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Magnesium an important element in the Kelley program

Posted by Jonathan Chamberlain on October 19, 2012


Dr Nicholas Gonzalez is well known as the man who has taken the Kelley approach forward. He recommends most of his patients take magnesium citrate

Dr  Gonzalez says: “We recommend magnesium for patients who tend to be more acid to take with the pancreas glandular because the pancreas works better in an alkaline environment. For patients already too alkaline this is not necessary.” (personal communication with John Gale Lmt  posted on my Cancer Recovery Facebook group)

The Cancer Survivor’s Bible – Everything everybody needs to know about cancer and how to recovery – www.fightingcancer.com

 

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kidney cancer life expectancy calculator

Posted by Jonathan Chamberlain on February 24, 2012


How long have I got, doc? Is the sort of natural question anyone with cancer is likely to ask when they’re talking about their diagnosis. Unfortunately being give a life expectancy can be a) depressing  b) self-fulfilling c) life affirming. We simply don’t know how we are going to react. Some people given three months die within days, others – like my wife – die on precise schedule and some gird their loins and go out and set out to disprove it – many succeeding gloriously. So this info is dangerous. But almost everyone hates uncertainty and imprecision. That’s the problem. Anyway, here is a kidney cancer life expectancy calculator that was posted on my Facebook Cancer Recovery group. Use it as you wish

http://lifemath.net/cancer/renalcell/outcome/index.php. (www.kidneycancer.org)

Note: The Cancer Survivor’s Bible (2012) is now available – see www.fightingcancer.com

“This book gives hope. …I wish I had read this book before I was diagnosed. My doctors and the cancer charities didn’t tell me any of this.”

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breast cancer: Unclogging lymph glands

Posted by Jonathan Chamberlain on May 2, 2011


Get the cancer information you need here and in my two cancer books – see www.fightingcancer.com for details

Unclogging lymph glands

Sometimes a discussion gets going and you uncover a wealth of real personal experience. This one concerns a woman diagnosed with breast cancer who has suffered extreme pain associated with clogged lymph nodes under the arm. She has chosen to treat her cancer using diet and supplements. Here was her original posting:

“I have breast cancer – diagnosed august 2010 – I did have a biopsy (rushed into it before I could think – on same day of mammogram).  There is an area – hard –  with dcis (4cm) but they found cells that were ‘indicative of metastases’ in my lymph nodes in armpit.   The oncologist said therefore that there must be an invasive cancer in my breast, and that it was in the area near my armpit (this area was not hard, just swollen and very very tender and very painful).  So to be clear, I had one hard lump, which they say is DCIS, and one area near the armpit that was so sore and tender i couldn’t even touch it. I have not done surgery, chemo or radiation and have been on juicing/raw diet with coffee enemas, plus taking oleander, pancreatin, selenium, milk thistle since last september. I also take the budwig mixture and put ground flax seeds in 3 of my daily juices – I have about 7-9 juices daily, mainly carrot, with some greens. Around Christmas the dcis area was still growing, actually quite agressively and my whole breast was hot and quite hard (like it had been at the start).  That began to change the middle of January and the breast was a lot softer.  In fact, the area that had been growing quite agressively became soft and is now like dense fatty tissue.  The hard lump is going like this – it gets like a blister at the side  –  feels squish- and then it seems to go into dense fatty tissue.  Where the sore area near the armpit was where originally i could not touch, this has grown into a kind of rubbery lump, or pile and this area is concerning me as it has gotten bigger recently.  Swollen.  The lymph node in my armpit is the same, but now there is more of this rubbery stuff.  Like a web of rubbery stuff.    The rubbery stuff is new! The heat that was there in the breast is now not there at all and there are no changes with my menstrual cycle.  My periods stopped nov/dec/jan, came back fine feb/march.”

A number of suggestions were made to help this lady.

Suggestion 1: “I use a machine called Light Beam Generator from ELF labs in america which is excellent to clear lymph nodes naturally. you can contact the company if they have any practioners near you. i am in england and i have 3 machines which have been fantastic to users with issues currently we are discussing, if you like to read more on these machines go to my website at www.bioenergy-rochdale.co.uk

Suggestion 2: “I’ve seen and experienced tremendous results for ridding clogged lymph in my breast tissues, under my arms where there has been much pain and inflammation, if I take high doses of S.O.D. Super Dioxy Dismutase. I’m not sure if I’m spelling it correctly.

I get the one from Biotec International here in California but I don’t know of resources in the UK. I actually use BioVet line for animals and use the same for myself. I’ve experienced that I can handle carrot juice in larger amounts only if my diet is completely raw. Otherwise the sugars seem to add to the problem if I consume too much when eating a partially cooked diet. Greens and more greens…Ginger and garlic juiced with everything aids in clearing toxic waste and lymph. Lemon juice juiced with garlic and ginger do allot separately from the vegetable juice. I have had great results using raw cold processed hemp seed protein powder by Manitoba Harvest in Canada. You can probably find a good source in the UK.

Lastly, I’m experiencing very good results taking powdered Humic Acid daily for detoxing and clearing infection. I bought 25 pounds bulk for $4. per pound. I bought it for my animals and soil as an organic agricultural supplement. The farmer I bought it from uses it as a tea daily. 1/4 teaspoon. He told me it’s critical to make sure its from a good source and no other ingredients are added. Humic Acid is ancient compost. It’s age can range from hundreds of years old to millions of years old. A friend who introduced me to the source puts some in water and after his shower each morning sprays his whole body with this and some sea minerals added to the mixture. He says he frills incredible after he sprays his body. It’s black so you only need a little in the spray. He advised me to use the 1/4 teaspoon daily.”

Suggestion 3: “I would highly suggest continuing the Budwig Protocol, Oleander, pancreatic enzymes, coffee enemas, etc.  Obviously what you are doing is having an effect. I would also suggest peforming a parasite cleanse and adding something for yeast overgrowth since most with cancer have a concern with yeast.  Oregano Oil is a good choice along with a good colloidal silver.  Also N-Acetyl-Cysteine.  Adding more greens to your juicing is always a great idea.  Be sure to keep your elimanation routes open and working – we eliminate by breathing, sweating, urination, defecation (2-3 bowel movements daily is recommended) and for women menses.  For exercise consider rebounding as this will help to keep the lymph system moving.  Dry skin brushing is another suggestion.

Please research the iodine protocol. In my opinion, anyone with breast cancer or the possibly of breast cancer should be on the entire iodine protocol.  I would suggest taking it orally and also applying it directly to the breasts. You can find more information at http://www.breastcancerchoices.org/iodineindex.html   There is also an iodine yahoo group that is helpful.

Getting your hormones (estrogen, progesterone, testosterone, DHEA and cortisol) saliva tested will let you know if you need to work on hormone balance and/or adrenal stress.  Often those with cancer have adrenal stress/fatigue from emotions that have not been dealt with or from living a high stress life.  Incorporating an adrenal glandular and/or some herbs such as ashwagandha, rhodiola rosea and astragalus is almost always wise.

Make sure that you are also dealing with any negative emotions, anger, fear, etc.  Personally, I believe that cancer has a very real emotional component (I am a stage III colon cancer survivor of eleven years).  A very good book is Feelings Buried Alive Never Die.  EFT (Emotional Freedom Technique) is also worth learning and implementing.”

NOTE: The 2012 edition of The Cancer Survivor’s Bible is now available – see www.fightingcancer.com for details.

“I work with cancer patients and I have found this book incredible helpful to them (and to me and my work colleagues).”

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Reducing Stress important when fighting Cancer

Posted by Jonathan Chamberlain on May 2, 2011


If you are looking for cancer related info then browse this site – this info supports my two cancer books – see www.fightingcancer.com for details.

Reducing Stress Important when Fighting Cancer

It is known that stress promotes cancer – reduce the one you reduce the risk of the other (or its aggressiveness if you already have cancer) – relaxation really is good for you. One sign of stress is ‘brain fog’ – the inability to think clearly. It has been shown that stress causes higher than desired levels of cortisol in the body. So how can we reduce these cortisol levels. Here are some suggestions:

1. Vitamin B complex

2. passionflower herb tincture

3. Omega 3 oils – ie fish oils or flaxseed oils. If you have a compromised liver then thoroughly blend (with a fork) flaxseed oil (1 tbsp) and low fat cottage cheese/flaxseed oil or quark (3 tbspn) x 3 day

4. Have a massage

5. Laugh

All of these will help reduce stress and strengthen your ability to fight cancer

NOTE: The 2012 edition of The Cancer Survivor’s Bible is now available – see www.fightingcancer.com for details

“The section on conventional treatment was riveting.”

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Ian Clements’ anti-cancer protocol

Posted by Jonathan Chamberlain on April 21, 2011


If you are looking for cancer information then you’ve come to the right place. There’s a lot here and in my two cancer books – see www.fightingcancer.com for details.

Dr Ian Clements’ Anti-Cancer CAM Regime

Ian Clements is not a medical doctor – he’s an engineer. He approaches problems in a pracgmatic but highly analytic way. This is how he approached his own diagnosis of terminal bladder cancer. He was told he had only weeks or months to live – and at one time he was admitted to a hospice with no expectation of emerging. Today, three a a half years later, he is still battling. Here is the protocol he has developed for himself. I have posted elsewhere lengthy docuuments on his own research into radical cystectomy for bladder cancer and his protocol for supporting yourself through chemotherapy

CANCER? – The Quick Start Back

DON’T PANIC! – Well, try to calm down.

You will not die overnight – cancer is not the same as a bullet or car accident. It will have been developing for months, if not years. Most people die from the side-effects of cancer, rather than the cancer directly. So you can usually take a couple of weeks to learn more before you decide anything.

The three standard orthodox treatments are surgery, chemotherapy, and radiation. All are strong assaults on the body. So it is best to prepare your body for this if you do decide to have any of these treatments.

Meanwhile, there are several proven things you can to improve your length of survival and help your body cope with any treatment:

Nutrition

  • Cut out sweet things[i], reduce carbohydrates (potatoes, pasta, bread, cakes) which get quickly converted to blood sugar, and alcohol
  • Go for salads, with organic produce if possible, and fresh fruit.
  • Cut out red and processed meat – sausages, bacon, steak, pork. Go for fish, white meat (chicken, turkey).
  • Drink green and/or white tea in preference to coffee or black tea (tho’ the latter is OK, just not as good as green or white).

Exercise[ii]

  • Aim to do as much as you can, getting more vigorous with time. If you are not used to doing any, then build up to half-an-hour’s walk a day. Then get faster and longer as you get more able to. Aim to get an hour a day. Other forms help too: swimming, weights, jogging, etc.

Supplements

Daily:

  • A comprehensive multi-vitamin and mineral pill/pills[iii]
  • Vitamin C[iv]– 3gm
  • Vitamin D3[v] – 10,000IU
  • Omega 3 oil[vi] – 5 gm

Contents

CANCER? – The Quick Start Back. 1

Nutrition. 1

Exercise. 1

Supplements. 1

General Cancer Theory. 6

Things to do right away. 7

Nutrition. 7

Exercise. 7

Supplements. 7

My Various CAM Treatments. 8

Lifestyle. 8

Exercise. 8

Nutrition. 8

Weight 9

Supplements. 9

Other Treatments I use. 11

Hyperthermia. 11

Enhanced oxygen. 11

Low-Dose Naltrexone – LDN.. 12

PsychoNeuroImmunology- PNI. 13

Chemotherapy Help. 13

My Daily regime. 13

Diet/nutrition: 14

Oxygenation/Exercise: 15

Being considered. 15

Feedback. 15

Alternatives I’ve Tried and Abandoned. 16

Fiery chillies, garlic and butter. 16

Alkalizing. 17

Veganism.. 17

Juicing. 17

Budwig Diet 17

Conclusions. 18

Acknowledgements. 18

Bibliography. 19

Introduction

You are probably reading this either because you have been diagnosed as having cancer, or that of a loved one who has. Please don’t panic. Cancer will not cause you or your loved one to die within days – so you have time to look at various alternative treatments:

  • the orthodox ones of surgery, chemotherapy and/or radiation;
  • and what are known as Complementary and Alternative Medicine (CAM), and to enhance survival independently of whatever you and your doctors decide is best.
  • There is a lot of information and advice available on the Internet on both orthodox treatments and CAM – sure, not all of it is good, but some is. This document will help guide you through all that.

Having been diagnosed with terminal bladder cancer in October 2007 at aged 71, and only been given a few weeks to live – (by 4 orthodox experts – the urological surgeon and three oncologists), my own experience and now extensive reading and discussions with other survivors has made me at least as expert as the medicos in many ways (but not all) in the following 3+ years (as of writing). This book is a collation of my wisdom on cancer and how to mitigate it. Given the present state of ignorance about the origination and causal chain development of cancer, no-one can be certain of how each proven anti-cancer treatment actually works – only that the evidence is that certain things actually do bring about cancer and other things cause an improvement in some or all patients. I believe that my now lengthy survival against the original prognosis is due to one or more of the various treatments I have undertaken. I offer this to others that it may help them. I am not a medical doctor; I am a retired research scientist, able to understand research reports and summarise them coherently, concisely and clearly.

Unlike some people offering anti-cancer advice or ‘cures’, I do not claim that either what I have done or my protocol will definitely increase survival time (or cure cancer – not even the orthodox medicos do that). What I am offering is evidence-based anti-cancer advice, quoting this evidence so that you can check it for yourself, that is known to generally enhance survival times for cancer patients.

Alas, there are some who proffer easy cures or help. These, I believe, are generally sincere. But (a) their own experience may have had nothing to do with their supposed treatment; (b) even if it was, it may be something that just works for them (however, if may work for you too). There are also a lot of well-documented cases of spontaneous remission – the cancers just went away, for no known reason; and so for people to whom this happened, this may lead them to think they did something to cause this.

I am not opposed to orthodox treatments – chemotherapy probably saved my life – but I do think that patients need to be well informed about them before deciding on doing one. There will always be time to do this; don’t let the doctors rush you into any particular treatment (I alas did). This will enable them to choose whichever is best for them – or non at all. From what I now know, the surgery I had to remove my tumour was unnecessary (it re-grew in 3 months; it was the chemotherapy that then drove my cancer into remission) and this surgery spread cancer cells throughout my body, reducing my survival chances significantly. I now realise what should have been obvious: the specialists are naturally committed to their speciality, often to that alone (their colleagues in ‘rival’ specialisms will often disagree with their rivals). This is not to doubt their sincerity, just their blinkered approach – which can equally be true of CAM specialists. I also now know that my continuing my complementary ‘treatments’ (supplements, exercise, nutrition) enabled the chemotherapy to work much better and reduced the severity of the side-effects.

CAM (Complementary and Alternative Medicine) is, as the name says, composed of two parts – that which helps orthodox medicine, and so is complementary to it; and that which is Alternative to standard treatment and so sometimes is opposed to it. Both are unfairly stigmatised by the orthodox medical community, who, to their shame, are usually ignorant of it. Some doctors will readily admit this, especially given that their training omits it – and refer patients to those who are expert in these areas. Others will denounce anything that they don’t themselves know, trusting that those experts who taught them, and their reading within their narrow speciality since, know all that there is to know of their area.

All of this is regrettable, because much of CAM conforms to that highest of medical standards – evidence-based, often the gold-standard of double-blind, placebo alternative research. Much of orthodox medicine is inheritance-based – passed on from predecessors without any evidence-based research behind it at all (it is claimed that 75% of patient advice and medicine is not evidence-based) this is no better than the anecdotal evidence that such practitioners denounce when used by CAM advocates. Perhaps worse, much of medical research is actually wrong[vii] (as is most expert advice[viii]). Fortunately, nowadays patients have access to a great deal of medical expertise via the Internet, including consultations with far-away orthodox specialists if they want.

One enormous advantage that much of CAM has over mainstream orthodox treatment is that much of the Alternative side is usually side-effect free and virtually of the Complementary is, unlike virtually all of traditional medicine. This is especially true of cancer treatment: surgery, chemotherapy, and radiation – all of which carry mortality risk and damage to healthy cells. But let me be clear: some Alternative treatments are invasive and need careful consideration before being undertaken – they can have serious and deleterious side-effects – such as intravenous vitamin C, and enemas. So far, none of what I have done falls in to that category.

There is much that CAM offers that supports orthodox treatment in becoming more efficacious and lowering the inevitable nasty side-effects, so it is surprising that the GPs and specialists are both ignorant of this enhancer of their treatments and preventing such treatments being more successful.

This resumé of this expertise, with references (tho’ all can easily be research and updated by Googling everything mentioned), may help others to improve their chances with both their cancer and their orthodox treatment (for instance, responses to chemo, radiation and surgery are enhanced as well as the side-effects reduced).

Complementary and Alternative Medicine covers many different treatments for the same spectrum of illnesses as that of the orthodox NHS. However, this does not mean there is not a respectable body of scientific evidence to support CAM – on the contrary, most such interventions do indeed have this. Whilst many NHS practitioners may be unfamiliar with some CAM, there are books by orthodox MDs which do report such evidence[ix].

My choosing which CAM to use is based on two principles: weight of evidence (even if anecdotal), and indications that there are no serious downsides. Note that ‘evidence’ here is exactly that – where the usage gives improvement, even if the intervening causal chain is unknown.

Within CAM there is a diverse field, only part of this relates to cancer. Within CAM cancer information, there is that which relates to prevention; other to enhancing survival (a better phrase than ‘cure’; tho’ ‘cures’ are claimed and so could be dismissed for that reason, this doesn’t mean any such CAM may not be useful); and that to supporting orthodox treatments (enhancing their efficacy or reducing the side-effects). Naturally, there is much overlap between these aspects.

To fully investigate and research both orthodox and CAM, I have of necessity spent much time and money on literature – books, membership to health newsletters, and forums. It is from all this, plus my own continuing research on the Internet, that I have evolved – and still evolve – my anti-cancer actions.  I have read much of both the orthodox approach and the many alternative cancer treatments – which I readily admit are often way to optimistic and misleading; but which, to my mind, are usually genuine (the same being applicable to orthodox medicine).

I offer this distillation of knowledge and advice. But, as always, the decision rests with you, the patient, as to what you do to optimise your own survival.

For those who wish to explore some of the Alternative medicine ideas in more depth, I recommend two books and their associated websites: “Cancer: The Complete Recovery Guide” by Jonathan Chamberlain (http://www.fightingcancer.com/) and “Conventional Cancer Cures: What’s the Alternative” by Chris Woollams (http://www.canceractive.com/).

You now have to hand the most empowering tool ever available for advice on any illness: the Internet. To get up-to-date information on any proposed treatment, food, or supplement, just enter the “illness and item” into a search engine such as Google. Examples: Bladder cancer and vitamin C; Kidney disease and eggs; etc. From this you will quickly know what may help or harm your illness and treatment.

General Cancer Theory

The complete aetiology (step-by-step chain of cause and effect) of cancer is not, at present, known. This is a summary of the present state of knowledge. Robert Weinberg[x] distilled six characteristics which all cancers are found to have (and are now accepted by the cancer specialists) plus two more that are usually present:

  1. Self-sufficiency in growth signals (rather than from other body signals)
  2. Insensitivity to anti-growth signals (the body usually can signal cells to stop growing)
  3. Tissue invasion and metastasis (cells and organs remain where they are normally)
  4. Limitless replicative potential (can and do keep growing continuously)
  5. Sustained angiogenesis (keep making blood vessels to feed the tumours)
  6. Evasion of apoptosis (avoid normal cell death – all other cells, apart from nerves, die after a time)
  7. Tumour promoting inflammation (turns on the body’s inflammation all the time, instead of just when it is injured)
  8. Gene instability and mutation (all other cells replicate clones; and, when they don’t, the body recognises this and makes them die)

We attempt to control cancer by interfering with each of these factors.

For cancer to develop into a life-threatening stage, it goes through three phases: initiation, promotion, and progression. The initiation can be due to a virus, parasite, emotional shock (such as a relative suddenly dying), poor nutrition, or poor environment (such as radiation, smoking, asbestos).  For a cancer to develop, a cell has to go ‘rogue’ – its DNA has to be damaged in such a way that it proliferates outside the control of the body’s normal regulatory mechanisms. So there are three aspects to this[xi]:

  • What makes the DNA corrupt?
  • Why don’t the body’s normal immune processes recognise this and destroy it (they normally do)?
  • And how does the rogue cancer cell then grow?

The changed cell then propagates daughter cells – the tumour is promoted. If the immune system is poor, due maybe to poor nutrition and lack of exercise – then progression is likely, generally via angiogenesis (growing a blood supply for the tumour). For example, bladder cancer (mine) risk factors include smoking, obesity, working with chemicals (painters and carpenters), arsenic in the tap water, eating processed or overdone meat, and being a USA Vietnam veteran. Medical and CAM treatments along with lifestyle changes attempt to address each of these three stages: cancer cell initiation, cancer cell death, cancer cell growth.

The embryonic cancer cells generally need a blood supply (angiogenesis) for tumours to grow to life-threatening size, and this process is susceptible to nutrition, supplements and drugs (Dr William Li: Can we eat to starve cancer? [xii] and David Agus: A new strategy in the war on cancer[xiii]).Genes only predispose, and are not causative.[xiv]

Cancers need much greater than normal amounts of energy to grow, and cause inflammation to hide from the body’s immune system – so much so, it is probable that inflammation and cancer generally go hand-in-hand[xv]. Restricting the glucose that cancer cells need (all sugars, including alcohol) is therefore a good thing. This includes what may be called fast carbs – easily digested carbohydrates like white bread, potatoes, etc[xvi]. Anti-inflammation (by such supplements as curcumin and omega3 oils) will damp it down.

Orthodox medicine has three main alternatives: radiation, surgery, chemotherapy. There is a little immunotherapy (BCG[xvii]for bladder cancer is probably the only established one; there is a lot of experimental vaccines; and a new prostate cancer one, Provenge). Or (if it is thought that the cancer is too far gone or not life threatening) just let it go on until death (which may be from other causes).

Points to bear in mind:

Since about 1940 there has been a significant increasing of cancer rates in Western countries – and this is not mainly due to better screening or diagnosis (which do have an effect on the figures, but only about 30%), as this has occurred in non-screened-for cancers and in children. Even breast cancer rates, which were falling, are no longer doing so[xviii].

It is thought that this increase of cancer in general is  must mostly be due to Western lifestyles (The National Cancer Institute estimates that roughly one-third of all cancer deaths may be diet related; WHO think 70% related to lifestyle); embracing less Western ones will likely lead to fewer succumbing to cancer.[xix] Whilst there has been a reduction in cancer death rates in the last 20 years, this is probably mostly (if not entirely) due to reduced smoking, rather than improved treatments.[xx] All this evidence leads to the inevitable conclusion that cancer is a disease of modern Western civilisation and is not ‘natural’; so we must look to our lifestyle and modern environment for causation and, by extension, to reducing the enhancement of cancer once we have it. Insulin appears to be a major factor, enhanced by fast carbs[xxi].

There are some strong criticism of orthodox treatment by some members of the medical profession themselves. I think these are too strong, but it would be unfair not to air them:

  • Surgery: Prof. of Medical Physics calculated that on balance, cancer patients are likely to live four times longer if they do nothing for their cancer rather than do something.
  • Surgery enhances the chances of metastasis (spreading the cancerous cells; see Surgery Could Accelerate Tumor Growth?[xxii] “Surgery Triggers Outgrowth of Latent Distant Disease in Breast Cancer: An Inconvenient Truth?”[xxiii], & “Proof That Cancer Surgery Increases Mortality”[xxiv].)
  • Radiation: Many experts consider it useless. Radiation itself can cause cancer (tho’ there’s some evidence that light radiation is actually good[xxv]. It also adversely affects the immune system.
  • Chemotherapy: Of the 75% receiving chemo, less than 15% are ‘cured’. Only 5% of cancers treated with chemo succeed. 58 of 79 (73%) of doctors referring patients for chemo said that they themselves would not have any chemo. “The overall contribution of curative and adjuvant (helping) cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.”[xxvi]Chemo seriously harms one’s immune system.
  • Some Cancers May Just Go Away[xxvii]

Note that the worst that can be said about CAM is that it may prevent/delay orthodox treatment – CAM itself has remarkably few other downsides.

Things to do right away

Whatever you decide to do, some things will help in various ways without interfering with whatever treatment you then undertake – in essence, optimal health things. These will fortify you for what lies ahead. For what may help with the specific treatment of chemotherapy, see here.

Nutrition

  • Cut out sweet things[xxviii], reduce carbohydrates (potatoes, pasta, bread, cakes) which get quickly converted to blood sugar, and alcohol
  • Go for salads, with organic produce if possible, and fresh fruit.
  • Cut out red and processed meat – sausages, bacon, steak, pork. Go for fish, white meat (chicken).
  • Drink green and/or white tea in preference to coffee or black tea (tho’ the latter is OK, just not as good as green or white).

Exercise[xxix]

  • Aim to do as much as you can. If you are not used to doing any, then build up to half-an-hours walk a day. Then get faster and longer as you get more able to. Aim to get an hour a day. Other forms help to: swimming, weights, jogging, etc.

Supplements

Daily:

  • A comprehensive multi-vitamin and mineral pill/pills[xxx]
  • Vitamin C[xxxi]– 1gm
  • Vitamin D3[xxxii] – 5,000IU
  • Omega 3 oil[xxxiii] – 1 – 5 gm

My Various CAM Treatments

This falls into three parts: lifestyle, supplements, and other treatments.

Lifestyle

Cancer was virtually unknown in ancient times (‘Data from across the millennia has given modern society a clear message: cancer is man-made and something that we can and should address’).[xxxiv],[xxxv] Cancer rates in non-advanced societies are virtually unknown.[xxxvi] Cancer incidences in 1870’s were less than 2%; now more than 33% (p.4) and rising. Death rates are 25%, and rising.

