The Gerson therapy is a complex regimen advocated by its supporters to treat cancer and other degenerative diseases. It consists of a specialized diet to “detoxify” the body and rebuild the immune system, adding vitamin and mineral supplements to help in these processes. Coffee enemas are an essential part of the regimen. The therapy is named for its developer, Max Gerson, a German physician who emigrated to the United States and started a medical practice in New York City in 1938.[1,2]

The Gerson therapy is rooted in the belief that cancer is a disease of the whole organism, the tumor being only a symptom of a diseased body. Gerson considered cancer to be an accumulation of several damaging factors that combine to cause the deterioration of the entire metabolic system. The goal of the Gerson therapy is to bring the body back to its normal metabolic state, or as near to this state as possible, and to keep the metabolism in natural equilibrium.[1,2]

Gerson observed that cancer patients exhibited markedly degenerated organs, especially the liver, presumably caused by the clearing of toxic materials of an unknown type that the disease produced. He also noted that the situation became worse after chemotherapy, probably because of more toxic products entering the bloodstream. Gerson’s regimen focused on helping the liver rid the body of toxic substances while restoring and maintaining healthy liver function.[1,2]

According to Gerson, during the detoxification process that results from the Gerson diet, the liver becomes progressively overburdened as the body rids itself of toxic substances formed by the breakdown of cancer cells. Coffee enemas, pancreatic enzymes, and crude liver extract are used to help the liver deal with the burden of removing toxic substances.[1-5]

Total control of everything that enters and leaves the body is the governing principle of the Gerson regimen. Its three main components are strict diet, nutritional supplements, and regular enemas.

The diet is strictly vegetarian for at least 6 weeks and consists of specific fruits and vegetables, eaten either raw or stewed in their own juices. No animal protein is allowed. Some whole grains such as oatmeal are included. Flaxseed oil is allowed only because it aids in the body’s use of vitamin A.[2] No other fat such as cooking oil and no salt or spices of any kind are allowed. A glass of freshly prepared juice from vegetables and fruits must be consumed every hour for 13 hours throughout the day. The vegetables and fruits used on the diet are very high in potassium and very low in sodium.

Food preparation is also controlled. Food may be prepared only in cast-iron pots and pans; no aluminum cookware is allowed. Juices must be prepared using a specific type of juicer that crushes the fruit or vegetable rather than grinding it into pulp. Gerson advocated organically produced food, with all fruits, vegetables, and grains grown and raised in soil free of pesticides and contaminants and enriched only with natural fertilizers.[2]

The protein and dairy restriction may be lifted to include buttermilk; however, this restriction may continue through the entire course of the therapy, depending on the individual patient. Some changes in the original diet have occurred over time, but the initiation phase of the diet has always been a vegetarian diet.[2]

Taking specific vitamin and mineral supplements plus pancreatic enzymes is the second component of the regimen. Although there have been additions and substitutions to the basic list of supplements, there have been few changes since the 1940s. The typical range of supplements includes the following:

1. Potassium solution
2. Lugol’s solution (potassium iodide, iodine, water)
3. Injectable crude liver extract (no longer used) with vitamin B12 (substitution: coenzyme Q10 and vitamin B12)
4. Vitamins A, C, and B3 (niacin)
5. Flaxseed oil
6. Pancreatic enzymes
7. Pepsin

The potassium solution (potassium dissolved in water) is to help increase the ratio of potassium to sodium in the cells. Lugol’s solution, which consists of 5 g of iodine and 10 g of potassium iodide dissolved in water, is given to increase the body’s metabolic rate. The potassium solution and Lugol’s solution are both added to the hourly juice intake.[1-5]

Originally, Gerson thought that using crude liver extract and juice (made by processing fresh calf and veal livers) would help maintain liver function. The extract and juice were given to patients via injection with the vitamin B12. In 1989, the use of injectable crude liver extract was banned by the U.S. Food and Drug Administration because it was found to be contaminated with Campylobacter.[1,2] Desiccated liver capsules replaced the crude extract, but this has now been replaced by coenzyme Q10.[2] As mentioned above, flaxseed oil is used to help the body utilize vitamin A. Pancreatic enzymes are given to assist in the digestion and the elimination of the breakdown products in the colon.

