That unloved little girl of the children's rhyme, who sat in the garden eating worms, may have been onto something. There is a new health product on the market called lumbrokinase, which is derived from the common earthworm, Lumbricus rubellus.

Along with ants, insects and other creepy-crawly things, earthworms have for thousands of years been a staple of traditional Chinese medicine (Mihara 1992). One ancient Chinese medical text, the Ben Cao Gang Mu (or Compendium of Medicine) states that earthworms (known as "Di Lung") are useful in unblocking the body's acupuncture meridians and channels, improving circulation and overcoming numbness in the limbs.

In a beautifully written 1883 book, The Formation of Vegetable Mould Through the Action of Worms, no less a luminary than Sir Charles Darwin observed the ability of worms to digest just about everything in their path. He compared the juices of the earthworm's digestive tract to the pancreatic secretions in humans:

"The digestive fluid of worms is of the same nature as the pancreatic secretion of the higher animals," wrote the great English biologist, "and this conclusion agrees perfectly with the kinds of food which worms consume. Pancreatic juice emulsifies fat, and we have just seen how greedily worms devour fat; it dissolves fibrin, and worms eat raw meat; it converts starch into grape-sugar with wonderful rapidity, and we shall presently show that the digestive fluid of worms acts on starch."

It was in fact the ability of the worm's digestive juices to dissolve fibrin that attracted the attention of scientists a century later. During the 1970s, Prof. Shan Hongren discovered the enzymatic functions of an extract of earthworms. For this he was honored with the United Nations Science Conference Award in 1978. In 1997, a product made from earthworms, named Plasmin, was approved by the Chinese government as a new medicine. In 1999, the China Medical Society made Plasmin a key product to be promoted all over China. In the same year it was registered by the China Supervisory and Administrative Bureau as a class two nationally protected TCM formula, and in 2000 it was included in the China National Pharmacopoeia - at least according to a number of promotional websites (Health King 2004).

Starting in the 1980s, Japanese scientists confirmed this observation experimentally when they isolated six proteolytic enzymes from earthworms. They collectively named these enzymes lumbrokinase (LK). (Proteolytic enzymes are natural substances that speed up the digestion of proteins into their constituent amino acids.) Lumbrokinase is now being made available by a number of American food supplement distributors, including Allergy Research Group of California.

There are presently 17 articles on lumbrokinase in the National Library of Medicine's encyclopedic database, PubMed. This is not a great number, and only one of these articles is a clinical study. However, this study concluded that "lumbrokinase is beneficial to the treatment of cerebral infarction [stroke, ed.]" (Jin 2000). The substance also shows some potential in the postoperative care of patients who have received prosthetic vascular grafts (Hwang 2002).

I learned about lumbrokinase from a prostate cancer patient, whose naturopath suggested it as an alternative treatment. There are currently no articles in PubMed on the use of lumbrokinase in cancer treatment. I therefore would not support the use of lumbrokinase for this purpose until the necessary clinical research has been done. But the basic concept is sound, and such research is certainly warranted.

Role of Pancreatic Enzymes

There is considerable evidence to suggest that taking digestive enzymes may be an important part of an overall anticancer program. This is the approach taken by Nicholas J. Gonzalez, MD, of New York City, whose pancreatic enzyme-based anticancer regimen is currently being studied by the US National Institutes of Health (NIH).

While the actual clinical trial of his regimen languishes for want of support by the oncology community, there was encouraging news this May from the University of Nebraska. An animal study co-authored by Dr. Gonzalez and published in the peer-reviewed journal Pancreas showed that the orally administered enzymes developed by Dr. Gonzalez and his colleagues had profound health-promoting and anticancer effects.

In this study, pancreatic cancer was first grafted into nude mice, rodents whose lack of a functioning immune system allows them to serve as living laboratories for the study of cancer. The mice were then treated with porcine (pig) pancreatic enzyme extracts (PPE) that were included in their drinking water. A control group received no enzyme supplements.

Treated mice "survived significantly longer than the control group," according to Murat Saruc, MD, and colleagues at the Eppley Institute for Research in Cancer and Allied Diseases in Omaha. Additionally, tumors in the PPE-treated group "were significantly smaller than in the control group." All mice in the control group showed abnormalities of metabolism in the early stages of tumor growth, "whereas only a few in the treated group showed some of these abnormalities at the final stage." The authors concluded that treatment with pancreatic enzymes "significantly prolongs the survival of mice… and slows the tumor growth." (Saruc, 2004).

