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Excerpted from
ImmunoPower
Harnessing the incredible healing power of Nature & Science!
by Patrick Quillin, PhD, RD, CNS
CHAPTER 9
NUTRITION CAN IMPROVE
OUTCOME
IN CANCER TREATMENT
*
"A well-nourished cancer patient can
better manage and beat the disease."
*
Nutrition is a low cost, non-toxic, and scientifically-proven helpful component in the comprehensive treatment of cancer. Adjuvant (helpful) nutrition and traditional oncology are synergistic, not antagonistic. The advantages in using an aggressive nutrition program in comprehensive cancer treatment are, in this critical order of importance:
THE NEED TO EXPLORE OPTIONS
President Richard Nixon declared "war on cancer" on December 23, 1971. Nixon confidently proclaimed that we would have a cure for cancer within 5 years, by the 1976 Bicentennial. However, by 1991 a group of 60 noted physicians and scientists gathered a press conference to tell the public "The cancer establishment confuses the public with repeated claims that we are winning the war on cancer... Our ability to treat and cure most cancers has not materially improved." The unsettling bad news is irrefutable:
-newly diagnosed cancer incidence continues to escalate, from 1.1 million Americans in 1991 to an anticipated 1.3 million in 1993
-deaths from cancer in 1992 are projected at 520,000, up from 514,000 in 1991
-since 1950, the overall cancer incidence has increased by 44%, with breast cancer and male colon cancer up by 60% and prostate cancer by 100%
-for decades, the 5 year survival has remained constant for non-localized breast cancer at 18% and lung cancer at 13%
-only 5% of the $1.8-$2.4 billion annual budget for the National Cancer Institute is spent on prevention
-grouped together, the average cancer patient has a 50/50 chance of living another five years; which are the same odds he or she had in 1971
-claims for cancer drugs are generally based on tumor response rather than prolongation of life. Many tumors will initially shrink when chemo and radiation are applied, yet tumors often develop drug-resistance and are then unaffected by therapy.
-39% of women and 45% of men alive today are expected to develop cancer in their lifetime. By the turn of the century, cancer is expected to eclipse heart disease as the number one cause of death in America. It is already the number one fear.
John Bailar, MD, PhD, former editor of the Journal of the National Cancer Institute, confronts the NCI's unfounded enthusiasm with his article in the New England Journal of Medicine, "We are losing the war against cancer" and has shown that the death rate, age-adjusted death rate and both crude and age-adjusted incidence rate of cancer continues to climb in spite of efforts by the NCI. Non-whites are excluded from the NCI statistics for vague reasons. Blacks, urban poor, and the 11 million workers exposed to toxic substances have all experienced a dramatic increase in cancer incidence and mortality. Less than 10% of patients with cancer of the pancreas, liver, stomach and esophagus will be alive in five years.
As a percentage of total annual deaths in America, cancer has
escalated from 3% in 1900 to 22% of today's deaths. Given the limited successes
in traditional cancer treatment, it is not surprising that 50% of all American
cancer patients seek "alternative therapies", however vaguely that
term is still defined. Unfortunately, there are no unqualified cures for all
cancers in either conventional or alternative modalities. While the conventional
therapies of chemotherapy, radiation, surgery, and biological therapies
oftentimes do reduce tumor burden, these therapies do not change the underlying
causes of the disease. In a recent pivotal paper from researchers published in
the official journal of the American Society of Clinical Oncology, "the
limits of the cancer killing model seem to have been reached…conventional
antineoplastic approaches will play a role as debulkers…the strategy will
change to one of reregulation." Given the blatant failures of conventional
cancer therapies, it is imperative that we examine optional and complementary
therapies to assist the swelling ranks of American cancer patients. ImmunoPower
is a crucial addition to the comprehensive cancer treatment of most cancer
patients.
Nutrients as Biological Response Modifiers
In the early phase of nutrition research, nutrient functions were linked to classical nutrient deficiency syndromes: e.g. vitamin C and scurvy, vitamin D and rickets, niacin and pellagra. Today nutrition researchers find various levels of functions for nutrients. For example, let’s look at the "dose dependent response" from niacin:
>> 20 milligrams daily will prevent pellagra
>> 100 mg becomes a useful vasodilator
>> 2000 mg is a hypocholesterolemic agent endorsed by the National Institutes of Health.
While 10 iu of vitamin E is considered the RDA, 800 iu was shown to improve immune functions in healthy older adults. While 10 mg of vitamin C will prevent scurvy in most adults, the RDA is 60 mg, and 300 mg was shown to extend lifespan in males by an average of 6 years.