Apart from a couple of cancers (lung, and prostate (men)/breast (women – probably due to the decline of smoking)[xxxvii], cancer incidences (diagnosis) have either not markedly declined or have increased since the 1930’s; in the EU, cases have increased 20% in the six years to 2008 (colon having increased since 1975)[xxxviii]; studies reveal substantial increases in non-melanoma skin cancers[xxxix]. Cancer death rates have slowly increased for all others. “…survival rates haven’t improved for most cancers”[xl].

This increase is not mainly due to better screening or diagnosis (which do have an effect on the figures, but only about 30%), as this has occurred in non-screened-for cancers and in children. It is thought that this increase must mostly be due to Western lifestyles (The National Cancer Institute estimates that roughly one-third of all cancer deaths may be diet related; WHO think 70% related to lifestyle); embracing less Western ones will likely lead to fewer succumbing to cancer.[xli] All this evidence leads to the inevitable conclusion that cancer is a disease of modern Western civilisation and is not ‘natural’; so we must look to our lifestyle and modern environment for causation and, by extension, to reducing the enhancement of cancer once we have it. Insulin appears to be a major factor, enhanced by fast carbs[xlii].

Most cancer patients will survive for years, but have a higher chance of dieing of something else than normal. “current recommendations for cancer survivors, which emphasize achieving and maintaining a healthy weight; encouraging regular physical activity (for adults at least 30 minutes of moderate to vigorous physical activity every day); eating a diet rich in vegetables, fruits, and whole grains; and limiting red and processed meats and alcohol consumption. Further, the current recommendations are that cancer survivors try and obtain their nutrients from foods, rather than supplements since there have been several studies that have linked supplement intake with higher cancer-specific and all-cause mortality among cancer survivors.”[xliii]

Note: nearly all cancer research money is spent on trying to find cures; very little is spent of prevention (1%?).

Exercise

There is now a mass of evidence that exercise of various sorts, indeed of any sort, increases survival. I thus try various sorts – walking, jogging, and weights.[xliv] It is possible that exercise works by causing an increase in internal heat and thus is anti-cancer by the same way that hyperthermia is – cancer cells are more sensitive to heat and become apoptotic – die. My target is about one hour a day vigorous walking (defined as such that one’s heart rate exceeds 50% of one’s maximum). I check this using a wrist watch heart-rate monitor.

Nutrition

Whilst there is as yet no certainty about the best nutrition overall, some have been proven and others are considered prudent:

Avoiding sugar[xlv], fast carbs (maybe carbohydrates altogether – see Gary Taubes “Good Calories, Bad Calories”)

Lower/zero alcohol[xlvi]

Eat lots of cruciferous vegetables[xlvii], berries, fresh organic fruit and veggies in general[xlviii]

Avoid red meat[xlix], processed meats

Avoid pollutants – smoking, aerosols, and poor water[l] (that is, use a water filter)

Particular foods are known to retard certain cancers[li],[lii], whilst others are good against most, such as green tea, and brassicas (Brussels’ sprouts, broccoli) [liii].

Weight

Overweight/obesity is known to enhance cancer[liv], altho’ there is some counter-evidence for breast cancer[lv].  Whilst overall weight reduction is probably good (as recognised by the BMI measure), it seems that it is mainly the fat around the waist that causes the most reduction in general survival[lvi]. For this, the best measure is the ratio of the waist to maximum outer-thighs; it is good to aim for a ratio of waist to thighs of less than 0.95.

Changes in weight are predominately brought about by nutrition, not exercise (as good as this may be for other reasons – see above; my personal data over 30 years is that there is no relationship between how much I exercised and my weight, fat or muscle mass). My experience is that weight and fatness loss is brought about by one of two ways:

  • alternate day ‘fasting’ (on ‘fasting days, just eating fruit – grapefruit for breakfast, big orange for lunch, big apple for dinner)
  • cutting out all obvious carbs: no potatoes, no bread, no pasta, no cakes, no crisps, etc.

Supplements

These do any of four things:

  • they drive cancer cells into apoptosis,
  • boost the immune system so that it recognises the cancer cells as in need of removal,
  • reduce inflammation (a known cancer stimulant[lvii]) and
  • they effect the tumour’s angiogenesis (grow feeding blood vessels) adversely.

There are many supplements for which there are claims that they help with cancer. I have checked a lot of them, and those that have credible evidence (often provided by orthodox medical scientists) I have tried. Here I give selected references to each supplement (sometimes the opposing views too) to give the reader some confidence in my use of these. Note too that I do not use all of these all the time. These references are generally the result of my collecting information since my diagnosis; but often also by the simple procedure of putting “X and Cancer” into Google – which I recommend doing for all of these if anyone wishes to use them, as new research appears all the time, some showing what was once thought good is now bad. Caution is the watchword; check for downsides and conflicts with any other treatment you may be having.

It is noteworthy that supplements are incredibly safe, unlike prescription drugs. For example, there was not one single death recorded in the USA in 2009 from supplements amongst the 2.5 million cases reported to the USA’s Poison Control Centres (there were 500 deaths from other causes).[lviii] There are horrendous figures for deaths due to orthodox medicine’s involvement – drug side-effects, often for drugs that are ineffective anyway; hospital-induced illnesses; medical accidents; etc. This is not to decry orthodox medicine’s undoubted successes, but just to highlight that caution is needed. However, all supplements have side-effects, albeit generally mild ones. It is prudent to check whether any you propose to take may make an existing illness (other than the cancer) worse; for example, if you have kidney problems, search for, say, “Astralagus and Kidney Disease” (in fact, Astralagus is actually good for kidneys).

I also give the daily quantities that I take.

This list is not exhaustive. Tho’ I believe all of these apply to most cancers, it is as well to check whether your particular cancer is known to be helped by those supplements you choose.

Aloe Vera[lix] – 6gm

Alpha Lipoic Acid[lx] – 300mg

Arginine[lxi] – 1gm

Astralagus[lxii] – 2 x 250mg

AveULTRA[lxiii] – 1 pack

Barley Grass[lxiv] – 1gm

Bee Propopolis[lxv] – 2 x 1gm

Beta Glucan[lxvi] – 500mg

Boswelia[lxvii] – 307mg (avoid for kidney problems)

Carnitine (as Acetyl L-Carnitine)[lxviii] – 500mg

Carnosine (as L-Carnosine)[lxix] – 2 x 250mg

Cat’s Claw 30mL[lxx] – 5 drops

Cherry Fruit Extract[lxxi] – 500mg

Chlorella[lxxii] – 1gm

Conjugated Linoleic Acid[lxxiii] – 500mg

Curcumin-0.9g + Piperene[lxxiv] – 6 x 900mg

Cysteine (as N-Acytel Cysteine)[lxxv] – 600mg

DHEA[lxxvi] – 25mg

DIM[lxxvii] – 2 x 100mg

DMAE[lxxviii] – 350mg

DMG[lxxix] – 100mg

EDTA[lxxx] – 400mg

Flora Flor Essence[lxxxi] (avoid for kidney problems)

Fucoidan[lxxxii] 2 x 300mg

Glutathione[lxxxiii] – 500mg

Graviola[lxxxiv] – 2 x 650mg

Green tea extract[lxxxv] – various, including green tea leaves

Indole-3-Carbinal[lxxxvi] – 2 x 200mg

Inositol[lxxxvii] – not taken separately (it is in some of the other supplements)

Lactoferrin + Colostrum[lxxxviii] – 960mg

Lycopene[lxxxix] – 15mg

Melatonin[xc] – 3mg

Melon – Bitter Melon Fruit[xci] – 450mg

Multi vitamin and mineral set[xcii]

Mushroom Extracts (Agaricus Blazei, Maitake, Mesima, Reishi, Shiitake)[xciii] various

Nattokinase[xciv] – 2 x 2,000FUs

Niacin[xcv] – 500mg (avoid for kidney problems)

Omega-3 DHA & EPA in various forms[xcvi] – 6mg[xcvii]

Papaya[xcviii] – 50mg

Pau d’Arco tea – 1 – 3 tea bags

PeakImmune4[xcix] – 8 x 250mg

Probiotics[c] – 2 x 16 billion various

Sterols – Phystosterol[ci] – 937mg

Proline + Lysine[cii] – 2 x 275mg each

Proteolytic Enzymes[ciii] – 3 different brands, so 3 x 500mg

Quercetin[civ] + Bromilain[cv] – 250mg + 375mg

Resveratrol[cvi] – 16mg

Rosehip[cvii] – 800mg

Saw Palmetto + Nettle[cviii] – 280mg

Seanol[cix] – 400mg

Selenium[cx] – 200mcg

Serrapeptase[cxi] – 2 x 80,000

SOD – GliSODin[cxii] – 250mg

Spirulina powder[cxiii] – 1gm

Teas – 5 – 7 teabags, of Pau d’Arco[cxiv], Tulsi[cxv], White Tea, or Green Tea (occasionally black)

Ubiquinol- Co-Enzyme Q10[cxvi] – 100mg

Vit C[cxvii] as Magnesium Ascorbate – 2gm

Vit D3[cxviii] – 5,000IU

Vit K[cxix] – 100mcg

Vit K2[cxx] – 450mcg

Wheatgrass[cxxi] – 1gm

Zinc (Gluconate)[cxxii]  – 4 x 25mg

Other Treatments I use

Hyperthermia[cxxiii]

It is known that cancer cells are more adversely sensitive to heat than normal cells, and thus more liable to die. So raised temperature enhances the immune system to deal with the cancer, and makes any chemotherapy or ingested supplements more efficacious. There are many examples of spontaneous remission following fever, thought to be the result of the high body temperature this caused – this is the basis too of BCG for bladder cancer, and Coley’s Vaccine for cancer generally.

Therapy that raises the body’s temperature is called hyperthermia, in which a device applies heat to the patient. The hyperthermia can be administered either locally or over the whole body.

In local hyperthermia, a device is placed over the specific area of the body to be heated. For example, the doctor applies the hyperthermia device to the breast of a breast cancer patient to heat up the area. This kind of hyperthermia can take place every other day.

Whole-body hyperthermia is altogether different. The patient, wrapped in towels, lies naked on a hyperthermia bed. The patient’s body temperature is gradually raised to about 105 degrees Fahrenheit and kept at that temperature for about two hours. It’s possible to go a little higher — up to 107 degrees, which is called “extreme hyperthermia.” Unlike local hyperthermia, whole-body hyperthermia can’t be done more than once a week. (German Cancer Breakthrough, p.13)

There are three kinds of whole-body hyperthermia:

Moderate hyperthermia, in which the patient’s core temperature is raised to 101-103 degrees Fahrenheit [=38-40C] for two hours, which simulates a natural fever.

Systemic hyperthermia, which raises the core temperature to 105 degrees F. = 40.5C

Extreme hyperthermia, which goes up to 107 degrees F. = 41.5C

I use a cocoon blanket-type hyperthermia kit, priced variably from about $250 to $600. This allows a three-zone temperature infra-red setting (top, middle and bottom). I use 50C/55C/50C and lie in it for 50 minutes (on alternate days) – my arm-pit temperature rises about 3C by the end, so presumably inner core from 36.8 to 39.8C – then shower off.

Enhanced oxygen[cxxiv]

An air ionizer (or negative ion generator) is a device that uses high voltage to ionize (electrically charge) air molecules. Negative ions, or anions, are particles with one or more extra electrons, conferring a net negative charge to the particle. Cations are positive ions missing one or more electrons, resulting in a net positive charge. Most commercial air purifiers are designed to generate negative ions. Another type of air ionizer is the ESD ionizer (balanced ion generator) used to neutralize static charge.[cxxv]

Low-Dose Naltrexone – LDN[cxxvi]

LDN is a safe and inexpensive prescription drug which can be used as immunotherapy for most types of cancer and may also have direct anti-tumour activity.

Naltrexone is an opioid antagonist. It blocks the receptors that bind heroin, morphine, other narcotic drugs and the body’s own endogenous opioids like beta endorphin. In doses of 50 mg a day or more, it is used in narcotic and alcohol withdrawal.

When used in low doses (usually 4.5 mg), however, naltrexone increases the secretion of these endogenous opioids, which not only relieve pain, but also regulate the immune system. This has led to its use as a treatment for HIV/AIDS, autoimmune diseases and fibromyalgia. It is especially popular as a treatment for multiple sclerosis.

LDN’s Mode of Action in Cancer

In the 1980s, researchers like Ian S. Zagon noticed that when used in large doses, naltrexone stimulated the growth of cancer, but low doses had the opposite effect. Low dose naltrexone increases the secretion of several opioid peptides, such as beta endorphin and methionine enkephalin (also known as met enkephalin and opioid growth factor or OGF).

Beta endorphin acts as a non-specific cancer immunotherapy by boosting the action of natural killer cells (NK cells). Met enkephalin/OGF has direct anti-tumour action through opioid receptors that have been detected in many types of malignant tumours. It inhibits angiogenesis (formation of new blood vessels), without which cancer cannot grow.

LDN is not a “cure for cancer.” It does not help everyone, but in many cases it can stop the growth of tumours or even shrink them, but still the patient has to continue taking it until the rest of his life or until a more effective treatment is found.

Clinical Trials, Studies and Publications

There are dozens of lab studies which show that either OGF or low doses of naltrexone can inhibit cancer growth in the following types of cancer:

ovarian cancer

thyroid follicular cancer

head and neck cancer

pancreatic cancer

renal cell cancer (kidney cancer)

neuroblastoma

colon cancer

melanoma

Additionally, receptors for OGF have been found in throat cancer, brain tumours, breast cancer, oesophageal cancer, stomach cancer, liver cancer, lung cancer, leukaemia and multiple myeloma. Beta-endorphin has been shown to suppress growth of prostate cancer.

Unfortunately, no proper clinical trials have been published on LDN. There are published case studies of impressive results with LDN in metastatic pancreatic cancer (which is one of the most notorious, if not the most notorious of all, cancers to treat) and B-cell lymphoma. In pancreatic cancer, it was combined with alpha lipoic acid, which suppresses cancer growth by inhibiting NF-kappa B.

Anecdotally, LDN has also been prescribed to help the following cancers:

bladder cancer

carcinoid tumor

uterine cancer

PsychoNeuroImmunology- PNI[cxxvii]

There is now much research proving the interrelationship between the mind and the body, including mental states affecting the outcomes of illnesses – of which the placebo effect is perhaps the most famous. This covers three main areas: hypnotherapy, cognitive behaviour therapy, and meditation. Each has been shown to have a positive outcome for cancer.

Chemotherapy Help[cxxviii]

Vit.D3  4,000IU-12,000IU daily – enhances efficacy of chemo

Magnesium 500mg daily – replaces severe depletion

Ubiquinol form of Co-enzyme Q10 – 200mg/day

glutamine powder 10 grams (3 scoops) 3 times a day to minimize the side effects of chemo including neuropathy

Vit.A – 3,000IU/850mcg

Vit.C –  5 gms/day

Curcumin + piperene – 8 – 10 gms/day – enhances chemo, especially cisplatin

Green or white tea[cxxix]

Astralagus – an immune booster[cxxx]; anti-cancer generally;

Aloe Vera – enhances chemo’s effects, enhances apoptosis, improves immune system

Milk thistle[cxxxi]

Bromelain – 500mg

Resveratrol 500mg – enhances chemo’s effect[cxxxii] – but may cause diarrhoea[cxxxiii]

Medicinal mushrooms – various

Exercise: as vigorous as possible – walking 30’ day, jogging if poss., and resistance training

Stay off sugar, sodium (salt) and fruit juices

My Daily regime

This is an example of how I implement my anti-cancer days

Each day this is made up of four components (which often overlap):

1.      General healthiness stuff:

  • Lots of fresh (raw) organic veggies and some low glycaemic fruits
  • Supplements such as vitamins & minerals, probiotics, proteolytic enzymes
  • Alkalising – lots of veggies
  • Minimise carbohydrates in general, but especially fast-carbs (sugar, bread, potatoes, pasta) & alcohol
  • Exercise – walk, about one hour daily
  • Avoid unhealthy stuff: smoking, pollutants (aerosols – air-fresheners, solvents, etc)

2.      Specific anti-cancer stuff

  • Supplements such as curcumin, Graviola, Astralagus, Bee Propolis, Vit.D3,         Co.Q10, Vit.C[cxxxiv]
  • Foods: pau d’arco & green/white tea (alternatively?), juicing & eating cruciferous veggies (such broccoli, beetroot), extra virgin olive oil[cxxxv]
  • Avoid sugar, red meat (and maybe dairy products[cxxxvi]), processed meats, fried foods – these foods promote cancer (especially sugar)
  • Oxygenate – ionisers, enhanced oxygen, vigorous exercise[cxxxvii]

3.      Specific immune boosting stuff

  • Supplements such as PeakImmune4, Beta-Glucan, AveULTRA
  • Foods such as wheat-grass & spirulina+chlorella
  • Ionised air & (enhanced air) oxygen

4.      Feedback – to let myself know how I’m going on

  • Daily: body composition: weight, muscle-mass, fat%, basal metabolic rat; urine pH.
  • Bi-monthly/quarterly cancer marker tests (NMP22, CEA, etc),
  • Less frequent inflammation checks, mineral & vitamin blood levels.

Diet/nutrition:

On getting up: Nattokinase, Acetyl L-Carnitine

Breakfast

Egg, veggie sausage, mushrooms and tomatoes;

Supplements: NutriShield[cxxxviii] package of vitamins, 2 x PeakImmune4, L-arginine 1gm, Vit.D3 2,400IU, Quercetin 800mg, L-Carnosine 250mg, fish-oil 1gm, folic acid 400mcg, flaxseed oil 1gm, CLA 500mg, Nattokinase, Vit.K 100mcg, Vit.K2, 2 x curcumin+piperene 1000mg, niacin 100mg, manganese chloride 100mg, Graviola x 2, Blue-Green algae; Cup of pau d’arco tea

Mid-morning – cup of white tea
Lunch

Organic green salad, mushroom, garnished olive oil & organic apple vinegar, cinnamon, chilli pepper, and Vit.D3 (& sometimes curcumin+biopiperene powder); pau d’arco tea

Mid-afternoon

Cup of white tea, with an apple and nuts

Dinner

greens (broccoli, sprouts, leaves),veggie protein, fish or white meat. Berries. White tea; L-Arganine 1gm, 1gm fish oil, Graviola 500mg x 2, Green sea algae, L-Carnitine, pau d’arco tea

Before bed

Low-Dose Naltrexone 4.5mg, Nattokinase, Serrapeptase, Melatonin

I also use coconut oil. I occasionally drink organic raw cocoa powder with xylitol & coconut milk.

Oxygenation/Exercise:

About one hour’s fairly vigorous walk a day. Sometimes interval aerobic jogging for about30’.

50’ of enhanced ionised oxygen (30%) daily; an all night ioniser by my bed. Filtered water.

Hyperthermia alternate days: 50′ @ about 50C

Being considered

If I detect a resurgence of my cancer, I may do one or more of the following (some of which I’ve done earlier but discontinued on the assumption either that it had done its work or was ineffective):

Mid-afternoon mashed ½ avocado & 8oz carrot juice (I did this for about a month early on).

The “How to stop cancer” protocol.[cxxxix]

Meditation.[cxl]

Revised Budwig[cxli]: 2 teaspoons of wild salmon oil & 2 tablespoons of un-denatured whey hand mixed together and spooned in, 2-10 times a day for three days; thence once a day thereafter. But there’s some debate about this revision. For original: http://www.youtube.com/watch?v=RSoddptWL0s and http://www.budwig-videos.com/

EFT, Ukrain, Intravenous Vit.C

Del-Immune, Ultra H3 Plus, lactoferrin, PectaSol, Oncovite, Flor-Essence, Coley’s vaccine cancer treatment, & Essiac – see http://www.geoffreyfalk.com/wp_blog/?p=3113)

Mix curcumin+piperene with coconut oil before taking it

Oxygen/ozone therapy

Feedback

An essential part of my cancer management is knowing how I am doing – feedback. Perhaps it is because I am an Engineer that I am more sensitive than most to this very important aspect of achieving a desired goal – encapsulated in the phrase “knowledge of results improves performance”. To this end, I measure and record all that I can on a daily basis:

  • Medical data – biochemistry, cancer markers, scans, consultations – so that I can detect any changes in my cancerousness
  • Body composition – a well-known side-effect of cancer is a rapid change in body composition; particularly of muscle-mass – cachexia[cxlii] (not to be confused with sarcopenia, muscle-loss due to ageing), which is itself enhanced by pro-inflammatory immune cells (cytokines)[cxliii]. Carnosine and Ubiquinol (enhance Co-enzyme Q10) may counteract this, as may hydrazine sulphate[cxliv].
  • Nutrition – there is an ocean of anti-cancer dietary advice, much in conflict with one another. For what it is worth, after reading a lot of this, I have come to believe that the best nutrition is one with a lot of fresh fruit and vegetables, preferably organic; as little carbs as possible (see Gary Taubes “Good Calories, Bad Calories”, and all the research that implicates blood sugar as a cancer feeder – carbs are the main source of sugar in the blood); filtered water (not osmotically derived); fish; avoid red and processed meat; little or no alcohol.
  • Medicines – I keep a note of all that I take, so that if something particularly badly effects me without any clear advantage, I can avoid it in future; and to see if, later, there’s any correlation with my other data.
  • Supplements – similar reason as for medicines
  • Exercise – to ensure I’m keeping on track to average the equivalent of one hour’s vigorous (heart-rate over 50% of max) walking a day. I have a watch heart-rate monitor that I wear most of the day. Such exercise may also counteract any tendency to cachexia.
  • Checking my urine pH – more acidic is probably not too good. As a side advantage, I collect my urine in a clear cup lately, and that has enabled me to see what I may have previously missed: blood specks/flakes/clots occasionally – to me, another ‘measure’ of my cancerousness. I also use biochemistry dipsticks, which often show out-of-normal readings. I hope to tie all these in to changes in my diet, supplements, and exercise – thus enabling me to take avoidance action. Different cancers would suggest different checks, such as the size of skin lesions and/or moles for skin cancers.

Alternatives I’ve Tried and Abandoned

Now bear with me. I’ve tried a lot of what may seem barmy treatments. Look, I have been desperate; and when the ‘experts’ (heh! why am I putting it in inverted commas? – they really are the acknowledged experts) told me I only had weeks to live, I was up for anything.

However, given the wide variance of human beings, what doesn’t work for one may work for another. For what it’s worth, I think most of those offering alternative ‘cures’ are genuine (in that they sincerely believe their treatment works) – and they may well have done so for themselves. But as there is a legion of examples of spontaneous remissions/cures, it could be that they had one of these and so were not cured by their suggested cure.

Fiery chillies, garlic and butter

Yes, I know this may sound barmy – but then so does injecting a strong poison into one’s veins and hoping it will kill all the cancer cells before it kills the rest of you (chemotherapy). There were, for me, three things that led me to try this:

  • The book “The Doctor Who Cures Cancer” by William Kelley Eidem, had impressive support – from Dr Barry Sears and Dr Atkins, both of whom I have respect for.
  • There didn’t seem to be any bad side-effects, apart from the intense ‘heat’ from the chilli and the possible adverse dietary factor of butter (which I’ve since learnt are wrongly made).
  • When I did try it, it cured one of the side-effects of my chemo: neuropathy of my inner-left thigh (deadness) – as long as I did it (or any other hot chilli intake).

So when the author, Mr Eidem, promoted a supposed cancer cure based on this book (tho’ I could never understand from my reading how he got to this cure), I tried it for a few months. Alas, during this time, my NMP-22 bladder cancer marker showed increased cancerousness. So I deemed this ‘cure’ as not one that works for me.

Alkalizing

There is a lot of chatter on the ‘net that alkalizing one’s body, via a diet very high in vegetables and fruit plus alkaline water. Couple that with the plausible anti-cancer theory based on Nobel prize-winning Dr Warburg’s idea of increasing the body’s oxygen state, and this become a reasonable anti-cancer treatment.

I even bought an expensive water alkalizer, before I learnt that this aspect of the theory is bunk.[cxlv]

Again, I didn’t find my cancerousness fell whilst following this approach, so I did not continue. However, I feel that there’s something in it, and so still check my urine pH as a possible indicator of my general healthiness – the less acidic it is, the better I am. This is because some things in my diet that I know are bad  (alcohol, sugar, meat, etc) make my urine more acidic.

Veganism

Throughout my adult life, I’ve been attracted to the supposed benefits of vegetarianism (no meat and, in the more extreme form, no fish) and veganism (no animal products whatsoever – no milk, cheese, eggs, yoghourt, etc as well as no meat or fish). So when I read “The China Study” by Dr Campbell & son with its convincing case for a vegan diet being both cancer-preventative and curative, I tried it for a couple of months. But again, my cancer marker signs increased rather than decreased, so I abandoned it.

I should add that there are good arguments against De Campbell’s views too – as there are to any anti-cancer theory. That’s why I need to weigh up as much as possible and decide for myself. A good medical doctor should support this approach; sadly, few do.

Juicing

I initially juiced twice a day. This was made up of:

  • Handful/cupful of broccoli
  • Ditto of cauliflower
  • A carrot
  • Half a beetroot
  • A knob of ginger
  • Two Brussels’ sprouts
  • An apple
  • A ring of pineapple

I still think this is probably a healthy thing to do, but as my cancer regrew during the doing of this; and later my cancer marker increased (having gone down); I decided that it probably didn’t make enough difference to warrant the expense and trouble. So I stopped.

Budwig Diet

Difficult one this. I did the mix of cottage cheese and flax-seed oil for about 3 months, but my cancer tumour regrew. I tried it again later, but, as with juicing above, my cancer marker went up after having been low. Now I know that there’s more to the Budwig diet than just the cottage cheese & oil – fresh veggies and fruit, for instance; and no supplements (which I continued). So it may be that a more rigorous following of her diet may be more successful.

