Online
publication only
The Society of Integrative Oncology
recently published an article titled "Integrative
Oncology Practices Guidelines," (263KB .pdf) written by
a team of doctors from the Memorial Sloan-Kettering Cancer Center
(New York), the MD Anderson Cancer Center (Houston, Texas), and
the Society of Integrative Oncology Executive Committee (New Jersey)
and others (2007; 5[2]: 65-68). As a private researcher and innovative
doctor known throughout the world, I have been involved with cancer
research for more than 35 years, and I am simply mad about this
article and feel that it requires some appropriate correction, which
will probably speak on behalf of hundreds of Complementary and Alternative
Medicine (CAM) doctors, naturopaths, and many others.
The article in question is divided into sections and begins with
the authors' definition of what they call the uses of "complementary"
and "alternative" therapies. According to them, Integrative
Oncology is limited to "safe methods," such as massage,
acupuncture, exercise, yoga, and other mind-body techniques. These
safe methods are presented as complementary therapies that have
been integrated into mainstream care and are considered helpful
in symptom control.
The authors of the article claim that there has been little evidence
to date to show that any CAM therapies can suppress or cure diseases
in a clinical setting. We may call this "scientific myopia,"
which is probably a deep-seated paradigm based on the conception
that natural molecules are ineffective compared to toxic drugs.
Toxic therapy has become a dogma of medical science (Der
Siegel, October 2004), and any significant results obtained
with or without surgery and/or chemotherapy including eliminating
the tumor and bone metastasis or decreasing tumor markers (or survival
expansion) is absolutely denied and considered either a result of
the mainstream therapy or a "spontaneous cure."
The Failure of
Oncology
According to a statement made in 2005 by Dr. Pierquin, a French
authority in cancerology at the Hospital Henri Mondor, Creteil,
France, "chemotherapy [needs] to be far more effective in all
cancer diseases." Chemotherapy is recommended in five percent
of cancer cases. In ten percent of cancer cases, it may give results,
and in 85% of cancer cases, its use is questionable.
Prof. Ben L. Pfeifer, MD, PhD is a professor of cancerology (Switzerland)
who has been working and teaching cancerology in the United States
for 20 years, as well as serving as an advisor at the Office of
Technology Assessment (OTA) on CAM therapies. He stressed that oncology
has failed to meet the expectations of curing cancer. In Europe,
there are now many voices coming from state researchers and universities
doubting the value of chemotherapy concerning life survival and
quality of life.1 Chemotherapy for patients in an advanced stage
has no effect on the survival rate, and palliative therapy is effective
in two to six percent of all cases. Relapses are still too high,
and complete remission or cures remain a rare event.
Basically, an anticancer drug is found to cause a definitive response
if it creates 50% (or more) shrinkage of measurable tumors for one
or two months or even extends lives. Clinical trials usually measure
the percentage of the response rate together with the median survival,
depending on the different anticancer drugs used alone or in combination
with others. Chemotherapy may reduce the tumor size, but we cannot
expect cures. Even so, many patients are considered in "complete
remission" (CR), which, in fact, does not always reflect the
real condition of the patient. Oncologists make the mistake of concentrating
only on some parameters, not on the patient's general status. As
we have observed from hospital records, a relapse may occur in a
period as short as three months.
Other examples demonstrate the total helplessness and incapacity
of oncology to help patients who are absolutely refractory to chemotherapy
after a so-called "complete remission." A report from
a British hospital about a cancer patient (who eventually came to
me) says that "there are no current open trials in the UK for
which he is suitable at present, and we do not feel there is any
further conventional therapy he (the patient) could tolerate or
which is likely to achieve another remission, etc…" Who
is responsible for this situation? And what about suggesting some
alternative therapies? This doesn't make sense when apparently experienced
academic doctors should do everything in their power for patients
and at least attempt some other therapies. But it makes sense when
it comes from oncologists with financial interest from pharmaceutical
industries paying to prescribe dubious drugs, no matter the consequence
(Ralph Moss, Townsend Letter. August/Sept
2007).