The dietary requirement of a nutrient may well depend on the health state of the individual and what you are trying to achieve. In animal studies, 7.5 mg of vitamin E per kilogram of body weight was found to satisfactorily support normal growth and spleen to body weight ratio. Yet, consumption at twice that level of vitamin E was essential to prevent deficiency symptoms of myopathy and testis degeneration. Intake at 7 times base level of vitamin E was required to prevent red blood cell hemolysis. Intake of 27 times base level provided optimal T- and B-lymphocyte responses to mitogens.
You can accelerate the rate of a reaction by increasing temperature, surface area, or concentration of substrates or enzymes. Clearly, above-RDA levels of nutrients can offer safe and cost-effective enhancement of metabolic processes, including immune functions. Therapeutic dosages of nutrients may be able to reduce tumor recurrence, selectively slow cancer cells, stimulate the immune system to more actively destroy tumor cells, alter the genetic expression of cancer, and more.
CAN NUTRITION HELP THE MALNOURISHED CANCER PATIENT?
A position paper from the American College of Physicians published in 1989 basically stated that TPN had no benefit on the outcome of cancer patients. Unfortunately, this article excluded malnourished patients, which is bizarre, since TPN only treats malnutrition, not cancer. Most of the scientific literature shows that weight loss drastically increases the mortality rate for most types of cancer, while also lowering the response to chemotherapy. Chemo and radiation therapy are sufficient biological stressors alone to induce malnutrition.
In the early years of oncology, it was thought that one could starve the tumor out of the host. Pure malnutrition (cachexia) is responsible for somewhere between 22% and 67% of all cancer deaths. Up to 80% of all cancer patients have reduced levels of serum albumin, which is a leading indicator of protein and calorie malnutrition. Dietary protein restriction in the cancer patient does not affect the composition or growth rate of the tumor, but does restrict the patient's well being.
Parenteral feeding improves tolerance to chemotherapeutic agents and immune responses. Malnourished cancer patients who were provided TPN had a mortality rate of 11% while a comparable group without TPN feeding had a 100% mortality rate. Pre-operative TPN in patients undergoing surgery for GI cancer provided general reduction in the incidence of wound infection, pneumonia, major complications and mortality. Patients who were the most malnourished experienced a 33% mortality and 46% morbidity rate, while those patients who were properly nourished had a 3% mortality rate with an 8% morbidity rate.
In 20 adult hospitalized patients on TPN, the mean daily vitamin C needs were 975 mg, which is over 16 times the RDA, with the range being 350-2250 mg. Of the 139 lung cancer patients studied, most tested deficient or scorbutic (clinical vitamin C deficiency). Another study of cancer patients found that 46% tested scorbutic while 76% were below acceptable levels for serum ascorbate. Experts now recommend the value of nutritional supplements, especially in patients who require prolonged TPN support.
RATIONALE FOR USING ADJUVANT NUTRITION IN CANCER TREATMENT
1) Avoiding malnutrition. 40% or more of cancer patients actually die from malnutrition, not from the cancer. Nutrition therapy is essential to arrest malnutrition.
2) Reducing the toxic effects of conventional medical treatment. Properly nourished patients experience less nausea, malaise, immune suppression, hair loss and organ toxicity than patients on routine oncology programs. Antioxidants, like beta carotene, vitamin C, vitamin E, and selenium appear to enhance the effectiveness of chemo, radiation, and hyperthermia while minimizing damage to the patient's normal cells; thus making therapy more of a "selective toxin." An optimally nourished cancer patient can better tolerate the rigors of cytotoxic therapy.
VITAMIN K. While in simplistic theory, vitamin K might inhibit the effectiveness of anticoagulant therapy (coumadin), actually vitamin K seems to augment the anti-neoplastic activity of coumadin. Patients with mouth cancer who were pre-treated with injections of K-3 prior to radiation therapy doubled their odds (20% vs. 39%) for 5 year survival and disease free status. Animals with implanted tumors had greatly improved anti-cancer effects from all chemotherapy drugs tested when vitamins K and C were given in combination. In cultured leukemia cells, vitamins K and E added to the chemotherapy drugs of 5FU (fluorouracil) and leucovorin provided a 300% improvement in growth inhibition when compared to 5FU by itself. Animals given methotrexate and K-3 had improvements in cancer reversal with no increase in toxicity to the host tissue.
