ACAM Educational Summit
I've been a longtime member of ACAM (American College for the Advancement in Medicine) and have attended many of its meetings over the past 30 years. In the old days the organization was known as AAMPS (the American Association of Medical Prevention Society). My first meeting was at the Fairmount Hotel in Dallas, Texas, in April 1977. I met Garry Gordon, MD, and Jim Frackleton, MD, at that convention – Drs. Gordon and Frackleton were also in attendance at the May 2012 San Diego meeting of ACAM. The 1977 Fairmount event actually was cosponsored by AAMPS as well as the American Homeopathic Association and another society that is now defunct. When I attended the AAMPS meeting, I was totally new to alternative medicine. I recall that Drs. Gordon and Frackleton were quite enthusiastic about a therapy that I knew little about – chelation therapy. Dr. Gordon, as some of you know, is nearly always bubbling over with the latest and greatest of medical research, especially as it relates to alternative therapies. At the recent spring meeting in San Diego, Dr. Gordon was still is a dynamo of energy. His current vision of reestablishing health focuses not on the use of chelation but PEMF (pulsed electromagnetic field therapy). I found that my own personal energy was reinvigorated at the spring ACAM meeting, not only by the workshop lectures but also by sharing stories with Gordon and Frackleton, who have certainly led the charge for establishing legitimacy to the alternative medicine arena.
Typically ACAM offers a four- to five-day medical meeting composed of workshops and general lectures. At the iMOSAIC meeting in April 2010 in Minneapolis, ACAM joined ICIM (International College of Integrative Medicine), AAEM (American Academy of Environmental Medicine), and AHMA (American Holistic Medical Association) for a multigroup conference. It was an interesting experiment. almost like the first meeting I attended in 1977. The iMOSAIC meeting did bring together a lot of folks who generally don't see each other, being members of independent organizations. That was a good thing. The downside was that the iMOSAIC meeting probably wasn't long enough; perhaps it should have been a week long with required participation in workshops. Perhaps a joint meeting needs to be limited to two groups. At the May 2012 ACAM meeting in San Diego, an "educational summit," the focus was on having attendees participate in intensive workshops rather than attend lectures. I think that ACAM may have hit on a good formula. Attending two intensive workshops offers a lot of educational value to the practitioner.
One of the pioneers in AAMPS and ACAM was a physician practicing in Oklahoma City: Charlie Farr, MD. Dr. Farr attended the first AAMPS meeting in 1977, but he did not attend the recent ACAM meeting, as he is deceased. Probably more than any other ACAM member, Dr. Farr researched and taught principles of oxidative medicine. He established a separate society to teach biooxidative medicine, called IOMA (the International Oxidative Medical Association). Oxidative medicine offers a wide range of therapies that support treatment of chronic fatigue, infection, inflammation, arthritis, neurologic disorder, and cancer. Most of the treatment modalities are considered controversial despite their efficacy. Intravenous administration of ascorbic acid probably represents the least contentious treatment; it still is not considered a treatment satisfying Medicare requirements for "standard of care." Less-acceptable therapies include the use of intravenous hydrogen peroxide and ozone. In fact, most methods for administering ozone are proscribed by medicine. Hydrogen peroxide is not recognized as a drug agent and would not be accepted as a medicine for intravenous administration.
Photoluminescence of blood by ultraviolet irradiation is a major treatment modality in oxidative medicine. Again this method is not recognized as an acceptable treatment regimen. Other agents that can be employed as an oxidative therapy include nanoparticle silver and DMSO. Once again, silver and DMSO have not been considered as accepted medical therapies. In other words, oxidative medicine offers a variety of treatment regimens, not considered within the purview of "standard of care," offering major therapeutic import, but also considered a red flag by many medical boards.
At the May meeting in San Diego, ACAM offered a workshop in oxidative medicine coordinated by Robert Rowen, MD. Dr. Rowen has been practicing oxidative medicine since 1986 and has been the president of IOMA since 2003 and is a longtime member of ACAM. Dr. Rowen is also the editor of the prestigious newletter Second Opinion. Rowen is not new to Townsend Letter readers. In our June 2011 issue #335, Rowen writes about prolozone ("Prolozone Arrives in India.") Prolozone is the administration of ozone into a joint area using the technique of prolotherapy. Medical ozone is administered into the joint area after the area is anesthesized locally with procaine. One of the cases reported in the article was a young man with severe lower back syndrome including herniated disc. He presented to the exam in a wheelchair and was unable to arise without assistance. The patient was scheduled to have disc surgery. Instead, medical ozone was administered to the L4-5 and S-1 facet joints. Within 3 hours of treatment, the patient was able to get out of bed without assistance; by the end of the day he was able to stand and touch his toes. Rowen presents a large number of patients who are treated for joint disease with prolozone. At his website, doctorrowen.com, Dr. Rowen offers video case presentations of patients who have undergone prolozone therapy.