Today, because of demand, pharmaceutical labs frantically put new
anticancer drugs on the market,2 and therefore, the Food and Drug
Administration (FDA) is usually very fast to license new drugs without
full clinical trials on their efficiency and safety. Often, tests
are still inconclusive, according to Steven Hirsdifield MD, an FDA
cancer expert who mentioned that many studies done in oncology are
incomplete (Oncology Times. Sept.
2007). No wonder many approved drugs are far from safe and may even
be carcinogenic or mutagenic. Toxic drug effects – including
serious damage to the liver, heart, kidney –affect 80% of
patients and are sometimes deadly to patients.
Nevertheless, cancer drugs can be largely promoted as any regular
pharmaceutical medication – without medical ethics. This has
been the case with Herceptin, which was presented years ago as a
"significant medical breakthrough," as if it were something
never seen before in cancer therapy and with virtually no side effects.
The bad news is that, on the contrary, Herceptin can cause a truckload
of toxic adverse and dangerous effects, including coma, anaphylactic
shock, edema, acute pulmonary, peripheral angioedema, cardiomiopathy,
pancreatitis, hepatic failure, leukemia, neuropathy, pulmonary fibrosis,
anorexia, and progression of neoplasia.
Herceptin has been associated with disabling cardiac failure, death,
and mural thrombosis leading to stroke (FDA 2003). The risk of cardiac
failure is augmented with Adriamycin as chemotherapy and, especially,
with radiotherapy. Herceptin's dangers are unbelievable, particularly
when compared to dietary supplementation or even herbal medicine.
Almost a bad joke, Herceptin is promoted as "rebuilding hope"
and "prolong[ing] life."3 Why aren't the interactions
of cancer drugs themselves4 discussed as well as the consequences
of chemotherapy? Cancer patients rarely die from the disease itself,
but rather from the treatment.
Am I dreaming! The reason that massage has been examined as an integrative–safe-method,
as Frank Wiewel mentioned recently in Townsend
Letter, "is to see if dying cancer patients feel better."
Frankly speaking, cancer patients expect more from medicine than
to feel better while dying. For many cancer patients, this politic
of conventional treatment too often leads patients to a dead-end-street.
However, we can show that cancer patients who don't respond to chemotherapy
and experience chemotherapy's additional toxic side effects may
improve under our therapy from significant regression of bone metastasis
and decreasing antigen tumor markers.5
According to the article's authors,
the goals of diet, dietary supplements, and herbal products, and/or
alternative therapies, including high doses of vitamin C, shark
cartilage, hydrazine sulphate, antineoplastons, mistheloe, Pau d'Arco,
laetrile, Bi Bella therapy, etc. are often unrealistic and unmet.
Apparently, alternative therapies have shown no evidence for safety
and efficacy, and some may even shorten survival rate. For over
three decades, we have suffered attacks over the insufficiency of
alternative therapies, not to say "quackery," but now
these therapies supposedly shorten survival? This is new to me.
In Europe, we use some very efficient alternative treatments available
in several reputable clinics and private oncology centers. Take
Ukrain, for instance, a natural chemotherapeutic agent6-8 that has
even been investigated by the National Cancer Institute (USA) for
its antineoplastic effects on 60 different human cancer cell lines
that demonstrate a growth inhibition between 50 to 100% and reduction
of cell mass.9 Ukrain is backed with impressive scientific reports
that are far from unrealistic.
While each of these therapies (or others) is not 100% efficient,
and some like Pau d'Arco are probably ineffective in therapeutic
applications, they have been useful and more efficient in a combination
therapy, and they have increased patients' rate of survival, even
in advanced cases. This is particularly true for Ukrain8,9 and liquid
cartilage extract (LCE), which has strong antiangiogenic properties
and which we have now used for over 14 years.10,11
In my experience, LCE does not shorten survival rate; on the contrary,
many of our cancer patients benefited from survival extension, including,
as I mentioned, in advanced cases. Many of our cancer patients now
enjoy ten- to 14-year remissions with good healthy conditions. LCE
(Neovastat) has been proven to be safe, even over long-term, with
signs of efficacy.12 And several tests demonstrated increased survival
in NSLCC patients refractory to standard therapy (stage II-III).13
These are the kinds of results obtained in our clinic.
