You might have heard about a cancer treatment known as Coley's toxins, and have questions about what it is and how it might work.
What Coley’s toxins are
Coley’s toxins treatment was developed by a bone surgeon called William Coley in New York City in the 1890s. It's also called Coley’s treatment, mixed bacterial vaccine, endotoxin treatment, or Issel’s fever therapy. Available scientific evidence doesn't currently support claims that Coley’s toxins can treat or prevent cancer.
Coley noticed that cancer patients who got infections after surgery seemed to do better than people who didn't get an infection. He believed that the infection had stimulated their immune system to fight the cancer.
At first Coley injected live bacteria into cancer tumours. But using live bacteria could cause serious illness or even death due to infection. So he began using bacteria that had been killed. This gives a high temperature (fever) but does not cause a serious infection.
How might Coley’s toxins work?
Boosting the immune system to attack cancer cells is called immunotherapy. Many researchers around the world are looking into immunotherapy and a lot of progress has been made in this field since Coley’s time.
Some modern cancer drugs work by stimulating the immune system. Doctors sometimes use immunotherapy on its own to treat certain types of cancer. But more often they use it alongside or after standard cancer treatments, such as surgery, radiotherapy or chemotherapy.
The original formula for Coley’s toxins is no longer available. Current formulas use killed bacteria called Streptococcus pyogenes and Serratia marcescens. Supporters of this treatment suggest that the bacteria directly boost the immune system to kill the cancer cells. Some people think the treatment stimulates a natural protein called tumour necrosis factor (TNF). Other doctors think it stimulates another protein called interleukin 12 (IL12).
The treatment causes a high temperature. Some people think cancer cells are more sensitive to heat than normal cells and that the high temperature kills the cancer cells.
Although some cancers did shrink in patients treated by Dr Coley, in others his treatment didn't help. Other researchers have found it difficult to repeat his successes. In trials since that time, some patients with certain types of cancer had shrinkage of the cancer or lived longer than expected. But it's not possible to know whether this is just by chance or because of other treatments they had.
The formula for the treatment varied a lot in the early trials and the toxins were used in different ways. Some patients had injections directly into the tumour and some into the bloodstream, so it's difficult to compare the trial results. At the moment there's no solid evidence from modern clinical trials to show that Coley’s toxins can reliably treat cancer or work better than other types of treatment.
Different types of Coley’s toxins were made by several drug companies in the USA until the early 1950s, but then other types of cancer treatment became more widely used.
Having Coley’s toxins
You have Coley’s toxins injections either directly into the tumour or into a vein. You have daily doses until it causes a constant high temperature. This often takes several months.
Is it available now?
Coley’s toxins treatment isn't available as a standard treatment in the UK. Some clinics still give it as a treatment in the USA, Central America, Germany and China. But it's not clear whether these clinics are using the original Coley formula or a combination of Coley’s toxins and other bacteria.
Possible side effects
Coley’s toxins cause a high temperature that can make you feel very unwell. You may also feel sick.
Some people have other effects, such as:
- back pain
- chest pain
- shock like reactions
There's a risk of serious infections in people with a weakened immune system.
Coley’s toxins haven't been thoroughly tested to find out how they interact with medicines, foods or dietary supplements. Taking Coley's toxins with other medicines or cancer treatments could be harmful. You must let your doctors know if you're thinking of using any type of alternative or complementary therapy.
Women who are pregnant or breastfeeding should not use Coley’s toxins.
Relying on this type of treatment alone and avoiding or delaying regular medical care for cancer might seriously harm your health.
Current bacterial therapy research
Following on from Dr Coley’s work, his daughter published several papers with her father’s results. She also founded the Cancer Research Institute in New York, which is still studying how immunology can help to diagnose and treat cancer.
We don't know of any active research into the original Coley formula at this time. But some research is looking into using pieces of DNA that might have caused cancer shrinkage in some patients.
Today scientists are looking at newer immunotherapy treatments using various natural and genetically modified bacteria. They are also using purified molecules and drugs to try to stimulate the immune system to destroy cancer cells.
Some researchers are looking into using bacteria to carry cancer treatments into cancer cells. The understanding of how the immune system works has developed a lot since Dr Coley’s time, so current immunotherapy treatments are likely to work much better.
Research into bacterial treatments is still at an early stage and they should only be used within clinical trials.