Oxidative Medicine for Cancer
Jeanne Drisko, MD, would like to "drill" into everyone's consciousness that intravenous vitamin C is not an antioxidant therapy. Dr. Drisko is also a long-term member of ACAM and was president of the society two years ago. She is the Riordan Professor of Orthomolecular Medicine and director of the Program in Integrative Medicine at the University of Kansas Medical Center. Dr. Drisko conducts integrative medicine research at the university. She teaches fourth-year medical students integrative medicine as an elective and has initiated a fellowship program in integrative medicine for primary care physicians.
How can a doctor thoroughly ensconced in academic medicine be infusing cancer patients with intravenous vitamin C? Unlike other oxidative therapies, ascorbic acid is an acceptable medical agent. It is recognized as a drug used for medical treatment of scurvy. Hence, it does not have the negative imprimatur associated with hydrogen peroxide, ozone, or photoluminescence.
That is not to say that vitamin C does not have its controversy. The late Linus Pauling, PhD (not a member of ACAM, but a lecturer at ACAM for many years), championed intravenous vitamin C for cancer patients. In 1979 Creagan and Moertel at the Mayo Clinic administered oral vitamin C to patients with metastatic cancer for a short time period and reported negative outcomes. They repeated the study with intravenous vitamin C and reported again reported negative results. However, critics of the two studies state that there were positive results and that patients receiving vitamin C were prematurely taken off treatment after only several months.
Drisko administers intravenous vitamin C to cancer patients. Most of these patients undergo "standard of care" treatment, including chemotherapy and radiation. However, the intravenous vitamin C is being administered during the time period when chemotherapy is administered. This goes against the grain of what oncologists claim – that vitamin therapy (including vitamin C) will negate the effect of chemotherapy. Drisko has seen that chemotherapy outcomes are enhanced with administration of intravenous vitamin C. She reminds us that IV ascorbic acid is a targeted pro-oxidative therapy. It achieves this role by producing hydrogen peroxide in the extracellular space. Drisko reviewed research demonstrating that in animal tumor trials, the administration of ascorbic acid shrank tumor masses. The animal tumors included glioblastoma and ovarian cancer).1 Chen and Drisko also report that glutathione might reduce the benefit of intravenous ascorbate if both agents are administered concurrently).2
We should not leave the discussion of oxidative medicine without mentioning a few points about hydrogen peroxide. At the ACAM meeting Robert White, ND, PhD, discussed the uses of intravenous hydrogen peroxide therapy. Dr. Charlie Farr was a fan of H2O2 treatment; in 1987 he published a report on "The Physiological and Biochemical Effects of Intravenous Hydrogen Peroxide in Man" in a supplement publication of the Arthritis Trust of America (ATA).3 Farr recognized that hydrogen peroxide offered tremendous support in the treatment of infection and cited medical literature from the 1930s. However, he was also concerned that intravenous hydrogen peroxide might cause adverse effects – primarily thrombophlebitis. Hydrogen peroxide does have a demonstrated effect on enhancing metabolic functioning. Improvement in insulin utilization suggested that hydrogen peroxide is supportive in diabetes. Hydrogen peroxide has also been shown to have important cardiovascular effects supportive in CHF and ischemia and improvement in pulmonary functioning in the treatment of COPD. Nevertheless, it has been difficult to study hydrogen peroxide clinically as it does not have a recognized drug status for IV use. In 1991 J. Verani et al. published a paper in the journal Inflammation that manganese (Mn+2) is capable of mitigating against the endothelial damage induced by hydrogen peroxide.4 Based on Varani's research, it is advised that intravenous hydrogen peroxide solutions should be administered with manganese and magnesium.
Intravenous hydrogen peroxide is very well tolerated and most patients experience improvement in their febrile state and fatigued condition. This contrasts with intravenous vitamin C, which frequently leads to post-IV fatigue.
Treating Metastatic Cancer with Integrative Medicine
Part of the allure of alternative medicine has been its long history of offering alternative approaches to cancer. On the one hand, it has been a ray of hope for many patients who wish to try something besides the failed approaches offered by conventional medicine. On the other hand, it has been labeled quackery and viewed as a bane to society with "quacks" making unconscionable profits swindling patients with "snake oil" treatment and depriving patients of "standard of care," "proven" therapies! One can easily talk about both camps treating cancer in the same light – both offer a ray of hope and both are quacks making huge profits, albeit the conventional camp is treated as legitimate by society and the medical boards. We have all witnessed family members, friends, and acquaintances, as well as patients who have been treated in the conventional medical setting, who have had miserable and painful medical treatments ultimately leading to death. Medicine considers this the "typical" long-term outcome for cancer. Metastatic cancer is looked upon as a losing game and the medical approach offers a few years or months for survival. No one is expecting long-term success. However, the marketing of cancer treatment presents a rosy picture with a depiction of a team of cancer specialists offering state-of-the-art treatment providing excellent care. I shudder when I read about new therapies for advanced cancer offering additional months of survival. Alternative cancer clinics claim to have unique treatment approaches not only providing a holistic approach that is more comfortable to undertake but also yielding major responses with frequent long-term survival. Unfortunately we all know too many patients who have followed the protocol of such clinics and their outcome was equally dismal.
