Traditional cancer treatment like standard Maximum Tolerated Dose (MTD) chemotherapy has always horrified me. These methods are highly toxic and often cause tremendous side effects and suffering. I have known close relatives and friends whose immune systems were so devastated by traditional aggressive chemotherapy and radiotherapy that they died of maladies like fever and flu just months after they were declared to be in remission from their cancer.

In MTD chemo, high doses of cytotoxic drugs – the highest doses possible without causing life-threatening levels of toxicity – are administered intravenously to cancer patients. Because it is very toxic to the body, MTD chemotherapy requires prolonged breaks (generally of 2-3 weeks in duration) between successive cycles of therapy. This gives the cancer an opportunity to recover and re-establish itself. This is why cancer cells often seem to quickly become resistant to MTD chemotherapy.

Recently, I learned about a gentle form of chemotherapy with virtually no side-effects called metronomic chemotherapy. Unlike MTD chemotherapy, metronomic chemotherapy involves taking low-dosage cytotoxic drugs orally – in tablet form – usually daily over a prolonged period, without the breaks necessitated by MTD chemotherapy.

Chemotherapy drugs are designed to inhibit or kill cancer cells by damaging DNA. However, cells can employ a number of mechanisms to repair this damage. When cells experience drug-induced breaks in their DNA strands, proteins called PARPs bind to the DNA at the sites of the breaks and recruit other proteins involved in DNA repair. This process can allow cancer cells to continue to survive and grow despite the damage caused by chemotherapy treatment.

With metronomic chemotherapy, the low-dose chemo drugs are administered regularly, without missing a beat, like the rhythmic beat of the metronome. Hence, the cancer is given little time to repair and restore itself, while toxicity and side effects are kept minimal.

Dr. Harold J. Burstein of the Dana-Farber Cancer Institute, who has led several early-stage trials of metronomic chemotherapy in women with breast cancer elucidates that “… metronomic chemotherapy …refers to repetitive, low doses of chemotherapy drugs designed to minimize toxicity and target the endothelium or tumor stroma as opposed to targeting the tumor”.

Low, non-toxic doses of chemotherapy drugs, when delivered frequently for a prolonged period of time, can retard tumor blood vessel growth (or angiogenesis) by destroying endothelial cells. Evidence is growing that more compressed or accelerated schedules of drug administration using much smaller individual doses than the MTD can be more effective in controlling tumor growth, and stabilising the patient’s condition for a longer period of time.

Angiogenesis is the creation of new blood vessels from an existing blood vessel – such as from established blood vessels to a tumor – and tumors use this source of nutrition to grow. This vascular structure is the target of drugs like Avastin. Endothelial cells form the lining of newly-formed blood vessels. Standard MTD chemotherapy destroys the endothelial cells in the small blood vessels but in the usual 2 – 3 weeks pause given before the next chemotherapy session, the blood vessel grows into the cancer again.

On February 23rd 2008, at the 28th annual German Cancer Congress, cancer researcher D. McDonald from San Francisco presented a lecture at a symposium entitled: “Anti-angiogenesis, Therapy for Solid Tumours”. McDonald showed pictures from his research and demonstrated that just one day after anti-angiogenesis treatment was stopped, the endothelial cells start sprouting and sending out growth processes from the basal membrane. One week from stopping the anti-angiogenesis treatment, the blood vessels and the blood supply to the cancer tumor – the tumor’s vascular system – are fully re-established.

The metronomic approach was initially proposed and tested in animal models by Dr. Timothy Browder in Dr. Judah Folkman’s lab at Harvard Medical School. The studies recorded that standard MTD chemotherapy regimens caused cell death of endothelial cells in the blood vessels feeding to the tumor first, followed by tumor cells. However, the long breaks needed between the MTD regimens allowed the damaged blood vessels, and thus the tumor, to recover.

On the other hand, significantly lower doses given more frequently on a prolonged schedule proved to be far more effective, including complete tumor regressions, even in mice that were resistant to the same drug when used in a standard MTD regimen.

Various other research groups have confirmed these findings. Further, studies conducted in cell lines and animal models have reported that combining metronomic chemotherapy with targeted anti-angiogenesis agents seems more effective than metronomic chemotherapy alone.

