“You did what to a hot dog?”

Surgical oncologists primarily evaluate and treat patients who have solid tumors. These are cancers that arise in various organs, including the brain, head and neck region, lungs, gastrointestinal system, skin, ovaries, uterus, cervix, kidneys, bladder, prostate, bone, or sarcomas that arise from mesenchymal tissues throughout the body.  Patients who have different types of leukemia or lymphoma, or so called “liquid” malignancies, are treated most commonly with chemotherapy and other drugs.  Occasionally, radiation therapy has a role in these patients, but surgical treatment is rarely indicated.  Accordingly, as surgeons, we infrequently interact to provide multidisciplinary patient care with our colleagues who are experts in leukemia and lymphoma treatment.  We may serve together on hospital or academic committees, but our exchanges generally consist of nothing more than a passing nod in the hallway or a, “Howdy.”

These infrequent interactions caused me to be curious one day in 2004 when a senior colleague from the leukemia section left me a message to call him. I called his office and in an imploring tone he asked me to help him out.  He explained he had a patient being treated for a rare form of leukemia who was a radio engineer and who had read some of my papers on invasive radiofrequency ablation to treat liver malignancies.  He went on to indicate this man believed he had a new radiofrequency-based treatment for cancer that would revolutionize the therapeutic approach to the disease.  He finished with a statement, “Please call him so he will quit asking me to connect you two.”

In oncology care, we frequently receive questions, letters, and emails asking about non-traditional therapies that patients, their families, or friends have found to treat cancer. I have learned to ask my patients if they are using any alternative medications or approaches in addition to their standard medical and surgical treatments.  I have personally received dozens of letters or messages from patients or inventors who boldly proclaim they have found the answer to cancer, and all I need to do is perform the clinical studies to validate their idea.  Thus, it was not a particularly unusual request from my colleague to talk with his patient about his cancer treatment idea.

I called the patient at his home in Pennsylvania. This was my first conversation with John Kanzius.  John thanked me for calling and immediately launched into a rapid-fire diatribe lasting several minutes.  He explained as a radio engineer he knew high-energy radiofrequency fields would heat metallic or conducting materials.  He told me of an incident when he was installing a large, powerful radio antenna in the Midwest in the middle of winter.  He had coins and keys in his pocket and when the radiofrequency generator was fired up to broadcast a signal from the antenna more than ten feet away, he was forced to empty his pockets quickly because the coins and keys were burning his skin.  He described the basic concepts and electronic principles of his idea, and proposed injecting copper sulfate into tumors and then treating a patient with a high power, non-invasive radiofrequency electric field heating the metal, thus killing the tumor.  He stated he believed his idea would produce a treatment to kill cancer cells but not be toxic or damaging to normal cells, unlike the chemotherapy drugs he was receiving to treat his leukemia.  He finished with a flourish telling me he had built a “cancer treatment machine” in his garage, had injected copper sulfate solution into the middle section of a hotdog, and then treated the test subject in the radiofrequency field resulting in “cooking” (his word) of the area injected with the metal salt.  His excitement mounting, he reported only the middle portion of the hot dog was heated and treated, the ends were unaffected and undamaged.  “Isn’t that amazing?” he gushed.

Take a deep breath. Okay, ready.

I allowed him to complete his monologue without interruption, and then politely replied. I remarked I knew from my work using various types of electromagnetic fields he was correct and a powerful electrical field could produce heating of metallic substances.  I went on to explain, however, his proposed approach was not a great idea because injecting copper sulfate directly into tumors located in organs throughout the body was invasive and not superior to established treatments with invasive radiofrequency or microwave probes.  Additionally, the copper sulfate would leak out of the tumor into surrounding tissues and both normal and malignant cells would be damaged. I also mentioned copper sulfate was potentially very toxic and could not be used to inject as a concentrated metallic salt solution into patients.  I informed him to prevent injury to normal cells and tissues, it would be critical to find a way to target conductive materials to only the cancer cells and to not produce heat levels so high that collateral damage to normal cells and tissues would be inevitable.  I ended the call thanking him for his time and interest, hung up the phone, and assumed I would never hear from him again.