A Caucasian woman with a large infiltrated neoplasic tumor of 6
x 5 cm at the uterus and extensive infiltration to iliac-pelvic
ganglions, peritoneum, and rectum wall has been followed during
four months on treatment of LCE, Ukrain, and MGn3 (functional food)
simultaneously with chemotherapy. The result is impressive, and
new scans show total regression of the tumor, including infiltrative
lesions in such ways that the patient does not need radiation as
was first expected. One can imagine the astonishment of the team
of doctors at the hospital. We simply demonstrated the strong effectiveness
of a combination therapy in synergy with chemotherapy.
Chemotherapy and
Antioxidants
In our clinical practice, we have used antioxidant compounds for
many years to work in a synergistic way with chemotherapy, obtaining
excellent results, including a decrease in resistant tumors. Many
doctors, on the contrary, object to people taking antioxidants simultaneously
with chemotherapy or radiation. They have been wrongly informed
or base their judgment on some hypothesis (Labriola 1998) and ignore
the scientific evidence that antioxidants protect the cancer cells
from the damaging effects of free radicals generated by toxic drugs,
or they believe that it may interact with drugs to decrease the
effectiveness of the treatment. Indeed, the Society of Integrative
Oncology article categorically maintains that antioxidants and high
doses of antioxidants during cytotoxic treatment can be problematic
since it may decrease the potential of the treatment.
It is strange that the article's authors follow only one hypothesis
to condemn the use of antioxidants and miss hundreds of references
that, contrary to their statements, show that antioxidants protect
from the damaging effects of chemotherapy14 without interfering
in the efficacy.15 This is simply illogical and irrational.
We help chemotherapy/radiation to be more efficient, and, quite
often, cancer patients improve more quickly from blood and chemical
parameters and experience a decrease and/or elimination of secondary
tumors with a better quality of life. (For more information, visit
www.sergejurasunas.com.)
These results should not be surprising since growing evidence demonstrates
that antioxidants are beneficial in improving the effectiveness
of chemotherapy. Many tests in vitro (animal studies) show the positive
effects of antioxidants such as vitamins C and E, beta-carotene,
and melatonin. These antioxidants actually enhance the effects of
chemotherapeutic agents compared to doxorubicin, cisplatine, 5 fluorouracil,
and bleomycin.16 Dr. Prasad, a radiation researcher,
showed that vitamin C added to X-rays increases the building of
cancer cells, and similar results were seen in Belgium without additional
harm to the patients.
Four studies of patients with advanced ovarian cancer have revealed
positive interactions with glutathione and chemotherapy regimens,17
resulting in overall better patient outcomes and an improved quality
of life. Other studies showed that high, but not toxic, levels of
vitamin C may enhance the effects of chemotherapeutic agents such
as doxorubicin and cisplatin, as well as paclitaxel, 5 fluorouracil,
and bleomycin.18,19 In addition, antioxidants provide
protection to healthy tissues from chemotherapeutic agents such
as cisplatin or doxorubicin, which lead to toxic side effects of
chemotherapy. Those toxic side effects can be reduced in 57-70%
of patients. Antioxidants improve patients' quality of life,20
which is most significant, since 80% of cancer patients suffer from
toxic adverse effects. One patient with ovarian cancer doing five
hours of chemotherapy at each session was protected with high-dose
antioxidants and did not suffer from adverse toxic effects. After
three months, the tumor marker CA15.3 decreased from 103 U/ml to
8.94 U/ml, illustrating that antioxidants do protect and increase
the effectiveness of chemotherapy.
Antioxidants are our antidote against excessive oxidation in the
body, but they also serve a dual role, since, at the same time,
they act as prooxidants that affect the tumor cell growth.21
Antioxidants may also balance free radical activity to control cell
behavior, cell signaling pathways,22 and tumor growth.
It occurred to me that most doctors have poor knowledge about oxidative
stress and cancer and know little too about how oxidative stress
can clinically influence tumor growth.23,24 As a result,
these doctors have a poor idea of the wide field of therapeutic
applications concerning antioxidants, including within pathologies
of cancer. Normally healthy cells absorb only a minute's worth of
the antioxidants they need, and healthy ones have an intact antioxidant
enzyme defense against an excess of free radicals. Cancer cells
poor in SOD and catalase may absorb higher doses of antioxidants,
which causes them to become toxic, increasing the synergistic effects
of radiation and chemotherapy.25
Thus, the Society of Integrative Oncology article supports the idea
that high doses of antioxidants can be problematic during chemotherapy,
a conclusion in total contradiction with many new lines of research.