Italian oncologists documented the long-term responses of patients with metastatic breast cancer to a metronomic regimen involving daily cyclophosphamide (50mg) and two weekly doses of methotrexate (5mg per dose)). 32% achieved either a complete or partial remission, or a stabilization of disease lasting at least 24 weeks. In about 16% of patients, no tumor progression was noted for over a year. Even in the patients in whom progression did occur, it was believed that the therapy slowed the spread of the disease.

As metronomic therapy is directed against endothelial cells, not cancer cells, a metronomic regimen that works well with one type of cancer should work with all types of cancer dependent on angiogenesis for growth.

A well-documented case study of a 36-year old patient with advanced epithelial ovarian cancer who had responded poorly to standard MTD chemotherapy reported that she performed well on metronomic chemotherapy. She went on to live a normal working and social life for five more years, without side effects.

A major benefit of metronomic chemotherapy is that it is essentially free of harmful side effects. Only a mild suppression of white cell count was observed in a small minority of the treated patients.

Yet another interesting benefit of metronomic chemotherapy is that it selectively kills a type of immune cell – T-reg cells – that function to suppress the activity of immune cells capable of attacking the tumor – the natural killer (NK) cells and T-cytotoxic cells. T-reg cells are often found within tumors and secrete hormone-like factors that “turn off” the immune cells trying to attack the cancer. Metronomic chemotherapy is therefore a useful adjuvant to therapeutic strategies intended to boost the tumor-killing capacity of NK and T-cytotoxic cells.

For people dealing with cancer, especially those adverse to aggressive cancer treatment, and particularly those for whom traditional MTD chemotherapy has failed, metronomic chemotherapy is good news. Those seeking a gentler, less-aggressive and less-harmful form of cancer treatment at least now have this option to explore.

In a 2010 ASCO (American Society of Clinical Oncology) report, promising results from administering metronomic chemotherapy with capecitabine to heavily pretreated patients with metastatic breast cancer – including those with HER2 positive breast cancer – were reported. This offers hope even to those with advanced breast cancer for whom standard aggressive cancer treatment like MTD chemotherapy has failed.

Of course, some people feel that metronomic chemotherapy may work too slowly for those with clearly progressive cancer. A hybrid approach may be the answer. In a phase III clinical trial which involved women with locally advanced or inflammatory breast cancer, a presurgical (or neoadjuvant), metronomic-like regimen – using higher doses of cyclophosphamide, given daily; doxorubicin; and growth factor support to ensure the continued production of white blood cells – was found to be superior to a standard MTD regimen at eliminating evidence of invasive cancer at the time of surgery.

This outcome, explained Dr. Robert Livingston, a co-investigator on the Southwest Oncology Group-led trial, generally has been found to predict superior long-term outcome in patients. The idea was to try to expose tumor cells to minimum concentrations of chemotherapy drugs for as long as possible.

“I think it’s fair to call the regimen we have developed a hybrid,” said Dr. Livingston. “It can destroy tumor cells and, at the same time, the continuous exposure, particularly to cyclophosphamide, is having an anti-angiogenic effect.”

The hybrid metronomic regimen delivers chemotherapy more frequently, even daily, at significantly higher doses than those used in most metronomic regimens but less than in MTD regimens. The toxicity might be greater than a “traditional” metronomic regimen, but so might the effectiveness.

If you’re looking for a gentler, less toxic and relatively safe form of chemotherapy, talk to your oncologist or check with your nearest cancer center. Clinical trials utilizing metronomic chemotherapy are also ongoing.

Posted: July 5th, 2010 under Alternative Remedies, Cancer.
Comments: none

I got really excited recently when I read that oncology researchers have reported that extra-virgin olive oil is an effective anti-cancer fighter against an aggressive form of breast cancer, HER2 breast cancer. According to the Mayo Clinic, “HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2), which promotes the growth of cancer cells. In about 1 of every 5 breast cancers, the cancer cells make an excess of HER2 due to a gene mutation. This gene mutation and the elevated levels of HER2 that it causes can occur in many types of cancer — not only breast cancer…..HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. They’re also less responsive to hormone treatment.”

