that he had given me a copy of his lab notes. So I was definitely on thin ice. But I had made my decision and I was never going back to business as usual as long as the laetrile cover-up continued.

Dinner with Good

The high point in my relationship with Robert A. Good, MD, Ph.D., the president of Sloan-Kettering Institute, came in the winter of 1976 when we dined together at New York’s swanky 21 Club. The public affairs director of a large German pharmaceutical company had come to town and, for reasons of his own, wanted to meet the famous Dr. Good. I had no particular interest in helping him (not least because his company was one of the successors of the notorious Nazi-era I.G. Farben chemical cartel), but I saw an opportunity to have some quality time with the Director. I wanted to find out what he really thought about a number of things, including primarily laetrile.

So, with Jerry’s agreement, I asked Dr. Good if he wanted to go to dinner and a Broadway show with the visiting Germans…and me. It was a long shot and I was happily surprised when he said yes. Once we got to the restaurant we sat next to each other and then more or less ignored the Germans for a couple of hours.

As part of my personal campaign to confront the leadership over their laetrile misstatements, I used this opportunity to raise the laetrile issue with the Director. But he only spoke in platitudes on this topic and seemed disinterested. But Good was genuinely excited by other things and had an urgent desire to have those stories told. That is where I came in. He had been among the first American scientists to tour China in the post-Nixon era. We discussed co-authoring a book about his travels in China but of course, that and many other plans soon fell by the wayside.

During dinner (out of earshot of the Germans) he gently but pointedly said to me, “I am just like you, Ralph. You can be fired, and I can be fired, too.” This ‘prophecy’ came true sooner than either of us could have realized. Incidentally, the next day, the German official offered me $1,000 cash under the table for having so ably arranged this meeting. When I turned it down, he offered me $2,000 “but no more,” he added, gruffly. I rebuffed him on this as well, but I did get an insight into the ways the pharmaceutical industry spread its influence, or at least the way it did so in 1976. Because of Good’s rather ominous mention of “firing,” I definitely felt that the noose was tightening. But I was determined to see the truth emerge about the laetrile testing.

Visit from Three Laetrilists

Not long afterward, I received an unexpected visit from three of the top officials of the Committee for Freedom of Choice in Cancer, Inc., based in Los Altos, California. Michael Culbert, Maureen Salaman, and Robert Bradford had come to New York City on a kind of exploratory expedition, trying to locate the source of the leaks at Sloan-Kettering. They had no appointment and no contacts but simply went to the reception desk of the hospital, asking questions about our laetrile testing program. Ultimately, they were directed to my office—not because the receptionists suspected me of being the source of the leak, but because I was the Public Affairs officer whose bailiwick included non-conventional treatments. In fact, many MSKCC telephone operators had sticky notes attached to their consoles reading, “Laetrile calls go to Moss in Public Affairs.”

The four of us had a strange conversation indeed. A new issue of the Second Opinion had been distributed that very morning and I quickly hid my own copy under my IBM Selectric as they crowded into my small office. But Culbert, the most inquisitive of the three, noticed a copy of Max Gerson’s unorthodox diet-oriented book, A Cancer Therapy: Results of 50 Cases, on my bookshelf. He shot me a quizzical look. By contrast, Bradford and Salaman simply looked uncomfortable. They had created a bogeyman out of MSKCC and they looked as if they were ready to flee enemy territory at a moment’s notice. Culbert and I later became friends and he told me that, at that moment, he strongly suspected that he had uncovered the source of the leak…namely, me.

In February 1977, Second Opinion published another issue. We again highlighted issues of racism and class discrimination at the Center. Memorial Hospital’s “Admissions Biased, Racist” and “Wu’s Case Stirs Action” were our front-page stories. Again, the laetrile article was deliberately relegated to page three.

Public Hearings

At this time, Federal Judge Luther Bohanon, as part of a ruling that legalized the use of laetrile by patients for their individual use, had ordered the FDA to hold public hearings. These took place on May 2, 1977, in Kansas City, Missouri. Dr. Stock appeared on behalf of SKI. His assignment was to refute the charge that Sloan-Kettering was covering up Sugiura’s positive results.