Growing evidence demonstrates that high doses of multiple antioxidants
are essential ingredients in improving the efficacy of standard
cancer therapy.26 Radiation treatment27 and
anticancer drugs reduces inherent antioxidants, inducing oxidative
stress and thus increasing the disease progression. New research
supports the fact that antioxidants, vitamins, and some phytochemicals
selectively induce apoptosis in cancer cells, but not in normal
cells, and they prevent angiogenesis and metastasic spread, therefore
increasing the effectiveness of chemotherapy.
There are several other reasons to use antioxidants during chemotherapy.
For instance, chemotherapy is an immunosuppressive, which increases
susceptibility to cancer metastasis and infection. Healthy immune
cells may be restored by antioxidants28 including immunostimulants
extracted from modified arabinoxylan rice bran as MGn-3,29
which, over the long term, has demonstrated no signs of toxicity
and an increased survival rate.30
There is, of course, the question of which antioxidant supplementation
to use – the quality and the dosage. Synthetic antioxidants
are to be banished from clinical practices or clinical trials, and
single antioxidants may not be effective. In fact, single antioxidants
can be harmful among high-risk populations in which some people
may already have precancerous or cancerous lesions not clinically
detected (Prasad 2001), while antioxidants in combination are more
effective in limiting tumor cell growth. In our clinical work, we
use our own developed formula, which is a low-molecular antioxidant
compound made from modified vegetables and seed and has great efficiency
in therapeutic applications31-32 and anticancer therapy.
We always need to use high doses of multiple antioxidants, as low
doses of individual antioxidants can stimulate the growth of cancer
cells in culture, which is true for both vitamin C and beta-carotene.
This is likely one of the reasons why clinical trials developed
to observe some possible benefits of beta-carotene in preventing
lung cancer in current smokers apparently failed.33 An
interesting fact to remember is that beta-carotene is efficient
only in a rich oxygen ground, which is not the case for smokers.
A clinical trial with SOD enzymes would have been more appropriate,
since SOD is the main antioxidant defense in lungs and links with
lung cancer. The authors of the article mentioned this particular
test and took advantage to explain that some supplements may do
more harm than good, but no reference was made about the quality
and dosage used in this clinical trial. First, synthetic beta-carotene
has no efficiency over natural beta-carotene.34 As explained
before, low doses may be harmful among the high-risk population,
although that conclusion requires more proof.
The French government study (SUVIMAX), which was conducted from
1944 to 2004, involved 13,017 volunteers and demonstrated that cocktails
of antioxidants have real beneficial effects in reducing the risk
of cancer (31%), and decreasing mortality from all diseases by 37%.
The result is in clear contradiction with speculations declaring
antioxidants useless in benefiting our health. (For more information,
visit www.mag.Pluspharmacie.com/pagelibre001047F.html.) (Aug.
2008: Bad link: Visit http://www.mag-pluspharmacie.com
)
Conclusion
The conclusions reached in the Society of Integrative Oncology article
are not really based on scientific evidence or on studies of various
clinical trials or experimentations; instead the article's authors
use hypotheses to support and/or condemn the practice of alternative
therapies. The article is based on negative opinions and ignores
many positive references that demonstrate the benefits of high doses
of vitamin C and especially high doses of antioxidants during chemotherapy.
The authors display a total lack of knowledge concerning the implications
of oxidative stress that may influence the effectiveness of chemotherapy,
since persistent oxidative stress in cancer may be considered as
a bad prognostic. It is difficult to believe the article of Labriola,
D. and Livingston, R. is included in a scientific journal (Oncology)
and referred in this article as a reference to deny the use of antioxidants.
The Oncology article makes no mention
of nutrition as support to chemotherapy, necessary since laboratory
tests may monitor decreasing vitamins, minerals, and antioxidant
levels in blood plasma after chemotherapy.