Metastatic cancer remains a very dicey endgame, with the odds deeply stacked against the patient. Over the past few decades, especially in the last 10 years, we have seen a growing "integration" of conventional and alternative approaches. Many oncologists freely allow their cancer patients to engage in alternative therapies concurrently or following conventional care. Numerous oncology clinics have begun working with integrative oncology naturopathic doctors who offer a naturopathic protocol to be employed with the conventional program. Insulin potentiated therapy (IPT) is considered an alternative medicine approach, but it uses conventional drug therapies rather than herbs and nutrients. Chemotherapy is infused in low doses after insulin is administered; tumor cells preferentially absorb the chemotherapy when blood glucose is lowered. It is an alternative use of a conventional therapy. Of course, IPT physicians employ other alternative modalities. It is not clear yet whether the coordination of conventional and alternative medicine is working better than either one alone. I had the recent experience of a very committed man who engaged in both camps and sought numerous interventions, conventional and alternative, and worked with them prodigiously. However, his head and neck tumor metastasized aggressively and was never satisfactorily controlled despite nearly heroic interventions. As Dr. Apostolides wrote in the August/September, October, and November 2011 issues of the Townsend Letter, we are clearly losing the war on cancer.5 We are not nearly at a point with any therapy of offering the patient with advanced disease decent odds. In this issue, Leigh Errin Connealy, MD, and Francisco Contreras, MD, report on an integrative approach that appears to be successful in managing patients with metastatic disease.
Drs. Connealy and Contreras employ an integration of conventional and alternative therapies for their patients at the Oasis of Hope Clinic in Irvine, California. However, patients are tracked into two groups: one group receives the integrative approaches with chemotherapy; the second group receives intravenous vitamin C instead of chemotherapy. Patients with cancers that have shown particular promise with chemotherapy are put in the chemotherapy group; otherwise the patients receive intensive vitamin C. A major part of the treatment protocol focuses on sensitizing the tumor cells to the chemotherapy. Drs. Connealy and Contreras employ a number of modalities to increase oxygenation to the tumor cell. One particular modality employed with both groups of patients is the administration of ozone autohemotherapy. This method of ozone administration mixes a small volume of the patient's blood with ozone and then the ozonated blood is reinfused in the patient. The doctors have established that selenium, salicylate, and silibinin are critical in sensitizing the tumor cells for chemotherapy administration. Connealy and Contreras argue that the evidence is clear that intravenous vitamin C produces intracellular hydrogen peroxide essential for the tumor cell killing process. IV vitamin C is administered to all patients, those receiving chemotherapy and those who do not. However, this work has shown that intravenous vitamin C is potentiated greatly by co-administration of vitamin K3 (menadione). Conneally and Contreras present patient statistics demonstrating improved long-term outcomes in patients with metastatic disease compared with conventional approaches. Their work appears to be more effective in treating metastatic disease then conventional approaches. Additionally, unlike many alternative cancer clinics, Conneally and Contreras work with supplementation of nutrients – something that many alternative cancer clinics denigrate, claiming that nutrients interfere with their proprietary treatments. I think that the approach at Oasis of Hope deserves careful attention.
Jonathan Collin, MD
1. Chen Q, Espey MG, Sun AY, et al. Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. PNAS. August 12, 2008;105(32):11105–11109. Available at http://www.pnas.org/content/105/32/11105.full.
2. Chen P, Stone J, Sullivan G, Drisko JA, Chen Q. Anti-cancer effect of pharmacologic ascorbate and its interaction with supplementary parenteral glutathione in preclinical cancer models. Free Radic Biol Med. 2011 Aug 1;51(3):681–687. Epub 2011 May 30.
3. Farr CH. The Therapeutic Use of Intravenous Hydrogen Peroxide [monograph]. Oklahoma City: Genesis Medical Center; 1987.
4. Varani J, Ginsburg I, Gibbs DF, et al. Hydrogen peroxide-induced cell and tissue injury: protective effects of Mn2. Inflammation. 1991 Aug;15(4):291-301.
5. Apostolides A, Apostolides I. The US Cancer Program and Specific Types of Cancer, 1975–2007. Townsend Lett. Aug–Nov. 2011;337–340. Available at townsendletter.com.