I didn’t know John Kanzius. Within a month he called my office.  He thanked me for my comments, and asked if I was willing to help him target heat-conducting materials into cancer cells.  I was amused, but also impressed by his energy and belief in his idea.  I knew lots about theory and measurements of electromagnetic energy, but I didn’t know John was an electronics wizard. He was a self-taught radio and television engineer, ham radio operator, and had no college or other advanced degree.  I learned over the next few years I could describe what I wanted a piece of electronic equipment to do, and John could scrabble together parts and equipment and build it. A remarkable man.  I didn’t know it at the time, but my introduction to John Kanzius would change the course of my research work completely.

Earlier in 2004, I had begun working with a variety of nano-materials in my laboratory to explore their fascinating physicochemical and electrical properties. Nanoparticles can be targeted to cancer cells by attaching onto the surface of the nanoparticles drugs, antibodies, or other agents that bind to a specific target molecule, like a key into the matching lock, on cancer or other cells within a malignant tumor.  We were using them to increase heating with invasive techniques or to help deliver different types of drugs and molecules to cancer cells.  Nano-scale materials are unimaginably tiny.  One centimeter equals 10,000,000 nanometers. The diameter of an average human hair is about 75,000 nanometers, which is massive in the nanotechnology world.  Nano-materials are usually less than 300 nanometers in diameter. We were studying particles and materials from 1-200 nanometers in size.  Nanoparticles can release heat in response to certain types of electromagnetic fields, including radiofrequency, microwave, and visible and infrared light. Their tiny size may allow them to bypass barriers preventing delivery of drugs or other agents into malignant tumors.  Potentially, the small size allows the nanoparticles to serve as a “Trojan horse” to deliver drugs or other cancer therapeutic agents into tumor cells.  I knew that conducting or semi-conducting nanoparticles were positively or negatively charged and wondered if they would produce heat in John’s external radiofrequency field.  With no small amount of cajolery, I convinced a colleague at Rice University to provide me with some single-walled carbon nanotubes, and carried them on an airplane to Pennsylvania to meet John.  He proudly showed me the radiofrequency field device he had created, literally cobbled together with parts from his home, businesses, garage, and electronics stores.  In a moment of understatement, he noted, “I know this isn’t fancy enough to treat a patient, but it’s a good start.”

A true statement. I placed a test tube with the solution of carbon nanotubes between the transmitting antenna and reciprocal receiving head of John’s device. I wasn’t expecting much, but incredulously after less than a minute in the radiofrequency field, the carbon nanotubes began to come out of solution and flocculate into visible aggregates.  I knew this meant the covalent bonds to the phenyl sulfate molecules on the surface of the carbon nanotubes that kept these otherwise hydrophobic, or water insoluble, structures dissolved in water were being broken, indicating a temperature at the surface of the carbon nanotubes of several hundred degrees centigrade.  My brief amazement was replaced by an expression John later described as a “real twinkle in your eye.”  I have already admitted I don’t have much of a poker face.  Maintaining some sense of self-control and decorum I turned to John and stated, “You may be on to something here.”

Comparable to an end of Casa Blanca Humphrey Bogart moment, this was the beginning of a beautiful friendship.  Over the next five years, John and I would speak several times a week.  Not infrequently we would speak several times a day.  John was innovative and impulsive.  He truly believed he had invented a new treatment to “cure” cancer.

I cringed every time I heard John proclaim his device would cure cancer. All of us involved in cancer patient care and research perceive that cure is the desired goal, but frequently, if not usually, cure is elusive.  Surgical oncologists have the greatest probability of producing cure in patients with early stage disease in many types of solid tumors.  Removing the cancer before it spreads can rid the patient of their cancer definitively.  My colleagues in medical oncology have more daunting tasks when treating patients with more advanced stage disease already metastasized to lymph nodes or other organs.  John was a brilliant, self-educated radio engineer, but he had a laymen’s understanding of cancer biology.  I spent the first year of our relationship teaching him about the role of different treatments in cancer therapy, and more importantly about the reality of the difficulties in treating a disease that mutates, evolves, and adapts rapidly to the multidisciplinary approaches we use to treat it. Even after our lengthy discussions about cancer, the “cure” word would escape from his lips occasionally.  When I was present and heard this, I would give him a quick glance and he would correct himself.  Heaven only knows how many times he made this grandiose pronouncement when I was not present to provide checks and balances.