Conclusions

Cancer is NOT a trauma – you won’t die within hours/days of diagnosis. So take time to know the full range of alternatives, both orthodox and CAM, upsides and downsides. Orthodox and much CAM can generally be done in parallel, to your benefit – even tho’ the docs won’t know much, if anything, about CAM research. People generally die of the wasting away of muscles (cachexia) due to the cancer taking up most of the energy, rather than the cancer itself. So ensure you eat well and check your muscle mass.

It is probable that whatever your lifestyle was, this led to or helped the cancer (such as smoking, poor nutrition, inadequate exercise, being fat, poor water supply, working with solvents/paints, hair dyes/deodorants/aerosols/cosmetics). Therefore you need to look to changing your lifestyle (stop smoking, improve nutrition, enhance exercising, move away from pollution)[cxlvi]. Cancer is a warning sign to become more congruent within yourself and your environment.

Improving your general healthiness will probably help your body slow down the cancer

Enhancing your immune system will probably slow down the cancer’s growth and maybe even drive it into regression (make it smaller) or remission (non-detectable). Getting rid of excess body fat will help.[cxlvii]

Taking anti-cancer foods and/or supplements will possibly drive the cancer into remission, with a greater chance than any of the orthodox treatments.

Initially, it is probably best to avoid surgery, chemotherapy, and radiation whilst doing some CAM helps and seeing if this improves your healthiness.

If you do do any of the orthodox treatments, my protocol will probably both minimise the side-effects and enhance to effectiveness of the treatment. Note also that the opiates for pain relief may be cancer enhancers[cxlviii]

This is not an exhaustive exposition, for two reasons: I cannot recall all that I have done; and this is an ongoing project, changing oft times.

But this will give a fair representation of the expenditure and time I have to spend since being diagnosed with terminal bladder cancer on 15th October, 2007. I hope knowledge of my successful journey will help you.

I can be contacted at ianclements@hotmail.com

Acknowledgements

First and foremost, my wife, children, and extended family – for their support, both emotionally and physically in looking after me.

Dr Bernardo Majalca, Preventive Medical Research, who gave me hope when the orthodox professionals gave non, and showed the way that CAM enhanced mainstream medicine.

Gene Early, who guided me to have greater congruence within myself.

Dr Huddart, of the Royal Marsden, who contradicted the first three experts by telling me that chemotherapy did indeed have a success for cases such as mine, albeit slight (5%).

Dr Marie Wilkins, the oncologist at the Royal Sussex Hospital, who tolerated my CAM support strategies whilst providing excellent chemotherapy.

Jonathan Chamberlain for his comprehensive CAM guide to effective cancer therapies

My fellow colleagues on the bladder cancer forums for their information and support (http://www.blcwebcafe.org/, http://www.inspire.com/groups/bladder-cancer-advocacy-network/) especially Peter Granger.

Bibliography

As well as virtually daily trawling of the Internet and reading various newspaper articles and magazines related to cancer (all of which has led to the endnoted references below), I have read and/or referred to the following books:

“Cancer: The Complete Recovery Guide” Jonathon Chamberlain, Long Island Press, 2008

“Anti-cancer: a new way of life” Dr David ServanpSchreiber, Penguin, 2007

“Definitive Guide To Cancer” – 2nd ed. Lise Alschuler & Karolyn A Gazella, Celestial Arts, 2007 –  very good survey of orthodox and CAM (Complimentary & Alternative Medicine).

“The Cancer Directory” – Dr Rosy Daniel, Thorsons, 2005

“The Hidden Story of Cancer” – Brian Scott Peskin, self-published, 2007 – a well argued alternative approach to dealing with cancer.

“Choices in Healing” – Michael Lerner, MIT Press, 1994

“Cancer: A Second Opinion” – Joseph Issels, MD, Avery, 199

“The Truth About Your Immune System” – Havard Medical School, 2007. The orthodox view of immune enhancing (it can’t be done!).

“The Official Anti-Aging Revolution” – Ronald Klatz & Robert Goldman, Basic Health Pub, 2007. Altho’ about anti-ageing, it has much to say about cancer.

“Snake Oil” – John Diamond, Vintage UK, 2001. A trenchant argument against CAM.

“Natural Compounds in Cancer Therapy” – John Boik, Oregon Medical Press, 2001. A good listing (tho’ a bit dated) of most CAM compounds.

“Nutritional Medicine” Dr Gaby, Fritz Perlberg Pub, 2010

“Spontaneous Regression” – Donald H MacAdam, self-published, 2003. A well argued, with evidence, case for immunotherapy alone.

“Conventional Cancer Cures – What’s The Alternative” – Chris Woollams, Health Issues, 2004

“Cancer Positive” – Dr James Colthurst, Michael O’Mara Books Ltd, 2003

“Dismantling Cancer” – Francisco Contreras, Jorge Barroso-Aranda, Daniel E Kennedy, Interpacific press, 2004

“The Breuss Cancer Cure” – Rudolf Breus, Alive Books, 1995

“Alkalize of Die” – Dr Theodore A Baroody, Holographic Health Press, 2006 – a bit dubious; probably Young’s book is better, or Murray’s http://acidalkalinediet.com/letter.htm

“The Doctor Who Cures Cancer” – William Kelley Eidem, self publication, 1997. An interesting CAM approach, with much supportive evidence.

“The China Study” by Dr Campbell & son. A convincing case for a vegan diet being both cancer-preventative and curative.

http://gotbladdercancer.blogspot.com/ A BC survivor who gives a blow-by-blow account of his own and other’s journey and ideas on improving survival chances, with an interesting flow-chart

“The Cancer Clock” Ed. Sotiris Missailidis, Wiley, 2007

“Say No to Cancer” Patrick Holford, Piatkus, 1999


[ii] http://www.sciencedaily.com/releases/2010/11/101115074040.htm

http://www.sciencedaily.com/releases/2010/11/101109133139.htm

http://www.curetoday.com/index.cfm/fuseaction/blog.showIndex/guest/2010/6/6/New-exercise-guidelines-for-cancer-survivors

http://latimesblogs.latimes.com/booster_shots/2010/06/exercise-cancer-new-guidelines-.html

http://www.longevitymeme.org/news/vnl.cfm?id=4695

http://www.naturalnews.com/028599_physical_health_mental.html

http://jiharun.blogspot.com/2010/04/runners-and-skin-cancer.html

http://www.sciencedaily.com/releases/2010/02/100215100757.htm

http://www.sciencedaily.com/releases/2010/01/100125172946.htm

http://www.sciencedaily.com/releases/2009/10/091025091138.htm

http://www.sciencedaily.com/releases/2010/01/100128122142.htm

http://www.sciencedaily.com/releases/2010/01/100125172946.htm

http://online.wsj.com/article/SB10001424052748704350304574638331243027174.html

http://www.sciencedaily.com/releases/2009/12/091214162322.htm

http://www.sciencedaily.com/releases/2009/12/091207200911.htm

http://www.sciencedaily.com/releases/2009/11/091130161806.htm

http://www.sciencedaily.com/releases/2009/11/091123171228.htm

http://www.imt.ie/clinical/cancer/high-intensity-exercise-can-re.html

http://www.ncbi.nlm.nih.gov/pubmed/19574095?dopt=AbstractPlus

http://www.sciencedaily.com/releases/2009/10/091029102740.htm

http://www.sciencedaily.com/releases/2009/04/090423154237.htm

[iii] I use NutriShield daily packs, from Uni-Vite (http://uni-vite.com/scripts/index.aspx). This is a set of 7 pills containing all the compounds that medical scientist Dr Paul Clayton recommends, being frequently updated in the light of the latest research

[v] http://www.dailymail.co.uk/health/article-1335364/Tanned-women-live-longer-say-scientists-Lund-University-Sweden.html

http://www.redorbit.com/news/health/1957903/taking_vitamin_d_calcium_supplements_not_necessary/

http://www.nutritionj.com/content/9/1/60

http://www.urotoday.com/37/browse_categories/bladder_cancer/serum_vitamin_d_and_risk_of_bladder_cancer__abstract11112010.html

http://www.sciencedaily.com/releases/2010/11/101104094038.htm

http://www.sciencedaily.com/releases/2010/06/100618081333.htm

http://www.naturalnews.com/028609_vitamin_D_lymphoma.html

http://en.wikipedia.org/wiki/Vitamin_D

http://www.foodconsumer.org/newsite/Nutrition/kick_yourself_for_the_next_decade_1603100745.html

http://www.sciencedaily.com/releases/2010/03/100312133716.htm

http://www.sciencedaily.com/releases/2010/03/100307215534.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+sciencedaily+%28ScienceDaily:+Latest+Science+News%29&utm_content=Google+Feedfetcher

http://www.nytimes.com/2010/02/02/health/02well.html

http://healthyweightlossprograms.net/?p=2472

http://www.sciencedaily.com/releases/2009/07/090706171500.htm

http://www.sciencedaily.com/releases/2009/12/091206112517.htm

http://www.cancerepidemiology.net/article/PIIS187778210900143X/abstract?rss=yes

http://www.vitamindcouncil.org/newsletter/2008-jan.shtml

http://www.sciencedaily.com/releases/2008/11/081117091614.htm

http://harmonyhealth.wordpress.com/2008/11/06/you-dont-have-to-be-afraid-of-cancer-any-longer/

http://www.ncbi.nlm.nih.gov/pubmed/18029190

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17218096

http://www.sciencedaily.com/releases/2009/10/091009090431.htm

http://www.sciencedaily.com/releases/2010/02/100216113553.htm

http://www.sciencedaily.com/releases/2009/12/091201182624.htm

http://www.beating-cancer-gently.com/134nl.html

http://www.sciencedaily.com/releases/2009/11/091116085038.htm

http://www.sciencedaily.com/releases/2009/11/091115123715.htm

http://articles.latimes.com/2010/mar/15/science/la-sci-vitamind16-2010mar16

http://www.sciencedaily.com/releases/2010/04/100407121227.htm

http://www.sciencedaily.com/releases/2010/04/100415143906.htm

http://www.sciencedaily.com/releases/2010/05/100501013417.htm

http://www.sciencedaily.com/releases/2010/04/100429153955.htm

http://www.sciencedaily.com/releases/2010/04/100427182609.htm

http://www.sciencedaily.com/releases/2010/04/100425151136.htm

http://www.mdlinx.com/urology/newsl-article.cfm/3285900/ZZ2388573897646011308991/?news_id=903&newsdt=090810&subspec_id=510

[vii] “’Amazingly, most medical treatment simply isn’t backed up by good, quantitative evidence’. ….. The whole point of carrying out a study was to rigorously examine a question using tools and techniques that would yield solid data. ….And yet these studies, and most types of studies Dr Ioannidis looked at, were far more often than not driving to wrong answers.  The two-out-of-three wrongness rate Ionnidis found is worse than it sounds. He had been examining only [a tiny amount] of published research in the most prestigious medical journals.  …the wrongness rate would only be worse from there [less prestigious journals].” Freedman (see below, pp. 5,6) quoting John Ionnidis, MD & research medical mathematician @ Tufts-New England Medical Center.

[viii] “Wrong: Why Experts Keep Failing Us – and How to Know When Not to Trust Them” David H Freedman 2010 Little, Brown

[ix] Dr David Servan-Schreiber in his “Anti-Cancer: a new way of life” 2008 (see http://www3.mdanderson.org/streams/MDACCFlvPlayer2.html?xml=publicEd/config/Anti-Cancer_cfg)

“Integrative Oncology Essentials:  A Patients’  Guide To Cancer Care And Prevention”  Brian D. Lawenda, M.D. 2010 (see http://www.integrativeoncology-essentials.com). [“Integrative oncology is no longer an “alternative” approach to cancer care. Increasingly, prestigious academic cancer centers (for example: Harvard, Memorial Sloan Kettering, MD Anderson, Duke, UCSF) are incorporating integrative oncology within their practice of taking care of patients living with and beyond cancer.”]

“Natural compounds in cancer therapy” John Boik, MD 2001

“Nutritional Medicine” Alan R Gaby, MD 2010

“Definitive Guide to Cancer” Alsschuler & Gazella 2007 (2nd Ed)

There are also many websites offering a collation of the best of CAM, of which the UK one of http://www.canceractive.com/ is very comprehensive and up-to-date.

[xiv] It was thought that we all have a few cells frequently turning cancerous, but that our immune system deals with this without our becoming aware of it (it is seen in autopsies). “It was claimed in the past that cancer cells were forming non-stop but the immune system destroyed them. And everything which weakens it, for instance stress, may impede fighting the intruder. “Nowadays no one holds that opinion anymore”, says dr. Pardoll. Experiments on mice devoid of immune system did not confirm saliently higher cancer morbidity. Also among people with immune disorders under the influence of drugs preventing transplant rejection or as a result of AIDS a higher cancer prevalence ratio was not found.” http://www.blog.reserva-matrix.com/2010/04/26/can-stress-cause-cancer/

[xvii] http://www.jurology.com/article/S0022-5347%2807%2902288-4/abstract “History of Bacillus Calmette-Guerin and Bladder Cancer: An Immunotherapy Success Story”

[xx] “The Secret History of the War on Cancer” Devra Davis, Basic Books, 2007

[xxi] See: Good Calories, Bad Calories by Gary Taubs, Anchor Books, 2008

[xxix] http://www.sciencedaily.com/releases/2010/11/101115074040.htm

http://www.sciencedaily.com/releases/2010/11/101109133139.htm

http://www.curetoday.com/index.cfm/fuseaction/blog.showIndex/guest/2010/6/6/New-exercise-guidelines-for-cancer-survivors

http://latimesblogs.latimes.com/booster_shots/2010/06/exercise-cancer-new-guidelines-.html

http://www.longevitymeme.org/news/vnl.cfm?id=4695

http://www.naturalnews.com/028599_physical_health_mental.html

http://jiharun.blogspot.com/2010/04/runners-and-skin-cancer.html

http://www.sciencedaily.com/releases/2010/02/100215100757.htm

http://www.sciencedaily.com/releases/2010/01/100125172946.htm

http://www.sciencedaily.com/releases/2009/10/091025091138.htm

http://www.sciencedaily.com/releases/2010/01/100128122142.htm

http://www.sciencedaily.com/releases/2010/01/100125172946.htm

http://online.wsj.com/article/SB10001424052748704350304574638331243027174.html

http://www.sciencedaily.com/releases/2009/12/091214162322.htm

http://www.sciencedaily.com/releases/2009/12/091207200911.htm

http://www.sciencedaily.com/releases/2009/11/091130161806.htm

http://www.sciencedaily.com/releases/2009/11/091123171228.htm

http://www.imt.ie/clinical/cancer/high-intensity-exercise-can-re.html

http://www.ncbi.nlm.nih.gov/pubmed/19574095?dopt=AbstractPlus

http://www.sciencedaily.com/releases/2009/10/091029102740.htm

http://www.sciencedaily.com/releases/2009/04/090423154237.htm

[xxx] I use NutriShield daily packs, from Uni-Vite (http://uni-vite.com/scripts/index.aspx). This is a set of 7 pills containing all the compounds that medical scientist Dr Paul Clayton recommends, being frequently updated in the light of the latest research

[xxxii] http://www.dailymail.co.uk/health/article-1335364/Tanned-women-live-longer-say-scientists-Lund-University-Sweden.html

http://www.redorbit.com/news/health/1957903/taking_vitamin_d_calcium_supplements_not_necessary/

http://www.nutritionj.com/content/9/1/60

http://www.urotoday.com/37/browse_categories/bladder_cancer/serum_vitamin_d_and_risk_of_bladder_cancer__abstract11112010.html

http://www.sciencedaily.com/releases/2010/11/101104094038.htm

http://www.sciencedaily.com/releases/2010/06/100618081333.htm

http://www.naturalnews.com/028609_vitamin_D_lymphoma.html

http://en.wikipedia.org/wiki/Vitamin_D

http://www.foodconsumer.org/newsite/Nutrition/kick_yourself_for_the_next_decade_1603100745.html

http://www.sciencedaily.com/releases/2010/03/100312133716.htm

http://www.sciencedaily.com/releases/2010/03/100307215534.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+sciencedaily+%28ScienceDaily:+Latest+Science+News%29&utm_content=Google+Feedfetcher

http://www.nytimes.com/2010/02/02/health/02well.html

http://healthyweightlossprograms.net/?p=2472

http://www.sciencedaily.com/releases/2009/07/090706171500.htm

http://www.sciencedaily.com/releases/2009/12/091206112517.htm

http://www.cancerepidemiology.net/article/PIIS187778210900143X/abstract?rss=yes

http://www.vitamindcouncil.org/newsletter/2008-jan.shtml

http://www.sciencedaily.com/releases/2008/11/081117091614.htm

http://harmonyhealth.wordpress.com/2008/11/06/you-dont-have-to-be-afraid-of-cancer-any-longer/

http://www.ncbi.nlm.nih.gov/pubmed/18029190

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17218096

http://www.sciencedaily.com/releases/2009/10/091009090431.htm

http://www.sciencedaily.com/releases/2010/02/100216113553.htm

http://www.sciencedaily.com/releases/2009/12/091201182624.htm

http://www.beating-cancer-gently.com/134nl.html

http://www.sciencedaily.com/releases/2009/11/091116085038.htm

http://www.sciencedaily.com/releases/2009/11/091115123715.htm

http://articles.latimes.com/2010/mar/15/science/la-sci-vitamind16-2010mar16

http://www.sciencedaily.com/releases/2010/04/100407121227.htm

http://www.sciencedaily.com/releases/2010/04/100415143906.htm

http://www.sciencedaily.com/releases/2010/05/100501013417.htm

http://www.sciencedaily.com/releases/2010/04/100429153955.htm

http://www.sciencedaily.com/releases/2010/04/100427182609.htm

http://www.sciencedaily.com/releases/2010/04/100425151136.htm

http://www.mdlinx.com/urology/newsl-article.cfm/3285900/ZZ2388573897646011308991/?news_id=903&newsdt=090810&subspec_id=510

[xxxvi] “Good Calories, Bad Calories” pp:89-99 Gary Taubes, Anchor Books, 2007

[xlii] See: Good Calories, Bad Calories by Gary Taubs, Anchor Books, 2008

[xliv] http://www.sciencedaily.com/releases/2010/11/101115074040.htm

http://www.sciencedaily.com/releases/2010/11/101109133139.htm

http://www.curetoday.com/index.cfm/fuseaction/blog.showIndex/guest/2010/6/6/New-exercise-guidelines-for-cancer-survivors

http://latimesblogs.latimes.com/booster_shots/2010/06/exercise-cancer-new-guidelines-.html

http://www.longevitymeme.org/news/vnl.cfm?id=4695

http://www.naturalnews.com/028599_physical_health_mental.html

http://jiharun.blogspot.com/2010/04/runners-and-skin-cancer.html

http://www.sciencedaily.com/releases/2010/02/100215100757.htm

http://www.sciencedaily.com/releases/2010/01/100125172946.htm

http://www.sciencedaily.com/releases/2009/10/091025091138.htm

http://www.sciencedaily.com/releases/2010/01/100128122142.htm

http://www.sciencedaily.com/releases/2010/01/100125172946.htm

http://online.wsj.com/article/SB10001424052748704350304574638331243027174.html

http://www.sciencedaily.com/releases/2009/12/091214162322.htm

http://www.sciencedaily.com/releases/2009/12/091207200911.htm

http://www.sciencedaily.com/releases/2009/11/091130161806.htm

http://www.sciencedaily.com/releases/2009/11/091123171228.htm

http://www.imt.ie/clinical/cancer/high-intensity-exercise-can-re.html

http://www.ncbi.nlm.nih.gov/pubmed/19574095?dopt=AbstractPlus

http://www.sciencedaily.com/releases/2009/10/091029102740.htm

http://www.sciencedaily.com/releases/2009/04/090423154237.htm

[xlvii] http://www.sciencedaily.com/releases/2010/07/100712191208.htm

http://www.sciencedaily.com/releases/2010/06/100629131316.htm

http://liveonearth.livejournal.com/868645.html

http://www.sciencedaily.com/releases/2010/06/100615105243.htm

http://www.ncbi.nlm.nih.gov/pubmed/20388854

http://lpi.oregonstate.edu/infocenter/phytochemicals/isothio/

http://brassicatea.com/blog/?p=291

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2226384

http://www.thebignm.com/regions-of-health/extract-of-broccoli-sprouts-may-protect-against-bladder-cancer/

http://www.sciencedaily.com/releases/2009/04/090420151225.htm

http://cancer.akacity.com/2008/12/17/the-anti-cancer-properties-of-broccoli/

http://www.bcan.org/stay-informed/bladder-cancer-news/

http://www.naturalnews.com/025893.html

http://www.dailymail.co.uk/health/article-1036857/Broccoli-juice-helps-patient-beat-bladder-cancer.html

http://www.cancerdaily.com/read.php?id=184, and
http://news.yahoo.com/s/hsn/20071207/hl_hsn/blackberriesbroccolisproutsbattlecancer

[xlviii] For a list of foods that fight cancer: http://www.wbay.com/Global/story.asp?S=9866954

[lviii] Via Orthomolecular Medicine News Service, January 5, 2011:

Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 27th Annual Report. Clinical Toxicology (2010). 48, 979-1178. The full text article is available for free download athttp://www.aapcc.org/dnn/Portals/0/2009%20AR.pdf  The data mentioned above are found in Table 22B, journal pages 1138-1148.

[lix] Aloe Vera: http://www.cnnexpress.info/2010/08/aloe-vera-and-cancer-treatments.html

WDDTY Vol20 No 11 p.20

http://erythemagroup.com/cancer-new-alternative-therapy.html

Dr Al Sears Newsletter 15 Apr 2010-04-15

Lim, Beong Ou, et al. “Efficacy of Dietary Aloe Vera Supplementation on Hepatic Cholesterol and Oxidative status in Aged Rats” J-Nutr-Sci-Vitaminol-(Tokyo). 2003 Aug; 49(4): 292-6.

http://erythemagroup.com/cancer-new-alternative-therapy.html

[lx] http://www.naturalnews.com/alpha_lipoic_acid.html

http://www.thehealthierlife.co.uk/natural-health-articles/cancer/intravenous-vitamin-c-cancer-treatment-00143.html http://www.cancerfightingstrategies.com/?engine=adwords!800&keyword=*cancer*&match_type=content&gclid=COydgO6Bi5cCFQ1PQgodY1uC9Q

“Other research on alpha-lipoic acid has shown that it might: inhibit the activation of “nuclear factor kappa-B,” a protein complex involved in cancer and the progression of AIDS. (Suzuki YJ, et al., Biochemical & Biophysical Research Communications, 1992;189:1709-15).  ‘The therapeutic potential of alpha-lipoic acid is just beginning to be explored,” observed Packer, “but this compound holds great promise.'”

[lxxiii] http://articles.mercola.com/sites/articles/archive/2004/07/17/cla-cancer.aspx

http://en.wikipedia.org/wiki/Conjugated_linoleic_acid

Excessive Dietary Fat Caused 300 Percent Increase in Metastasizing Tumor Cells In Animal Models

http://www.sciencedaily.com/releases/2009/02/090225172639.htm

http://www.health.am/cr/more/calcium-associated-with-lower-risk-of-cancer-in-women/

http://www.apjohncancerinstitute.org/cancer/bladder.htm

file:///D:/Health/Info/Nutrition%20&%20Supplements/CLinoleicAcid%20&%20Cancer.htm

Supplementation with trans10cis12-conjugated linoleic acid induces hyperproinsulinaemia in obese men: close association with impaired insulin sensitivity http://www.ncbi.nlm.nih.gov/pubmed/15168020?dopt=Abstract

http://www.sciencedaily.com/releases/2009/04/090413180545.htm

[lxxiv] http://www.canceractive.com/cancer-active-page-link.aspx?n=1571&Title=Curcumin,%20or%20turmeric

http://www.sciencedaily.com/releases/2010/10/101019111712.htm

http://www.nutrivene.com/view_item.php?ProductID=331&

Serum-Solubilized Curcumin. Via Pete Granger on Bladder Cancer Web Café 15:21 16 Jul 2010

http://www.urotoday.com/61/browse_categories/prostate_cancer/polybetacyclod extrincurcumin_selfassembly_a_novel_approach_to_improve_curcumin_delivery_a nd_its_therapeutic_efficacy_in_prostate_cancer_cells__abstract07092010.html

http://www.sciencedaily.com/releases/2010/04/100428204552.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+sciencedaily+(ScienceDaily:+Latest+Science+News)&utm_content=Google+Feedfetcher

http://www.irishtimes.com/newspaper/health/2010/0427/1224269145536.html

WDDTY Vol 20 No 11 p.21

http://timesofindia.indiatimes.com/life/health-fitness/health/Turmeric-pepper-help-keep-breast-cancer-at-bay/articleshow/5313733.cms

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2225845

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2225526

http://kitchen-leopardfourwings.blogspot.com/2009/08/early-study-shows-spice-stunts-deadly.html

Cancer Research 68, 5345-5354, July 1, 2008. doi: 10.1158/0008-5472.CAN-07-6805

http://www.goodhealth.nu/News_Articles/050111-curcumin-anti-cancer-US.htm

http://www.nutraingredients-usa.com/news/ng.asp?id=75745-curcumin-cancer-turmeric

http://lpi.oregonstate.edu/infocenter/phytochemicals/curcumin/

http://cancerres.aacrjournals.org/cgi/content/abstract/68/13/5345

http://www.ncbi.nlm.nih.gov/pubmed/18342436

International Braz J Urol Vol. 35 (3): 354-361, May – June, 2009

http://www.eyesight.nu/curcumin/Cucumin_Issue_01.htm

[lxxxii] http://www.sciencedaily.com/releases/2010/03/100311074123.htm

Health Sciences Institute Special Research Alert “Cancer’s Kryptonite?”