Similar claims about pancreatic enzymes have been made for nearly a century. However this was a rigorously conducted scientific study that was peer reviewed and published in the official journal of the American Pancreatic Association and the Japan Pancreas Society.

For years opponents of alternative medicine have argued that enzymes taken by mouth would be broken down in the stomach and inactivated before being able to do much good at all. This point of view was thoroughly refuted in 2002 when three physiologists at the University of California-San Francisco showed that digestive enzymes can be absorbed into blood, reabsorbed by the pancreas, and reutilized, instead of being reduced to their constituent amino acids in the intestines. This is called an enteropancreatic circulation of digestive enzymes (Rothman 2002). But clearly news of this established fact hasn't reached the implacable opponents of complementary medicine. For instance, an attack on the work of Dr. Gonzalez states:

"Like all dietary proteins, enzymes are dismantled into constituent amino acids by host proteolytic enzymes in the gastrointestinal tract, thus destroying their enzymatic activity" (Green 1998).

This bucket-of-cold-water argument has now been thoroughly undercut by yet another careful scientific study. We are often warned of the harmful effects of unduly favorable statements about food supplements. But what about unduly negative statements? It was because of such dogmatic statements on the alleged destruction of enzymes in the stomach that thousands of people have been dissuaded from taking enzymes. Now we learn that certain enzymes can not only survive the stomach but can enter the bloodstream in their active form. However I have yet to hear a word of correction or apology from the self-proclaimed refuters of CAM cancer treatments on this important topic.

Enzymes are an endlessly fascinating and extremely promising area of medicine, including CAM. They are a natural part of most raw foods and are created by our bodies to aid digestion. Explored and then forgotten, they have been repeatedly rediscovered around the world. I have mentioned the Asian work with earthworm enzymes.

In England, not long after Darwin's time, a brilliant embryologist at the University of Edinburgh, John Beard, PhD, first suggested the use of pancreatic enzymes as a treatment for cancer. He even wrote a book in 1911 called The Enzyme Treatment of Cancer. He got little for his pains but trouble at the hands of a furious medical profession. Today his work is all but forgotten.

For my earlier discussion of the John Beard enzyme theory,go to the CancerDecisions Newsletter for June 26, 2002.

In the US in the 1950s and 60s, a doctor named Frank. L. Shively, MD, of Dayton, Ohio used a similar approach. He reported excellent results in human patients using injected enzymes. When he tried to convince his colleagues of the efficacy of this treatment he was stymied. Being unable to find a regular publisher, Shively self-published a long typewritten manuscript on this approach, The Multiple Proteolytic Enzyme Therapy of Cancer, with documentation of many successes. He was scorned by most of his medical colleagues. Today he is almost completely unknown and copies of his manuscript are very rare. (I have one of the few existing copies.)

In Germany, where natural treatments are widely accepted by the medical profession, the use of enzymes has been more favorably regarded. Much of this goes back to the post-World War II-era work of Max Wolf, MD, and his disciple, Karl Ransberger, PhD, who together wrote the classic book, Enzyme Therapy. Together they founded Mucos Pharma to market enzyme products, such as the celebrated Wobenzyme. A visit to the bookstore at the annual Medicine Week meeting in Baden-Baden reveals numerous titles in German on the same topic. Almost every European clinic that I have visited enthusiastically embraces some form of enzyme therapy.

Yet the use of digestive enzymes remains almost completely unknown to most conventional oncologists in the US. For instance, during the past eleven years (1994-2004) there have been tens of thousands of presentations on a wide variety of other topics at the annual meetings of the American Society of Clinical Oncology (ASCO). Yet in that time there has not been a single study on the topic presented at ASCO.

According to Clifton Leaf, executive editor of Fortune magazine, since 1971 America has spent $200 billion on the war on cancer – with precious little to show for it.

Of this massive sum, only $1.4 million has been spent on the Gonzalez trial and it took a considerable political struggle to get even that single grant approved. The Gonzalez trial moves at a snail's pace for lack of cooperation on the part of conventional oncologists. Every attempt to expose this imbalance in research priorities is met with defensiveness on the part of the cancer establishment. This serves to further isolate proponents of innovative methods, such as enzymes, from the scientific mainstream. In other words, huge sums are poured into dead-end pharmacological solutions, while potential alternatives for cancer are dismissed out of hand as "unproven methods."

It is an intolerable situation.

But rest assured, one of these days the worm is going to turn.