THERAPY IN CANCER

[Published in Art of Healing/Fit4Life on 30/9/2012]

Originally submitted as - NUTRITIONAL THERAPY –

THE FUTURE OF CANCER THERAPY

There was a lively discussion at the recent International Conference on Holistic Healing for Breast Cancer organized by Cansurvive Malaysia. I was privileged to be involved as session moderator, panelist and speaker as well. Being a conference on holistic healing, there were speakers with a wide range of expertise and perspectives (from Ayurveda to Modern Medicine to Vasthu to Yoga). What I would like to share here is something I did not have the opportunity to elaborate on during the panel discussion due to time constraints.

When it comes to cancer, the main worries are – what are the causes? Why is the incidence rising? What are the treatment options? And why do most cancer patients still die despite the advancements in medical science and the trillions spent on cancer research?

We were fortunate to have Dato Dr Suseela Nair as a speaker and panelist. She is one of the most senior breast surgeons with much knowledge and experience in managing the breast cancer patients, at least from the surgical perspective. It would not have been a balanced discussion if only the complementary health practitioners were there. Even though I am a medical doctor, my interest in cancer management is in the role of nutritional therapy and qigong. It would have been even better if we also had an oncologist on board. However, attempts to get an oncologist to be involved in the Cansurvive holistic healing for cancer conferences in the last 2 years have been futile. We may be luckier next year.

I would like to invite readers to contemplate the dilemma of the overall failure of the gold-standard medical treatments in the management of cancer. Why do I say that it has been a failure? Let me refresh you with findings published in several of the top medical journals on the usefulness of chemotherapy for cancer:

Clinical Oncology (2004)16:549-560) - overall, chemotherapy contributes just over 2% to improved survival in cancer patients in Australia and USA. Now 8 years later, this conclusion has not been refuted.

Journal of the National Cancer Institute of NIH (USA), Sept 1993 – chemotherapy helped only 7% of the patients in terms of “durable response” and prolonging survival.

Lancet, 1991, Vol. 337, p. 901 - “Many oncologists recommend chemotherapy for almost any type of cancer, with a faith that is unshaken by the almost constant failures”. (Albert Braverman, MD, “Medical Oncology in the 90s”).

Followers of this column would also know that I had a close-up experience of this failure when my own sister died of breast cancer last year after undergoing all the surgery, radiotherapy, chemotherapy, and smart-drug therapy that her doctors recommended. It is one of many recurring stories of cancer patients dying despite the best of what modern medicine can offer.

I am not saying that there have been no success stories, but the statistics (as published in the medical journals and reported regularly by the authorities) tell us that overall, cancer treatment has failed. For example, last year there were about 230,000 new cases of lung cancer in USA (arguably the most advanced in medical science) with about 160,000 deaths. For breast cancer, it was 230,000 new cases with 40,000 deaths.

UNDERSTANDING STATISTICS

Why is this so when we always read fantastic reports on new chemo or smart drugs that show improved survival rates?

To understand the whole picture, you need to understand simple statistics and how results can be presented to look good.

For example, a new drug is claimed to give 25% longer survival rate than the current best drug. That sounds impressive indeed - until you look into the details and discover that the survival rate using the previous drug was 4 months, and the new drug gives 5 months (1 month longer = 25% improvement). There are also the potentially dangerous side-effects that the new drug may cause which may further make it nonbeneficial. And the newer drugs are usually more expensive!

In fact this has been the typical snail-paced advancements in the development of new drugs for cancer therapy. Of course, many small steps would eventually equal a big step, but the progress has been painfully slow in spite of the trillions spent over many decades on research.

THE AVASTIN STORY

In 2008, the “smart” drug bevacizumab (Avastin) received “fast-track” approval as a treatment for metastatic breast cancer from US FDA because of reported improved survival rates. It became the “hot” drug for those who could afford (RM7000-15,000 per month depending on subsidy received), even though the side-effects can sometimes be severe (eg. hypertension, bleeding and perforations in the intestines).