Cell Bio Toxicol 1997 Feb; 13(2): 95-102

Radiats Biol Radioecol 1999 Sep-Oct; 39(5):572-7

Eur J Haematol 1995 Jan; 54(1): 27-33

[lxxxv] http://www.sciencedaily.com/releases/2010/10/101027202507.htm

http://www.sciencedaily.com/releases/2010/06/100607101702.htm

http://www.sciencedaily.com/releases/2010/06/100609171802.htm

http://www.postbulletin.com/newsmanager/templates/localnews_story.asp?z=10&a=455834

http://www.canceractive.com/cancer-active-page-link.aspx?n=1007&Title=Green%20Tea

http://www.sciencedaily.com/releases/2009/08/090810085312.htm

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2226418

http://salud.momento24.com/en/2010/01/16/does-green-tea-offers-protection-against-lung-cancer/

http://doctor.ndtv.com/storypage/ndtv/id/4034/Green_tea_lowers_blood_cancer_risk.html

http://www.sciencedaily.com/releases/2009/08/090810085312.htm

http://www.thecamreport.com/index.php/2009/07/14/does-green-tea-prevent-cancer/

http://articlesofhealth.blogspot.com/2009/07/green-tea-is-acidic-and-may-cause.html

http://www.eurekalert.org/pub_releases/2009-06/aafc-gtm061509.php

http://www.thenews.com.pk/print1.asp?id=165149

http://www.hsibaltimore.com/ealerts/ea200609/ea20060920b.html

http://www.thehealthierlife.co.uk/natural-health-articles/cancer/green-tea-prevent-cancer-warning-women-00126.html

http://www.wp-wordpress.com/123808/cancer-open-question-does-anyone-know-someone-preferably-women-who-hadhas-bladder-cancer#respond

http://www.sciencedaily.com/releases/2009/05/090526163010.htm

http://www.emaxhealth.com/1275/77/33408/green-tea-reduces-heart-disease-risk.html

From a Dr Al Sears email on 17 Sep 09

1 R. Chan, J. Woo, E. Suen, J. Leung, N. Tang, “Chinese tea consumption is associated with longer telomere length in elderly Chinese men” British Journal of Nutrition, Aug, 12, 2009 http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6047776

http://www.sciencedaily.com/releases/2009/09/090916103424.htm

http://www.naturalnews.com/028600_eye_disease_green_tea.html

[xcii] I use NutriShield daily packs, from Uni-Vite (http://uni-vite.com/scripts/index.aspx). This is a set of 7 pills containing all the compounds that medical scientist Dr Paul Clayton recommends, being frequently updated in the light of the latest research

[xciii] http://www.naturalnews.com/028344_folk_remedies_cancer.html

http://www.naturalproductsinsider.com/hotnews/d-fraction-may-be-therapeutic-to-bladder-canc.html

http://www.mdlinx.com/UrologyLinx/newsl-article.cfm/2703727/ZZ2388573897646011308991/?news_id=903&subspec_id=510

http://resultsfitness.wordpress.com/2009/01/21/17-medicinal-mushrooms-containing-anti-cancer-phytochemicals/

http://www.allvoices.com/s/event-6482304/aHR0cDovL3d3dy5OYXR1cmFsTmV3cy5jb20vMDI5NDI0X211c2hyb29tc19pbW11bmVfc3lzdGVtLmh0bWw=

http://www3.interscience.wiley.com/journal/123359220/abstract?CRETRY=1&SRETRY=0

http://www.naturalnews.com/028344_folk_remedies_cancer.html

WDDTY Vol 20 No 11 p.22

http://www.canceractive.com/cancer-active-page-link.aspx?n=1488&Title=Medicinal%20Mushrooms%20help%20fight%20cancer

http://www.sciencedaily.com/releases/2009/12/091223094729.htm

http://www.freshplaza.com/news_detail.asp?id=54914

http://www3.interscience.wiley.com/journal/122590057/abstract?CRETRY=1&SRETRY=0

http://www.naturalproductsinsider.com/hotnews/d-fraction-may-be-therapeutic-to-bladder-canc.html

http://www.mdlinx.com/UrologyLinx/newsl-article.cfm/2703727/ZZ2388573897646011308991/?news_id=903&subspec_id=510

http://resultsfitness.wordpress.com/2009/01/21/17-medicinal-mushrooms-containing-anti-cancer-phytochemicals/

http://www.happytrucker.com/smokehouse/324022/phellinus-linteus-medicinal-mushrooms-popularity-exploding-world-wide/

http://www.nature.com/bjc/journal/v98/n8/abs/6604319a.html

http://www.reishi.com/cancer.htm

[xcvii] I prefer the purer form, without Vit.A. There is much evidence, from various sources (Rivici, Peskin, Barry Sears) that the outer membrane of the body’s cells is a key factor in treating cancer. That unless there is a relatively high intake of Omega3, the cell membrane will be compromised by other fats and hence a source of the cells’ poor performance.

[cxvi] Sakano K, Takahashi M, et al. Suppression of azoxymethane-induced colonic premalignant lesion formation by coenzyme Q10 in rats. Asian Pac J Cancer Prev. 2006 Oct; 7 (4): 599-603
Folkers K, Brown R, Judy WV, Morita M. Survival of cancer patients on therapy with coenzyme Q10. Biochem Biophys Res Commun. 1993 Apr 15;192(1): 241-5
Lockwood K, Moesgaard S, Folkers K. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochem Biophys Res Commun 1994 Mar 30;199 (3):1504-8

http://home.caregroup.org/clinical/altmed/interactions/Nutrients/Coenzyme_Q10.htm

http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional/allpages

Alternative Medicine Review Volume 12, Number 2 2007

[cxviii] http://www.dailymail.co.uk/health/article-1335364/Tanned-women-live-longer-say-scientists-Lund-University-Sweden.html

http://www.redorbit.com/news/health/1957903/taking_vitamin_d_calcium_supplements_not_necessary/

http://www.nutritionj.com/content/9/1/60

http://www.urotoday.com/37/browse_categories/bladder_cancer/serum_vitamin_d_and_risk_of_bladder_cancer__abstract11112010.html

http://www.sciencedaily.com/releases/2010/11/101104094038.htm

http://www.sciencedaily.com/releases/2010/06/100618081333.htm

http://www.naturalnews.com/028609_vitamin_D_lymphoma.html

http://en.wikipedia.org/wiki/Vitamin_D

http://www.foodconsumer.org/newsite/Nutrition/kick_yourself_for_the_next_decade_1603100745.html

http://www.sciencedaily.com/releases/2010/03/100312133716.htm

http://www.sciencedaily.com/releases/2010/03/100307215534.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+sciencedaily+%28ScienceDaily:+Latest+Science+News%29&utm_content=Google+Feedfetcher

http://www.nytimes.com/2010/02/02/health/02well.html

http://healthyweightlossprograms.net/?p=2472

http://www.sciencedaily.com/releases/2009/07/090706171500.htm

http://www.sciencedaily.com/releases/2009/12/091206112517.htm

http://www.cancerepidemiology.net/article/PIIS187778210900143X/abstract?rss=yes

http://www.vitamindcouncil.org/newsletter/2008-jan.shtml

http://www.sciencedaily.com/releases/2008/11/081117091614.htm

http://harmonyhealth.wordpress.com/2008/11/06/you-dont-have-to-be-afraid-of-cancer-any-longer/

http://www.ncbi.nlm.nih.gov/pubmed/18029190

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17218096

http://www.sciencedaily.com/releases/2009/10/091009090431.htm

http://www.sciencedaily.com/releases/2010/02/100216113553.htm

http://www.sciencedaily.com/releases/2009/12/091201182624.htm

http://www.beating-cancer-gently.com/134nl.html

http://www.sciencedaily.com/releases/2009/11/091116085038.htm

http://www.sciencedaily.com/releases/2009/11/091115123715.htm

http://articles.latimes.com/2010/mar/15/science/la-sci-vitamind16-2010mar16

http://www.sciencedaily.com/releases/2010/04/100407121227.htm

http://www.sciencedaily.com/releases/2010/04/100415143906.htm

http://www.sciencedaily.com/releases/2010/05/100501013417.htm

http://www.sciencedaily.com/releases/2010/04/100429153955.htm

http://www.sciencedaily.com/releases/2010/04/100427182609.htm

http://www.sciencedaily.com/releases/2010/04/100425151136.htm

http://www.mdlinx.com/urology/newsl-article.cfm/3285900/ZZ2388573897646011308991/?news_id=903&newsdt=090810&subspec_id=510

[cxxiii] http://www.sciencedaily.com/releases/2010/11/101123095639.htm

http://www.urotoday.com/37/browse_categories/bladder_cancer/longterm_outcomes_of_a_randomized_controlled_trial_comparing_thermochemotherapy_with_mitomycinc_alone_as_adjuvant_treatment_for_nonmuscleinvasive_bladder_cancer_nmibc__abstract11192010.html

http://www.eurekalert.org/pub_releases/2010-03/aafc-tmr030510.php

http://www.wral.com/lifestyles/healthteam/story/7138492/

http://www.tulsaworld.com/news/article.aspx?subjectid=17&articleid=20100116_17_A13_OKLAHO60333

http://www.reuters.com/article/pressRelease/idUS155039+30-Oct-2009+BW20091030

http://www.cancerdecisions.com/content/view/285/2/lang,english/

http://www.salutedomani.com/il_weblog_di_antonio/2009/09/my-entry-64.html

http://www.urotoday.com/37/browse_categories/bladder_cancer/combined_thermochemotherapy_for_recurrent_bladder_cancer_after_bacillus_calmetteguerin__abstract09032009.html

http://www.wctv.tv/medicalminute/headlines/47224812.html

http://www.upi.com/Health_News/2009/01/16/Hyperthermia_used_to_help_treat_cancer/UPI-64091232166098/

http://www.dailymail.co.uk/health/article-1313773/Can-fever-cure-cancer-Jordan-baffled-doctors-leukaemia-vanished-new-evidence-suggests-remarkable-explanation-.html#ixzz10J1Z72cR

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2222219

http://medicalphysicsweb.org/cws/article/research/26117

http://www.seekwellness.com/cancercontrol/hyperthermia.htm

http://blcwebcafe.org/hyperthermia.asp

http://www.a1chimachines.com/hyperthermia.htm

http://www.hyperthermie-zentrum.de/english/Flyer_Praxis_Engl.pdf

http://www.globenewswire.com/newsroom/news.html?d=159263

http://www.iconmag.co.uk/page.php?n=992

[cxxviii] http://www.eurekalert.org/pub_releases/2010-10/sumc-cc102610.php

http://www.canceractive.com/cancer-active-page-link.aspx?n=1906&Title=Resveratrol

http://www.sciencedaily.com/releases/2010/10/101019111712.htm

http://www.canceractive.com/cancer-active-page-link.aspx?n=705&Title=A%20Diet%20for%20Chemotherapy%20by%20Chris%20Woollams

http://ihealthbulletin.com/blog/2007/04/26/latest-review-antioxidants-may-help-cancer-patients-chemotherapy/

http://www.inspire.com/groups/bladder-cancer-advocacy-network/discussion/supplements-during-gem-cis-yes-or-no/

http://www3.interscience.wiley.com/journal/123349719/abstract?CRETRY=1&SRETRY=0 via http://www.mdlinx.com/UrologyLinx/newsl-article.cfm/3116371/ZZ2388573897646011308991/?news_id=903&subspec_id=510

http://www.naturalnews.com/028652_chemotherapy_milk_thistle.html

http://www.sciencedaily.com/releases/2008/03/080331172534.htm

http://www.dailymail.co.uk/health/article-1230347/Feast-famine-The-diet-wont-just-help-lose-weight-youll-live-longer-brainier.html

http://www.sciencedaily.com/releases/2010/05/100520213110.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Feedfetcher

http://www.oncologychannel.com/chemotherapy/care.shtml

[cxxix] http://cancerres.aacrjournals.org/cgi/content/abstract/67/13/6493

http://www.sciencedaily.com/releases/2010/10/101027202507.htm

http://www.sciencedaily.com/releases/2010/06/100607101702.htm

http://www.sciencedaily.com/releases/2010/06/100609171802.htm

http://www.postbulletin.com/newsmanager/templates/localnews_story.asp?z=10&a=455834

http://www.canceractive.com/cancer-active-page-link.aspx?n=1007&Title=Green%20Tea

http://www.sciencedaily.com/releases/2009/08/090810085312.htm

http://www.urotoday.com/index.php?option=com_content&task=view_ua&id=2226418

http://salud.momento24.com/en/2010/01/16/does-green-tea-offers-protection-against-lung-cancer/

http://doctor.ndtv.com/storypage/ndtv/id/4034/Green_tea_lowers_blood_cancer_risk.html

http://www.sciencedaily.com/releases/2009/08/090810085312.htm

http://www.thecamreport.com/index.php/2009/07/14/does-green-tea-prevent-cancer/

http://articlesofhealth.blogspot.com/2009/07/green-tea-is-acidic-and-may-cause.html

http://www.eurekalert.org/pub_releases/2009-06/aafc-gtm061509.php

http://www.thenews.com.pk/print1.asp?id=165149

http://www.hsibaltimore.com/ealerts/ea200609/ea20060920b.html

http://www.thehealthierlife.co.uk/natural-health-articles/cancer/green-tea-prevent-cancer-warning-women-00126.html

http://www.wp-wordpress.com/123808/cancer-open-question-does-anyone-know-someone-preferably-women-who-hadhas-bladder-cancer#respond

[cxxix] http://www.sciencedaily.com/releases/2009/05/090526163010.htm

http://www.emaxhealth.com/1275/77/33408/green-tea-reduces-heart-disease-risk.html

From a Dr Al Sears email on 17 Sep 09

1 R. Chan, J. Woo, E. Suen, J. Leung, N. Tang, “Chinese tea consumption is associated with longer telomere length in elderly Chinese men” British Journal of Nutrition, Aug, 12, 2009 http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6047776

http://www.sciencedaily.com/releases/2009/09/090916103424.htm

http://www.naturalnews.com/028600_eye_disease_green_tea.html

[cxxxvii] http://www.alsearsmd.com/pace/ seems the best made case for short, sharp vigorous exercise

[cxxxix] www.howtostopcancer.com J Dean 2009 Nile River Publications Inc

[cxl] See “How to Meditate” Lawrence LeShan, Thorsons 1974 – a classic and still thought the best guide

[cxliii] The Anti Inflammation Zone, pp.263-269, Dr Barry Sears, Regan Books, ISBN 0-06-059546-9, 2005

[cxlv] See “DRINKING WATER AND WATER TREATMENT SCAMS” by James E. Hairston, Professor and Water Quality Coordinator, Donn Rodekohr, Agricutural Program Associate, Evaden F. Brantley, Agricultural Program Associate, Lori L. Bice, Undergraduate Student Assistant; 23 Oct 2003

And http://www.chem1.com/CQ/ionbunk.html

[cxlvi] “Researchers from Denmark found that following recommendations on physical activity, waist circumference, smoking, alcohol and diet could reduce the risk of developing bowel cancer considerably — by 23%.” http://www.sciencedaily.com/releases/2010/10/101026203640.htm

Posted in cancer and diet, cancer suppplements, cancer survivor, Comments and Suggestions, complementary therapies | Tagged: , , | 11 Comments »

Ian Clements: ‘radical cystectomy alternatives’ research – for bladder cancer

Posted by Jonathan Chamberlain on April 21, 2011


See also my two cancer books – http://www.fightingcancer.com for details

Ian Clements ‘ Radical Cystectomy Alternatives’ Research

RC Alternatives

Contents

Arguments against organ preservation in patients with muscle invasive bladder cancer. 2

Trimodality treatment for bladder cancer: Does modern radiotherapy improve the end results?. 2

Drug May Be an Alternative to Cystectomy for BCG Failures. 3

Phase II Study Of Conformal Hypofractionated Radiotherapy With Concurrent Gemcitabine In Muscle-Invasive Bladder Cancer. 3

Radiation plus gemcitabine might be as good as surgery for bladder cancer. 4

Improved method for RC?. 5

Update of clinical trial data for trimodality therapy. 5

Surgery not always necessary for bladder cancer patients. 6

Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC). 6

Response and progression-free survival in T2 to T4 bladder tumors treated with trimodality therapy with bladder preservation. 7

Robotic cystectomy: Is it ready for prime time?. 7

RC versus Alternatives. 8

Outcome of patients who refuse cystectomy after receiving neoadjuvant chemotherapy for muscle-invasive bladder cancer. 8

Updated results of bladder-sparing trimodality approach for invasive bladder cancer, 9

Gemcitabine sensitizes invasive bladder tumors to radiation. 10

Quality of life assessment after concurrent chemoradiation for invasive bladder cancer. 10

Failure of bacille Calmette-Guérin in patients with high risk non-muscle-invasive bladder cancer unsuitable for radical cystectomy. 11

Organ-sparing strategies in the management of invasive bladder cancer. 12

Bladder Preservation in Octogenarians With Invasive Bladder Cancer. 12

Long-Term Follow-Up of Cisplatin Combination Chemotherapy in Patients With Disseminated Nonseminomatous Germ Cell Tumors. 13

Total Cystectomy Versus Bladder Preservation Therapy for Locally Invasive Bladder Cancer. 14

Bladder-Sparing Therapy a Good Alternative. 14

An Alternative to Radical Cystectomy. 16

Conservative treatment of invasive bladder cancer. 16

A 10-year retrospective review of a nonrandomized cohort of 458 patients undergoing radical radiotherapy or cystectomy in Yorkshire, UK. 17

Radiochemotherapy for bladder cancer. 18

Safety of active surveillance program for recurrent nonmuscle-invasive bladder carcinoma. 18

What happens to the patients with muscle-invasive bladder cancer who refuse cystectomy after neoadjuvant chemotherapy?. 19

Radical Cystectomy versus Radical Radiotherapy. 21

Arguments against organ preservation in patients with muscle invasive bladder cancer

http://www.urotoday.com/images/stories/documents/cury_2011/10.34%20U.%20Studer.pdf

Trimodality treatment for bladder cancer: Does modern radiotherapy improve the end results?[i]

by Mohamed S. Zaghloul, MD Tue, 05 April 2011

BERKELEY, CA (UroToday.com) – Recent trimodality organ-preservation strategies combine maximal transurethral resection of bladder tumour (TURB), chemotherapy and radiation.

The rationale for performing TURB and radiation is to achieve local tumour control. Application of systemic chemotherapy, most commonly as cisplatin-based regimen, aims at the eradication of micro-metastasis and to act as radio-sensitizers. This role has been established in many diseases and several studies. Cisplatin-based chemotherapy in combination with radiotherapy, following TURB, results in a complete response rate of 50-81%.It is recommended and stressed upon that early cystectomy is performed in individuals who do not achieve a complete response following combination therapy. This will allow about 42-78% of patients to survive with an intact bladder at 3-5 years. A comparable long-term survival rate of 50-60% at 5 years’ follow-up is reported by both multimodality bladder-preserving trials and cystectomy series. Trimodality therapy has the advantage that about half of patients expected to survive with their native bladder intact. However, both therapeutic approaches have never been directly compared. It is worth noting that bladder-preserving multimodality strategy requires very close multidisciplinary co-operation and a high level of patient compliance. Even if a patient has shown a complete response to a multimodality bladder-preserving strategy, the bladder remains a potential source of recurrence, or new tumour appearance. Pathological complete remission at repeat TUR after the initial transurethral resection of the primary tumour, followed by chemotherapy in combination with radiotherapy, was identified as a prognostically important variable. However, even the latter patients are at a life-long risk of developing intravesical tumour recurrences with the need for meticulous surveillance. Despite the absence of such direct randomized trials comparing both modalities, trimodality treatment comprising maximal TURBT followed by different regimens of combined radiochemotherapy achieved comparable results to radical cystectomy in many trials.

With the application of modern radiotherapy, it is possible to safely deliver a high radiation dose, with the sensitizing effect of the concomitant chemotherapeutic agents. These variable regimens of radiochemotherapy were successful in achieving the goal of improved survival rates, with preservation of the native bladder. The clinical target volume (CTV) for irradiating the bladder should encompass the entire outer circumference of the bladder, any extravesical disease spread and any region deemed to be at risk of microscopic disease spread. It has also been extended to include the prostate and prostatic urethra in males or upper vagina in females. The pelvic nodal CTVs extend around external and internal iliac vessels. The external iliac CTV extends anteriorly to include the lateral external iliac nodes. The internal iliac CTV extends laterally to the pelvic sidewall. The contours around the external and internal iliac vessels are joined to create a single volume on each side of the pelvis, including the obturator nodes. The pre-sacral CTV extends anteriorly to the first and second sacral prominence. The planning tumor volume (PTV) margins are 5–10 mm according to the institutional policy of creating CTV–PTV margins. Partial bladder irradiation (bladder tumor with safety margin) may be used as a boost – either through intensity-modulated radiotherapy (IMRT) external beam or via brachytherapy. The partial bladder approach permitted the delivery of a considerably higher dose without increased toxicity. It is estimated that the tolerance of part of the bladder volume is higher than that of the organ as a whole, with tolerance doses estimated at 80 Gy for two-thirds of the bladder compared with 65 Gy for the whole organ.

Radiation uncertainties include set-up errors, patient movement, internal organ movement, and volume changes due to continuous bladder filling (both inter- and intrafraction). The advancement in treatment verification procedures in modern radiotherapy and the use of fiducial markers applied during TUR, reduces set-up errors, while adaptive radiotherapy could decrease the unnecessary irradiation of normal tissues by tracking bladder volume changes. In addition, new radiotherapeutic techniques, such as IMRT and volume-modulated radiotherapy (VMAT), permit dose escalation to the target without increasing the dose to the surrounding normal tissues. The value of this trimodality treatment depends upon the extent and adequacy of TURBT, the use of effective chemotherapeutic agents both as sensitizing and adjuvant agents for radiotherapy, and more importantly, upon the precise technique of irradiation to achieve the desired results. Ensuring target coverage may improve the tumor control probability by ensuring the target receives the intended dose, while reducing dose to critical normal tissues.

Urodynamic tests and quality of life (QoL) studies for long-term survivors treated with trimodality treatment showed that 75% were considered to have bladders with normal function. Furthermore, a questionnaire study revealed that 78.8% were ‘delighted’ or ‘pleased’ in terms of urinary function after trimodality conservative therapy. More than half of men had erections hard enough for intercourse and around 59% were satisfied with their sex life after conservative therapy. Sexual function was reported in 50% of men and 71% of women following bladder preservation. These rates compare favorably with a contemporary questionnaire-based study that reported 13% and 42% potency rate following radical surgery and nerve-sparing cystectomy, respectively.

Drug May Be an Alternative to Cystectomy for BCG Failures[ii]

Jody A. Charnow March 21, 2011

VIENNA—Mycobacterial cell wall DNA complex (MCC) may provide an alternative to cystectomy for patients with non-muscle invasive bladder cancer refractory to bacillus Calmette-Guérin (BCG) treatment, according to preliminary study findings.

Alvaro Morales, MD, of Queen’s University in Kingston, Ontario, Canada, and colleagues tested MCC in 129 Caucasian patients with non-muscle invasive bladder cancer who failed to respond to one or more courses of BCG. The treatment consisted of six weekly intravesical instillations of 8 mg MCC (induction), followed by three once-weekly instillations at three, six, 12, 18, and 24 months (maintenance). MCC has two modes of action: immune stimulation and direct anticancer activity.

Of the 129 patients, 95 (73.6%) were male. At study entry, 91 (70.5%) had carcinoma in situ and 38 (29.5%) had papillary tumors.

The overall one-year disease-free survival (DFS) rate was 25%, the researchers reported at the 26th Annual Congress of the European Association of Urology. The one-year DFS rate was 21.0% for patients with CIS tumors and 35.1% for those with papillary tumors. The treatment was well tolerated, and most adverse events were mild to moderate in intensity and few led to treatment discontinuation.

Dr. Morales’ group explained that patients with tumors refractory to BCG generally have a poor response to second-line therapies. Radical cystectomy, they noted, is the standard of care following BCG failure, but some patients refuse surgery or are not good surgical candidates.

The drug, which has the trademark name Urocidin, is being developed by Endo Pharmaceuticals, of Chadds Ford, Pa., and Bioniche Life Sciences, of Belleville, Ontario.

Phase II Study Of Conformal Hypofractionated Radiotherapy With Concurrent Gemcitabine In Muscle-Invasive Bladder Cancer[iii]

Written by Lynda Coghlan    Monday, 07 February 2011 09:03

The Christie NHS Foundation Trust, Manchester, United Kingdom. The Royal Preston Hospital, Preston; Leicester Royal Infirmary, Leicester; and The Gray Institute for Radiation Oncology and Biology, Oxford, United Kingdom.

The aim of this prospective, phase II trial was to determine the response of muscle-invasive bladder cancer (MIBC) to concurrent chemoradiotherapy of weekly gemcitabine with 4 weeks of radiotherapy (RT; GemX).

Fifty patients with transitional cell carcinoma, stage T2-3, N0, M0 after transurethral resection and magnetic resonance imaging, were recruited. Gemcitabine was given intravenously at 100 mg/m(2) on days 1, 8, 15, and 22 of a 28-day RT schedule that delivered 52.5 Gy in 20 fractions. Chemotherapy was stopped for Radiation Therapy Oncology Group (RTOG) grade 3 bladder or bowel toxicity. The primary end points were tumor response, toxicity, and survival.

All patients completed RT; 46 tolerated all four cycles of gemcitabine. Two patients stopped after two cycles, and two stopped after three cycles, because of bowel toxicity. Forty-seven patients had a post-treatment cystoscopy; 44 (88%) achieved a complete endoscopic response. At a median follow-up of 36 months (range, 15 to 62 months), 36 patients were alive, and 32 of these had a functional and intact bladder. Fourteen patients died; seven died as a result of metastatic MIBC, five died as a result of intercurrent disease, and two died as a result of treatment-associated deaths. Four patients underwent cystectomy; three because of recurrent disease and one because of toxicity. One patient required a bowel resection for late toxicity. By using Kaplan-Meier analyses, 3-year cancer-specific survival was 82%, and overall survival was 75%.