VITAMIN C. Tumor-bearing mice fed high doses of vitamin C (antioxidant) along with adriamycin (pro-oxidant) had a prolonged life and no reduction in the tumor killing capacity of adriamycin. Lung cancer patients who were provided antioxidant nutrients prior to, during, and after radiation and chemotherapy had enhanced tumor destruction and significantly longer life span. Tumor-bearing mice fed high doses of vitamin C experienced an increased tolerance to radiation therapy without reduction in the tumor killing capacity of the radiation.
FISH OIL. EPA improves tumor kill in hyperthermia and chemotherapy by altering cancer cell membranes for increased vulnerability. EPA increases the ability of adriamycin to kill cultured leukemia cells. Tumors in EPA-fed animals are more responsive to Mitomycin C and doxorubicin (chemotherapy drugs). EPA and GLA were selectively toxic to human tumor cell lines while also enhancing the cytotoxic effects of chemotherapy.
VITAMIN A & BETACAROTENE. There is a synergistic benefit of using vitamin A with carotenoids in patients who are being treated with chemo, radiation and surgery for common malignancies. Beta-carotene and vitamin A together provided a significant improvement in outcome in animals treated with radiation for induced cancers.
VITAMIN E. Vitamin E protects the body against the potentially damaging effects of iron and fish oil. Vitamin E deficiency, which is common in cancer patients, will accentuate the cardiotoxic effects of adriamycin. The worse the vitamin E deficiency in animals, the greater the heart damage from adriamycin. Patients undergoing chemo, radiation and bone marrow transplant for cancer treatment had markedly depressed levels of serum antioxidants, including vitamin E. Vitamin E protects animals against a potent carcinogen, DMBA. Vitamin E supplements prevented the glucose-raising effects of a chemo drug, doxorubicin while improving the tumor kill rate of doxorubicin. Vitamin E modifies the carcinogenic effect of daunomycin (chemo drug) in animals.
NIACIN. Niacin supplements in animals were able to reduce the cardiotoxicity of adriamycin while not interfering with its tumor killing capacity. Niacin combined with aspirin in 106 bladder cancer patients receiving surgery and radiation therapy provided for a substantial improvement in 5 year survival (72% vs. 27%) over the control group. Niacin seems to make radiation therapy more effective at killing hypoxic cancer cells. Loading radiation patients with 500 mg to 6000 mg of niacin has been shown to be safe and one of the most effective agents known to eliminate acute hypoxia in solid malignancies.
SELENIUM. Selenium-deficient animals have more heart damage from the chemo drug, adriamycin. Supplements of selenium and vitamin E in humans did not reduce the efficacy of the chemo drugs against ovarian and cervical cancer. Animals with implanted tumors who were then treated with selenium and cis-platin (chemo drug) had reduced toxicity to the drug with no change in anti-cancer activity. Selenium supplements helped repair DNA damage from a carcinogen in animals. Selenium was selectively toxic to human leukemia cells in culture.
CARNITINE. Carnitine may help the cancer patient by protecting the heart against the damaging effects of adriamycin.
QUERCETIN. Quercetin reduces the toxicity and carcinogenic capacity of substances in the body YET at the same time may enhance the tumor killing capacity of cisplatin. Quercetin significantly increased the tumor kill rate of hyperthermia (heat therapy) in cultured cancer cells.
GINSENG. Panax ginseng was able to enhance the uptake of mitomycin (an antibiotic and anti-cancer drug) into the cancer cells for increased tumor kill.
==>> In both human and animal studies, nutrients improve the host tolerance to cytotoxic medical therapies while allowing for unobstructed death of tumor cells. Nutrition therapy makes medical therapy more of a selective toxin on the tumor tissue.
3) Bolster immune functions. When the doctor says: "We
think we got it all." what he or she is really saying is: "We have
destroyed all DETECTABLE cancer cells, and now it is up to your immune system to
find and destroy the cancer cells that inevitably remain in your body." A
billion cancer cells is about the size of the page number at the top of this
page. We must rely on the capabilities of the 20 trillion cells that compose an
intact immune system to destroy the undetectable cancer cells that remain after
medical therapy. There is an abundance of data linking nutrient intake to the
quality and quantity of immune factors that fight cancer.
4) Selectively starve the tumor. Tumors are primarily obligate glucose
metabolizers, meaning "sugar feeders". Americans not only consume
about 20% of their calories from refined sucrose, but often manifest poor
glucose tolerance curves, due to stress, obesity, low chromium and fiber intake,
and sedentary lifestyles. In an animal study, there was a dose-dependent
response: the more sugar from the diet, the quicker the breast cancer's killed
the animals.
5) Anti-proliferative factors. Certain nutrients, like selenium, vitamin K, vitamin E succinate, and the fatty acid EPA, appear to have the ability to slow down the unregulated growth of cancer. Various nutrition factors, including vitamin A, D, folacin, bioflavonoids, and soybeans, have been shown to alter the genetic expression of tumors.
