I and colleagues from many parts of the world are interested in creating a Society of Chinese Medicine practitioners interested in Integrative Oncology. The endeavor to bring this Society to life is about creating community, and organizing standards and competencies and then teaching to those standards.
For more information about the AIOCM click here.
Monday, February 28, 2011
Mechanism for Link Between High Fat Diet and Risk of Prostate Cancer and Disorders Unveiled
ScienceDaily (July 16, 2010) — Prostate cancer is the second leading cause of cancer-related deaths in men with an estimated 192,280 new cases diagnosed in the US in 2009. Diet is considered one of the most important controllable risk factors for inflammation and prostate diseases including benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer.
Sanjay Gupta, MS, PhD, Carter Kissell associate professor & research director in the Department of Urology and associate professor in the Department of Nutrition in the Case Western Reserve School of Medicine, and his team of post-doctoral fellows have focused on understanding the mechanisms of the deleterious effects of a high fat diet on the prostate. Previously, Dr. Gupta's team demonstrated that nuclear factor kappa B (NF-κB), a protein complex that controls DNA transcription which is activated as a result of inflammation and stress, is constitutively activate in human prostate adenocarcinoma and is related to tumor progression (Shukla S et al, Neoplasia, 2004).In a new study published in the journal The Prostate, Dr. Gupta and his team demonstrate that a high fat diet results in activation of NF-κB in the abdominal cavity, thymus, spleen, and prostate. Non-obese NF-κB reporter mice were fed a high fat diet for four, eight, and 12 weeks. Compared with mice fed a regular diet, the high fat diet group had significant increases in prostate weight, and in the prostate expression of markers of oxidative stress (such as NADPH), and inflammation (such as the downstream targets of NF-κB: nitric oxide synthase, and cyclooxygenase [COX-2]) were increased. These studies provide direct evidence that a high fat diet causes proliferation, inflammation, and oxidative stress that can lead to benign prostatic hyperplasia, prostatitis, and cancer of the prostate, some of the most common disorders affecting adult men.
"Our studies provide evidence that a high-fat diet increases the activation of NF-κB along with elevated levels of NADPH oxidase components which might lead to intraprostatic inflammation. This study strengthens the link between a high-fat diet -- typical of "Western style" high fat diet -- as a potential cause of prostatic diseases including BPG and prostate cancer," said Dr. Gupta.
This work was supported by grants from the National Cancer Institute, the National Center for Complementary and Alternative Medicine, and the Sullivan Foundation for the Study of Prostatitis.
Alex's note: There are plenty of natural products to control NF-κB
Saturday, December 04, 2010
CHANGING LIFESTYLE CHANGES GENE EXPRESSION A Talk with Dean Ornish
[DEAN ORNISH:] For the last 30 years or so, I have directed a series of clinical research studies proving that the simple choices that we make in our lives each day can have a powerful impact on our health and our well being, and much more quickly than had once been thought possible, even at a cellular level. Ironically, we have been using very high tech, expensive, state of the art measures to prove how powerful very simple and low tech and often ancient interventions can be.
Our prostate study was a randomized control trial of men who had biopsy proven prostate cancer and who have elected not to be treated conventionally for reasons unrelated to our study. What made this interesting from a scientific standpoint is that we could take men who knew they had cancer from biopsies, randomly divide them into two groups, and have a true non-intervention control group so we could determine the effects of comprehensive lifestyle changes alone without being confounded by other treatments. You can't do that with breast cancer because almost everybody gets treated right away, so you don't know if any improvements were due to the lifestyle changes or the chemo or the radiation or the surgery.
After a year we found that PSA levels, a marker for prostate cancer, went up (worsened) in the comparison or control group, but went down significantly (improved) in the experimental group that made the lifestyle changes we recommended. The degree of change in lifestyle was directly correlated with the degree of change in their PSA levels.