What about mentioning immune defense and immune cell activity? Does
Integrative Oncology fail to admit the importance of the immune
system and the fact that strengthened immune cells decrease with
chemotherapy? Where are examples of clinical cases supported by
hospital check-ups, scans, or blood parameters that show chemotherapy-alone
is better than chemotherapy combined with nutrition, antioxidants,
functional foods, and/or some anticancer non-toxic molecules? To
show that, in some cases, mainstream treatments combined with nutrition,
antioxidants, and/or anticancer non-toxic molecules increase the
effectiveness of chemotherapy with quicker results and remission,
a positive step would be to visit a reputable European clinic of
CAM therapy, study medical records, study cancer cases treated for
one to four years, speak to patients, and at least admit that alternative
therapies may be useful and, in some cases, offer extraordinary
results.
We understand that oncologists do not like to hear about the effectiveness
of other treatments because it may raise questions about their own
deeply rooted theory and paradigm of toxic drugs, but obviously
there is a failure in the perspective to cure cancer. Cancer patients
cannot wait another 15 or 20 years for a possible cure. When President
Nixon declared the war on cancer, a cure for cancer was projected
by 1976. That timeline was extended to 2000, and now, apparently,
the cure will arrive by 2015. I hardly believe people today will
buy these types of stories. It is time to demonstrate a more open
mind and a more open view on cancer and not to spend time on arguments,
criticism, denial, or even the ridiculing of alternative therapies
as I see done in Lancet. It does
not show professional ethics or even respect for other systems that
are not well understood, but are likely to be efficient.
Serge Jurasunas
Holiterapias Institute
Rua da Misericórdia, 137 – 1º
1200-272 Lisbon – Portugal
Phone: +351 21 3471117
Fax: +351 21 3471119
E-mail: info@sergejurasunas.com
For the complete article and more details,
you may consult our Internet page: www.sergejurasunas.com.
Notes
1.Useless poisonous cure. Der Siegel.
41/2004 – 4 Oct 2004. Available at:
www.pilliar.com/news/press/2004/004 (Aug
2008: Bad link.)
2. Paris Match. Economy section.
2007:108.
3. Lancet Oncology. May 2007;7 (5).
4. McLeod HL. Clinically relevant drug – drug interactions
in oncology. Br. J. Clin Pharmacol.
1998: 45-539-44.
5. Serge Jurasunas. A case where combination of natural compound
was effective in a metastatic breast cancer.
6.Nowicky JW. Cancer treatment using anticancer preparation; Alkaloid
derivate Ukraine IV. Mediterranean Congress of Chemotherapy. 19-25
Oct 1984, Rhodes, Greece. Chemotherapia.
1985; 4 ( suppl):2, 1169 AP.
7. Retrospective study of Ukraine treatment in 203 patients with
advanced stage tumors. Drugs Exp.Clin.Res.
2000: 26(5-6): 249-52.
8. Uglyanotsa KN, Nefyodov LI, Doroshenko YM, Nowicky JW, et al.
Ukraine: a novel antitumor drug. Drugs
Exp. Clin.Res. 2000: 26 (5-6) 341-58 Review.
9.Efficassy of Ukrain in the treatment of pancreatic cancer. Lagenbecks
Arch Surg. 2002, Jun: 387 (2), 84-89.
10. Lee A. and Langer R. Shark Cartilage contains inhibitors of
angiogenesis. Science. 1983; 221:
1185-1187.
11. Bilodeau D. A liquid extract with angiogenic and blood modulating
activities, for the support of first line cancer treatment. 1st
International Conference of the Society of Integrative Oncology.
Poster nº 36 NY. 2004 Nov. 17-19.
12. Lactile J, Batist G, et al. Phase I-II trial of the safety and
efficassy of AW941. (Neovastat) in the treatment of NSCLC. Chin
Lung Cancer. 2003; Jan:4(4) 231-6.
13. . Combination chemotherapy plus radiation therapy with or without
AE 941 in treating patients with stage III NSCLC that cannot be
removed by surgery. Clinical Trials Gov.
1-09-2006.
14. Conkin KA. Dietary antioxidants during cancer chemotherapy:
Impact on chemotherapy effectiveness and development of side effects.
Nut. Cancer. 2000;37-1-18.