NUTRITION THERAPY IMPROVES OUTCOME IN CANCER TREATMENT
Finnish
oncologists used high doses of nutrients along with chemo and radiation for lung
cancer patients. Normally, lung cancer is a "poor prognostic"
malignancy with a 1% expected survival at 30 months under normal treatment.. In
this study, however, 8 of 18 patients (44%) were still alive 6 years after
therapy.
Oncologists at West Virginia Medical School randomized 65
patients with transitional cell carcinoma of the bladder into either the
"one-per-day" vitamin supplement providing the RDA, or into a group
which received the RDA supplement plus 40,000 iu of vitamin A, 100 mg of B-6,
2000 mg of vitamin C, 400 iu of vitamin E, and 90 mg of zinc. At 10 months,
tumor recurrence was 80% in the control group (RDA supplement) and 40% in the
experimental "megavitamin" group. Five year projected tumor recurrence
was 91% for controls and 41% for "megavitamin" patients. Essentially,
high dose nutrients cut tumor recurrence in half.
In a non-randomized clinical trial, Drs. Hoffer and Pauling instructed patients to follow a reasonable cancer diet (unprocessed food low in fat, dairy, and sugar), coupled with therapeutic doses of vitamins and minerals. All 129 patients in this study received concomitant oncology care. The control group of 31 patients who did not receive nutrition support lived an average of less than 6 months. The group of 98 cancer patients who did receive the diet and supplement program were categorized into 3 groups:
Poor responders (n=19) or 20% of treated group. Average
lifespan of 10 months, or a 75% improvement over the control group.
Good responders (n=47), who had various cancers, including leukemia, lung, liver, and pancreas; had an average lifespan of 72 months (6 years).
Good female responders (n=32), with involvement of reproductive areas (breast, cervix, ovary, uterus); had an average lifespan of over 10 years. Many were still alive at the end of the study.
In examining the diet and lifespan of 675 lung cancer patients over the course of 6 years, researchers found that the more vegetables consumed, the longer the lung cancer patient lived. Of the 200 cancer patients studied who experienced "spontaneous regression", 87% made a major change in diet, mostly vegetarian in nature, 55% used some form of detoxification and 65% used nutritional supplements.
Researchers at Tulane University compared survival in patients who used the macrobiotic diet versus patients who continued with their standard Western lifestyle. Of 1467 pancreatic patients who made no changes in diet, 146 (10%) were alive after one year, while 12 of the 23 matched pancreatic patients (52%) consuming macrobiotic foods were still alive after one year.
THE COMPONENTS OF A NUTRITIONAL ONCOLOGY PROGRAM
1) Food. If the gut works and if the patient can consume enough food through the mouth, then this is the primary route for nourishing the patient. The diet for the cancer patient should be high in plant food (grains, legumes, colorful vegetables, some fruit), unprocessed (shop the perimeter of the grocery store), low in salt, fat, and sugar, with adequate protein (1-2 grams/kilogram body weight).
2) Supplements. Additional vitamins, minerals, amino acids, food extracts (i.e. bovine cartilage), conditionally essential nutrients (i.e. fish, flax, and borage oil; Coenzyme Q-10), and botanicals (i.e. echinacea, golden seal, astragalus) can enhance the patient's recuperative powers. ImmunoPower is the most clinically-tested, cost-effective and convenient way to take nutritional supplements.
3) Total parenteral nutrition (TPN). There are many cancer patients who are so malnourished (weight loss of 10% below usual body weight within 1 month period and/or serum albumin below 2.5 mg/dl) that we must interrupt this deterioration with TPN. When the patient cannot or will not eat adequately, TPN can be an invaluable life raft during crucial phases of cancer treatment.
4) Assessment. It is important to determine the patient's general health and nutrient status, which helps the clinician provide patient-specific therapy. Means of assessment include: health history form to detect lifestyle risk factors, physician's examination, anthropometric measurements of height, weight, and percent body fat, calorimeter measurement of basal metabolic needs, and various other laboratory tests.
5) Education. The patient needs a sense of involvement and control in the therapy, which can improve his or her chances for recovery. Just as much as the patient's lifestyle may have contributed to the problem, a pro-active patient can help reverse the underlying causative factors.
6) Research. Those who advance the knowledge base have a responsibility to properly gather data and report their findings to the world.
ImmunoPower
Patrick Quillin, PhD, RD, CNS
$14.95 US
ISBN 0-9638372-6-5