At his own expense along with additional funds, time, equipment built at no charge, and dozens of hours of labor from friends and people he knew in the business world of Erie, Pennsylvania and Sanibel, Florida, John delivered a custom radiofrequency field treatment device for me to use in the laboratory early in 2005. I had never seen anything like it.  It was quite a contraption and I looked it over carefully before deciding to turn it on and test it.  My inspection was not thorough enough because as soon as I turned on the radiofrequency generator, every fire alarm in the basement research facility began shrieking.  Red-faced, I turned off the generator, and alarms still wailing, I quickly discovered the reason why.  John and his colleagues had forgotten to provide Faraday shielding over the fan housing of the radiofrequency antenna and the machine had broadcast a signal throughout the basement.  This signal happened to coincide with the test frequency for the fire alarm system.

Oops! I was not a popular chap in the laboratory area that day; the equivalent of having the teenager next door start a loud, blaring garage band.  Everyone on the floor evacuated following fire code regulations, and glared at me as they returned 20 minutes later.  I made a quick set of modifications to the equipment and after fashioning my own Faraday fan housing, our second attempt to “fire up” the machine was successful. No recurrent agitation or forced evacuation for my laboratory neighbors.

We began testing the heating of different types of metallic salts and conducting and semi- conducting nanoparticles in the radiofrequency field. We quickly learned we could heat materials rapidly when dissolved in water.  In a proof of principle experiment, we also learned that if I injected single-walled carbon nanotubes into malignant tumors growing in the liver of rabbits, treatment in the radiofrequency field produced a marked temperature elevation in the tumor and led to complete killing of the tumor.  However, some of the carbon nanotubes injected directly into the tumor leaked into the surrounding normal liver producing thermal damage to a zone of normal tissue around the tumor.

John had a simply stated goal with his idea; he wanted to produce a better and less toxic treatment for cancer. John was diagnosed in 2003 with a rare form of leukemia.  Sadly, his diagnosis came within six months of him selling his businesses in Pennsylvania and retiring to what he hoped to be leisure time spent fishing, golfing, and enjoying his family and grandchildren.  After he was diagnosed with cancer, his focus shifted markedly and he became a whirling dervish of activity intent on solving the problem of cancer.

I watched John go through numerous different regimens of chemotherapy to treat and control his leukemia. He maintained his physical appearance fastidiously and presented a stoic appearance to those around him.  However, his family and his physicians knew the toll treatment was talking on him.  Despite the fatigue and the discomforts associated with chemotherapy treatments, John maintained a vigorous schedule of fundraising and promotion of his cancer treatment idea.  He had owned television and radio stations and knew a great deal about the media.  He gave print and television interviews regularly.  To my amazement, he attracted the interest of the television news show “60 Minutes”.  A producer from the show came and visited me to gather facts and to ascertain if there really was a story.  I explained to her the research was producing some intriguing results and I believed there was potential.  I also honestly told her testing was early and a long way from human clinical trials.  John was a charismatic, tirelessly self-promoting force of nature and the producer decided to proceed with an interview featuring the non-traditional inventor of a potential cancer treatment device.

This led to me being interviewed by Leslie Stahl for a “60 Minutes” piece. John and his wife were also interviewed.  “60 Minutes” is known for doing the occasional tough, in your face interview to uncover unsavory behaviors of individuals, groups of people, or representatives of various government or corporate entities.  They also report on important scientific discoveries, novel medical treatments, or interesting features about people or businesses around the world.  I called my mother the week before the “60 Minutes” piece ran.  I explained to her I was going to be on the national television journalism program on Sunday evening.  Before I could describe the nature of the story,  she exclaimed, “What did you do?”  Thanks for the vote of confidence, Mom.