15. Chinery R, et al. Antioxidants enhance the cytotoxicity of chemotherapeutic
agents in colorectal cancer a P53 independent induction of P21 WAF1/C1P1
.- via C/EBP Beta. Nat Med. 1997
Nov; 3 (11): 1233-41.
16. Cole WC, Rasad JE. Multiple antioxidant vitamins as an Adjunct
to standard and experimental cancer therapies. Journal
of Oncology. 1999; 31: 101-108.
17. Bohur S, et al. Dose intensification of platinum compounds with
glutathione protection as induction chemotherapy for advanced ovarian
carcinoma. Oncology. 1999;57 (2):
115.20.
18. Kurbacher CM, et al. Ascorbic acid (vitamin C) improves the
antineoplastic activity of doxorubicin, cisplatin and paclitaxel
in human breast carcinoma in vitro. Cancer.
1996;103-183-9.
19. Prasad KN, et al. Sodium ascorbate potentiates the growth inhibitory
effects of certain agents on neuroblastoma cells in culture. Proc.
Natl Acad. Sc. USA. 1979;76 (2): 829-32.
20. Pathology Oncology Research.
2005; 11(3):139-144.
21. Schawartz JL. The clinical roles of nutrients as antioxidants
and prooxidants: their effects on tumor cell growth. J.
Nutr. 1996 Ap; 126 (4) suppl: 1221-575.
22. Irani K. Oxidant signalling in vascular cell growth, death and
survival: A review of the role of reactive oxygen species in smooth
muscle and endothelial cell mitogenic and apoptotic signalling.
Circ. Res. 2000; 87:179-183.
23. Brown, Bickwell R. Hypoxia and oxidative stress in breast cancer:
oxidative stress its effects on the growth, metastasic potential
and response to therapy of breast cancer. Breast
Cancer Res. 2001; 3: 323-327.
24. Shacter E, Williams JA, Hunson RM, et al. Oxidative stress interfere
with cancer chemotherapy-inhibition of lymphoma cell apoptosis.
Blood. July 1, 2000; 96 (1): 307-313.
25. Nicco C, et al. Superoxide dismutase (SOD) Mimics control tumor
growth Modulating endogenous production of Reactive Oxygen Species
(ROS). Lab. Immunology. Dept. Oncology Hospital Cochin – Paris
V.
SOD 2004 – Conference – June 19:11 2004. Institute Pasteur-Paris-France.
26. Prasad KN, et al. High doses of multiples antioxidant, vitamins:
essential ingredients in improving the efficacy of standard cancer
therapy. J. Am. Col.- Nutr. 1999;18:13-25.
27. Clemens MR, et al. Plasma vitamin E and betacarotene concentrations
during radiochamotherapy preceding bone marrow transplant. Am
J. Clin. Nat. 1990 Feb; 51 (2): 216-9.
28. Nakama K, Matsunga K. Susceptibility of natural killer (NK)
cells, to reactive oxygen species (ROS) and their restoration by
the mimics of superoxidedismutase (SOD). Cancer
Biother Radiopharm. August 1998; 13 (4):275-90.
29. Ghoneum M. Immunomodulatory and anticancer function in 27 cancer
patients by MGn3 a modified arabinoxylane from rice bran. Abstract.
87th Annual Meeting,
American Association of Cancer Research. Washington DC. April 20-24,
1996.
30. Kazutoshi K. A case where an immunomodulatory food was effective
in conservative therapy for progressive terminal pancreatic cancer.
Clin. Pharm and Therapy. 2004;14:273-279.
31. Serge Jurasunas. Therapeutic application of a new molecular
antioxidant compound (Anoxe) in ROS activity. International Symposium
on Reactive Oxygen and Nitrogen Species – Diagnostic, preventive
and therapeutic values. July 8-12, 2002 – Russia.
32. Anti-inflammatory and COX 2 inhibitory property of Anoxe. Bioactive
Natural Products Lab.
33. Omenn GS. Chemoprevention of lung cancer: the rise and demise
of betacarotene. Annu Rev. Public Heath.
1998: 19:73-99.
34. Xue KX, et al. Comparative studies on genotoxicity of antigenotoxicity
of natural and synthetic betacarotene stereoisonners. Mutat.
Res. 1998.
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