Concurrent gemcitabine-based chemoradiotherapy (ie, GemX) produces a high response rate in MIBC and has durable local control and acceptable toxicity, which allows patients to preserve their own bladder. This treatment modality warrants additional investigation in a phase III setting.

Written by: Choudhury A, Swindell R, Logue JP, Elliott PA, Livsey JE, Wise M, Symonds P, Wylie JP, Ramani V, Sangar V, Lyons J, Bottomley I, McCaul D, Clarke NW, Kiltie AE, Cowan RA.

Reference: J Clin Oncol. 2011 Jan 4. Epub ahead of print. doi: 10.1200/JCO.2010.31.5721

PubMed Abstract PMID: 21205754

Radiation plus gemcitabine might be as good as surgery for bladder cancer[iv]

Radiation plus gemcitabine may be as good as cystectomy for muscle-invasive bladder cancer, a phase II study suggests.

“After radiotherapy and four cycles of gemcitabine, three-year cancer-specific survival was 82% and overall survival was 75%, the study investigators reported online January 4th in the Journal of Clinical Oncology.

“These results with gemcitabine and radiotherapy are as good as the best reported results of cystectomy, although ours is only a small group of selected patients,” said Dr. Richard Cowan, a consultant in Clinical Oncology at Christie Hospital in Manchester, England

Improved method for RC?[v]

“Hybrid laparoscopic endoscopic single-site surgery for radical cystoprostatectomy and orthotopic ileal neobladder: An initial experience of 12 cases

“Laparoscopic endoscopic single-site surgery (LESS) has recently emerged as an attempt to enhance cosmetic benefits and reduce morbidity; however, LESS for radical cystectomy is still not well established. Here we describe the technique of hybrid LESS for radical cystoprostatectomy and orthotopic ileal neobladder (RC-OIN), and evaluate its feasibility and safety.

“All operations were performed successfully without conversion to conventional laparoscopic radical cystectomy or open surgery. There was no perioperative mortality or port-related complications. The median operative time was 383 minutes. Median blood loss was 150 mL. A median of 25 lymph nodes were removed. Surgical margins were tumor free in all cases.

Hybrid LESS for RC-OIN is technically feasible with effects similar to those of conventional laparoscopic procedures. Further instrument and technique improvement are necessary to shorten operative time and reduce intraoperative difficulties.

 Update of clinical trial data for trimodality therapy[vi]

Written by Christopher P. Evans, MD

Monday, 13 December 2010

BETHESDA, MD USA (UroToday.com) – Tridmodel therapy includes maximal TURBT followed by XRET (40Gy) with chemotherapy, next is cystoscopic response evaluation, and if good response, then XRT for 24 Gy more.

In 348 patients treated at the Massachusetts General Hospital (where Dr. Efstathiou is a radiation oncologist) between 1986-2002, 10-year overall survival (OS) was 35% and disease-specific survival (DSS) was 59%. Ultimately cystectomy was necessary in 29%. There were very few cancer events after 5 years. Use of neoadjuvant chemotherapy did not impart any DSS or OS benefit. Their data showed that complete TURBT is essential to the outcome.

A trial called SPARE in the UK to compare surgery to trimodal therapy closed due to poor accrual. A UK trial comparing XRT alone vs. XRT plus MMC and 5-FU was recently reported. Early on there was no survival benefit, but for local-regional DFS there was benefit to the addition of chemo at 3 years. He touched on biomarkers predicting response, and Her-2 is one such that is stratifying patients for the addition of Herceptin. Another is MRE11 that predicts for CSS following radical radiotherapy for muscle invasive bladder cancer. QOL after XRT is critical and 78% have compliant bladders and 50% of men have maintained erectile function. Overall about 70% of trimodal patients retain their native bladder.

Surgery not always necessary for bladder cancer patients[vii]

October 05, 2010 / TAMPA, Fla. / Bladder cancer is the fifth most common cancer in the United States says Dr. Randy Heysek, founder of the Central Florida Cancer Institute. He says approximately 50,000 people are diagnosed with bladder malignancies each year. As a staff member at H.L. Moffitt Cancer Center and Research Institute, Dr. Heysek has the opportunity to teach resident physicians about treatment options for a variety of cancers, as he did before a group of radiation oncology residents about bladder cancer.

“I take my role at Moffitt seriously,” says Dr. Heysek. “I want to give cancer patients the best care and treatment possible. I also want to make sure the resident physicians learn as much as they can about the techniques and procedures being used.”

Currently, radical cystectomy is the common treatment for bladder cancer. The procedure removes the entire bladder, nearby lymph nodes, part of the urethra and nearby organs that may contain cancer cells. However, the surgery can reduce a patient’s sexual function. Dr. Heysek, a board-certified radiation oncologist, says there is a non-surgical alternative.

“Patients can receive a carefully administered radiation therapy with concomitant chemotherapy given daily over a seven week period,” he says. “The long term results reveal a very satisfactory bladder function following radiation and chemotherapy. A majority of patients are able to keep their own bladders, rather than having them removed or having an artificial bladder constructed.”

Dr. Heysek adds the use of this bladder conserving treatment requires close collaboration between the urologist, medical oncologist and radiation oncologist. He says this ensures perfect integration and timing.

Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC)[viii]

BJU International, 10/05/2010  Clinical Article

Colombo R et al. – The authors present long–term efficacy data of intravesical thermochemotherapy vs chemotherapy alone with mitomycin–C (MMC) randomly administered to patients with non–muscle–invasive bladder cancer (NMIBC) as an adjuvant treatment after complete transurethral resection. This is the first analysis of long–term follow–up of patients treated with intravesical thermochemotherapy. The high rate of patients who were tumour–free 10 years after treatment completion as well as the high rate of bladder preservation, confirms the efficacy of this adjuvant approach for NMIBC at long–term follow–up, even in patients with multiple tumours.

Response and progression-free survival in T2 to T4 bladder tumors treated with trimodality therapy with bladder preservation[ix]

Monday, 04 October 2010

Departamento de Urología, Clínica Universidad de Navarra, Navarra, España.

To evaluate the response and the free-survival progression in patients diagnosed of invasive bladder cancer who have been treated with transurethral resection, chemotherapy and radiotherapy. This multimodal treatment is compared with a not random serie of patients treated by radical cistectomy.

Retrospective analysis of 43 cases of invasive bladder cancer treated with two schemes of bladder preservation between 1994-2007. They are compared with 145 cases treated with radical cistectomy in the same period of time. Pronostic variables included in the study are clinical stage, grade of differentiation, presence of ureteral obstruction, chemotherapy modality, radiotherapy doses and p53 and ki-67 expression.

Mean and median time are 51 and 39 months in patients with multimodal treatment. Complete response is achieved in 72% of cases treated with bladder preservation. Ureteral obstruction is a prognostic factor (OR: 7,3;p:0,02). 72% patients with complete response mantain it at the end of the study. None of analyzed variables are predictors of maintenance of the response. Survival rates with a intact bladder were 69±7% and 61±7% at three and five years. Radiotherapy doses greater than 60Gy (OR: 6,1; p<0,001) and the absence of ureteral obstruction (OR: 7,5; p<0,002) were pronostic variables. Free-survival in patients with complete response was 80±7% and 58±10% at three and five years. At the end of the study, 53,5% of patients had a intact bladder and free-disease.In the same period of time, 145 radical cistectomies were performed due to muscle invasive bladder cancer. Mean and median time in this group were 29 and 18 months respectively. Stadistical analysis reveals a worse clinical stage in the group of patients treated with multimodal treatment (p:0.01). Free-survival was 72±5% and 63±7% at 3 and 5 years in the group of radical cistectomies. There was not statistical significant differences between cistectomies and bladder preservation.

Patients treated with bladder preservation have a free-survival similar to those treated with radical cistectomy. Radiotherapy doses greater than 60Gy and absence of ureteral obstruction were free-survival prognostic variables.

Written by: Rincón Mayans A, Rosell Costa D, Zudaire Bergera JJ, Rioja Zuazu J, Barba Abad J, Tolosa Eizaguirre E, Romero Vargas L, Pascual Piedrola I.

Reference: Actas Urol Esp. 2010 Oct;34(9):775-80.

PubMed Abstract PMID: 20843454

Robotic cystectomy: Is it ready for prime time?[x]

Slide Presentation

RC versus Alternatives

Date: Mon, 13 Sep 2010 07:57:37 -0400
From: jmikemann@COMCAST.NET
Subject: Re: [CAFE] MIBC treated with TURB, Chemo & Radiation instead of RC
Ian –

Many doctors have been working with this for years and have published the results.

I read reports over ten years ago from Dr. Shipley of Harvard Medical School, and Mass General were reporting approximately equal
results from RC or multimodality.  This was my reasoning to go that route rather than an RC.

Note that my Uro who had recommended an RC disagrees with me.  He has only recently moved me to yearly checkups previously insisting on every six months for eleven years.  He told his assistant at my last check that “I had dodged a bullet” but (I?) disagree.  At the time I made the decision the long term statistics for the two approaches were similar and it has seemed to work out for me.

Mike
07:22 AM 9/13/2010, Ian Clements wrote:
This seemingly good outcome seems to me to have been prematurely assessed – only 4 weeks later. As there’s a lot of evidence of recurrence long after this period, it would be nice to see this being compared with RC for similar patients over a longer period.

Bladder preservation multimodality therapy as an alternative to radical cystectomy for treatment of muscle invasive bladder cancer[xi]
BJU International, 09/13/2010

Maarouf AM et al. ­ In this prospective study, the authors includded 33 patients with transitional cell carcinoma (TCC) (T2 and T3, Nx, M0) who were amenable to complete transurethral resection. These patients refused radical cystectomy as their first treatment option. After maximum transurethral resection of bladder tumour (TURBT), all patients received three cycles of adjuvant chemotherapy in the form of methotrexate, vinblastin, adriamycin and cisplatin (MVAC) followed by radical radiotherapy. Four weeks later, all cases had radiological and cystoscopical re­eevaluation. Complete responders were considered to be those patients who had no evidence of residual tumour.

Outcome of patients who refuse cystectomy after receiving neoadjuvant chemotherapy for muscle-invasive bladder cancer[xii]

Between 1995 and 2001, 63 patients were evaluated who declined to undergo a planned cystectomy, because they achieved a complete clinical response to neoadjuvant cisplatin-based chemotherapy.Forty patients (64%) survived, with 54% of them having an intact functioning bladder. The number and size of invasive tumors were strongly associated with overall survival.

Of 23 patients (36%) who subsequently died of disease, 19 (30%) relapsed with invasive cancer in the bladder. Over 90% of surviving patients had solitary, small, and low-stage invasive tumors completely resected, and 83% survived without relapses in the bladder.

Editorial Comment

In Northern America neoadjuvant chemotherapy before radical cystectomy became standard few years ago. What happens if patients (or their doctors, the medical oncologists who deliver chemotherapy) refuse radical cystectomy if a complete response is found in the bladder? This paper gives some very important answers.

The study group was well chosen with only patients having residual muscle-invasive tumors receiving neoadjuvant chemotherapy. After at least 85% of the planned four cycles of cisplatinum-based chemotherapy, complete clinical response and negative transurethral resection (TUR) of the primary tumor site, these patients were deemed complete responders and were evaluable for follow-up in this group.

The good news is that 64% of these patients survived at least 5 years and 54% of them with functioning bladders. The bad news is that 36% died of bladder cancer after a mean of 32 months. The survivors could be identified by their good prognostic factors, namely single (p < 0.001), or small tumor (p < 0.01), complete restaging TUR (p = 0.02), and noninvasive stage after relapse (p = 0.05). Thus patients with worse tumor features, despite responding completely to chemotherapy, should be strongly advised to undergo radical cystectomy at the earliest convenience.

Updated results of bladder-sparing trimodality approach for invasive bladder cancer[xiii],[xiv]

Received 15 December 2008;  revised 21 January 2009;  accepted 22 January 2009.

Purpose

To update long-term results with selective organ preservation in invasive bladder cancer using aggressive transurethral resection of bladder tumor (TURBT) and radiochemotherapy (RCT) and to identify treatment factors that may predict overall survival (OS).

Materials and methods

Between 1990 and 2007, a total of 74 patients with T2-T4 bladder cancer were enrolled in 2 sequential bladder-sparing protocols including aggressive TURB and RCT. From 1990 to 1999, 41 patients were included in protocol no. 1 (P1) that consisted of three cycles of neoadjuvant methotrexate, cisplatin, and vinblastine (MCV) chemotherapy prior to re-evaluation and followed by radiotherapy (RT) 60 Gy in complete responders. Between 2000 and 2007, 33 patients were entered in protocol no. 2 (P2) that consisted of concurrent RCT 64, 8 Gy with weekly cisplatin. In case of invasive residual tumor or recurrence, salvage cystectomy was recommended. Primary endpoints were OS, overall survival with bladder preservation (OSB), and late toxicity.

Results

The mean follow-up for the whole series was 54 months (range 9–156), 69 months for patients in P1 and 36 months for patients in P2. The actuarial 5-year OS and OSB for all series were 72% and 60%, respectively. Distant metastases were diagnosed in 11 (15%) patients. Grade 3 late genitourinary (GU) and intestinal (GI) complications were 5% and 1.3%, respectively. There were no significant differences in the incidence of superficial recurrences (P = 0.080), muscle-invasive relapses (P = 0.722), distant metastasis (P = 0.744), grade ≥2 late complications (P = 0.217 for GU and P = 0.400 for GI), and death among the 2 protocols (P value for OS = 0.643; P value for OSB = 0.532).

Conclusion

These data confirm that trimodality therapy with bladder preservation represents a real alternative to radical cystectomy in selected patients, resulting in an acceptable rate of the long-term survivors retaining functional bladders.

Gemcitabine sensitizes invasive bladder tumors to radiation[xv]

“Adding gemcitabine (Gemzar) to concurrent radiotherapy and cisplatinum in invasive bladder cancer could preserve the organ even when the tumor has invaded the muscle, according to French researchers. In their pilot study, they sought to determine the maximum tolerated dose of gemcitabine to use with the gold standard of cisplatinum + radiotherapy.

“The patients in the study received a diagnosis of urothelial invasive bladder cancer but without hydronephrosis or diffuse carcinoma in situ. The cancer stage was T2-T4a with negative nodes and no metastasis.

“…..  cystectomy is the gold standard for treatment of invasive bladder cancer, but because of a high morbidity rate, patients often opt for bladder preservation. With standard bladder preservation treatments, about 50% of patients have a functioning bladder at five years

“Seven of the nine patients who completed the experimental regimen were cancer-free with intact bladders at a median follow up of 24 months.

Quality of life assessment after concurrent chemoradiation for invasive bladder cancer[xvi]

To evaluate bladder preservation and functional quality after concurrent chemoradiotherapy for muscle-invasive cancer in 53 patients included in a Phase II trial.

Pelvic irradiation delivered 45Gy, followed by an 18-Gy boost. Concurrent chemotherapy with cisplatin and 5-fluorouracil by continuous infusion was performed at Weeks 1, 4, and 7 during radiotherapy. Patients initially suitable for surgery were evaluated with macroscopically complete transurethral resection after 45Gy, followed by radical cystectomy in case of incomplete response. The European Organization for Research and Treatment of Cancer quality of life questionnaire QLQ-C30, specific items on bladder function, and the Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic (LENT-SOMA) symptoms scale were used to evaluate quality of life before treatment and 6, 12, 24, and 36 months after treatment.

Median age was 68 years for 51 evaluable patients. Thirty-two percent of patients had T2a tumors, 46% T2b, 16% T3, and 6% T4. A visibly complete transurethral resection was possible in 66%. Median follow-up was 8 years. Bladder was preserved in 67% (95% confidence interval, 52-79%) of patients. Overall survival was 36% (95% confidence interval, 23-49%) at 8 years for all patients, and 45% (28-61%) for the 36 patients suitable for surgery. Satisfactory bladder function, according to LENT-SOMA, was reported for 100% of patients with preserved bladder and locally controlled disease 6-36 months after the beginning of treatment. Satisfactory bladder function was reported for 35% of patients before treatment and for 43%, 57%, and 29%, respectively, at 6, 18, and 36 months.

Concurrent chemoradiation therapy allowed bladder preservation with tumor control for 67% patients at 8 years. Quality of life and quality of bladder function were satisfactory for 67% of patients.

Written by: Lagrange JL, Bascoul-Mollevi C, Geoffrois L, Beckendorf V, Ferrero JM, Joly F, Allouache N, Bachaud JM, Chevreau C, Kramar A, Chauvet B.

Reference: Int J Radiat Oncol Biol Phys. 2010 Apr 10. doi: 10.1016/j.ijrobp.2009.10.038

PubMed Abstract PMID: 20385453

Failure of bacille Calmette-Guérin in patients with high risk non-muscle-invasive bladder cancer unsuitable for radical cystectomy[xvii]

An update of available treatment options

Tuesday, 16 March 2010

Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorks, UK.

Academic Department of Urology of la Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, University Paris VI, Faculte de medicine Pierre et Marie Curie and Centre d’Etudes et de Recherche sur les pathologies prostatiques, France.

Although the accepted standard upon failing intravesical bacille Calmette-Guérin (BCG) in patients with high-risk non-muscle-invasive bladder cancer (NMIBC) is radical cystectomy, there are some patients for whom this is not an option. We critically reviewed previous reports on the treatment possibilities available in such a clinical scenario. The options available can be categorized as chemotherapy, immunotherapy, device-assisted therapy and combined therapy. Combining new with established intravesical treatments seems to hold the most promise. Maintenance thermo-chemotherapy gives a reported 2-year disease-free survival rate of 50% and in small early-phase studies of intravesical gemcitabine administered in combination with mitomycin-C, tolerance and efficacy data would suggest the need for larger trials, given the early encouraging results. Electromotive mitomycin-C given sequentially with BCG might not only reduce the recurrence rate but also reduce progression and disease-specific mortality, although currently there is no trial in a specific population with ‘BCG failure’.

Written by:  Yates DR, Rouprêt M.

Reference: BJU Int. 2010 Mar 1. doi:10.1111/j.1464-410X.2010.09272.x

PubMed Abstract PMID:20201829

Organ-sparing strategies in the management of invasive bladder cancer[xviii]

Bladder cancer is the second most common genitourinary malignancy. Radical cystectomy and pelvic lymphadenectomy is the standard of care in the management of muscle-invasive bladder cancer. However, recently, bladder-preservation trials conducted by both single- and multi-institutional groups have gained momentum because of comparable survival and recurrence rates in select patients. While single-modality therapies have failed to provide adequate results, multimodal combination therapies consisting of a thorough transurethral resection with radiotherapy and concomitant chemotherapy have been promising. Careful patient selection, maximum transurethral resection of bladder tumor, cystoscopic evaluation of response with prompt salvage cystectomy for nonresponders and strict long-term follow-up for complete responders constitute the hallmarks of optimal bladder-preservation protocols. Advances in molecular-targeted therapy, chemotherapy and radiotherapy hold promise to improve survival and local control and decrease side effects and toxicity.

Bladder Preservation in Octogenarians With Invasive Bladder Cancer[xix]

Received 26 July 2009; accepted 15 October 2009. published online 17 December 2009.

Objectives

To analyze mortality and morbidity of octogenarians with newly diagnosed invasive transitional cell cancer (TCC) of the bladder who were managed without cystectomy.

Methods

Retrospective chart review of all patients with newly diagnosed invasive TCC (≥pT1) in the period of 1997-2007, who were 80 years or older at diagnosis.

Results

A total of 71 patients (86 + 4 years, mean + standard deviation [SD], pT1: n = 29; >pT2: n = 42) entered this analysis. In this geriatric population, treatment regimens were highly individualized. After transurethral resection, 61% of pT1-patients received bacillus Calmette-Guerin and 62% of those with >pT2-tumors external beam radiation. Mean overall survival (OS) of the entire cohort (n = 71) was 22 + 26 months for pT1-patients 34 + 33 versus 14 + 15 months for those with ≥pT2-tumors (P = .001). Mean cancer-specific survival was 58 months for pT1-patients and 11 months for ≥pT2-patients (P <.001). OS was correlated to tumor stage and the degree of mobility, to a lesser extent to the American Society of Anesthesiologists (ASA) score, and only marginally to chronologic age. Satisfactorily bladder function was preserved in 73%. pT1-patients spent 16% of their remaining life-span in the hospital compared with 23% for patients with >pT2-tumors.

Conclusions

OS in TCC is dependent on tumor stage, age, mobility, and comorbidities, and a risk-stratified management is necessary. Patients with pT1G3 tumor and low ASA score have satisfying OS with bladder preservation, but in patients with ≥pT2 and ASA 3-4 the prognosis is very bad. It remains questionable whether patients with tumor stages ≥pT2 and ASA 1-2 despite high age would benefit from radical cystectomy.

Long-Term Follow-Up of Cisplatin Combination Chemotherapy in Patients With Disseminated Nonseminomatous Germ Cell Tumors[xx]

Is a Postchemotherapy Retroperitoneal Lymph Node Dissection Needed After Complete Remission?

Abstract

Purpose Controversy arises regarding the optimal management of patients with nonseminomatous germ cell tumor (NSGCT) who achieve a serologic and radiographic complete remission (CR) to systemic chemotherapy. Some authors recommend postchemotherapy retroperitoneal lymph node dissection (PC-RPLND), whereas others omit surgery and observe these patients. In an attempt to address this question, we report the long-term follow-up of patients treated at Indiana University who were observed without PC-RPLND.

Patients and Methods This is a retrospective analysis of patients with NSGCT who achieved a CR to first-line chemotherapy and were monitored without further therapy. CR was defined as normalization of serum tumor markers and resolution of radiographic disease (residual mass < 1 cm).

Results One hundred forty-one patients were identified. Five patients (4%) had less than 2 years of follow-up. After a median follow-up of 15.5 years, 12 patients (9%) experienced relapse. Of these 12 patients, eight patients currently have no evidence of disease (NED), and four patients died of disease. The estimated 15-year recurrence-free survival (RFS) and cancer-specific survival rates were 90% and 97%, respectively. The estimated 15-year RFS for good-risk patients (n = 109) versus intermediate- or poor-risk patients (n = 32) was 95% and 73% (P = .001), respectively. Six patients (4%) experienced recurrence in the retroperitoneum, of whom two patients died of disease. Five patients had late relapse (range, 3 to 13 years), including two patients in the retroperitoneum. All five patients currently have NED.

Conclusion Patients obtaining a CR after first-line chemotherapy can be safely observed without PC-RPLND. Relapses are rare and potentially curable with further treatment.


Total Cystectomy Versus Bladder Preservation Therapy for Locally Invasive Bladder Cancer[xxi]

Effect of Combined Therapy Using Balloon-Occluded Arterial Infusion of Anticancer Agent and Hemodialysis With Concurrent Radiation

Objectives: We tested the usefulness of balloon-occluded arterial infusion (BOAI) of anticancer agent (cisplatin/gemcitabine), concomitant with hemodialysis, which delivers an extremely high concentration of anticancer agent to the site of a tumor without systemic adverse effects, along with concurrent radiation [Osaka-Medical College (OMC)-regimen] in patients with locally advanced bladder cancer. The results were compared with those of cystectomy.

Methods: One hundred twenty-four patients were assigned to receive cystectomy (Gp1, n = 62) or OMC-regimen (Gp2, n = 62). In Gp2, patients besides undergoing complete response subsequently received secondary-BOAI with gemcitabine (1600 mg).

Results: In Gp1, 27 of 62 patients (43.5%) suffered disease recurrence, and more than half died within 1 year; the remainder died thereafter. The overall 5-, 10-, and 15-year survival rates were 53.8%, 46.0%, and 40.0%, respectively. In contrast, in Gp2, >70% of patients (44 of 62), especially >95% of patients with locally invasive tumors achieved complete response with no evidence of recurrent disease or metastasis after a mean follow-up of 163 (range, 32-736) weeks. At 14 years, overall survival was significantly improved at 79.7% (P = 0.015 vs. Gp1). Moreover, salvage therapy for secondary-BOAI with gemcitabine was effective in all 3 patients with T4 tumors or lymph node involvement, who showed stable disease (SD) after primary therapy with CDDP. No patients suffered Grade III or more severe toxicities.

Conclusion: OMC-regimen, a new strategy for patients with locally-invasive bladder cancer, can be curative not only in patients for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment and for whom merely palliative treatment would otherwise seem the only option.

Bladder-Sparing Therapy a Good Alternative[xxii]

By Charles Bankhead, Staff Writer, MedPage Today
Published: November 05, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

CHICAGO — Organ-sparing multimodal therapy for invasive bladder cancer achieves survival comparable to that of radical cystectomy, but with better quality of life, according to a study reported here.

The combination of transurethral tumor resection, radiation therapy, and chemotherapy led to complete responses in 72% of patients. Disease-specific and overall survival at five, 10, and 15 years compared favorably with results from contemporary patient series of radical cystectomy.

“The results support the acceptance of modern bladder-sparing trimodality therapy for selected patients as a proven alternative to cystectomy,” Jason Efstathiou, MD, PhD, of Massachusetts General Hospital in Boston, said at the American Society of Radiation Oncology.

Action Points

  • Explain to patients that a bladder-preserving therapy for invasive bladder cancer appears to attain results similar to those of radical surgery in selected patients.
  • Note that the findings came from a retrospective review of data from a single institution.
  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.

“The optimal regimen of combined chemoradiation, as well as the addition of rational molecular targeted therapy, continues to be investigated.”

The findings came from an analysis of long-term follow-up data in 343 patients with muscle-invasive bladder cancer treated with trimodal therapy. The patients were treated from 1986 to 2002.

Treatment began with a 40-Gy dose of radiotherapy, followed by repeat biopsy and urinary cytology. Patients who achieved a complete response or who were not candidates for cystectomy received boost chemoradiation to 64 or 65 Gy.