The television news story ran and the next week my secretary, my laboratory staff, and my email file were inundated by patient requests to be treated with this wonderful new cancer treatment. To their credit, “60 Minutes” did an exact and correct job of reporting that all of the research to date was in cancer cells or in animals with malignant tumors.  They stated precisely and properly no human had yet been treated.  That did not dissuade hundreds of patients and their families from contacting me.  And it wasn’t just human patients who contacted me.  At the end of that week my secretary, emotionally exhausted by the pleading calls, presented to my office in tears with a letter putatively written by a dog named Henry from Ontario, Canada. Henry requested I consider treating him with the “Kanzius device” for his otherwise untreatable, lethal malignant tumor.  The letter was signed with a paw print.

Enough. The hospital’s media office put out a statement explaining human clinical trials were years away and thanking the public for their interest in the research project.  I asked John to cool it and cut back on the media exposure and interviews.  This led to a brief respite, but soon John was back in the spotlight.  I traveled to Erie, Pennsylvania for a fundraising event and John picked me up at the airport.  We rode through town on a pleasant summer day in 2008 with the windows down.  As we came to stop lights or drove through downtown, people would wave and yell at John.  He would shout a greeting and wave back.  I looked at him and laughing said, “Wow, now I know what it’s like to ride around with a rock star!”  He turned to me, flashed a brilliant smile, and wordlessly drove on.

That fall, John’s leukemia had become recalcitrant and unresponsive to all standard and experimental therapies. To my incredulity, in an act of desperation, he treated himself several times in the radiofrequency field device he kept in his garage to show to friends and people interested in supporting his research.  He did a second interview on “60 Minutes.” He confessed to Leslie Stahl and the world he had treated himself in the radiofrequency field device.  He sent me copies of his blood test results, asking if I thought the numbers looked better.  They did not.  The radiofrequency field device itself did nothing to treat the leukemia and did not alter the course of John’s disease.  John was hospitalized in Houston over the Christmas holiday in 2008.  I sat with him in his room one afternoon for over an hour talking about his ideas, the progress of our research, our friendship, and the future.  Toward the end of our conversation as I rose to leave, he said something I will never forget, “I don’t think I have much longer.  I won’t see another Christmas.  Promise me that you will continue this research and see if this treatment makes a difference for cancer patients.”

It’s chilling to hear a cancer patient who still seems relatively strong say they know their time is drawing short. Patients often know their own body and what is happening better than we can measure with all of our sophisticated testing.  In February 2009 John developed pneumonia and was hospitalized near his winter home in Florida.  His immune system was ravaged by years of toxic chemotherapy treatment so he could mount no response.  He died from sepsis and uncontrolled pneumonia related to years of cancer treatment.  His family, friends, and I mourned the loss of a beloved, generous, visionary, and great man.  I lost a colleague, a scientific collaborator, and a dear friend.

When John told me during a phone call in the fall of 2008 he had treated himself in the radiofrequency machine I was first astonished, then angry, but quickly calmed myself and recognized a basic reality. Patients with cancer, or other chronic, life-threatening diseases, cling to any hope science and technology will find new miraculous treatments.  Despite his powerful intellect and incredible ability to imagine an electronic device and actually build it, John was no different.