It was bad enough that Good, Martin, and Thomas had made outrageous statements that denied the simplest facts about the testing program. But the audience at this Kansas City hearing included ardent and generally well-informed laetrilists. They certainly knew about the leaks from Sugiura’s laboratory. Stock knew that, in that company, he could hardly deny that Sugiura had achieved positive results in animal systems. At the same time, with high-placed anti-laetrilists also breathing down his back, he could not very well confirm these either. So this is what he said:

  • “Early observations of Sugiura featured an apparent inhibition of the appearance of metastases in the lungs of mice given daily doses of amygdalin.”

Second Opinion promptly took him to task for this:

  • “Apparent inhibition? Dr. Stock is Dr. Sugiura’s immediate boss and he also heads the Walker Laboratory, where most of the laetrile experiments took place. Can’t he tell us in fact whether or not the mice that received the laetrile had less [sic] secondary tumors than the controls? Didn’t he look with his own eyes while the experiment was in progress? We believe he did.”

Dr. Stock had been given the delicate task of phrasing things so that they appeared credible to a scientifically sophisticated audience. He needed to create a scientific fig leaf for the cover-up. Thus, Stock continued in his FDA Affidavit:

  • “In [Sugiura’s] three initial experiments the treated mice showed lung metastases in 20 percent, while 80 percent of the controls had metastases…Subsequent experiments showed that the initial results were not consistently observable.”

Finely Worded

This was finely worded indeed. We’ll leave aside the fact that Sugiura had performed six consecutive CD8F1 treatment experiments, not three, all of which showed marked inhibition of metastases. Second Opinion noted at the time:

  • “Stock constantly tries to whittle down the number of positive experiments.”

Part of what he was saying was true. These “subsequent experiments” did not “consistently” confirm Sugiura’s results. Drs. Franz Schmid, Elisabeth Stockert, and Daniel Martin did not consistently report positive results in all their experiments. But what Stock failed to mention was that in the one experiment that really rose to the level of a genuine confirmatory study, the so-called Schmid-Sugiura Collaborative Test, results were positive in both Schmid and Sugiura’s visual observations as well as, most importantly, in the independent pathologists’ report.

Two Months Later

In April 1977 Second Opinion published its third issue. This time we had a front-page article on the topic that interested me most: “Laetrile: Publish or Perish.”

This reported that SKI officials had completed “the latest, and probably the last, animal test with laetrile (amygdalin) at the Sloan-Kettering Institute.” That was correct since no further test has been done there, even to this day.

  • “According to SKI officials,” Second Opinion wrote, “This latest test does not confirm earlier findings that laetrile inhibited cancer growth, stopped the spread of cancer, and improved the health and well-being of mice. This conclusion would seem to doom the controversial anti-cancer ‘vitamin,’ which has been tested for over four years. But no sooner had SKI announced the alleged failure than the new study was plunged into controversy.”

As we explained in Second Opinion, Sugiura immediately contested the results, an unprecedented act of defiance on his part, after almost 60 years at the institution. In particular, he told reporter Mort Young of the San Francisco Examiner that “the tests were not done to my satisfaction.” He also told colleagues at the Walker Laboratory that he would stick by his earlier findings that “laetrile prevents metastases” or secondary growths in mice.

The SKI Press Conference

June 1977 was a turning point for laetrile at Sloan-Kettering. The assault on laetrile that month began with a blistering op-ed in the New York Times titled “Laetrile: A ‘Fraud.’” Responding to the legalization of laetrile in two dozen states, Daniel Martin pulled out all the stops:

  • “State governments are being manipulated to legalize the quack cancer nostrum laetrile…worthless product…unproved drug…danger…deception… illusion… propaganda being propagated by laetrile’s promoters….”
  • “Laetrile use, he continued, victimized huge swaths of the population …the uninformed, the naïve, the innocent, the cultists, the gullibles, the fanatics, the poor, the very young, and the desperately sick….”