HER2 positive breast cancer is one of the most frightening breast cancers to deal with and the drug which is typically used to treat it – Herceptin – is very expensive. So the news that phytochemicals in extra-virgin olive oil – an affordable, easily obtainable and harmless food – can shrink certain breast tumors should give hope to many.

The extra-virgin olive oil study was performed at the Catalan Institute of Oncology in Girona, Spain, and reported in the open-access journal BMC Cancer. It focused on tumor tissue in laboratory culture that the researchers exposed to different fractions of extra-virgin olive oil containing various natural phytochemicals. When rats with induced breast cancers were fed large amounts of extra-virgin olive oil, their tumors’ malignancy diminished.

“Our findings reveal for the first time that all the major complex phenols present in extra-virgin olive oil drastically suppress overexpression of the cancer gene HER2 in human breast cancer cells,” said Javier Menendez, who, along with Antonio Segura-Carretero from Spain’s University of Granada, led the team of researchers who determined to investigate which parts of extra-virgin olive oil battle cancer best.

Some past studies have suggested that the olive-oil-rich Mediterranean diet prevents cancer, while other studies have not. So the Spanish scientists theorized that olive oil compounds kill only certain forms of breast cancer. Their research found that the olive-oil polyphenols known as secoiridoids and lignans are highly effective breast-cancer-cell fighters – but only against the 20 percent to 30 percent of breast cancers that express the so-called HER2 gene.

Extra-virgin olive oil comes from pressing olives in a cold state – without the use of heat or chemicals. It contains natural complex anti-cancer chemicals that the industrial refining process destroys. So will eating large quantities of such olive oil actually prevent or cure breast cancer? Sadly, the authors note that “The active phytochemicals exhibited tumoricidal effects against cultured breast cancer cells at concentrations that are unlikely to be achieved in real life by consuming olive oil.”

Still, the scientists say, “These findings, together with the fact that that humans have safely been ingesting significant amounts of lignans and secoiridoids as long as they have been consuming olives and extra-virgin oil, strongly suggest that these polyphenols might provide an excellent and safe platform for the design of new anti breast-cancer drugs.”

I don’t know about you, but I’m still going to add more extra-virgin olive oil to my salads.

Posted: June 19th, 2010 under Alternative Remedies, Cancer, Healing Foods.
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When you think about it, most communities which follow a native diet and lifestyle STRICTLY have very low cancer rates, if at all. It’s the people who adulterate this “formula” who start getting all kinds of sicknesses, including cancer. Let’s look at the elements which are common to relatively cancer-free societies, whether they are Asian, European or African:

1. They eat foods native to their territory, whether it be plant or animal in origin. Don’t forget that the Mongolians and Eskimos eat a predominantly meat and fat based diet, with hardly any plant food. The Mongolians, in addition, eat plenty of dairy foods. Many traditional European, Middle-Eastern and Indian diets also feature dairy products and meats.

2. Each native group obviously adapted to their respective diets, eating whatever was naturally available in order to stay alive. This is why a diet abundant in meat and fat was not harmful to the Eskimos or the Mongolians. In fact, it was protective for them, living in their harsh, wintry environments.

3. The foods they ate and beverages they drank were organic, unprocessed, unrefined and free from artificial additives like chemicals, hormones and antibiotics. Meat and dairy were completely natural and uncontaminated.

4. Foods were generally eaten fresh, freshly harvested or freshly killed. Any food preservation or storage was usually limited to salting, fermenting, drying or pickling. Modern societies tend to eat food which has been canned, packaged in some way or frozen for quite some time.

5. Cooking methods were completely natural. Nothing strange like microwaving or “nuking” in any way.

6. Kitchen utensils, cookware and materials used were also completely natural (clay, leaves, wood etc). Certainly no plastic.

7. Condiments, spices and flavorings were kept simple and natural. Nothing artificial.

8. In Asia, if oil was used for cooking, it was what was indigenous to the territory eg. peanut oil, coconut oil, soya bean oil, ghee (clarified butter), or lard (made from animal fat). “Healthy” fats like olive oil or grapeseed oil were unheard of.