We also found that the prostate tumor growth in vitro was inhibited 70 percent in the group that made these changes compared to only nine percent in the group that didn't. The inhibition of the tumor growth was itself a direct function of the degree of change in lifestyle. In other words, the more people changed, the more it directly inhibited the growth of their prostate tumors.
J. Craig Venter has shown that one way you can change your genes is by making new ones. We are finding that another way you can change your gene expression is simply by changing your lifestyle.
In May of this year, we published an article in the Proceedings of the National Academy of Sciences (Craig was the communicating editor). We found that changing lifestyle actually changes gene expression. In only three months, we found that over 500 genes were either up-regulated or down-regulated—in simple terms, turning on genes that prevent many chronic diseases, and turning off genes that cause coronary heart disease, oncogenes that are linked to breast and prostate cancer, genes that promote inflammation and oxidative stress and so on.
Our prostate study was a randomized control trial of men who had biopsy proven prostate cancer and who have elected not to be treated conventionally for reasons unrelated to our study. What made this interesting from a scientific standpoint is that we could take men who knew they had cancer from biopsies, randomly divide them into two groups, and have a true non-intervention control group so we could determine the effects of comprehensive lifestyle changes alone without being confounded by other treatments. You can't do that with breast cancer because almost everybody gets treated right away, so you don't know if any improvements were due to the lifestyle changes or the chemo or the radiation or the surgery.
After a year we found that PSA levels, a marker for prostate cancer, went up (worsened) in the comparison or control group, but went down significantly (improved) in the experimental group that made the lifestyle changes we recommended. The degree of change in lifestyle was directly correlated with the degree of change in their PSA levels.
We also found that the prostate tumor growth in vitro was inhibited 70 percent in the group that made these changes compared to only nine percent in the group that didn't. The inhibition of the tumor growth was itself a direct function of the degree of change in lifestyle. In other words, the more people changed, the more it directly inhibited the growth of their prostate tumors.
J. Craig Venter has shown that one way you can change your genes is by making new ones. We are finding that another way you can change your gene expression is simply by changing your lifestyle.
In May of this year, we published an article in the Proceedings of the National Academy of Sciences (Craig was the communicating editor). We found that changing lifestyle actually changes gene expression. In only three months, we found that over 500 genes were either up-regulated or down-regulated—in simple terms, turning on genes that prevent many chronic diseases, and turning off genes that cause coronary heart disease, oncogenes that are linked to breast and prostate cancer, genes that promote inflammation and oxidative stress and so on.
Friday, December 03, 2010
Is Cancer a Man Made Disease?
Alex's note: This group of articles I found on one hand disturbing and on the other enlightening. Wow! This is the toxic world we live in! But there is a lot we can do to prevent cancer and that is the important take away message. Once you need heroic measures like chemo. and radiation things have progressed. It is always better to cut the grass while it is still short. However since my grass was not cut that way (I got cancer). It has become a life transforming event and I am dedicated to understanding cancer and its prevention.
A study of ancient bodies has determined that cancer is a man-made disease, one fueled by the excesses. Tumors turn out to be extremely rare until very recent times, when pollution and poor diet became issues.
Researchers analyzed potential references to the disease in classical literature, and also searched for signs in the fossil record and in mummified bodies. But despite examining tissue from hundreds of Egyptian mummies, they confirmed only one case of cancer
According to the Daily Mail:
Cancer September 1977; 40(3): 1358-1362
A study of ancient bodies has determined that cancer is a man-made disease, one fueled by the excesses. Tumors turn out to be extremely rare until very recent times, when pollution and poor diet became issues.
Researchers analyzed potential references to the disease in classical literature, and also searched for signs in the fossil record and in mummified bodies. But despite examining tissue from hundreds of Egyptian mummies, they confirmed only one case of cancer
According to the Daily Mail:
"Dismissing the argument that the ancient Egyptians didn't live long enough to develop cancer, the researchers pointed out that other age-related disease such as hardening of the arteries and brittle bones did occur ...