This diatribe set the stage for Memorial Sloan-Kettering Cancer Center’s press conference. June 15, 1977, dawned as a bright, balmy day on Manhattan’s Upper East Side. Within MSKCC, almost 100 reporters and observers and half a dozen film crews from the leading television stations had assembled to hear the long-awaited verdict on the unconventional treatment from doctors at the world’s most prestigious cancer research center.

On the dais of the new conference room sat men and women whose credentials in the scientific world, and even among the public, were impeccable: Robert A. Good, Lewis Thomas, Daniel Martin, and eight other Memorial Sloan-Kettering scientists (C. Chester Stock, Ph.D., Kanematsu Sugiura, DSc, Isabel M. Mountain, Ph.D., Elizabeth Stockert, D. d’Univ., Franz A. Schmid, DV, George S. Tarnowski, MD, Dorris J. Hutchison, Ph.D., and Morris N. Teller, Ph.D.).

Lloyd J. Old

Conspicuously absent was Lloyd J. Old, MD, who had enthusiastically launched the laetrile experiments in spontaneous tumors and had asked Sugiura to do the tests. When I first visited Sugiura in July 1974 he told me “Dr. Old believes in my results.” Old had convened the laetrile meetings at SKI, brought in the top practitioners and experts, and was the driving spirit behind the confidential meetings at FDA headquarters in 1974 and at NCI in 1975. But as time progressed, he disassociated himself from the controversy and made his last public comment in Medical World News in 1975.

I don’t know if he was told to recuse himself or decided to do so on his own accord. The bottom line was that he did not publicly defend Sugiura. But at least he, unlike the other top leaders, refused to make false statements about the outcome of his tests. At the time of the Press Conference, Old simply absented himself. His office let out that he was traveling in some inaccessible place—I think they actually said Tahiti!— and could not be reached for comment.

Sugiura Fights Alone

Old could have supported Sugiura in word and deed. But he knew that he would have to pay a heavy price for doing so—perhaps even losing his academic stature, the way a comparable figure, Andrew Conway Ivy, MD (1893-1978), past president of the American Physiology Society and vice-chancellor of the University of Illinois, had lost his reputation over Krebiozen a decade before. So he simply made himself inaccessible on that fateful day.

Besides Second Opinion’s attempts to support him, Sugiura had to fight on alone. All of the Sloan-Kettering leaders agreed, apparently, in the words of the official press release, that, after almost five years of testing, “laetrile was found to possess neither preventive nor tumor-regressant, nor anti-metastatic, nor curative anticancer activity.”

The press conference was intended to put an end to the laetrile controversy at Sloan-Kettering and to prepare the way for Lewis Thomas’ testimony before Senator Kennedy’s subcommittee hearings the following month.

Sugiura’s Statement

Officials of the center cleared their throats; reporters put down their danishes and coffee and picked up their pencils. Dr. Good began to speak. After general remarks condemning laetrile and its use, he passed the microphone to Chester Stock. In a voice sometimes shaking with nervousness, Stock repeated Sugiura’s findings, almost word for word from Sugiura’s memos. This was part of the deal that had brought Sugiura himself to that very conference table.

Stock said the following (which I transcribed from raw video footage that NBC and others took that day):

  • “Laetrile is not curative but is a palliative agent. He [Sugiura, ed.] bases this on his own observations, reported with his experiments, which include inhibition of lung metastases, temporary initial stoppage of growth of small primaries, inhibition of the appearance of new tumors, and better health and appearance of treated mice. And this was a statement that Dr. Sugiura approved for this publication.”

Sugiura, perhaps invoking some of the techniques he had learned as a martial artist, had skillfully extracted a promise from Sloan-Kettering to include all of his most pertinent findings in the final report, and of having Stock then recite this verbatim in his presentation. In the NBC footage of the press conference one can see Stock leaning over the table to catch Sugiura’s eye—as if to say, “Look, I did exactly as you asked.”