Coffee (or chamomile) enemas are the third component of the Gerson therapy. Coffee enemas supposedly dilate the bile duct in the liver, thereby allowing the liver to release the breakdown products more easily and speed their removal to the intestine. At the beginning of therapy, a patient may take four or more coffee enemas per day. Literature suggests that coffee enemas help relieve the pain associated with gastrointestinal cancers; however, there is only anecdotal evidence to suggest that the enemas actually dilate the bile ducts.[6,7]

Central to the therapy is an abundance of potassium and the lack of sodium. Gerson had observed that as soon as his cancer patients started on the diet regimen, they released large amounts of sodium in their urine. He noticed that cells in the patients’ bodies that had been bloated with fluid started to shrink as the fluid was released.[1] After studying the research in cancer cell biology available to him at the time and noting the ratio of potassium to sodium in cancer cells versus healthy cells, he deduced that the reason for this sodium excretion was that the diet regimen was correcting generalized tissue damage caused by excess sodium. Healthy cells had a high ratio of potassium to sodium; diseased cells had a low ratio of potassium to sodium or an abundance of sodium.[1]

The implications of this observation led Gerson to believe that part of the process of recovery from cancer was the replacement of excess sodium by potassium in damaged tissues.[8] This belief is the theoretical basis for Gerson’s choice of high-potassium, low-sodium fruits and vegetables in his prescribed diet: a high intake of potassium was needed to restore a normal ratio of potassium to sodium in the cell.

The Gerson therapy is the basis for other CAM therapies that include cleansing enemas or special diets as part of their regimens, most notably the Gonzalez regimen. (Refer to the PDQ summary on the Gonzalez Regimen ¹ for more information.)

References

1. Gerson M: A Cancer Therapy: Results of Fifty Cases and The Cure of Advanced Cancer by Diet Therapy. San Diego, Calif: The Gerson Institute, 2002. 
   
   
2. Gerson C, Walker M: The Gerson Therapy: The Amazing Nutritional Program for Cancer and Other Illnesses. New York, NY: Kensington Publishing Corp, 2001. 
   
   
3. Gerson M: Effects of a combined dietary regime on patients with malignant tumors. Exp Med Surg 7 (4): 299-317, illust, 1949.  [PUBMED Abstract]
   
   
4. Gerson M: Dietary considerations in malignant neoplastic disease: preliminary report. Rev Gastroenterol 12: 419-25, 1945. Also available online. ² Last accessed September 4, 2007. 
   
   
5. Gerson M: The cure of advanced cancer by diet therapy: a summary of 30 years of clinical experimentation. Physiol Chem Phys 10 (5): 449-64, 1978.  [PUBMED Abstract]
   
   
6. Green S: A critique of the rationale for cancer treatment with coffee enemas and diet. JAMA 268 (22): 3224-7, 1992.  [PUBMED Abstract]
   
   
7. Brown BT: Treating cancer with coffee enemas and diet. JAMA 269 (13): 1635-6, 1993.  [PUBMED Abstract]
   
   
8. Cope FW: A medical application of the Ling association-induction hypothesis: the high potassium, low sodium diet of the Gerson cancer therapy. Physiol Chem Phys 10 (5): 465-8, 1978.  [PUBMED Abstract]
   
   

Glossary Terms

A tube through which bile passes in and out of the liver.

Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices generally are not considered standard medical approaches. Standard treatments go through a long and careful research process to prove they are safe and effective, but less is known about most types of CAM. CAM may include dietary supplements, megadose vitamins, herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual healing, and meditation. Also called complementary and alternative medicine.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

In medicine, a sac of tissue and blood vessels that surrounds an organ, joint, or tumor. A capsule is also a form for medicine that is taken by mouth. It usually has a shell made of gelatin with the medicine inside.

A family of plants with daisy-like flowers. Two types are German chamomile and Roman or English chamomile. These are used in teas to calm and relax, to improve sleep, and to help with stomach problems. The essential oil (scented liquid taken from plants) of chamomile is used in perfumes, shampoos, lotions, and aromatherapy.

Treatment with drugs that kill cancer cells.

A substance found in most tissues in the body, and in many foods. It can also be made in the laboratory. It is used by the body to produce energy for cells, and as an antioxidant. It is being studied in the treatment of cancer and in the relief of side effects caused by some cancer treatments. Also called CoQ10, Q10, ubiquinone, and vitamin Q10.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

A disease in which the function or structure of the affected tissues or organs changes for the worse over time. Osteoarthritis, osteoporosis, and Alzheimer disease are examples.

To make something less poisonous or harmful. It may refer to the process of removing toxins, poisons, or other harmful substances from the body.

The things a person eats and drinks.