Fossil evidence of cancer is also sparse, with scientific literature providing a few dozen, mostly disputed, examples in animal fossil".
Sources:
Cancer September 1977; 40(3): 1358-1362
Tuesday, November 30, 2010
Utilizing Chinese Medicines to Improve Cancer Therapy - Fiction or Reality?
Click here to see the abstracts of the entire journal is devoted to the use of Chinese Medicine in modern Oncology.
Authors: Sing Sum Chow, Moses; Huang, Ying
Source: Current Drug Discovery Technologies, Volume 7, Number 1, March 2010 , pp. 1-1(1)
Publisher: Bentham Science Publishers
Authors: Sing Sum Chow, Moses; Huang, Ying
Source: Current Drug Discovery Technologies, Volume 7, Number 1, March 2010 , pp. 1-1(1)
Publisher: Bentham Science Publishers
Abstract:
Despite the tremendous effort on research and development by government and industry, effective treatment of cancer in most patients remains elusive at present. Even if a given chemotherapeutic regimen is very effective at onset, it eventually will fail, due to drug resistance and /or organ toxicity. Thus, there is a great need to incorporate new mode of therapeutic approach in prevention and treatment of cancer. Chinese medicines (CM) have been used in China for about 5000 years for symptomatic treatment of diseases including cancer. The traditional approach of CM is to use different herbal formulae to restore the balance of Yin-Yang of body energy so body function can be normalized. Can this traditional Chinese medicine (TCM) approach provide an alternative to the evidence based conventional cancer chemotherapy? It would be a fiction to expect TCM to substitute as an alternative approach to modern cancer chemotherapy, despite its thousands of years of use in China. However, there are distinct potentials, from theory to herbal compounds, which could be derived from CM. For example, the balance concept of TCM may be an intriguing therapeutic approach for future cancer therapy— aiming not to eradicate all cancer cells but to keep it in balance with normal cells to result in bodily function as close to normal as possible and maintain in such a state as long as possible. Another potential contribution of TCM is its rich source of active anticancer compounds and their combinations which could be developed and proved to be effective therapeutic regimens (or adjunctive regimens) in the future. In tracing the source of new drugs for cancer, more than half of current anticancer agents used clinically in USA are either natural occurring or derived from natural products. These include Vinca alkaloids, taxanes, podophyllotoxin, camptothecins and anthracyclines. Despite the interest in plant-based new drug discovery, only a small portion of more than 250,000 known plant species have been investigated for cancer drug discovery. It is likely that herbs used in TCM can be a useful source of new anticancer drugs. Furthermore, the TCM formulae themselves (which always composed of mixtures of components) may simultaneously target multiple cancer-causing genes/pathways and thus achieve superior effect as compared to single agents aiming for a single molecular target. Nevertheless, before any TCM product can be accepted by the Western world as complementary and alternative medicine for cancer treatment/prevention, it is crucial to identify bioactive components, understand their pharmacological mechanisms, and achieve quality control of a given product along with demonstrating its clinical efficacy. In this issue of Current Drug Discovery Technologies, eight review articles highlighting in more detail some of these important points relating to development of CM as anti-cancer drugs. These articles describe the potential use of the balance concept, examples of CM-derived drugs that have been approved by US FDA and new technology (chemoinformatics) and targets (drug transporters and other molecular targets) as well as TCM products and formulations used for lung cancer. We hope that this special issue will provide a glimpse of examples and new technologies that can be applied toward improving the development of CM, potentially leading to new and effective anti-cancer agents in the future.
