Pancreatic cancer strikes nearly 30,000 Americans each year, with most people living approximately six months after diagnosis. Surgery and chemotherapy may extend this lifespan by an additional two years, but in the most advanced cases - where the cancer has metastasized, or spread throughout the body - conventional doctors usually give patients about three months to live.

But not Nicholas Gonzalez, M.D. Using a controversial and little-understood therapy involving pancreatic enzymes, Dr. Gonzalez, in private practice in New York City, has given life to patients other doctors have given up for dead. Here are some of the questions he's most often asked:

Q: How does enzyme therapy fight cancer?

A: Studies suggest that pancreatic enzymes, in addition to aiding in digestion, also have significant cancer-fighting properties. When taken in high doses, these pig-derived pancreatic enzymes, like chemotherapy, seem to stop tumor cells from dividing so that they cease growing or die. How this process specifically works is unclear.

Q: What else does the therapy involve?

A: Enzyme therapy is administered as one element of a four-part regimen. Patients on this treatment not only take large doses of enzymes, but also maintain an organic, minimally processed diet, take high doses of vitamin and mineral supplements, and undergo daily detoxification procedures. Vitamin therapy and diet modification are used to help strengthen the patient's system, while the enzymes are taken to directly attack the cancer. Detoxification routines such as daily coffee enemas are used to clean out the resulting buildup of waste material in the liver.

Q: How are the enzymes administered?

A: The enzymes are taken by mouth in pill form. The exact number of pills taken depends on a patient's individual circumstances, but on average, patients receive about 60 enzyme pills per day, plus roughly 100 vitamin, mineral, and other nutritional supplements each day for two to three weeks. A five-day break from all pills follows. It should be noted too that these enzymes are not commercially available.

Q: Am I a candidate for enzyme therapy?

A: For the specific criteria for a clinical trial using this therapy under way at Columbia University, interested patients should call Michelle Gabay at (212) 305-9467.

Q: Is enzyme therapy a cure for cancer?

A: We can't yet call it a cure but we've had some encouraging study results. In a small pilot study of 11 patients, nine (81 percent) survived one year, five (45 percent) survived two years, and at this time, four have survived three years. These results are far above the 25 percent survival at one year typical of pancreatic cancer patients. Larger studies are being done to further test the effectiveness seen so far.

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