Another evaluation of the Gerson treatment's efficacy comes from Steve Austin, a naturopathic physician who recently completed a survey tracking twenty-one Gerson cancer patients over a five-year period.2 Austin, who teaches nutrition at Western States Chiropractic College in Portland, Oregon, visited the Gerson clinic in Mexico in 1983 and, at random, asked approximately thirty cancer patients for permission to follow their progress. He was able to track twenty-one of these patients over a five-year period, or until death, from 1983 to 1988, through annual letters or phone calls. At the end of the five years, only one of the twenty-one patients was still alive. All the rest had succumbed to their cancers. This also suggests a recovery rate of around 5 percent.

Austin, who plans to publish his study, comments, "The patients tracked had a wide variety of cancers. Many appeared to do well when they were at the Gerson clinic, but when they went home they died 'on schedule.' I was favorably predisposed, even prejudicially so, toward the Gerson therapy, because you hear so many remarkable stories about recovered Gerson patients in alternative cancer circles. But the reality turned out to be different. The Gerson staff may be out of touch with the ultimate results of the therapy. They see patients doing well while they're at the clinic, something I observed myself. When these people go back home, however, most of them go downhill. The data admittedly are based on a very small sample, but they suggest that the therapy does not work as well as its advocates claim."

Interestingly, Austin also tracked eighteen late-stage cancer patients at Hospital Del Mar in Tijuana, a clinic run by Drs. Francisco Contreras and Ernesto Contreras, which combines metabolic therapy with detoxification, laetrile, enzyme supplements, megadoses of vitamins, and special vaccines. All eighteen patients died within three years of their stay at the Contreras clinic, according to Austin. "On the basis of these results, I recommend that all cancer patients avoid the laetrile clinics, despite the fact that I've run across occasional anecdotes suggesting efficacy. Even if a rare patient is helped, zero out of eighteen is a terrible indicator," says Austin.

More positive evaluations of the Gerson therapy, and scientific research supporting the validity of key components in the Gerson protocol, will be discussed later in this chapter.

The Gerson clinic lacks the staff to monitor patients' conditions once they return home. Gerson Institute members tend to explain the therapy's failures by saying those patients either did not follow the regimen strictly enough or went off the therapy. This is often true, but sometimes patients discontinue the therapy because they are no longer seeing results: tumors continue to grow or the patient becomes too weak to adhere to the program.

What is beyond dispute is that the therapy is not easy to follow. It's a rigorously demanding approach and should not be undertaken without the intention to persevere. Sticking to the regimen may sometimes seem like a full-time job. In his book, Max Gerson cautions, "It is advisable not to start the treatment, if for any reason strict adherence to it is not possible." Each element in the therapy is important, and all are interrelated in their workings. The diet is restrictive. Milk, most cheeses, and butter are forbidden, as are tobacco, salt, coffee, tea, cocoa, chocolate, alcohol, sharp spices, refined sugar and flour, candies, ice cream, cakes, nuts, mushrooms, soybeans, pickles, cucumbers, and all berries with the exception of red currants. Also taboo are canned, frozen, processed, smoked, salted, dehydrated, powdered, or bottled foods.