Subsequently, 102 patients underwent radical cystectomy, 60 of whom did not have a complete response and 42 because of tumor recurrence.

The patients had a five-year overall survival of 52% and disease-specific survival of 64%. The rates at 10 years were 35% and 59% for overall and disease-specific survival, respectively, and 22% and 57% at 15 years.

“Eighty percent of patients who were alive at five years still had their native bladders,” said Efstathiou.

Among patients who had cystectomy, five-year overall survival was 29%. Survival was similar in patients who underwent immediate or delayed cystectomy.

The completeness of transurethral resection of the bladder tumor significantly influenced the likelihood of response and patient survival.

The 227 patients who underwent complete tumor resection had a complete response rate of 79%, decreasing to 57% for patients with incomplete resection (P<0.001). Overall survival at five years was 57% with complete resection and 43% without (P=0.003).

Disease-specific survival was 68% with complete tumor resection and 56% without (P=0.03).

In multivariate analyses, independent predictors of survival were complete response to induction therapy (HR 0.62, P=0.013) and low clinical T stage (HR 0.66, P=0.018).

For comparison, Efstathiou reviewed five- and 10-year overall survival with cystectomy reported from the University of Southern California in Los Angeles, Memorial Sloan-Kettering Cancer Center in New York, and the Southwest Oncology Group.

Five-year survival ranged between 36% and 49%, while 10-year survival was 27% to 32%. The five-year results at Massachusetts General were slightly better but still consistent with data from other studies of chemoradiation therapy for invasive bladder cancer.

As previously reported, a subset of 221 patients had urodynamics evaluations and completed a quality-of-life questionnaire. The results showed that 78% of the patients had compliant bladders with normal capacity and flow parameters, 85% had occasional or no urinary urgency, and 50% of the male patients reported normal erectile function (J Urol 2003; 170: 1772-76).

Data on a subset of 157 patients with bladder preservation who were followed for a median 5.2 years showed a 22% incidence of grade 1 late pelvic toxicity, 10% grade 2, and 7% grade 3 (J Clin Oncol 2009; 27: 4055-61).

Efstathiou had no disclosures.

Primary source: American Society for Radiation Oncology
Source reference:
Efstathiou J, et al “15-year outcomes of selective bladder preservation by combined-modality therapy for invasive bladder cancer: the long-term MGH experience” ASTRO 2009; Abstract 21

An Alternative to Radical Cystectomy[xxiii]

September 18, 2009

Bladder-sparing treatment in which brachytherapy is added to external beam radiotherapy (EBRT) may be a valuable alternative for bladder cancer patients who refuse radical cystectomy or who are poor candidates for major surgery, according to researchers.

J.L.H. Ruud Bosch, MD, of University Medical Center Utrecht in the Netherlands, and colleagues reviewed data from 111 patients with solitary T1-T2 bladder tumors (5 cm or less in size). After undergoing transurethral resection of the tumors, patients were treated first with EBRT and then brachytherapy with iridium-192 at a dose of 40 Gy. A partial cystectomy was performed in nine patients, of whom five had a T3 tumor.

The study population had a mean follow-up of 6.2 years.

At the last follow-up, 75 patients were alive without evidence of disease and 17 had died without evidence of disease, the investigators reported in European Urology (2009;56:113-122). Nineteen patients died of bladder cancer after a mean follow-up of 2.9 years.

Overall survival rates at five, 10, and 15 years were 70%, 55%, and 51%, respectively. Disease-specific survival rates were 82%, 73%, and 73%, respectively. Disease-free survival rates were 60%, 47%, and 23%. Patients with T3 tumors had a nearly 20-fold increased risk of dying from bladder cancer. Additionally, 27% of patients experienced local recurrence and 9% underwent salvage cystectomy. Bladder function was preserved in 99 patients (89%).

From the September 2009 Issue of Renal And Urology News

Conservative treatment of invasive bladder cancer[xxiv]

Tuesday, 01 September 2009

Department of Radiation Oncology, McGill University Health Centre, Montreal, QC.

The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion. Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer. Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy.

Written by: Rene NJ, Cury FB, Souhami L.

Reference: Curr Oncol. 2009 Aug;16(4):36-47.

PubMed Abstract PMID:19672423

A 10-year retrospective review of a nonrandomized cohort of 458 patients undergoing radical radiotherapy or cystectomy in Yorkshire, UK[xxv]

Monday, 31 August 2009

Department of Urology, Mid Yorkshire NHS Trust, Pinderfields Hospital, Aberford Road, Wakefield.

We have previously reported on the mortality, morbidity, and 5-year survival of 458 patients who underwent radical radiotherapy or surgery for invasive bladder cancer in Yorkshire from 1993 to 1996. We aim to present the 10-year outcomes of these patients and to reassess factors predicting survival.

The Northern and Yorkshire Cancer Registry identified 458 patients whose cases were subjected to Kaplan-Meier all-cause survival analyses, and a retrospective casenote analysis was undertaken on 398 (87%) for univariate and multivariate Cox proportional hazards modeling. Additional proportional hazards regression modeling was used to assess the statistical significance of variables on overall survival.

The ratio of radiotherapy to cystectomy was 3:1. There was no significant difference in overall 10-year survival between those who underwent radiotherapy (22%) and radical cystectomy (24%). Univariate analyses suggested that female sex, performance status, hydronephrosis and clinical T stage, were associated with an inferior outcome at 10 years. Patient age, tumor grade, treatment delay, and caseload factors were not significant. Multivariate analysis models were created for 0-2 and 2-10 years after treatment. There were no significant differences in treatment for 0-2 years; however, after 2 years follow-up there was some evidence of increased survival for patients receiving surgery compared with radiotherapy (hazard ratio 0.66, 95% confidence interval: 0.44-1.01, p = 0.06).

A 10-year minimum follow-up has rarely been reported after radical treatment for invasive bladder cancer. At 10 years, there was no statistical difference in all-cause survival between surgery and radiotherapy treatment modalities.

Written by: Munro NP, Sundaram SK, Weston PM, Fairley L, Harrison SC, Forman D, Chahal R.

Reference:  Int J Radiat Oncol Biol Phys. 2009 Aug 6. doi:10.1016/j.ijrobp.2009.04.050

PubMed Abstract  PMID:19665319

See also: http://www.springerlink.com/content/ax07pj2lfgphqk50/

Conclusion: Our results indicate that a smaller dose of anticancer drugs should be infused from the bilateral internal iliac arteries for safer pelvic BOAI.

http://www.ncbi.nlm.nih.gov/pubmed/2471758

These results demonstrate that BOAI therapy is effective for the treatment of progressive cervical carcinoma by increasing intratumoral concentrations of the drugs.

http://www.biomedexperts.com/Abstract.bme/9313660/Balloon-occluded_arterial_infusion_as_a_useful_neoadjuvant_chemotherapy_for_bladder_cancer

CONCLUSION: In patients diagnosed as stage T2 and T3a, or stage T1 with multiple large tumours difficult to be treat by transurethral resection, BOAI should be considered as the first choice to decrease the stage or to confirm the pathological staging.

Radiochemotherapy for bladder cancer[xxvi]

Wednesday, 22 July 2009

Department of Radiation Oncology, University Hospitals, Erlangen, Germany.

Standard treatment for muscle-invasive bladder cancer is cystectomy. Multimodality treatment, including transurethral resection of the bladder tumour, radiation therapy, chemotherapy and deep regional hyperthermia, has been shown to produce survival rates comparable with those of cystectomy. With these programmes, cystectomy has been reserved for patients with incomplete response or local relapse. During the past two decades, organ preservation by multimodality treatment has been investigated in prospective series from single centres and co-operative groups, with more than 1000 patients included. Five-year overall survival rates in the range of 50-60% have been reported, and about three-quarters of the surviving patients maintained their bladder.

Clinical criteria helpful in determining patients for bladder preservation include such variables as small tumour size (< 5cm), early tumour stage, a visibly and microscopically complete transurethral resection, absence of ureteral obstruction, and no evidence of pelvic lymph node metastases. On multivariate analysis, the completeness of transurethral resection of a bladder tumour was found to be one of the strongest prognostic factors for overall survival. Patients at greater risk of new tumour development after initial complete response are those with multifocal disease and extensive associated carcinoma in situ at presentation. Close co-ordination among all disciplines is required to achieve optimal results. Future investigations will focus on optimising radiation techniques, including all possibilities of radiosensitisation (e.g. concurrent radiochemotherapy, deep regional hyperthermia), and incorporating more effective systemic chemotherapy, and the proper selection of patients based on predictive molecular makers.

Written by: Ott OJ, Rödel C, Weiss C, Wittlinger M, Krause FS, Dunst J, Fietkau R, Sauer R.

Reference: Clin Oncol (R Coll Radiol). 2009 Jun 27. doi:10.1016/j.clon.2009.05.005

PubMed Abstract PMID:19564101

Safety of active surveillance program for recurrent nonmuscle-invasive bladder carcinoma[xxvii]

Urology, 07/07/09

In a study to explore the experience with a group of pts with low-risk tumors included in an observation and monitoring program after diagnosis of recurrence, it was found that pts with recurrent, small (<1 cm), nonmuscle-invasive bladder tumors can be safely offered monitoring under an active surveillance protocol, with minimal risk of progression in either grade or stage, thus reducing the amount of surgical intervention pts might undergo.

Methods

  • A prospective cohort study was done in pts diagnosed with recurrent, nonmuscle-invasive bladder cancer maintained under an active surveillance protocol.
  • Inclusion criteria were papillary tumors with negative cytology findings, previous nonmuscle-invasive tumor (Stage pTa, pT1a), grade 1-2, size <1 cm, and number of tumors <5.
  • No symptomatic pts or those with carcinoma in situ or grade 3 tumors were included.
  • A retrospective analysis of a control group of pts with clinical characteristics similar to those of pts on active surveillance, but who underwent transurethral resection immediately after recurrence was diagnosed was also performed.

Results

  • Data from 64 pts (70 observation events) were analyzed.
  • Mean pt age was 66.7 yrs.
  • Median follow-up was 38.6 mos.
  • Median time pts remained in observation was 10.3 mos.
  • Tumor histologic features before observation were Stage pTa in 77.1%, Stage pT1a in 22.9%, grade 1 in 67.1%, and grade 2 in 23%.
  • After 10.3 mos, 93.5% of pts had not progressed in stage and 83.8% had not progressed in grade.
  • None of the pts experienced progression to muscle-invasive disease.
  • Comparison between rates of progression and control groups showed no statistically significant difference.

What happens to the patients with muscle-invasive bladder cancer who refuse cystectomy after neoadjuvant chemotherapy?[xxviii]

Ruchir Maheshwari, Aneesh Srivastava
Department of Urology and Renal Transplantation, SGPGIMS, Raibareilly Road, Lucknow-226 014, India

Date of Web Publication24-Jun-2009

Summary

This is a prospective study carried out to determine the outcome of patients who refuse cystectomy after receiving neoadjuvant chemotherapy for muscle-invasive bladder cancer. Sixty-three patients were evaluated between 1995 and 2001 who declined to undergo a planned cystectomy because they achieved a complete clinical response to neoadjuvant cisplatin-based chemotherapy. Herr assessed patient, tumor and treatment features for a median follow- up of 86 months, all patients being followed-up for more than 5 years. Forty patients (64%) survived, with 54% of them having an intact functioning bladder. The number and size of invasive tumors were strongly associated with the overall survival. The most significant treatment variable predicting better survival was complete resection of the invasive tumor on restaging transurethral resection (TUR) before starting chemotherapy. Of 23 patients (36%) who subsequently died of disease, 19 (30%) relapsed with invasive cancer in the bladder. Over 90% of the surviving patients had solitary, small and low-stage invasive tumors completely resected and 83% survived without relapses in the bladder. [1]

Comments

Radical cystectomy and pelvic lymph node dissection is an excellent treatment for organ-confined disease. Many patients with extravesical or lymph node-positive bladder cancer will develop recurrent disease, often with distant metastases, and will ultimately die of their disease. Given the lethality of muscle-invasive bladder cancer, there is a definite need for effective systemic chemotherapy. Neoadjuvant chemotherapy has been extensively investigated in muscle-invasive bladder cancer. When taken together, the randomized controlled trials of neoadjuvant cisplatin-based combination chemotherapy demonstrate an improved survival over cystectomy alone. In addition, neoadjuvant chemotherapy can result in downstaging of primary tumors. [2]

The Advanced Bladder Cancer Metaanalysis Collaboration concluded that platinum-based combination neoadjuvant chemotherapy and cystectomy continues to show a clear and modest benefit for survival and disease-free survival of patients with muscle-invasive bladder cancer over radical surgery alone. [3] Downstaging after neoadjuvant chemotherapy was associated with improved survival in patients with muscle-invasive, extravesical (T > 3a) disease at presentation. Chemotherapy aims to treat undetected metastasis and radical cystectomy provides the best control of the primary tumor. Most survivors achieve major response to chemotherapy and have an increased likelihood of having no residual tumor (pT0) in the cystectomy specimen. [4] The author has analyzed whether patients who have pathological pT0 tumors after chemotherapy would have survived without subsequent cystectomy.

In the present study, 64% of the patients survived, with 54% of them having an intact functional bladder (35% of total cohort). Relapse occurred in the majority of the patients (64%), resulting in an additional disease-related mortality of 30%. The patients most likely to relapse had multiple or large tumors that were not clinically confined to the bladder. Delayed cystectomy salvaged fewer than half of the patients relapsing with persistent or new invasive bladder cancers.

Few other studies have dealt on conservative, bladder- sparing management of muscle-invasive transitional cell carcinoma (TCC) bladder using multimodality treatment. [5] These authors have used chemoradiotherapy for tumor control. Perdonà et al., have reported 121 patients with T2, T3 or T4 bladder cancer who underwent induction by TUR of the tumor and received two cycles of neoadjuvant chemotherapy followed by radiotherapy (RT) or radiochemotherapy (RCT). Six weeks after RT or RCT, responses were evaluated by restaging TUR. Patients who achieved a complete response were observed at regular intervals. In patients who had persistent or recurrent invasive tumor, further treatment was recommended. Treatment modality, tumor classification and resection status after initial TUR had an impact on survival rates (P = 0.04, 0.02 and 0.02, respectively).

These studies highlight the fact that patients refusing cystectomy after chemotherapy are at high risk for disease-related mortality. At the same time, patients with small, clinically confined single tumors, which can be visibly and microscopically completely resected before neoadjuvant chemotherapy, are most likely to survive without cystectomy. They need a close follow-up as they remain at risk for new tumors in the bladder.

References

1.Herr HW. Outcome of Patients Who Refuse Cystectomy after Receiving Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer. Eur Urol 2008;54:126-32.

2.Vaughn DJ, Malkowicz SB. Neoadjuvant Chemotherapy in Patients with Invasive Bladder Cancer. Urol Clin N Am 2005;32:231-7.

3.Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Neoadjuvant chemotherapy in invasive bladder cancer: Update of a systemic review and meta-analysis of individual patient data. Eur Urol 2005;48:202-6.

4.Schultz PK, Herr HW, Zhang ZF, Bajorin DF, Seidman A, Sarkis A, et al . Neoadjuvant chemotherapy for invasive bladder cancer: Prognostic factors for survival of patients treated with M-VAC with 5-year follow- up. J Clin Oncol 1994;12:1394-401.

5.Perdonà S, Autorino R, Damiano R, De Sio M, Morrica B, Gallo L, et al . Bladder-sparing, combined-modality approach for muscle-invasive bladder cancer: A multi-institutional, long-term experience. Cancer 2008;112:75-83.

Radical Cystectomy versus Radical Radiotherapy[xxix]


A study of the morbidity, mortality and long-term survival following radical cystectomy and radical radiotherapy in the treatment of invasive bladder cancer in Yorkshire.

Chahal R, Sundaram SK, Iddenden R, Forman DF, Weston PM, Harrison SC.

Department of Urology, Orchard House, Pinderfields and Pontefract NHS Trust,

Wakefield, West Yorkshire WF1 4DG, UK

.

OBJECTIVES: To study the morbidity of radical cystectomy and radical

radiotherapy in the treatment of patients with invasive carcinoma of the bladder and to report the long-term survival following these treatments.

PATIENT AND METHODS: 398 patients with invasive carcinoma of the bladder treated between 1993 and 1996 in the Yorkshire region were studied. Of 398 patients studied, 302 patients received radical radiotherapy and 96 underwent radical cystectomy. A retrospective review of patients' case notes was performed to construct a highly detailed database. Crude estimates of survival differences were derived using Kaplan-Meier methods. Log-rank tests (or, where appropriate, Wilcoxon tests) were used to test for the equality

of these survivor functions. These functions were produced as all-cause survival. The proportional hazards regression modelling was used to assess the impact of definitive treatment on survival. A backwards-stepwise approach was used to derive a final predictive model of survival, with likelihood ratio tests to assess the statistical significance of variables to be included in the model.

 

CONCLUSIONS: This retrospective regional study shows that there is no

significant difference in the 5-year survival of patients with invasive bladder cancer treated with either radical radiotherapy or radical cystectomy. All forms of radical treatment for bladder cancer are associated with a significant treatment-associated morbidity and mortality.

Gastrointestinal complications were responsible for the majority of

complications. The clinical T stage, the sex and the ASA grade of the

patient were the only independent predictors of survival. The data in this series suggests that radical radiotherapy and radical cystectomy should be both considered as valid primary treatment options for the management of invasive bladder cancer.

Copyright 2003 Elsevier Science B.V


[xiv] Almudena Zapatero M.D., Ph.D.a, Carmen Martin de Vidales M.D., Ph.D.a, Ramón Arellano M.D.b, Gloria Bocardo M.D.b, Mar Pérez M.D.c and Patricia Ríos M.D.a (aDepartment of Radiation Oncology, Hospital Universitario de la Princesa, Madrid, Spain; bDepartment of Urology, Hospital Universitario de la Princesa, Madrid, Spain; cDepartment of Medical Oncology, Hospital Universitario de la Princesa, Madrid, Spain)

[xxix] Eur Urol. 2003 Mar;43(3):246-57.

Posted in Cancer Perspectives, Comments and Suggestions, surgery | 1 Comment »

Ian Clements’ ‘Chemotherapy Help’ document

Posted by Jonathan Chamberlain on April 21, 2011


See also my two cancer books – http://www.fightingcancer.com

Chemotherapy Help – Alternative ways you can support yourself while undergoing chemotherapy

Contents

Summary. 2

Major Component in Turmeric Enhance Effect of Chemotherapy Drug in Head and Neck Cancer. 2

Advice from Cancer Active. 4

1. Clean Your Liver. 4

2. Prepare Yourself. 4

4. Certain Supplements Improve Treatment Success. 5

Antioxidants and Chemotherapy – Findings. 5

Supplements during gem/cis Yes or No ?. 6

1,25D3 [Vitamin D3] Enhances antitumor activity of gemcitabine and cisplatin in human bladder cancer models  6

Pete Granger’s Comments on Vit. D3 research above. 7

Milk thistle herb protects liver from damage caused by chemotherapy. 7

Neuropathy & Glutamine. 8

Glutamine for neuropathy and other chemo supplements‏. 8

New Way To Fight Cancer: Protect Healthy Cells With The Silver Shield. 10

The diet that won’t just help you lose weight, you’ll live longer and be brainier!. 13

Exercise May Keep Cancer Patients Healthier During, After Treatment. 15

New exercise guidelines for cancer survivors. 17

How to Take Care of Yourself During Chemotherapy. 17

Recommendations – Supplements To Take With Specific Chemotherapy Drugs. 18

Chemo, Tinnitus‏ & Hearing Loss. 19

Cold Caps Prevent Hair Loss. 19

Fruit, etc Help, but No Sugar or Fruit Juices. 21

Summary

Vit.D3  4,000IU-12,000IU daily – enhances efficacy of chemo[i]

Magnesium 500mg daily – replaces severe depletion

10 grams (3 scoops) of glutamine powder 3 times a day to minimize the side effects of chemo including neuropathy

Vit.A

Vit.C – 1 – 5 gms/day

Curcumin + piperene – up to 10 gms/day – enhances chemo, especially cisplatin, and reduces chemo damage[ii]

Co-Enzyme Q10 100mg/day – chemo harms the heart; Co-Q10 helps it[iii]

Omega 3 oil 5gms EPA – helps preserve muscle in cancer patients on chemo[iv]

Green or white tea

Astralagus – an immune booster[v]; anti-cancer generally;

Aloe Vera – enhances chemo’s effects, enhances apoptosis, improves immune system

Milk thistle

Bromelain

Resveratrol – enhances chemo’s effect[vi]

Medicinal mushrooms

Stay off sugar, sodium (salt) and fruit juices

Exercise: as vigorous as possible – walking 30’ day, jogging if poss., and resistance training

Immune-Boost Treatment Might Help Some With Advanced Colon Cancer[vii]

But whether the approach beats chemo-plus-Avastin/Erbitux remains unanswered, experts say

Posted: April 6, 2011 By Amanda Gardner HealthDay Reporter

WEDNESDAY, April 6 (HealthDay News) — By giving more intensive chemotherapy along with drugs designed to boost the body’s own immune system, researchers were able to roughly double survival time for patients with advanced, metastatic colorectal cancer compared to patients receiving standard chemotherapy alone.

In fact, the trial, results of which are being presented at the annual meeting of the American Association for Cancer Research in Orlando, was stopped early because of the promising findings.

“With this study, we have produced for the first time strong proof-of-concept that chemo-immunotherapy may be active and more efficacious than standard [chemotherapy] in metastatic colon cancer patients,” said study lead author Dr. Pierpaolo Correale, an oncologist with Siena University School of Medicine in Siena, Italy.

The standard of care right now for patients with colorectal cancer that’s spread to other regions is to use one of two dual-drug combinations of chemotherapy alone, or use them alongside a newly developed monoclonal antibody treatment such as Avastin (bevacizumab) or Erbitux (cetuximab). These approaches can boost overall survival to about 20 to 22 months.

For this study, the research team randomized 130 patients to receive either chemotherapy alone (with a regimen known as FOLFOX) or to receive FOLFOX plus drugs to ramp up the immune system (this regimen is known as GOLFIG).

The chemo/immune boost approach involves first giving patients gemcitabine plus standard FOLFOX chemotherapy (oxaliplatin, levofolinic acid and 5-FU/GOLF) that targets and kills the cancer cells in a number of ways — all the while sending off signals alerting the immune system to the cancer.

This is then followed up with the administration of signaling molecules called cytokines that spur key immune cells into action. Another immune-boosting cancer drug, called aldesleukine, is also given to help boost the population of immune cells targeted against tumor cells.

At the time of data collection, the patients treated with this approach have survived an average 16.5 months without a relapse, compared with just 7.5 months in the chemo-only group.

But the study began in 2005, before the advent of drugs like Avastin or Erbitux, meaning that investigators do not yet know if GOLFIG would outperform regimens that include those medications. This needs to be looked at, said Correale.

On the other hand, many patients do not see a benefit from biological agents such as Erbitux or Avastin because they have the wrong genetic profile, noted one outside expert.

“Essentially, we have a very problematic subset of patients with metastatic colorectal cancer which are limited to two lines of chemotherapy and [perhaps] one biological agent,” said Dr. Igor Astsaturov, assistant professor of medical oncology at the Fox Chase Cancer Center in Philadelphia.

“For those patients, which are about one-third of the overall patient population, this [new finding] will be particularly welcome news,” Astsaturov said, while adding the caution that the results are still preliminary.

However, clinical use of the protocol may be delayed further by the fact that “there is no direct commercial interest of pharmaceutical companies,” noted Correale, who is nevertheless planning larger trials.

The costs associated with GOLFIG, he added, are “four-to-five times lower than that produced by the current use of Avastin or Erbitux with apparently similar therapeutic results.”

Because this study was presented at a medical meeting, the findings should be viewed as preliminary until they are published in a peer-reviewed journal.

Curcumin and Resveratrol – Chemoresistance[viii]

The following studies suggest growth factor IGF-1 is involved in the late stage invasiveness of various cancers, including bladder and colon cancers, and inhibition of IGF-1 may minimise this effect. Curcumin and resveratrol – especially in combination, block IGF-1
expression. They also appear to enhance the efect of chemotherapy.

Pete

‘In this study, the researchers looked at the role of the protein receptor for the growth factor IGF-I, an important modulator of cell proliferation in bladder cancer cells. They found that although activation of IGF-IR did not affect growth of bladder cancer cells, it did promote the migration and invasion of these cells’.

‘IGF-IR activated other molecules in cancer-promoting pathways (Akt and MAPK) that allow cancer cells to break its bond with other cells in a tumor in order to travel to others sites in the body.

“These data seem to indicate that this protein receptor (IGF-IR) may play a more prominent role in later stages of bladder cancer, not in the initiation of the cancer,” said Dr. Morrione’.

http://www.sciencedaily.com/releases/2010/05/100514123502.htm

‘Curcumin (diferuloylmethane), which has no discernible toxicity, inhibits initiation, promotion and progression of carcinogenesis. 5-Fluorouracil (5-FU) or 5-FU plus oxaliplatin (FOLFOX) remains the backbone of colorectal cancer chemotherapeutics, but produces an
incomplete response resulting in survival of cells (chemo-surviving cells) that may lead to cancer recurrence. The present investigation was, therefore, undertaken to examine whether addition of curcumin to FOLFOX is a superior therapeutic strategy for chemo-surviving cells

‘Our data suggest that inclusion of curcumin in conventional chemotherapeutic regimens could be an effective strategy to prevent the emergence of chemoresistant colon cancer cells’.

http://www.ncbi.nlm.nih.gov/pubmed/20332435

‘more recently we have demonstrated that curcumin not only inhibits the activation of EGFR and family members, but also IGF-IR in colon cancer HCT-116 cells’

‘The combination of resveratrol and curcumin causes a significantly greater inhibition of growth of tumors than either agent alone’.

http://www.encognitive.com/files/Curcumin%20Synergizes%20With%20Resveratrol%20to%20Inhibit%20Colon%20Cancer.pdf

Major Component in Turmeric Enhance Effect of Chemotherapy Drug in Head and Neck Cancer[ix]

ScienceDaily (Oct. 24, 2010) — Curcumin, the major component in the spice turmeric, when combined with the drug cisplatin enhances the chemotherapy’s suppression of head and neck cancer cell growth, researchers with UCLA’s Jonsson Cancer Center have found.