In November 2011, the FDA revoked the approval for its use in breast cancer because follow-up studies showed women taking the drug did not live longer than those not taking it. Many oncologists refused to follow this, and continued prescribing to their breast cancer patients. Many patients also trusted their oncologists and willingly continued with the hope for better survival. In fact, because of this hope, there is a movement to demand that the FDA reverse its decision.

In July 2012, The Cochrane Database of Systemic Reviews (one of the most respected independent reviewer of research data) published results of their review of all the 7 randomized controlled studies on Avastin. It found that Avastin neither prolongs the lives of breast cancer patients nor improves their quality of life. Researchers found that patients who took Avastin along with their chemotherapy treatments survived about two to six weeks longer than those who took a placebo with their chemotherapy — but the difference between the groups could have been due to chance or factors other than the drug, according to the study.

The drug is still approved as a treatment for colon cancer and certain types of lung cancer and brain cancer in USA, and still approved for breast cancer in UK. It is still used for breast cancer by many oncologists.

I relate this story to illustrate that the trust put on evidence-based medicine is very high, but when the evidence prove contrary to their expectations, even the doctors ignore the evidence.

There have been other drugs that were withdrawn after more comprehensive studies negated the initial studies that led to their approval.

THE APIGENIN STORY

Apigenin is a bioflavonoid found in many fruits and veggies (eg. celery, parsley). Since 2005, studies (on cancer cells and cancers grown in live rats) have shown that apigenin induces cancer cell-death (apoptosis) and shrinks the tumours of several types of cancer, with minimal or no side-effects. Earlier this year (2012,) a University of Missouri study on rats showed apigenin to be effective in shrinking aggressive human breast cancer tumour stimulated by a progestin (MPA - medroxy progesterone acetate – is a progestin or synthetic progestagen hormone, a common component of female HRT drugs).

However, unlike Avastin, which was relentlessly researched and even received “fast-track” approval, the research on apigenin is likely to stop here despite the encouraging results. The reasons, as stated by researcher Salman Hyder, are as follows:

“Clinical trials of apigenin with humans could start tomorrow, but we have to wait for medical doctors to carry out that next step… but finding funding for clinical testing of apigenin in humans may be difficult…since apigenin is easily extracted from plants, pharmaceutical companies don’t stand to profit from the treatment; hence the industry won’t put money into studying something you can grow in your garden.”

THE NUTRITIONAL THERAPY STORY

Sadly, many potential nutritional therapies for cancer remain at the “unproven” stage because nobody is interested to proceed with the expensive human clinical trials, even though lab and animal studies have proven them to be effective. Until randomized controlled human trials are done, no valid claims/conclusions can be made, and the treatment method cannot be accepted widely. So many nutrients with good lab study results are abandoned without sufficient human clinical trials, eg. fucoidan (brown seaweed extract), ß-glucan, and many others.

CHEMO & SMART-DRUGS VS NUTRITIONAL THERAPY

The basic difference in the approach to fighting cancer between the two contrasting methods is this:

Chemotherapy (and the smart drugs) attempts to damage/kill cancer cells but also damage/kill normal cells – including the defence/immune cells that are required to fight the cancer and infections. The challenge is to reduce the “collateral damage” which is often severe and can even be fatal.

Nutritional therapy has three aims -

1) Provide general nutritional support in the situation of poor appetite and undernutrition/cachexia (especially if undergoing chemo/radiotherapy)

2) Empower the defence/immune cells to fight the cancer

3) Directly damage/kill cancer cells (eg. by causing apoptosis) just as the chemo drugs do, but without harming the normal cells.

My opinion is that the concept of fighting cancer the chemotherapy way is wrong. That is why finding the perfect chemo drug (kills cancer effectively, with no or minimal side-effects) will be a never-ending story. We have better hope if we spend the trillions researching the nutritional therapies that have shown promising results thus far. In other words, we have been betting on the wrong horse.

It is my fervent belief that the definitive answer to cancer is in nutritional therapy, and not chemotherapy, and not even the so-called “smart” drugs.

[addendum - read nutritional and herbal therapies instead of nutritional therapy]

                  

DR AMIR FARID ISAHAK