Halting the wasting syndrome instead of directly attacking the cancer cells with poison was Dr. Gold's plan of attack. As he explains, "Each of these processes [the tumor invasion of vital organs and cachexia] has its own metabolic machinery, each is amenable to its own therapy, and each is to some degree functionally interdependent on the other. In the interest of treating the totality of malignant disease, each of these processes warrants intervention. Such an approach, dealing with both major underpinnings of the cancerous process-mitogenic and metabolic-affords the greatest promise for eliciting long-term, symptom-free survival and the potential for disease eradication."5

But what causes cachexia? Cancer cells gobble up sugar ten to fifteen times more than normal cells do. The sugar consumed by the cancer cells is generated mainly from the liver, which converts lactic acid into glucose. (Normal cells are far more efficient users of glucose, which they derive from the food we eat, not from lactic acid.) When cancer cells use sugar (glucose) as fuel, they only partially metabolize it. Lactic acid-the waste product of this incomplete combustion- spills into the blood and is taken up by the liver. The liver then recycles the lactic acid (and other breakdown products) back into glucose, and the sugar is consumed in ever-increasing amounts by voracious cancer cells. The result is a vicious cycle, what Dr. Gold calls a "sick relationship" between the liver and the cancer. The patient's healthy cells starve while the cancer cells grow vigorously. Some healthy cells even dissolve to feed the growing tumor.

To break this sick relationship, Gold reasoned, all he needed was to find a safe, nontoxic drug that inhibits gluconeogenesis (the liver's recycling of lactic acid back into glucose). In 1968, he outlined his theory in an article published in Oncology. "The silence was deafening," he recalls.

A year later, by a remarkable coincidence, Gold heard biochemist Paul Ray deliver a paper explaining that hydrazine sulfate could shut down the enzyme necessary for the production of glucose from lactic acid. Gold had chanced upon an eminently logical way of starving cancer. He immediately tested hydrazine sulfate on mice and found that in accord with his theory, the drug inhibited both gluconeogenesis and tumor growth.

Over the years, many dramatic remissions in patients on hydrazine sulfate therapy have been reported. In one case, a sixty-two-year-old woman with widely disseminated cancer of the cervix, in a very debilitated condition, was put on the drug. After one week, a secondary tumor the size of an orange had completely disappeared, much to the amazement of the woman's doctors, and neck nodes had become markedly smaller. After three weeks on the therapy, the patient had gained weight and was active and in good spirits. The woman was discharged from the hospital a short time later.6

In 1987, Erna Kamen, a sixty-three-year-old lung cancer patient, was administered hydrazine sulfate after her discharge from a Sarasota, Florida, hospital. "Basically, my mother was sent home to die," says Jeff Kamen, an Emmy-winning television reporter. "She'd lost a significant amount of weight by then, and she had no appetite and virtually no will to do anything."

A doctor had told Jeff's father, Ira Kamen, that hydrazine sulfate offered at least "a shot in the dark." So one Monday in August 1987, a home nurse gave Mrs. Kamen one hydrazine sulfate pill shortly before serving lunch. "On Tuesday morning," recalls Jeff, "there was a commotion in the house. My mother had risen from her bed like the phoenix rising from the ashes. She was demanding that the nurse bring her downstairs so that she could have breakfast with me.... When people you love get into this kind of facedown with death, you're just incredibly grateful for each moment."7