Despite the tremendous effort on research and development by government and industry, effective treatment of cancer in most patients remains elusive at present. Even if a given chemotherapeutic regimen is very effective at onset, it eventually will fail, due to drug resistance and /or organ toxicity. Thus, there is a great need to incorporate new mode of therapeutic approach in prevention and treatment of cancer. Chinese medicines (CM) have been used in China for about 5000 years for symptomatic treatment of diseases including cancer. The traditional approach of CM is to use different herbal formulae to restore the balance of Yin-Yang of body energy so body function can be normalized. Can this traditional Chinese medicine (TCM) approach provide an alternative to the evidence based conventional cancer chemotherapy? It would be a fiction to expect TCM to substitute as an alternative approach to modern cancer chemotherapy, despite its thousands of years of use in China. However, there are distinct potentials, from theory to herbal compounds, which could be derived from CM. For example, the balance concept of TCM may be an intriguing therapeutic approach for future cancer therapy— aiming not to eradicate all cancer cells but to keep it in balance with normal cells to result in bodily function as close to normal as possible and maintain in such a state as long as possible. Another potential contribution of TCM is its rich source of active anticancer compounds and their combinations which could be developed and proved to be effective therapeutic regimens (or adjunctive regimens) in the future. In tracing the source of new drugs for cancer, more than half of current anticancer agents used clinically in USA are either natural occurring or derived from natural products. These include Vinca alkaloids, taxanes, podophyllotoxin, camptothecins and anthracyclines. Despite the interest in plant-based new drug discovery, only a small portion of more than 250,000 known plant species have been investigated for cancer drug discovery. It is likely that herbs used in TCM can be a useful source of new anticancer drugs. Furthermore, the TCM formulae themselves (which always composed of mixtures of components) may simultaneously target multiple cancer-causing genes/pathways and thus achieve superior effect as compared to single agents aiming for a single molecular target. Nevertheless, before any TCM product can be accepted by the Western world as complementary and alternative medicine for cancer treatment/prevention, it is crucial to identify bioactive components, understand their pharmacological mechanisms, and achieve quality control of a given product along with demonstrating its clinical efficacy. In this issue of Current Drug Discovery Technologies, eight review articles highlighting in more detail some of these important points relating to development of CM as anti-cancer drugs. These articles describe the potential use of the balance concept, examples of CM-derived drugs that have been approved by US FDA and new technology (chemoinformatics) and targets (drug transporters and other molecular targets) as well as TCM products and formulations used for lung cancer. We hope that this special issue will provide a glimpse of examples and new technologies that can be applied toward improving the development of CM, potentially leading to new and effective anti-cancer agents in the future.
Document Type: Research article
Click here to see the abstracts of the entire journal is devoted to the use of Chinese Medicine in modern Oncology.
Click here to see the abstracts of the entire journal is devoted to the use of Chinese Medicine in modern Oncology.
Tuesday, November 23, 2010
Lymphoma, Chemotherapy, & Antioxidants
Oxidative stress is defined as a type of physiological stress on the body caused by the damage done by free radicals inadequately neutralized by antioxidants. It has long been known that oxidative stress is an essential mechanism by which chemotherapy works to treat cancer. However, the question of whether this is always the case is seldom debated openly. Taking a deeper look into the research literature yields many examples where oxidative stress on cancer cells has been shown to be counterproductive. For example, a study using human Burkitt lymphoma cells found that oxidative stress actually interferes with the ability of the chemotherapy drugs doxorubicin, cisplatin, etoposide, and cytarabine to cause cancer cell death.
When oxidative stress levels are reduced in cancer cells, their growth is more easily controlled through a process called apoptosis. During apoptosis, cells are removed by the immune system before they lose their cell wall, thus avoiding an inflammatory response to the dying cells.
However, when oxidative stress levels go up, cancer cell death happens through a slower, messier, and less effective pathway called pyknosis or necrosis. Additionally, the ability of the body to “clean up” the resulting cellular debris from cancer cell death is also inhibited by oxidative stress. The body’s house-cleaning cells (called monocyte-derived macrophages) cannot function optimally under conditions of oxidative stress (i.e. low oxygen levels).