Stock continued to explain some fine details of laetrile testing but as his voice droned on, the eyes of many turned toward the figure on his left: a small, old Japanese scientist in a dark suit, sitting upright and impassive, blinking at the lights through thick, rimless glasses. When the conference was thrown open for questions, someone in the audience asked the 85-year-old Member Emeritus for an explanation of his presence on the dais. This seemed, perhaps, to imply that he too now agreed with the negative verdict on laetrile.

CBS News Feed

Here is the actual dialogue with Sugiura, which was included in the CBS News feed recorded that morning:

Q. Dr. Sugiura, do you agree with the conclusions in the summary statement?

A. Which conclusions?

Q. To the effect that laetrile does not either cure or prevent cancer?

A. I agree. Of course, my results don’t agree (smiling nervously) but I agree with what our Institute says.

Q. Why, if your results don’t agree?

A. I don’t know why but I think…

Q. (Someone interrupting him): Doctor, do you stick by your results?

A. Yes, I stick! I hope somebody is able to confirm my results later on.

Q. Have any other of your results ever been disputed before in the 40 years that you’ve been here?

A. I’m here for almost 60 years. Nobody disputes my work. Every paper I sent to publication has always been accepted.

Q. Why not this one then?

A. These results also were accepted for publication… I’m hoping that somebody is able to confirm my results.

What then followed was an hour-long attempt by Stock to undermine everything that Sugiura had found in his years of meticulously documented testing. I have since attended many press conferences but cannot remember any that remotely resembled this one. I would venture to say that it was an unprecedented occurrence in the history of American science: a major media event called to refute a senior scientist, a member of the same institute, who was himself sitting on the dais, and who disagreed with the main premise of the conference itself!

Questioning Stock

One reporter then questioned Stock:

Q. Don’t you think that there are further studies that are warranted?

A. We don’t see any further experiments that we should conduct….All those agents that are effective in the treatment of cancer in man could be detected in the battery of tumor systems that I mentioned to you.

Stock then elaborated on a comparison that, at the time, was considered highly damaging to laetrile:

  • “And I also might point out, as we do in the manuscript, that the spontaneous tumor system of Dr. Martin’s, with which he’s had so much experience, has been quite good at predicting, or could predict, it’s actually confirmed that those materials that are active in breast cancer in man are effective in treating the spontaneous tumor system in the CD8F1 mouse.”

This statement would soon come back to haunt him.

Good then chimed in:

  • “We have looked at all available methods for any evidence of anticancer activity and we have not found it. All other anticancer agents would be revealed positively.”

This was an outrageous distortion of the truth. No other agents were curative against primary breast tumors in CD8F1 mice. Before the year was out, Stock at least would have to eat these words, in no less a venue than the New York Times.

Meanwhile, in the NBC footage of the event, one can see Good fidgeting, touching his face, rolling his eyes, and glancing at his watch. To me, he was sending a clear message: “I’m too busy curing cancer to bother with this nonsense!”

When it came to his turn to speak he said, in his foghorn voice:

  • “With respect to this compound and the evidence from all of these studies that we have, we would certainly not take any other compound to [a] clinical trial. There’s another issue here that is not scientific. And I think that this might justify a clinical trial. It is not possible to evaluate critically the influence on pain or well-being of experimental animals. The anti-cancer influence can be evaluated.”

Judging from its impact on reporters, we in the Public Affairs Department had accomplished our job. Only two reporters asked to see the actual paper under discussion, while the rest contented themselves with the press release (which I in fact had written!) The media swallowed the idea that Sugiura’s results had been successfully refuted. Time magazine’s coverage typified the general agreement that laetrile had flunked its test at SKI:

  • “After five years of exhaustive studies with mice, researchers at this world-renowned institute concluded that in spite of early indications it might control the spread of tumors, the controversial drug laetrile showed no anticancer properties.”

Essentially, it was all over on the scientific level. The prestige of Sloan-Kettering Institute had been thrown into the balance against laetrile, and (barring the unlikely event of a positive human trial) it was all over but the shouting. All that remained was to mop up the laetrile movement at the federal level. And that was already in the works.