A naturally occurring spice widely used in South Asian and Middle Eastern cooking, Turmeric has long been known to have medicinal properties, attributed to its anti-inflammatory effects. Previous studies have shown it can suppress the growth of certain cancers, said Dr. Marilene Wang, a professor of head and neck surgery, lead author of the study and a Jonsson Cancer Center researcher.

“Head and neck cancers, particularly cases diagnosed in a later stage, are terrible cancers that often require very radical surgeries and chemotherapy and radiation,” Wang said. “They often don’t present until late, and the structures in the head and neck are so vital that our treatments often cause disfigurement and severe loss of function. So using non-toxic curcumin as a treatment was a very appealing idea.”

The study, done in cells in Petri dishes and then in mouse models, appears in the October issue of the journal Molecular Cancer Therapeutics.

In India, women for years have been using turmeric for medicinal purposes, as an anti-aging agent rubbed into their ski, to treat cramps during menstruation, as a poultice on the skin to promote wound healing and as an additive in cosmetics, said scientist Eri Srivatsan, an adjunct professor of surgery and a Jonsson Cancer Center researcher who, along with Wang, has been studying curcumin and its anti-cancer properties for six years.

A 2005 study by Wang and Srivatsan first showed that curcumin suppressed the growth of head and neck cancer cells, first in cells and then in mouse models. In the animal studies, the curcumin was applied directly onto the tumors in paste form because it did not dissolve in saline, which would have allowed it to be injected.

In need of a better way to deliver the curcumin, the team collaborated with Dr. Kapil Mehta of M.D. Anderson Cancer Center and found that encapsulating the tumor in a liposome, an artificially prepared vehicle that enclosed the spice component within its membrane, made the treatment injectable. The curcumin was injected into the tail vein of a mouse, where it circulated into the blood stream, slowing down and eventually stopping the cancer growth, a study in 2008 found.

“This was a very positive finding, developing an efficient way to deliver the treatment,” Wang said. “Our study also showed that the curcumin was very well tolerated.”

In this study, the team wanted to combine the curcumin with the chemotherapeutic drug cisplatin, which is very toxic at the doses needed to fight head and neck cancers, damaging kidneys, the ears and the bone marrow. They hoped that if they added curcumin to the mix, they might be able to lower the cisplatin dose and cause less organ damage. Their finding, that the curcumin made the cisplatin work better, was very promising, Wang said.

“We knew that both the curcumin and the cisplatin, when given alone, had an effect against head and neck cancers,” Wang said. “This finding that curcumin enhances cisplatin means that, in the future, we may be able to give this chemotherapy in lower doses.”

The study noted that “the mechanisms of the two agents through different growth signaling pathways suggest potential for the clinical use of sub-therapeutic doses of cisplatin in combination with curcumin, which will allow effective suppression of tumor growth while minimizing the toxic side effects.”

The study found that curcumin suppressed head and neck cancer growth by regulating cell cycling, Srivatsan said. It binds to an enzyme and prevents the enzyme IKK, an inhibitor of kappa B kinase, from activating a transcription factor called nuclear factor kappa B (NFκB), which promotes cancer growth. Cisplatin’s suppressive action involves a different pathway through the tumor suppressor proteins p16 and p53, both proteins that again inhibit the activity of cancer growth promoter NFκB.

“We needed to know the mechanism to help us translate this from the lab into the clinic,” Wang said. “That information will help us make better decisions on how to design therapies.”

The next step in the clinical setting is to give patients oral curcumin prior to surgery and, after surgery, study the excised tumors to determine curcumin’s effect on tumor markers, specifically whether there is reduced expression of markers such as growth promoting NFκB. They also will be monitoring to determine if the curcumin results in any side effects. After that, the team would give curcumin to patients also getting chemotherapy and radiation to see if the tumor suppression found in the cells lines and mouse models can be replicated in humans.

Although turmeric is used in cooking, the amount of curcumin needed to produce a clinical response is much larger, about 500 milligrams. Expecting a positive effect through eating foods spiced with turmeric is not realistic, the researchers said.

Curcumin also has a suppressive effect on other cancers, Wang said, including breast, colon and pancreatic cancers. However, the mechanism of suppression in those cancers has not yet been uncovered. It also may be effective against Alzheimer’s and aging, Wang said.

Advice from Cancer Active[x]

So let us try to build up a plan, based on science, to give patients a strong route forward.

1. Clean Your Liver

Before and after chemotherapy, clean out the fats, the gallstones, the dead cells, the lactic acid build up. For if the liver is inefficient the whole immune system is affected. Take milk thistle, boldo tea, dandelion or a proprietary detox. Add turmeric to some meals, drink two litres of clean filtered water a day (not from tap or plastic bottles). Think about a serious liver flush and coffee enemas to remove gallstones and clean out some of the dead cells and fats. Click here for info on  the liver flush.

2. Prepare Yourself

a) Boost your immune system:  Anti-cancer herbs like Astragalus, Cat´s Claw, and echinacea are extremely effective. Add curcumin, total vitamin E and Chlorella plus probiotics and you really will target an improvement in your weeakened immune system. You can read about all of these on our web site, but most impressive is astragalus. All have all been shown to be excellent immune boosters but astragalus has been shown by the University of Texas Cancer Center in Houston to be an excellent anti-cancer agent lighting up the cancer cells to be ´spotted´ by the immune system..

Cut sodium from your diet

b) Cut sodium from your diet. Increase potassium and magnesium. Sodium displaces potassium in the power stations of your cells, making them more toxic and more acidic. Cancer thrives in acid bodies. Cut sodium foods like salt, soy sauce, gravy granules, hams, cooked meats, salami, turkey roast slices, sliced bread, breakfast cereals, sausages, bacon, processed food, prepared meals and Chinese meals. Consume high potassium and magnesium foods like fresh nuts in moderation, jacket potatoes, whole grains, green leaf vegetables, carrots, fresh apples, bananas, whole brown rice, broad beans, peas and pulses. A little rice milk or soya milk is acceptable.

Take a good, ideally liquid vitamin and mineral supplement, plus the anti-oxidants beta-carotene (use chlorella, which is natural, rather than the synthetic high street form, which anyway is not advisable if you have lung cancer), natural vitamin C with bioflavenoids and natural total vitamin E, zinc, selenium and co-enzyme Q10 (if you are over 30). A good B complex vitamin containing choline and inositol (also in soy lecithin), biotin and folic acid would be very protective prior to chemotherapy and radiotherapy.

Take long chain omega 3. For example, a good source would be Seven Seas Pure Cod Liver Oil. We have known since 1982, and a Nobel Prize by Sir John Vane, about the positive benefits of omega 3 in the cancer process. Omega 3 can also be found from a flaxseed source in Dr Joanna Budwig´s anti-cancer diet. Omega 3, garlic, ginger, salicylic acid (in Aloe Vera) and curcumin can all reduce inflammation and agressive eicosanoids, both of which stimulate cancers.

4. Certain Supplements Improve Treatment Success

Up front it needs to be said that there has long been a debate over whether cancer patients having chemo should take antioxidants. We have reviewed the argument several times on this web site. The Truth is that various expert cancer centres like MD Anderson and UCLA have stated that antioxidants can actually improve the success of chemotherapy, rather than hinder it as some people claim. MD Anderson have actually conducted several clinical trials (covered in Cancer Watch) showing vitamin E enhances the action of specific chemotherapy drugs.

But this argument is also a bit of a red herring.

Elsewhere on this site you will find articles on:

* vitamin D

* Medicinal Mushrooms

* Green Tea

* Astragalus

* Selenium

Each and all of these have been shown in expert research to decrease tumour size and/or improve survival when taken on their own or in conjunction with chemotherapy.

Furthermore Selenium (Brazil nuts, pumpkin and sunflower seeds, oily fish), and/or soya/fruit isoflavones and/or curcumin and/or astragalus have been shown to improve the action of radiotherapy.

MGN-3 (Biobran) reduced side effects of chemotherapy and radiotherapy in Japanese Clinical Trials. It is a rice bran and Japanese medicinal mushroom formula. The same trials show improved survival rates.

The various orthodox treatments leave an imbalance of flora in the intestine. You should take a multi-strain probiotic daily (Neways Advanced Probiotic, or Probiota 8) and try to keep yeasts in check. A teaspoon of sodium bicarbonate in warm water first thing in the morning, Pau D´arco supplement, oregano and wormwood will do this.

Antioxidants and Chemotherapy – Findings[xi]

  • All of the studies that included survival data showed similar or better survival rates for the antioxidant group than the control group.
  • None of the trials supported the theory that antioxidant supplements diminish the effectiveness of chemotherapy treatments.
  • All but one of the studies that reported treatment response showed similar or better response in the antioxidant group than in the control group.
  • 15 of 17 trials that assessed chemotherapy toxicities, including diarrhea, weight loss, nerve damage and low blood counts, concluded that the antioxidant group suffered similar or lower rates of these side effects than the control group.

Supplements during gem/cis Yes or No ?[xii]

cisplatin beats the magnesium out of your blood…..so i take 500mg magnesium daily…over the counter…doctors orders and nulasta 24hrs after last chemo treatment…..have good insurance….$3000 a shot can be overwhelming, unless it is covered in a clinical trial – daveyo

1,25D3 [Vitamin D3] Enhances antitumor activity of gemcitabine and cisplatin in human bladder cancer models[xiii]

BACKGROUND:

1,25 dihydroxyvitamin D3 (1,25D3) potentiates the cytotoxic effects of several common chemotherapeutic agents. The combination of gemcitabine and cisplatin is a current standard chemotherapy regimen for bladder cancer. The authors investigated whether 1,25D3 could enhance the antitumor activity of gemcitabine and cisplatin in bladder cancer model systems.
METHODS:

Human bladder cancer T24 and UMUC3 cells were pretreated with 1,25D3 followed by gemcitabine and cisplatin. Apoptosis was assessed by annexin V staining. Caspase activation was examined by immunoblot analysis and substrate-based caspase activity assay. The cytotoxic effects were examined by using 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and in vitro clonogenic assay. p73 protein levels were assessed by immunoblot analysis. Knockdown of p73 was achieved by siRNA. The in vivo antitumor activity was assessed by in vivo excision clonogenic assay and tumor regrowth delay in the T24 xenograft model.
RESULTS:

1,25D3 pretreatment enhanced gemcitabine and cisplatin-induced apoptosis and the activities of caspases 8, 9, and 3 in T24 and UMUC3 cells. 1,25D3 synergistically reduced gemcitabine and cisplatin-suppressed surviving fraction in T24 cells. 1,25D3, gemcitabine, or cisplatin induced p73 accumulation, which was enhanced by gemcitabine and cisplatin or 1,25D3 and gemcitabine and cisplatin. p73 expression was lower in human primary bladder tumor tissue compared with adjacent normal tissue. Knockdown of p73 increased clonogenic capacity of T24 cells treated with 1,25D3, gemcitabine and cisplatin, or 1,25D3 and gemcitabine and cisplatin. 1,25D3 and gemcitabine and cisplatin combination enhanced tumor regression compared with 1,25D3 or gemcitabine and cisplatin alone.
CONCLUSIONS:

1,25D3 potentiates gemcitabine and cisplatin-mediated growth inhibition in human bladder cancer models in vitro and in vivo, which involves p73 induction and apoptosis. Cancer 2010. © 2010 American Cancer Society.

Yingyu Ma, MD, PhD 1, Wei-Dong Yu, MD 1, Donald L. Trump, MD 2, Candace S. Johnson, PhD 1

 

Pete Granger’s Comments on Vit. D3 research above

From:   Peter Granger (pete.granger@GMAIL.COM) 30 April 2010 22:01:57

This lab research suggests taking vitamin D3 with chemo (gemcitabine
and cisplatin) reduces bladder cancer progression. This does not
necessarily mean it will work with all chemo, but it might be worth a
try. Apparently, vitamin D3 induces expression of the p73 gene – a
gene with close similarities to the p53 gene. P53 senses DNA damage,
and places cell cycle on hold while enzymes restore the damaged DNA.
If the damage is irreparable, p53 commits the cell to
self-destruction. In cancer, including bladder cancer, the p53 gene is
often damaged (mutated) so it is incapable of carrying out this
critical function. Incidentally, there are some nutrients which assist
in carrying out similar functions to p53 via alternate pathways.
However, the role of p73 is far from clear. Unlike p53, p73 mutations
are rare in cancer. Moreover, p73 does not directly repair DNA itself,
and mutations do not necessarily directly cause cancer. It is more
likely p73 mutations interact with p53 mutations, compounding the
negative effect of the latter – perhaps via the immune system or some
other pathway.

One possibility is that vitamin-d-induces an enhanced immune response
to the chemo, or it mitigates against some of the negative,
deleterious effects of chemo – which is after all, a very blunt
‘instrument’.

Expressed another way, vitamin D3 may help correct the negative
influence of (rare) p73 mutations on (common) p53 mutations.

Pete

Milk thistle herb protects liver from damage caused by chemotherapy[xiv]

(NaturalNews) The herbal supplement milk thistle may prevent liver damage in people undergoing chemotherapy, according to a new study conducted by researchers from Columbia University Medical Center and published in the journal Cancer.

Researchers conducted the study on 50 children undergoing a “maintenance” round of chemotherapy for acute lymphoblastic leukemia (ALL), a type of blood cancer. Approximately two-thirds of all children undergoing treatment for ALL usually develop liver toxicity during their treatment, presenting doctors with the choice between scaling back the treatment and risking a resurgence of the cancer, or continuing with treatment unaltered and risking permanent liver damage and lifelong health complications. There is currently no known way of preventing liver toxicity in chemotherapy patients.

Study participants were assigned to take either a milk thistle pill or a placebo capsule for one month. At the start of the study, all 50 children were suffering from liver inflammation due to prior rounds of chemotherapy. By the end, children taking milk thistle had significantly lower levels of two liver inflammation markers than children taking a placebo.

Milk thistle has been used for more than 2,000 years as an herbal treatment for liver and gallbladder problems. Although researchers have looked for evidence that the herb might help prevent or even treat liver damage in people with hepatitis or cirrhosis, results have been inconclusive.

However, recent studies suggest that milk thistle contains an active antioxidant known as silybin that might help block toxins from breaching cell walls.

Milk thistle supplements are already sold over the counter. Striking a cautionary note, however, senior researcher Kara M. Kelley noted that further research is needed before the plant can be recommended as a treatment. She advised against patients self-medicating with milk thistle, noting that all patients undergoing treatment for cancer should always check with their doctors before taking any new kinds of supplements.

Neuropathy & Glutamine

From:   Nancy Neuman (neuman.nancy@GMAIL.COM)

Sent:  09 June 2010 21:16:35

Every time a friend has started chemo, no matter what their cancer is, I
tell them to ask their oncologist about neuropathy. I am stunned that the
patient still has to take charge of this issue in too many cases. I was
lucky that my oncologist asked me early on if I felt any numbness in my feet and when I said I thought so he immediately prescribed Glutamine (at the natural food store) and Vitamin B6. It seems to have done the trick.
Glutamine is expensive so he cut the dose in half and it still worked. It is not to be confused with Glucosamine.

Nancy

Glutamine for neuropathy and other chemo supplements‏

From:   Wendy Ramsay (ramsaycafe@COMCAST.NET)

Sent:  12 March 2010 20:47:17

Hi Robert.
In 2006 I had a lot of strong chemo (gemzar/cisplatin, adriamycin/taxol, MVAC). My doc prescribed me 10 grams (3 scoops) of glutamine powder 3 times a day to minimize the side effects of chemo including neuropathy. I was told to start the day before chemo and continue for 5 days after. Since I had chemo once a week I was taking this supplement 6 days/week 3 x’s a day. I can personally attest to it’s effectiveness. I have no neuropathy even after all that chemo.

During chemo I slacked off a bit and began taking glutamine only twice a day. I noticed numbing in my feet and hands. As soon as I got back on track with taking the supplement 3 times a day, the numbing went away. I think it’s important to prevent neuropathy but I also think it can be reversed (or lessened) at some point before it becomes too severe.

Also, below is an old post (2006) of the supplements I took during chemo and some reasons why they were prescribed to me:

Fruit, etc Help, but No Sugar or Fruit Juices

From: Wendy Ramsay
Sent: Saturday, May 27, 2006 7:25 AM
Subject: [CAFE] chemo and supplements

Hi Anne,
I know this is a late reply, but there are supplements that work in conjuction with specific chemotherapies. You would need to hook up with a naturopath working in the field of cancer and/or bladder cancer. I have been taking supplements to aid, specifically, my gemzar/cisplatin treatments. Different chemos affect the body in different ways. The oncologist that is treating me doesn’t necessarily ‘believe’ in them either. I do need to take the time to print out the research supporting the supplements so that he can have it and hopefully bridge the gap a bit. In addition to supplements which I will list below, I was told adamantly to stay away from sugar except for the day I am receiving chemo. On that day, I should eat some sugar. I should not drink fruit juices but whole fruit is OK (there are differing opinions on staying away from fruit altogether). Two cups of coffee on the day of chemo was also recommended (he said I could still drink coffee the rest of the time but limit to 16 oz/day).  Soy every day. Also wild salmon, olive oil, 6 brazil nuts/day, sesame tahini (1 tablespoon/day), and lots of green tea. Below are the supplements prescribed to me. Several related specifically to decreasing metastases by binding the connectors of the cancer cells preventing them from taking hold and seeding (quercitin, fractionated fruit pectin, great tonifying formula herbal packets). Others support increased immune support or response to the chemo (melatonin, Coriolis mushroom, curcumin).

melatonin (20mg/ once before bed)
multi nutrients V (2 caps – 2x’s/day)
cal/mag    (500g 2x’s/day)
vit c    (1000 – 1x/day)
green tea (3 to 5 cups/day)

Greens First powder juice mix (1 scoop/day)     contains: barley grass juice powder, chlorella, spirulina, carrot juice powder, broccoli juice powder, cauliflower juice powder, spinach jjice powder, parsley juice powder, kale juice powder, green tea extract (decaf) blueberry, plum, grape seed extract, cranberry, rasberry, tart cherry, pine bark extract, bussel sprout, natural flavors, stevia, citric acid.

Whey protein (2 tsp – 1x/day)
cod liver oil (2 tsp/day)
curcumin (4 caps – 2 x’s/day take only the 3 days prior to chemo and not on day of chemo)
Coriolis mush (2 caps in am/ 3 caps in pm)

great tonifying extract powder formula (2 cups tea/day)    contains:   ginseng, angelica sinensis, peony root, atractylodes rhizome, hoelen, cinnamon bark, astragalus root, cnidium rhizome, licorice, tehmannia root)

quercitin (500 – 2 x’s/day)
fractionated pectin (1 scoop 2x’s/day)

Other supplements are prescribed for me depending on my individual labs etc as needed but these are the basics for my chemo regiment. The naturopath I see is Paul Reilly from Seattle Cancer Treatment and Wellness Center (Cancer Treatment Centers of America). His book (How to Prevent and Treat Cancer with Natural Medicine) does reference studies supporting various supplements to treatment.

Wendy Ramsay
Diagnosed 1994. Neobladder 2004. Right nephrectomy/chemo 2006. Upper tract chemo 2007/08. Left nephrectomy 2008. Home dialysis 6-7 x’s/week.

New Way To Fight Cancer: Protect Healthy Cells With The Silver Shield[xv]

ScienceDaily (Apr. 1, 2008) — A unique study proposes a new paradigm in cancer treatment: instead of selectively attacking cancer cells, protect all the healthy cells. Animal studies and in vitro human cell studies show that a short fast protects healthy cells against chemotherapy, while tumor cells remain sensitive to the drugs.

Fasting for two days protects healthy cells against chemotherapy, according to a study appearing online the week of Mar. 31 in PNAS Early Edition. Mice given a high dose of chemotherapy after fasting continued to thrive. The same dose killed half the normally fed mice and caused lasting weight and energy loss in the survivors.

The chemotherapy worked as intended on cancer, extending the lifespan of mice injected with aggressive human tumors, reported a group led by Valter Longo of the University of Southern California. Test tube experiments with human cells confirmed the differential resistance of normal and cancer cells to chemotherapy after a short period of starvation.

Making chemotherapy more selective has been a top cancer research goal for decades. Oncologists could control cancers much better, and even cure some, if chemotherapy were not so toxic to the rest of the body.

Experts described the study as one of a kind.

“This is a very important paper. It defines a novel concept in cancer biology,” said cancer researcher Pinchas Cohen, professor and chief of pediatric endocrinology at the University of California, Los Angeles.

“In theory, it opens up new treatment approaches that will allow higher doses of chemotherapy. It’s a direction that’s worth pursuing in clinical trials in humans.”

Felipe Sierra, director of the Biology of Aging Program at the National Institute on Aging, said: “This is not just one more anti-cancer treatment that attacks the cancer cells. To me, that’s an important conceptual difference.”

Sierra was referring to decades of efforts by thousands of researchers working on “targeted delivery” of drugs to cancer cells. Study leader Longo focused instead on protecting all the other cells.

Sierra added that progress in cancer care has made patients more resilient and able to tolerate fasting, should clinical trials confirm its usefulness.

“We have passed the stage where patients arrive at the clinic in an emaciated state. Not eating for two days is not the end of the world,” Sierra said.

“This could have applicability in maybe a majority of patients,” said David Quinn, a practicing oncologist and medical director of USC Norris Hospital and Clinics. He predicted that many oncology groups would be eager to test the Longo group’s findings, and advised patients to look for a clinical trial near home.

Longo, an anti-aging researcher who holds joint appointments in gerontology and biological sciences at USC, said that the idea of protecting healthy cells from chemotherapy may have seemed impractical to cancer researchers, because the body has many different cells that respond differently to many drugs.

“It was almost like an idea that was not even worth pursuing. In fact it had to come from the anti-aging field, because that’s what we focus on: protecting all cells at once,” Longo said.

“What really was missing was a perspective of someone from the aging field to give this field a boost,” UCLA’s Cohen said.

The idea for the study came from the Longo group’s previous research on aging in cellular systems, primarily lowly baker’s yeast.

About five years ago, Longo was thinking about the genetic pathways involved both in the starvation response and in mammalian tumors.

When the pathways are silenced, starved cells go into what Longo calls a maintenance mode characterized by extreme resistance to stresses. In essence the cells are waiting out the lean period, much like hibernating animals.

But tumors by definition disobey orders to stop growing because the same genetic pathways are stuck in an “on” mode.

That could mean, Longo realized, that the starvation response might differentiate normal and cancer cells by their stress resistance, and that healthy cells might withstand much more chemotherapy than cancer cells.

The shield for healthy cells does not need to be perfect, Longo said. What matters is the difference in stress resistance between healthy and cancerous cells.

During the study, conducted both at USC and in the laboratory of Lizzia Raffaghello at Gaslini Children’s Hospital in Genoa, Italy, the researchers found that current chemotherapy drugs kill as many healthy mammalian cells as cancer cells.

“(But) we reached a two to five-fold difference between normal and cancer cells, including human cells in culture. More importantly, we consistently showed that mice were highly protected while cancer cells remained sensitive,” Longo said.

If healthy human cells were just twice as resistant as cancer cells, oncologists could increase the dose or frequency of chemotherapy.

“We were able to reach a 1,000-fold differential resistance using a tumor model in baker’s yeast. If we get to just a 10-20 fold differential toxicity with human metastatic cancers, all of a sudden it’s a completely different game against cancer,” Longo said.

“Now we need to spend a lot of time talking to clinical oncologists to decide how to best proceed in the human studies.”

Edith Gralla, a research professor of chemistry at UCLA, said: “It is the sort of opposite of the magic bullet. It’s the magic shield.”

Funding from the study came from NIA (part of the National Institutes on Health), the USC Norris Cancer Center and the Associazione Italiana per la Lotta al Neuroblastoma.

USC graduate student Changhan Lee and Gaslini’s Raffaghello performed key experiments. The other authors were Fernando Safdie, Min Wei and Federica Madia of USC, and Giovanna Bianchi of Gaslini.

Longo has been studying aging at the cellular level for 15 years, and has published in the nation’s leading scientific journals. He is the Albert L. and Madelyne G. Hanson Family Trust Associate Professor in the USC Leonard Davis School of Gerontology with joint appointments as associate professor of biological sciences in the USC College of Letters, Arts and Sciences, and in the Norris Cancer Center.

For clinicians and patients

Fasting before chemotherapy has unknown risks and benefits for humans, Longo cautioned. Only clinical trials can establish the effectiveness and safety of fasting before chemotherapy.

“Don’t try and do this at home. We need to do the studies,” said Quinn, the USC Norris oncologist.


Adapted from materials provided by University of Southern California.

The diet that won’t just help you lose weight, you’ll live longer and be brainier! [xvi]

“But there’s now an effective weight-loss regimen that is not only simple, it promises significant health benefits – from easing asthma symptoms and reducing blood sugar levels, to fending off heart disease and breast cancer and protecting brain cells. Apparently, you’ll also live longer.

The diet goes under various names – The Alternate-Day Diet, Intermittent Fasting or The Longevity Diet – but the principle is the same: eat very little one day (50 per cent of your normal intake) and as much as you like the next.

This appears to trigger a ‘skinny’ gene that encourages the body to burn fat.

The Alternate-Day diet triggers a skinny gene that encourages the body to burn fat

Researchers first discovered the benefits of low-calorie eating in the Thirties. They found that putting a rat – or a worm, or a fruit fly or just about any animal, as it turned out – on a permanent very low calorie diet helped the animal live about 30 per cent longer than normal.