The authors of the above-mentioned study on Burkitt lymphoma cells and chemotherapy suggest that including antioxidants in the treatment protocol may enhance chemotherapy-induced apoptosis and phagocytosis. (Shacter, Williams et al. 2000) A second study, involving the chemotherapy drugs etoposide and calcimycin, confirms this finding: Human Burkitt’s lymphoma cells were unable to die quickly by apoptosis in the presence of oxidative stress and instead died using the slower and messier method of necrosis. In this study, it was found that oxidative stress inhibited apoptosis by depleting cells of their energy source, which is called adenosine triphosphate (ATP). (Lee and Shacter 1999)
Related to these observations about the relationship between cellular oxidative stress levels is the widely held view in medicine that the use of antioxidant dietary supplements diminishes chemotherapy’s effectiveness. However, when one looks more closely at the existing published science on how antioxidants and chemotherapy combine, the true answer is not so definitive. Many research studies, encompassing cell culture tests in the laboratory and also animal and some human studies, are coming to a conclusion often very different from the conventional perspective that chemotherapy and antioxidants should never be combined.
One example is a human study in which researchers discovered that higher levels of the antioxidant selenium in the blood of patients with aggressive B-cell non-Hodgkin’s lymphoma correlated with increased achievable doses of anthracycline based chemotherapy, better treatment response, achievement of long term remission, and longer overall survival. It is important to note that in this study, however, the level of selenium present in the blood of patients was from their diet; the study was not a test of supplemented selenium. (Last, Cornelius et al. 2003) As seen in this study, higher levels of natural antioxidants can help treatment outcomes.
On the other hand, the decreased levels of antioxidants (or oxidative stress) that are caused by many chemotherapy treatments correlates with increased side effects. In patients with Hodgkin’s lymphoma, chemotherapy with Adriamycin, bleomycin, vincristine, and dexamethasone significantly decreases antioxidant levels. (Kaya, Keskin et al. 2005) In children with acute lymphoblastic leukemia who received high-dose methotrexate, oxidative damage to proteins as well as other factors was related to toxic side effects. (Carmine, Evans et al. 1995)
Using antioxidants during chemotherapy is an important and controversial question among health care providers, patients, and their support teams. In previous issues of Avenues, we have researched this subject thoroughly for prostate, breast, lung, colon, and ovarian cancers. In this article, we turn our focus to lymphoma, conducting a systematic search for published research that would support or discourage the use of antioxidants in combination with chemotherapy. The overwhelming majority of studies find a favorable interaction between antioxidants and chemotherapy, providing evidence that antioxidants can decrease chemotherapy side effects, increase treatment effectiveness, and decrease resistance to chemotherapy.
For this paper, we searched for clinical or laboratory data published in peer-reviewed medical journals, conducted by cancer researchers in universities and medical research facilities around the world. Some of these studies are still in early stages and include only laboratory or animal data while others have advanced to include human volunteers. We organized these data into the major categories of specific chemotherapy drugs. Within each section for a specific drug are found the research on combinations of that drug with various antioxidants, grouped by the name of the antioxidant in alphabetical order. We also point out specifically which studies were conducted in a laboratory (i.e. used cancer cell cultures), used animals, or involved human volunteers. As each antioxidant appears in the paper for the first time, we provide some introduction to the antioxidant including what food sources naturally contain it, other common applications in clinical use, and typical dosages. The dosages given are not necessarily appropriate for all patients and should be individualized with practitioner guidance.
Click here for the rest of the article
Tuesday, November 09, 2010
How Is This Cancer Different From All Other Cancers?
Alex Comments: As genetic medicine begins to enter the clinic Western Medicine has come full circle to embrace a concept that is germane to Chinese Medicine which is to classify the patients unique pattern with a disease not only the disease itself. On the genetic level disparate cancers may have the same genetic mutation.