A product that is added to the diet. A dietary supplement is taken by mouth, and usually contains one or more dietary ingredient (such as vitamin, mineral, herb, amino acid, and enzyme). Also called nutritional supplement.

The process of breaking down food into substances the body can use for energy, tissue growth, and repair.

To widen or enlarge an opening or hollow structure beyond its usual size, such as the pupil of the eye or a blood vessel.

The injection of a liquid through the anus into the large bowel.

In medicine, a preparation of a substance obtained from plants, animals, or bacteria and used as a drug or in drugs.

The seed of the flax plant. It is a rich source of omega-3 fatty acid, fiber, and a compound called lignin. It is being studied in the prevention of prostate cancer. Also called linseed.

Liquid.

An agency in the U.S. federal government whose mission is to protect public health by making sure that food, cosmetics, and nutritional supplements are safe to use and truthfully labeled. The Food and Drug Administration also makes sure that drugs, medical devices, and equipment are safe and effective, and that blood for transfusions and transplant tissue are safe. Also called FDA.

Refers to the stomach and intestines. Also called GI.

A diet plan that has been claimed to be a treatment for cancer, migraine, tuberculosis, and other diseases. It is a vegetarian diet that includes eating organic fruits and vegetables and 13 glasses of fresh juice each day. It also includes supplements with iodine, vitamin B-12, potassium, thyroid hormone, liver extract, and pancreatic enzymes. No clinical trial to test Gerson therapy has been reported.

An alternative therapy that is being studied as a treatment for pancreatic cancer. It includes a special diet, nutritional supplements, pancreatic enzymes, and coffee enemas.

The complex group of organs and cells that defends the body against infections and other diseases.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called bowel.

An element that is necessary for the body to make thyroid hormone. It is found in shellfish and iodized salt.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

Having to do with metabolism (the total of all chemical changes that take place in a cell or an organism to produce energy and basic materials needed for important life processes).

The total of all chemical changes that take place in a cell or an organism. These changes make energy and the materials needed for growth, reproduction, and maintaining health. They also help get rid of toxic substances.

A nutrient required to maintain health.

A product that is added to the diet. A nutritional supplement is taken by mouth, and usually contains one or more dietary ingredient (such as vitamin, mineral, herb, amino acid, and enzyme). Also called dietary supplement.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and watchful waiting.

A part of the body that performs a specific function. For example, the heart is an organ.

A living thing, such as an animal, a plant, a bacterium, or a fungus.

A protein secreted by the pancreas that aids in the digestion of food.

Medical doctor.

A metallic element that is important in body functions such as regulation of blood pressure and of water content in cells, transmission of nerve impulses, digestion, muscle contraction, and heartbeat.

A doctor's order for medicine or another intervention.

A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.

A treatment plan that specifies the dosage, the schedule, and the duration of treatment.

A mineral needed by the body to keep body fluids in balance. Sodium is found in table salt and in many processed foods. Too much sodium can cause the body to retain water.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A group or layer of cells that work together to perform a specific function.

Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.

A key nutrient that the body needs in small amounts to grow and stay strong. Examples are vitamins A, C, and E.

One of several vitamins that the body needs in small amounts to function and stay healthy. Vitamin A is needed for vision, bone growth, reproduction, growth of epithelium (cells that line the internal and external surfaces of the body), and fighting infections. It is fat-soluble (can be stored in the body’s fatty tissue). Foods with vitamin A include fish oils and liver, egg yolks, and whole milk dairy products from animals. It also can be made in the body from a substance found in fruits and vegetables such as cantaloupes, carrots, spinach, and sweet potatoes. Vitamin A is being studied in the prevention and treatment of some types of cancer. Also called retinol.

A vitamin that is needed to make red blood cells and DNA (the genetic material in cells) and to keep nerve cells healthy. It is found in eggs, meat, poultry, shellfish, milk, and milk products. Vitamin B12, along with folate, may be given to help reduce side effects in cancer patients being treated with drugs called antimetabolites. Also called cobalamin. Also called cobalamin and cyanocobalamin.

A key nutrient that the body needs to fight infection, heal wounds, and keep tissues healthy, including the blood vessels, cartilage, ligaments, tendons, bones, muscle, skin, teeth, and gums. It is an antioxidant that helps prevent tissue damage caused by free radicals. The body does not make or store vitamin C, so it must be taken in every day. It is found in many fruits and vegetables, especially green peppers, citrus, strawberries, tomatoes, broccoli, leafy greens, potatoes, and cantaloupe. Also called ascorbic acid.