9. If a sweetener was used, it was natural eg. cane sugar, palm sugar or honey.

10. Carbohydrates were fine and even essential, but they were usually natural, unrefined and free from artificial additives eg. tapioca, sweet potatoes, corn, beans, nuts, seeds, potatoes and other tubers.

11. No leftover food was kept. Everything was made fresh and finished in one sitting, so food did not have a chance to deteriorate further.

12. Usually, native people ate only what they needed, or even starved at times for a while. Excess was a luxury, and generally reserved for special occasions. Modern people are literally indulging themselves to death.

13. With the exception of people living in harsh environments like the Mongolians and Eskimos – where meat and fat was more readily available than plant foods – most native diets are dominated by plant foods. Meat was considered a luxury item to be eaten sparingly or reserved for special occasions. If seafood was available, that was eaten more often than meat. Modern societies consume far more meat than our forefathers did, and the meat we eat today is mostly adulterated and contaminated.

14. Almost all native societies have some fermented foods. These foods are rich in anti-cancer properties. Think sauerkraut, kimchi, miso, tempeh and yoghurt.

15. Almost all native societies have a rich tradition of using herbs for food, healing and beauty. The Chinese, for instance, have a vast variety of herbal teas, using herbs, flowers, roots, tree bark, fungi etc. I grew up drinking herbal teas and soups, but switched to Western concoctions and drugs and soda pop from my early teens. Now that I’m older and (hopefully) wiser, I’m beginning to rediscover Traditional Chinese Medicine (TCM) and learning how to use traditional herbs at home.

16.The true native lifestyle is physically active, even rigorous, on a daily basis. Exercise was a way of life. People living in urban societies are very sedentary, and obesity has become an epidemic.

17 The environment and air was clean and pure. There was no exposure to modern contaminants like chemicals, radiation, electrical currents, vehicle and industrial emissions etc.

18. Furniture, building materials, fabrics etc was all organic.

19. There was no obsession with cleaning or enhancing body or home with products saturated with chemicals, unlike today.

20. People slept early and woke up early. Their sleeping environments were completely dark and quiet, except perhaps for the sounds of nature. No night lights, street lights, blinking lights, TV etc. Perfect for melatonin production.

These are just a few of my observations. As I said in my opening paragraph, the people who adulterate this “formula” are the ones who start getting all kinds of sicknesses, including cancer. Of course, observing a strict native diet and way of life is challenging in an urban society. But I believe we need to try our level best, in order to be cancer-free, even if it means re-locating. Major miracles often require major changes.

So, should we consume green tea, or soy, or turmeric, or flaxseed, or berries, or cruciferous vegetables, or iodine, or dark chocolate etc. or load up on more supplements? I think we know by now that each in itself CANNOT defeat cancer. Diet alone won’t cut it. Even vegetarians and exercise fanatics get cancer, right? A radical, holistic approach is required, and this may include some medical intervention. To keep cancer and other diseases at bay, it’s back to basics, back to our roots.

GO NATIVE, as far as it makes sense. In other words, if you’re a Mongolian working in a nice, cushy office in New York, the traditional Mongolian diet may not be healthy for you in this context. Adapt it to your present living environment, eliminating elements which are harmful (eg. unnatural foods, high-fat diet, chemicals, being sedentary) and adding those which are protective (eg. daily exercise, lots of plant foods, natural foods, fresh foods, safe personal care and household care products, conducive sleeping environment and times).

As long as your foods are natural and your way of life is as native as possible, a little dairy food or meat or dessert once in a while is not going to kill you. Just make sure it is pure, unrefined, unprocessed and fresh. Food which has travelled a long way to get to you is often “preserved” in some way to make it last the journey and storage. They also lose their nutritional value with each passing day.

Avoid anything artificial or unnatural, eat fresh, don’t over-indulge, lose weight, learn how to use herbs for everything, eat some fermented foods regularly, live in a pure and uncontaminated environment, sleep well and exercise everyday. GO NATIVE!

Posted: June 4th, 2010 under Alternative Remedies, Cancer, Diet, Health Basics 101.
Comments: 1