"I was just diagnosed with BRAF-mutated colon cancer." I've never heard anyone say that, but there's no reason I should not. Our knowledge of cancer genomics is increasingly enabling physicians to target therapies at the aberrant biochemistry that underlies individual tumors. This is truly taking personalized medicine 1 step further -- not only is therapy tailored to patients, it is also tailored to the unique deficits and/or vulnerabilities of each patient's tumor.
My thoughts along these lines were jump-started by a recent research study published in The New England Journal of Medicine.[1] The report focused on mutations in ARID1A, a gene that is often mutated in ovarian clear-cell carcinomas and in endometrioid carcinomas. Among 119 cases of clear-cell carcinoma, 46% demonstrated ARID1A mutations; 10 of 33 cases of endometrioid carcinoma (30%) also showed ARID1A mutations. By contrast, no ARID1A mutations were found in the 76 high-grade serous ovarian carcinomas examined.
Both clear-cell and endometrioid ovarian carcinomas are relatively insensitive to platinum/taxane chemotherapy, which is the treatment of choice for high-grade serous carcinomas. Could this be related to the ARID1A mutations? If yes, would ARID1A mutations found in other tumor types also be resistant to platinum/taxane chemotherapy?
When BRAF is mutated, the normal function of the B-raf protein is altered in ways that can lead to birth defects early in life or to cancer in adults. PLX4032 inhibits the mutated B-raf protein regardless of the cell type in which it resides, but only in tissues with the BRAF mutation.
Considering the striking impact of PLX4032 on malignant melanomas, and its focused action against the aberrant B-raf protein, would PLX4032 also be active against other tumors with this same BRAF mutation?
According to the database of the Cancer Genome Project of the Wellcome Trust Sanger Institute, BRAF is mutated in 45% of thyroid cancers.[3] Not surprisingly then, a paper presented at the 2009 Annual Meeting of the American Society of Clinical Oncology[4] showed that PLX4032 is active in thyroid cancers as well: tumor regression rates were 9%-16% in thyroid cancer patients with BRAFV600E mutations, and patients showed no tumor progression for 4-7 months.
A 2008 study reported that inhibition of BRAF caused apoptosis in melanoma cells, but only arrested growth in thyroid carcinoma cells, with little or no cell death -- which might explain why although PLX4032 is clearly active in thyroid cancer, it has such different effects in melanoma than it does in thyroid cancer.[5]
The more we learn about cancer genomes, the more we're beginning to understand that "BRAF-mutant colon cancer" should be treated differently from BRAF-normal colon cancer. Whether we'll ultimately be able to unravel every genetic mutation in every tumor type remains to be seen. But, in the meantime, investigations into treatments tailored toward a range of tumor types with ARID1A and BRAFV600E mutations clearly provide a window into the future of clinical oncology.
"I was just diagnosed with BRAF-mutated colon cancer." I've never heard anyone say that, but there's no reason I should not. Our knowledge of cancer genomics is increasingly enabling physicians to target therapies at the aberrant biochemistry that underlies individual tumors. This is truly taking personalized medicine 1 step further -- not only is therapy tailored to patients, it is also tailored to the unique deficits and/or vulnerabilities of each patient's tumor.
My thoughts along these lines were jump-started by a recent research study published in The New England Journal of Medicine.[1] The report focused on mutations in ARID1A, a gene that is often mutated in ovarian clear-cell carcinomas and in endometrioid carcinomas. Among 119 cases of clear-cell carcinoma, 46% demonstrated ARID1A mutations; 10 of 33 cases of endometrioid carcinoma (30%) also showed ARID1A mutations. By contrast, no ARID1A mutations were found in the 76 high-grade serous ovarian carcinomas examined.
Both clear-cell and endometrioid ovarian carcinomas are relatively insensitive to platinum/taxane chemotherapy, which is the treatment of choice for high-grade serous carcinomas. Could this be related to the ARID1A mutations? If yes, would ARID1A mutations found in other tumor types also be resistant to platinum/taxane chemotherapy?
