Note
from Dr. Moss: This week I begin a two-part discussion in my
occasional Friendly Skeptic series, looking at a group of products
sold by Mannatech, Inc., a network marketing giant. My goal, as a Friendly
Skeptic, is not to prejudge or to disparage unfairly, but simply to determine
whether or not there is a solid scientific basis for the claims made on behalf
of these products.
I
take the same strictly objective, evidence-based approach in the 200 Moss Reports,
each one of which is an in-depth study of the available conventional and alternative
treatments for a particular type of cancer. My aim in writing these reports is
to present an impartial and clear-eyed analysis of the most promising treatment
options. People dealing with cancer need a reliable source of up-to-date information,
a source they can count on to be honest and even-handed in assessing the many
conflicting claims that assail them. The Moss Reports are designed to do
just that.
If
you would like to order a Moss Report for yourself or someone you love,
you can do so from our website at www.cancerdecisions.com,
or by calling Diane at 1-800-980-1234 (814-238-3367 from outside the US). We
look forward to helping you.
Recently
a client asked my opinion of Ambrotose®. She had advanced cancer and
her doctors held out little hope. Her medical history had been a succession of
failures. After being told that her condition was essentially untreatable, she
found details of a promising clinical trial on the Internet. She tried to enroll,
but at the last minute was rejected because of the trial's rigid exclusion criteria.
(It turned out that her 9-millimeter diameter tumor was one millimeter too small
to permit her inclusion in the study.)
She
became increasingly frustrated with the medical profession, perhaps understandably
transferring onto her doctors some of the anger she felt at this cruel disease.
She then turned towards alternative medicine. In particular, a neighbor sold her
on a substance called Ambrotose.
What
exactly is Ambrotose, and does it have any role in the treatment of cancer?
Ambrotose
is the brand name for a mixture containing certain plant sugars called glyconutrients.
It is widely promoted for its health-giving properties. Ambrotose is produced
and marketed by Mannatech, Inc., a publicly traded company based in Coppell,
Texas, which does about US $190 million per year in business (2003) and has grossed
more than US $1.5 billion since its start in 1994. Its various nutritional products
- there are now about thirty - are sold through what the company calls a global
network marketing program.
In
this sort of multi-level sales structure, independent entrepreneurs become associated
with the parent company as private contractors. They themselves receive a discount
for shopping within the network, for selling products, and for expanding their
network of people (the so-called "downline") who are doing the same
thing. Those who sign up receive a percentage of the profits that are generated
by the network of all other entrepreneurs who are introduced to the system by
him or her, and also of the profits generated by the people introduced by those
entrepreneurs, and so on.
In
practice, this means that the sales pitch you hear tends to come from someone
you know personally, who not only uses and sells the stuff, but has a strong incentive
to recruit you to become a "downline" salesperson of the same products.
I have had people in my own extended family try to convince me of the virtues
of Mannatech's products.
Only
later did I realize this was not a disinterested excursion into medical science
but part of a well rehearsed sales pitch. It is hard to resist this sort of pressure
when it is a friend, neighbor or relative who comes a-calling. This helps account
for the remarkable growth not just of Mannatech but of this network marketing
phenomenon. The network marketing of health products (including other huge sellers
such as noni and mangosteen juices) appeals to two
of the most fundamental human desires, the simultaneous quest for health and wealth.
Mannatech
began its meteoric rise in the world of network marketing with the development
of a proprietary substance called Manapol® [Carrington Laboratories
makes Manapol and holds the trademark -Ed]. The company offers a scientific
rationale for the use of this product, claiming that various sugars - technically,
monosaccharides and polysaccharides - provide specific sugars to the body that
help support the immune system and facilitate cell-to-cell communication. In 1996,
the company introduced its Ambrotose Complex®, a blend of Manapol
and additional glyconutrients.
Describing
Ambrotose, the company's website states the following:
Ambrotose is
a glyconutritional, a blend of specific plant saccharides that provides support
for the immune system. These saccharides are necessary for the body's creation
of glycoforms, the structures on cell surfaces used to talk' to other cells.
Ambrotose
later evolved into Ambrotose Complex®, which, according to the company,
is a mixture of Arabinogalactan (a gum from the Larix decidua tree), Manapol,
which is a gel extracted from the inner leaf of aloe vera gel plant, gum ghatti,
and gum tragacanth. Advanced Ambrotose in turn is said to contain gum acacia,
aloe vera gel extract (inner leaf gel) or Manapol powder, oat fiber, brown macroalgae
(Undaria pinnatifida) sporophyll, vegetarian glucosamine-HCl, ghatti gum, gum
tragacanth and xylitol.
The
price of Advanced Ambrotose is between $69 and $76 for 75 grams in bulk,
almost one dollar per gram or $28 per ounce.