The animal had clearer arteries, lower levels of inflammation, better blood sugar control and its brain cells were less likely to get damaged. Meanwhile, rates of diseases linked to ageing all dropped.

But while scientists have known for years that animals on a low-calorie diet were healthier, no human – except a few iron-willed fanatics – could permanently stick to this regime.

The big breakthrough came in 2003 when Dr Mark Mattson, an American neuroscientist, discovered rats still enjoyed all those health benefits even when their calories were cut only on alternate days.

In other words, you don’t have to starve yourself all the time.

This was a crucial discovery, because the diet suddenly became a realistic option. In particular, it is far more palatable for the obese. The standard diet for them involves a daily intake of between 20 per cent and 40 per cent of what they would normally have.

‘These are very hard diets to follow,’ says Krista Varady, assistant professor of kinesiology and nutrition at the University of Illinois, Chicago.

You are constantly hungry. The eat-every-other-day-diet seems to offer an easier and more effective option.’

She’s just published the results of a ten-week trial of 16 patients, all weighing more than 14st.

They ate 20 per cent of their normal intake one day and a regular, healthy diet the next. Each lost between 10lb and 30lb; much more than the 5lb or 6lb expected.

‘It takes about two weeks to adjust to the diet and, after that, people don’t feel hungry on the fast days,’ says Varady.

Weight watching: Dieters should only consume around 500 calories on fasting days

Dr James Johnson, author of The Alternate-Day Diet, and a lecturer in plastic surgery, has now been doing the diet for five years.

‘I’ve always been a bit overweight. When I first started, I lost 35lb in 11 weeks.

‘Now I use the diet to keep my weight stable. If it starts going up, I’ll just go back on it for a few weeks. The evidence says this is about the most healthy thing you can do for yourself.’

One specific health benefit is relieving the symptoms of asthma – and that’s not just because the patients have lost weight.

A small study of ten obese asthmatics found that after eight weeks they’d lost eight per cent of their body weight; their symptoms of the disease had also greatly improved.

The study, conducted by Dr Johnson with scientists from the National Institute on Ageing ( including Dr Mattson) and Stamford University, showed patients had less inflammation in their lungs, making it easier for them to breathe.

They also had lower levels of damaging free radicals – the substances we produce simply by eating and breathing – which have been linked with heart disease and cancer.

‘The level of inflammation was down by 70 per cent and the level of free radicals by 90 per cent,’ says Dr Johnson. ‘No other dietary approach to asthma has recorded anything like that benefit.’

About two weeks after coming off the diet the patients’ symptoms began to return.

Meanwhile, British researchers are now looking at the benefits of the diet in preventing breast cancer in highrisk patients.

‘We’ve found a very low 800 calories-a- day diet dramatically lowers the enzymes that metabolise fat and glucose in breast tissue,’ says Dr Michelle Harvie, of the Genesis Breast Cancer Prevention Centre in Manchester. ‘These enzymes are always raised in breast cancer patients.’

When Dr Matteson made his discovery, it wasn’t clear exactly why very low calorie diets had such an effect on health and lifespan.

But in the past couple of years it’s emerged that a specific gene – SIRT1 – might explain the diet’s success; it seems the sudden, sharp stress of a big drop in food intake triggers this ‘skinny’ gene. ‘This then blocks another gene involved in storing fat,’ explains Dr Johnson.

‘The body starts using up more of the fat stores. As a result you lose more weight than you would from just eating fewer calories.’

The SIRT1 gene also seems to be responsible for all the benefits of semi-starvation found in animals – the drop in inflammation, lower blood sugar levels – as Dr Mattson and others reported this year in the journal Brain Research Reviews.

Perhaps not surprisingly, drug companies are working hard to develop medicines that imitate some of the diet’s effects by targeting the SIRT1 gene.

The weight-loss benefit could also be due to the way the diet tricks your body’s metabolism.

The problem with most diets is that after 48-to-72 hours this slows to compensate for the drop in food.

When you stop the diet and eat normally, the weight goes back on faster, as you’re eating more than your body thinks it needs to function.

The alternate day diet seems to get round that because it allows normal eating as well.

‘We’ve run trials that haven’t found any reduction in metabolic rate when people are on the alternate day diet,’ says Dr Johnson.

Enjoy: You can eat as much as you want on alternate days

How it works doesn’t matter to many people – the internet is already buzzing with those who claim dieting on alternate days has made weight loss easier.

One woman writing on a U.S-based website found that very little of the weight she’d lost went back on.

‘At the end of 2008 I lost 15lb and then I stopped the diet. Nine months later, in October, I’d only put on 2lb.

‘By the end of that month I’d lost what I’d gained and another 7.5lb. It is gone forever! Woohoo.’

Another described how the not eating days – described as ‘down’ days – are actually the easiest ones to manage.

‘It’s strangely true, but down days are a lot easier to stick to than the up days. I haven’t cheated on them once.

‘It really does work knowing you can “have it” tomorrow. It’s the eating days you have to be careful with as it would be quite easy to go over the top.’

Yet some British experts are concerned about the approach. ‘We advise anyone trying to lose weight should follow a healthy balanced diet,’ said a spokesperson for the Food Standards Agency.

‘It may not be possible to achieve this with very low calorie diets.’

However, Catherine Collins, spokesperson for the British Dietetic Association, was more enthusiastic about the weightloss benefits.

‘It sounds absolutely fine,’ she says ‘It would certainly make it easier to stick to a weight-loss programme, although I’d want to be sure people got enough fibre and protein and that they didn’t starve and binge in a fanatical way.’

However, she is sceptical about the health benefits being triggered by the SIRT1 gene.

‘We know weight loss has all sorts of metabolic benefits,’ she says.

‘That is probably what is going on rather than one gene being responsible.’

The big question now is to find the best schedule of eating and fasting that will bring the benefits and be the easiest to stick to. Alternate-day dieting has made the breakthrough, but it is only one option.

‘At the moment we are studying the benefits of having just two fasting days a week when you have very few calories, then eating normally for the rest of the week,’ says Dr Harvie.

‘Some form of fasting regime is definitely the way to go to get big health benefits. It just needs more research.’

• For more, visit: http://www.johnson updaydowndaydiet.com/index.html 

THE SIMPLE RULES YOU NEED TO FOLLOW

  • For the first fortnight Dr Johnson suggests you stick to just 500 calories on the fasting days to make sure you trigger the skinny gene (to make certain of your intake, try pre-packaged shakes or meal replacements).
  • After that, you can eat regular food on the fasting days. How much depends on your goal. Up to 35 per cent of your recommended daily intake will help you lose weight. Eating 50 or 60 per cent should allow you to maintain your weight.
  • You can eat as much as you want on the alternate days, but don’t binge. Make sure you have fruit and vegetables. It’s important to enjoy these days to avoid getting fed up with being on a diet.
  • Drink plenty of water and exercise regularly, especially on the eating days. Weigh yourself only once a week, on the morning after a fasting day, so you won’t become frustrated by normal weight variations.

Exercise May Keep Cancer Patients Healthier During, After Treatment[xvii]

ScienceDaily (May 20, 2010) — Breast and prostate cancer patients who regularly exercise during and after cancer treatment report having a better quality of life and being less fatigued, according to researchers at Henry Ford Hospital in Detroit.

“Using exercise as an approach to cancer care has the potential to benefit patients both physically and psychologically, as well as mitigate treatment side effects,” says study lead author Eleanor M. Walker, M.D., division director of breast services in the Department of Radiation Oncology at Henry Ford Hospital.

“Plus, exercise is a great alternative to patients combating fatigue and nausea who are considering using supplements which may interfere with medications and chemotherapy they’re taking during cancer treatment.”

Dr. Walker will present a poster with the study’s design and intervention methods June 7 at the 2010 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. The abstract is now available online at www.ASCO.org.

To study how exercise impacts cancer patients, Dr. Walker and her colleagues at Henry Ford’s Josephine Ford Cancer Center and the Henry Ford Heart & Vascular Institute developed a unique program called ExCITE (Exercise and Cancer Integrative Therapies and Education).

ExCITE works with patients who are receiving cancer treatment to create individualized exercise programs. Some patients come into one of Henry Ford’s fitness centers to workout, while others have plans that allow them to exercise at home during various stages of their care.

The study group thus far includes 30 female breast cancer patients and 20 prostate cancer patients, all ranging in age from 35 to 80. All were newly diagnosed when they began ExCITE. The study followed the patients during treatment and for one-year following completion of cancer treatment.

Before beginning the exercise program, Henry Ford’s Preventative Cardiology Division measured the patients’ exercise capacity, skeletal muscle strength and endurance. General blood work, metabolic screens, bone density and inflammatory biomarkers also were obtained at the start of the program.

Exercise and diet recommendation for each patient were based on their baseline exercise tolerances, weight, overall health, and type of cancer treatment they would receive. Acupuncture was used for patients who experienced hot flashes, pain, nausea/vomiting, insomnia and neuropathy as the result of cancer treatment.

Cheryl Fallen of Gross Pointe Park, Mich., was undergoing chemotherapy for breast cancer while she took part in the ExCITE program. Through a mix of exercise, acupuncture and good nutrition, she didn’t experiencing some of the more common side-effects from treatment — nausea, fatigue and trouble with memory.

“ExCITE offers cancer patients a way to holistically approach their cancer care by tailoring a specific exercise routine to fit the needs of the patient, whether it’s rehabilitation after surgery, or to enhance circulation or improve the immune system prior to chemotherapy or radiation,” says Fallen.

When her white blood cell count fell during chemotherapy, Fallen would work out at home using an exercise band or by walking outdoors. When she was well enough to return to the gym, her workouts consisted of using the exercise ball and treadmill, and doing other strength-training exercises.

“Overall, the program makes you feel better about yourself. It’s a positive support for cancer patients, and I really think it’s allowed me to be more productive during my treatment,” says Fallen.

Study of the ExCITE program is ongoing, with Dr. Walker and her colleagues continuing to investigate the potential benefits of exercise for cancer patients.

Study funding: Josephine Ford Cancer Center, part of the Henry Ford Health System, and Mothers, Daughters, Sisters & Friends, a group dedicated to raising funds for breast cancer care and research at Henry Ford.

Story Source:

Adapted from materials provided by Henry Ford Health System, via EurekAlert!, a service of AAAS.

See Also:

New exercise guidelines for cancer survivors

The first and most important guideline, Schmitz said, is that patients and survivors must avoid inactivity. They must continue their normal activities during and after treatment, and resume daily life as soon as possible after surgery. Other specific recommendations include:

> Over the course of one month, it’s safe to build sedentary patients up to 150 minutes of moderate-intensity aerobic exercise per week
> It’s safe for patients undergoing stem cell transplant to exercise every day, but these patients should reduce intensity and progression of intensity because of the effects on the immune system
> For patients suffering from weight loss, resistance training can help build strength
> For those with prostate, hematologic, and colon cancers, twice-weekly resistance training is recommended: one exercise for each major muscle group for eight to 10 repetitions, and one to three sets per exercise
> Women with breast and gynecologic cancers should start with a supervised resistance training program given the risk for lymphedema
> Given side effects such as incontinence and sexual dysfunction, floor exercises should be added to an exercise routine for men with prostate cancer
> Colon cancer patients with an ostomy should avoid excessive intra-abdominal pressures

How to Take Care of Yourself During Chemotherapy[xviii]

Continue all of the recommendations for what to do in preparation for chemotherapy, and increase protein powder supplementation to twice a day. If you are still experiencing some nausea, try these strategies:

  • Eat smaller, more frequent meals. Five or 6 snack-type meals a day can reduce some of the stress on your digestive tract. Smoothies make a perfect meal.
  • Do not lie down after eating. Allow yourself an hour or more to digest. Try a short walk after meals or, if you need to rest, sit with your legs stretched out and your head propped up with pillows.
  • Do not drink liquids with your meals. This keeps your digestive juices at full strength, promoting complete digestion and reducing indigestion.
  • Drink plenty of liquids between meals (at least 1 hour before or after meals). Ginger tea and peppermint time have anti-nausea/stomach settling properties. Drink them warm or iced, as you prefer. Also include vegetable and fruit juices (fresh squeezed for the highest nutrient content, if possible) and clear broths. Avoid sugar as it can increase your risk for intestinal candida infection that is very common at this vulnerable time. If you must use a sweetener, use a grain-derived sweetener like rice syrup or barley malt.
  • Avoid all fatty foods. Focus your diet on fresh fruits, steamed or boiled vegetables, light grains and proteins.
  • If you are experiencing vomiting and severe diarrhea, include sea salted vegetable broths or miso broth. These salty additions will help to keep your electrolytes balanced and can revive you when you are feeling faint. (Miso is a salty paste made from soybeans and can be found in health food stores, Asian food markets and some supermarkets).

Recommendations – Supplements To Take With Specific Chemotherapy Drugs
The side effects of chemotherapy can be reduced by decreasing the toxicity of the chemotherapy medication. Contrary to what one might expect, this does not make the chemotherapy any less effective at doing its job —killing cancer cells. More often than not, decreasing its toxicity increases a drug’s effectiveness. Supplements known to decrease various chemotherapy drugs’ toxicity are listed below. Also listed are substances known to increase the effectiveness of certain drugs.

Drug Substances That Decrease Toxicity Substances That Increase Effectiveness
Adriamycin CoQ10, Vitamin E, Riboflavin, NAC (N-Acetylcysteine), Vitamin C, Antioxidants Vitamin E, Green Tea, Vitamin A
CIS Platinum Recancostat*, Glutathione IV*, Ginkgo biloba, Milk Thistle, Selenium, Magnesium Recancostat* Vitamin C, Vitamin A
Neosar Ashwaganda herb* Aloe Vera Extract, Bu Zhong Yi Qi Wan*, Vitamin A
5 FU Vitamin B6, CoQ10, Chamomile mouthwash, Glutamine mouthwash Vitamin A, L-cysteine, Vitamin E, Aloe Vera, Calcium Butyrate
Methotrexate Glutamine Vitamin A, Glutamine, Proteolytic enzymes/Wobenzyme
Taxol Vitamin C
Tamoxifen Soy isoflavones, natural progesterone, Remifemin Melatonin
Vincristine Vitamin C Vitamin A

Chemo, Tinnitus‏ & Hearing Loss

From:   S. Norbash (sidnorbash@SBCGLOBAL.NET)

Sent:  10 June 2010 11:45:00
My husband has had transitional cell carcinoma and is followed every 6 months at MD Anderson. (left kidney, ureter and bladder “cuff” removed, BCG, etc….)  I “lurk” here to try to keep up with the latest and read the recent posts about tinnitus.  I am an audiologist and have monitored hearing in cancer patients for clinical trials, etc… It always pains me to know the likely consequences as far as hearing, but usually there is no choice.  my husband had gemzar and cisplatin chemo and now wears hearing aids.  the full effects of the chemo on hearing will often not show up for months after treatment is concluded.  His tinnitus is not severe, but he has mild to moderate hearing loss.  He had “no choice” since hearing aids are what I do,   🙂 but he does get great benefit from them and I would encourage you to see what’s out there, especially a new device that is an advanced digital hearing aid AND a tinnitus masker in one.  I have heard of
good success with it.  If you are interested, I would suggest contacting a local audiologist and asking about it.  The name is ReSound Live TS.  Most audiologists offer a trial period where you could see if it is helpful or not.

Cold Caps Prevent Hair Loss

From:  clozie@COMCAST.NET
> Subject: [CAFE] Glutamine to prevent neuropathy, and “cold cap” to prevent hair loss
> To: BLADDER-CANCER-CAFE@LISTSERV.ACOR.ORG Date: Thu, 9 Sep 2010 16:58:12 -0400

Nancy and Wendy,

I totally agree with both you.  Though I am not surprise, I find it revolting that so many oncologist won’t even “mention” Glutamine as well as other things that might be outside the “mainstream” of current oncology but which, nonetheless, “might” or are even “very likely” to help palliate some of the terrible side-effects of the “mainstream” pharmaceutical drugs that they recommend without any hesitation.

Here is another example which I want to pass along:  in my current chemo, I have been using a “cold cap” — a cap, made of cold-gel packs, which I keep over my head 15 minutes before, during and for another hour or so after the infusion;  and, after 10 infusions of Andriamycin, I still have all the hair on my head!  I am totally hairless everywhere else in my body (nice, actually — I have not needed to shave since March!), EXCEPT on my head — so, there is no question whatsoever that the “cold cap” is what prevented me from losing my hair.  And even though hair loss is, as Nancy pointed out, a “temporary” side-effect, it is still one of the most annoying ones.  I lost my hair in each one of the 4 chemos that I did before this one — that got really old!

Just like with Glutamine to preven neuropathy, why don’t oncologist doctors and nurses at least “mention” cold caps as a “possible” way to prevent hair loss??

I can understand that some would hesitate to “recommend” such things based on the common (and I think truthful, in many cases) allegation that “not enough studies have been done about it to *proof* anything scientifically”.  However, they must know, or at least should know that not enough studies will *EVER* be done about some of these things, NOT because they don’t make sense logically/theoretically or because they are not worth-studying, but because obviously these things are not patentable, therefore no profit-seeking corporation will ever dump the necessary millions or billions of dollars that are usually needed to do repeated studies in order to “proof” anything scientifically.

However, though in comparatively limited numbers and with less “rigor” (scientific rigor usually requires more money), both in the case of Glutamine as well as for the “cold caps” there HAVE been studies done — I don’t have the reference handy but I have read a couple of them by searching the net or Pubmed.  And they HAVE “demonstrated” that they worked for at least a great number of the patients in these particular studies!  I am quoting this “by memory”, so I might not get the figures right, but in the case of “cold caps” the study that I read demonstrated that it had prevented hair loss in more than 85% of the cases — that is a HUGE percentage, given that most of the toxic chemos that oncologists recommend, particularly in the metastatic stage, only work for much less than that!  I was once recommended a chemo that it is “proven” to work for only about 13% of the cases!  And although the numbers are a lot more promising in the first line treatments — as you all know, fortunately many people ARE cured by the first and only chemo that they ever take! — I believe that in the metastatic stage, unfortunately, the average response rates are around 15-30% at best.

Given that Glutamine and “cold caps” don’t seem to have any “toxic” side effects — from what I read, EVEN if they don’t work, they at least are not likely to cause any serious damage —  it is really revolting that we, the patients, are not at least “told” about the “possibility” of using these things to palliate these two very bad potential side effects of chemo.

In any event, now that I am sure it has worked for me, I am telling everybody I know to Google “cold cap chemo” before their first infusion to judge for themselves whether they should give it a try and perhaps save their hair.  I was told about this by a friend of mine and I did not have time to purchase the commercially available caps, so my husband made one for me using those “blue” cold gel packs that are used for sore muscles and that he bought, cheaply, at our local CVS pharmacy.  Once I have more time, he and I are planning on writing about it in more details for people that don’t want or can not afford the commercial caps.

As to Glutamine, I learned about it a couple of years ago right here at the WebCafe, probably thru one of your emails, Wendy — thanks for sharing your experience always so generously!  Unfortunately, that was not in time for my cysplatin chemo, and obviously I wish my doctor had told me about it.  I have used it during other chemos ever since, and I have been telling every patient I know about it.

I hope this long email helps save someone’s hair one day :)!!

Best,

–Claudia

Fruit, etc Help, but No Sugar or Fruit Juices

From: Wendy Ramsay
Sent: Saturday, May 27, 2006 7:25 AM
Subject: [CAFE] chemo and supplements

Hi Anne,
I know this is a late reply, but there are supplements that work in conjuction with specific chemotherapies. You would need to hook up with a naturopath working in the field of cancer and/or bladder cancer. I have been taking supplements to aid, specifically, my gemzar/cisplatin treatments. Different chemos affect the body in different ways. The oncologist that is treating me doesn’t necessarily ‘believe’ in them either. I do need to take the time to print out the research supporting the supplements so that he can have it and hopefully bridge the gap a bit. In addition to supplements which I will list below, I was told adamantly to stay away from sugar except for the day I am receiving chemo. On that day, I should eat some sugar. I should not drink fruit juices but whole fruit is OK (there are differing opinions on staying away from fruit altogether). Two cups of coffee on the day of chemo was also recommended (he said I could still drink coffee the rest of the time but limit to 16 oz/day).  Soy every day. Also wild salmon, olive oil, 6 brazil nuts/day, sesame tahini (1 tablespoon/day), and lots of green tea. Below are the supplements prescribed to me. Several related specifically to decreasing metastases by binding the connectors of the cancer cells preventing them from taking hold and seeding (quercitin, fractionated fruit pectin, great tonifying formula herbal packets). Others support increased immune support or response to the chemo (melatonin, Coriolis mushroom, curcumin).

melatonin (20mg/ once before bed)
multi nutrients V (2 caps – 2x’s/day)
cal/mag    (500g 2x’s/day)
vit c    (1000 – 1x/day)
green tea (3 to 5 cups/day)

Greens First powder juice mix (1 scoop/day)     contains: barley grass juice powder, chlorella, spirulina, carrot juice powder, broccoli juice powder, cauliflower juice powder, spinach jjice powder, parsley juice powder, kale juice powder, green tea extract (decaf) blueberry, plum, grape seed extract, cranberry, rasberry, tart cherry, pine bark extract, bussel sprout, natural flavors, stevia, citric acid.

Whey protein (2 tsp – 1x/day)
cod liver oil (2 tsp/day)
curcumin (4 caps – 2 x’s/day take only the 3 days prior to chemo and not on day of chemo)
Coriolis mush (2 caps in am/ 3 caps in pm)

great tonifying extract powder formula (2 cups tea/day)    contains:   ginseng, angelica sinensis, peony root, atractylodes rhizome, hoelen, cinnamon bark, astragalus root, cnidium rhizome, licorice, tehmannia root)

quercitin (500 – 2 x’s/day)
fractionated pectin (1 scoop 2x’s/day)

Other supplements are prescribed for me depending on my individual labs etc as needed but these are the basics for my chemo regiment. The naturopath I see is Paul Reilly from Seattle Cancer Treatment and Wellness Center (Cancer Treatment Centers of America). His book (How to Prevent and Treat Cancer with Natural Medicine) does reference studies supporting various supplements to treatment.

Wendy Ramsay
Diagnosed 1994. Neobladder 2004. Right nephrectomy/chemo 2006. Upper tract chemo 2007/08. Left nephrectomy 2008. Home dialysis 6-7 x’s/week.


[viii] Date: Sun, 6 Feb 2011 09:12:26 +1100 From: pete.granger@GMAIL.COM Subject: [CAFE] Curcumin and Resveratrol – Chemoresistance To: BLADDER-CANCER-CAFE@LISTSERV.ACOR.ORG

[xviii] http://www.oncologychannel.com/chemotherapy/care.shtml

NOTE: The 2012 edition of The Cancer Survivor’s Bible is now available – see www.fightingcancer.com for details

“The section on conventional treatment was riveting.”

 

Posted in Cancer Perspectives, Comments and Suggestions, Supporting chemo | Tagged: , , , | 7 Comments »

Anti-radioactivity Foods

Posted by Jonathan Chamberlain on April 16, 2011


If you’re looking for cancer related info – then browse this site. Also read my two cancer books 0 see http://www.fightingcancer.com for details

Anti-radioactivity foods

The continuing crisis in Fukushima and the certainty that radiation levels worldwide will be impacted (bringing in its wake increases in thyroid cancer and leukemia)  leads to the obvious question of how we can protect ourselves.

The first answer is to take potassium iodide everyday 4-12mg – you can get this as a liquid called Lugol’s solution or as pills under the brand name Iodoral. I anddition you need to soak all your vegetables in water and throw the water away. Finally here is a list of foods that will be part of the optimal diet. This was prepared by Russian scientists based on their experience of Chernobyl

1.      Brown rice

2.      Seaweed

3.      Kelp

4.      Miso

5.      Pumpkin

6.      Spirulina (& Chlorella)

7.      Bee pollen

8.      Wheat grass

9.      Rosemary

10.  Blue-green algae

11.  Beets

12.  Garlic

13.  Ginger

14.  Alfalfa sprouts

15.  Broccoli

16.  Onions

17.  Olive oil

18.  Leafy greens

Apples and other sources of pectin

Note: The Cancer Survivor’s Bible (2012 edition) is now available – see www.fightingcancer.com

“This book tells me everything. Why didn’t my doctors tell me this?”

Posted in cancer and diet, Comments and Suggestions, Health Issues | Tagged: | Leave a Comment »

Lymphoedema – what can be done?

Posted by Jonathan Chamberlain on March 30, 2011


If you’re looking for cancer information – there’s a lot on this site so do browse – also in my two cancer books – see www.fightingcancer.com

Lymphoedema – what can be done

Some useful suggestions can be found at this site.

http://health.groups.yahoo.com/group/oleandersoup/message/24393

Note: The Cancer Survivor’s Bible (2012) is now available – see www.fightingcancer.com

“You book has become as important to me as my dead mother’s letters.”

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Supplements to help you sleep

Posted by Jonathan Chamberlain on March 30, 2011


There is a lot of cancer related information on this site so do browse – this supports the info and critical discussion in my two cancer books – see www.fightingcancer.com for details

Supplements to help you sleep

We don’t know why we sleep, or indeed, why sleep is so necessary for good functioning and good health – but we do know that, generally speaking, the more you sleep the healthier you are.

Here are some supplements that will certainly help you sleep:

1. lavender essential oil – put 6 drops in a warm bath or place a few drops neat on your upper lip (Lavender is one of the essential oils you can place directly on the skin with no negative effects.

2. valerian root

3. passionflower herb

4. MMS – just a few drops with lemon juice/vinegar (wait 2 minutes then add water and drink)

Note: The Cancer Survivor’s Bible (2012) is now available – see www.fightingcancer.com

“should be on the shelves of every medical practitioner who counsels or treats cancer patients.”

Posted in Comments and Suggestions, complementary therapies | Tagged: , , , | 1 Comment »