John provided hope to thousands of cancer patients by believing new treatments could be developed that would ease the suffering associated with cancer and traditional therapies. His goal was to produce better survival and outcomes.  His belief at times bordered on zealotry, and it was infectious.  I have continued the work on what we now call the Kanzius radiofrequency treatment device.  We have made several interesting discoveries and learned the device can alter the blood flow and microenvironment within malignant tumors in animals, can be used for non-biologic purposes to heat a variety of nano-materials and other chemical substances, and may function synergistically to produce low-level heating within tumors to improve killing of cancer cells by chemotherapy drugs, biologic agents, immunologic therapies, and nanoparticles used to deliver anti-cancer payloads.  We’ve also learned in biologic solutions or cancer cells in culture dishes, the nanoparticles themselves don’t release much heat.   However, in the more relevant situation of malignant tumors growing in animals, when we deliver nanoparticles into malignant tumors and then treat the animal in the RF field, we repeatedly demonstrate significant increases in temperature within the tumors and killing of populations of the cancer cells.  We are working furiously to understand biologically what is going on using this novel treatment approach.  We also recognized limitations using John’s original approach and in my laboratory we are modifying his device to address the issues we have encountered.  John and I discussed such contingencies while he was alive.  I give him full credit for his brilliance and we proceed with the Kanzius treatment approach.

As is true with many basic research projects, there have been bumps in the road. Some experiments didn’t work or yield the expected results.  Some hypotheses were incorrect and we changed direction and altered approaches.  We learned from positive and negative results, serendipity, and by thoughtful analysis of unexpected events.  We have expanded our knowledge of the behavior of nanoparticles, chemicals, drugs, cells, and malignant tumors in the radiofrequency field.  We learned many nanoparticles don’t heat well in actual tumors in animals because of all of the charged particles (ions) in the cells.  We also learned, not surprisingly, that every cancer is a little different and operating at only a single frequency will not be optimal if we actually want to treat patients with non-invasive electromagnetic fields.  We recently developed a mathematical model demonstrating for John’s idea to succeed, we must radically alter his original design and produce a more complicated piece of equipment to achieve our goals of using heat to help kill malignant cells.  I still believe John’s basic vision has great merit, and we continue to work on this project, however long it takes.

A few of the members of my laboratory group met John while he was alive. They are as driven as he was to seek and study novel treatment approaches for patients with cancer.  I still get emails or hand written letters every week asking if the Kanzius device is yet available for human use, or if clinical trials have been initiated.  We are not there yet, and we have gained a tremendous amount of new knowledge and insight on the use of electromagnetic energy to treat cancer alone, or in concert with chemotherapy drugs, targeted therapies, and immunotherapies.  I believe we will prevail.  We will learn if John’s invention works, or if it does not.  The results are the results and must be considered and reported honestly.  If we are to honor and respect John, we must learn if his idea to build a more effective and less toxic treatment for cancer patients is valid.

Many people don’t realize getting a new drug or device approved to treat patients with cancer is a long and arduous process. A decade or more of research to reach the point where clinic trials are initiated and completed is not unusual.  A significant portion of the research we have performed has been supported by a research foundation founded in John’s name based in the communities of Erie, Pennsylvania and Fort Myers and Sanibel, Florida, the location of his summer and winter homes, respectively.  People respected John and believed in him.  I believe in him.  I am deeply indebted to these communities and others who selflessly and hopefully supported John’s ideas.  I am amazed by the results we achieved using his approach to treat cancer.  We only have these more advanced devices because of the incredible skill and dedication of the Rutkowski family at Industrial Sales and Manufacturing in Erie.  We are designing the next generation device in my laboratory now.  The therapeutic process is not working the way John initially envisioned, but with changes and a better scientific understanding of the interaction of radiofrequency fields with malignant and normal tissues, we are working to produce a new therapy designed to help patients diagnosed with solid tumors.  I learned from John the importance of relentless and unwavering belief regardless of the odds stacked against you.

I am occasionally asked if it is unique for a cancer patient to imagine and develop a concept to create a rational and effective cancer treatment. It is unusual in my experience, but I have learned to listen and consider ideas from all sources.  Gathering, collating, and decoding information is part of what we do in cancer therapy and research.  It has allowed us to develop new treatment approaches and to improve the outcome of many cancer patients.  However, the human cost is still high with painful and toxic side effects.  Cancer cells can develop resistance to standard and novel therapies, which still stymies our attempts to produce the word I asked John not to use, a cure.

Keep trying. Don’t quit.  The loftier the goal, the greater the potential benefit and reward for our patients.

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