In
2001, the company further broadened its line of proprietary ingredients by developing
Ambroglycin®, which it describes as a balanced food-mineral matrix
that helps deliver certain nutrients to the body. Additionally, in 2004 Mannatech
developed a proprietary blend of antioxidant nutrients, called MTech AO Blend,
which is used in its proprietary antioxidant product Ambrotose AO®.
(AO stands for antioxidants.)
Trademarked
Terminology
Don't
be surprised if you have difficulty keeping all this new and registered or trademarked
terminology in mind. It is dizzyingly complicated. As far as I can gather almost
all of the company's products contain Ambrotose, which in turn contains
Manapol. An earlier key ingredient was Acemanan. Then there's Ambroglycin.
I
do not mean to disparage or diminish the totally respectable field of glycobiology
or the potential use of polysaccharides in cancer. There is for instance the work
of Prof. Hans-Joachim Gabius of the Ludwigs-Maximilians University of Munich
and his coworkers. They have done pioneering research in glycobiology, investigating
cell-agglutinating proteins known as lectins and the role they play in tumor formation.
Another
very important area in glycobiology concerns the investigation of polysaccharides
in mushrooms such as maitake, shiitake and reishi. This kind of research deserves
the most serious consideration. So too do the lipopolysaccharides (LPS) that are
associated with the cancer treatment known as Coley's toxins (mixed bacterial
vaccine). But this is a very far cry from the claims sometimes made by proponents
of Mannatech's products concerning the efficacy of orally administered
sugars, such as are found in Ambrotose or related products.
A
Promising Avenue
Glycobiology
is a promising avenue of research, to be sure. However, network marketing creates
a rah-rah atmosphere, in which a chemical becomes a product and a product then
becomes a profit center and an ideological cause.
There
have been reports in the media that glyconutrients have been sold with an implicit
claim that they have benefit in the management of existing cancers. What is the
scientific basis of such claims? I experienced a disconnect when I tried to track
down the hard science behind such claims. Here for instance are the numbers of
Google search engine 'hits' for various Mannatech products or their
components compared to the number of citations in the standard 15-million entry
US medical database, PubMed.
Product
Google
Hits
PubMed
PubMed
+ Cancer*
Acemanan
19
400
42
7
Ambrotose
20
700
0
0
Manapol
14
100
0
0
*PubMed
+ Cancer refers to peer-reviewed article delimited by the further search term
'cancer'
For
Ambrotose in particular, we see an enormous popularity in publications
by and for lay people but nothing listed in the standard medical literature to
substantiate claims of health benefits, at least not under this particular brand
name. To put it mildly, this isn't very reassuring.
I
also searched for arabinogalactan, a prime ingredient in Ambrotose. This
is a sugar derived from the wood of the Larix, or larch, tree. Larch arabinogalactan
is in fact approved by the Food and Drug Administration (FDA) as a source
of dietary fiber. I had more success with this search. There were nearly 600 references
to this topic in PubMed. But when I limited my search to articles investigating
arabinogalactan in relation to cancer, there were only 17, mostly cell line studies.
According
to PDRhealth.com, arabinogalactans mainly occur in the Western larch. It
is not one substance but in fact a mixture of several different arabinogalactans
with widely varying molecular weights. Arabinogalactans are water-soluble polysaccharides
widely found in plants, fungi and bacteria. They may be involved in intercellular
signal transduction pathways in plants.
Dietary
sources of arabinogalactans are found in carrots, radishes, tomatoes, pears and
wheat, among other plant foods. So whether we realized it or not, we all probably
had some today. Gum arabic, a commonly used food additive, is also composed of
highly branched arabinogalactans (from which the substance derives its name).
Arabinogalactans are also found in herbs such as Echinacea and edible mushrooms
such as Ganoderma lucidum (reishi) and may contribute to their possible immune-enhancing
ability. But does this mean that Mannatech's products, taken orally, would be
good for cancer patients?
I
can find no hard evidence for this at all. While there is some indication that
products derived from aloe, polysaccharides in particular, may possibly have a
role in cancer treatment, the substantiation of such an effect is weak at best,
and I can find no evidence whatever in standard sources that would point to the
superiority of Mannatech's products. What's more, they seem quite expensive compared
to other sources of monosaccharide sugars, such as generic aloe or plant gums.
According
to a press release from a non-profit trade organization, the International
Aloe Science Council, Inc.:
To
assert, as several writers have done - seemingly with information obtained from
the developers of Manapol - that aloe-based products not containing
Manapol cannot offer the benefits associated with aloe vera - seems little
more than product ballyhoo...
The
main danger I believe is that patients will not only lose money but will also
lose precious time. Cancer is a complex disease. It requires professional help.
Regardless of the sometimes uncaring attitude of certain errant members of the
medical profession, one should not reject everything that conventional medicine
has to offer in favor of a regimen discovered on the Internet.
The
answer is not simply to construct a do-it-yourself program, but to find expert
and sympathetic guidance in the rapidly expanding realm of complementary oncology.
Note from
Chet: Be sure to sign up for Dr. Moss's excellent newsletter at his website.
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