Cracking the Code to "Beat" Cancer
A study published in The New England Journal of Medicine in August[2] described the effectiveness of PLX4032 in shrinking the tumors of 81% of metastatic melanoma patients with the BRAFV600E mutation. Of 32 patients studied, 2 had no sign of disease at the end of the trial and 24 had tumor shrinkage of 30% or more. Only 2 patients' tumors showed no regression at all.When BRAF is mutated, the normal function of the B-raf protein is altered in ways that can lead to birth defects early in life or to cancer in adults. PLX4032 inhibits the mutated B-raf protein regardless of the cell type in which it resides, but only in tissues with the BRAF mutation.
Considering the striking impact of PLX4032 on malignant melanomas, and its focused action against the aberrant B-raf protein, would PLX4032 also be active against other tumors with this same BRAF mutation?
According to the database of the Cancer Genome Project of the Wellcome Trust Sanger Institute, BRAF is mutated in 45% of thyroid cancers.[3] Not surprisingly then, a paper presented at the 2009 Annual Meeting of the American Society of Clinical Oncology[4] showed that PLX4032 is active in thyroid cancers as well: tumor regression rates were 9%-16% in thyroid cancer patients with BRAFV600E mutations, and patients showed no tumor progression for 4-7 months.
A 2008 study reported that inhibition of BRAF caused apoptosis in melanoma cells, but only arrested growth in thyroid carcinoma cells, with little or no cell death -- which might explain why although PLX4032 is clearly active in thyroid cancer, it has such different effects in melanoma than it does in thyroid cancer.[5]
A Rose By Any Other Name...
So how might our understanding of tumor classification change as genomic medicine moves into the clinic? In tissues such as thyroid, which is unique in its affinity for iodine, or in breast cancers requiring estrogen to thrive, these characteristics should obviously be exploited in ways that achieve apoptosis or growth inhibition. But it might be equally important to exploit the ways in which other tumors -- which might be dissimilar at first glance -- are actually similar on a genetic level. Just as PLX4032 seems to be active in a variety of BRAF-mutated tumors, other chemotherapeutic agents can be designed to target tumors with common genetic variants. Or, conversely, just as clear-cell ovarian cancers with ARID1A mutations are unresponsive to platinum/taxane chemotherapy, we might be able to avoid the use of these chemotherapies in other tumor types with the same mutation.The more we learn about cancer genomes, the more we're beginning to understand that "BRAF-mutant colon cancer" should be treated differently from BRAF-normal colon cancer. Whether we'll ultimately be able to unravel every genetic mutation in every tumor type remains to be seen. But, in the meantime, investigations into treatments tailored toward a range of tumor types with ARID1A and BRAFV600E mutations clearly provide a window into the future of clinical oncology.
Thursday, November 04, 2010
Clinical Implications of Tai Chi Interventions: A Review: Abstract and Introduction
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| Michael Sieverts |
Tai Chi, a Chinese bodymind exercise, has been used in China for thousands of years for both prevention and therapeutic purposes. In the 1990s, the Western research community started to examine the effectiveness of Tai Chi interventions using scientific research design and standardized outcome measures. A number of reviews of these studies have been published. Based on an extensive literature search, this state-of-the-art review identified 25 such reviews published since 2000, provides a description of them, and summarizes what was learned from these reviews. Although there is still a need to understand more about Tai Chi interventions, especially Tai Chi's mechanism, it is concluded that Tai Chi is a very useful exercise format that can be used for a variety of chronic disease conditions. It requires no equipment and little space, and it can be practiced anytime, anywhere, and by older adults and individuals with chronic diseases. Since short forms (eg, 10 or 24 forms) have been shown to have similar benefits as longer ones, beginners should start using simple, short forms first. Like other exercise interventions, regular practice is a must to be able to gain maximal benefits. Tai Chi can be used safely as a complementary addition to conventional medical treatment, physical therapy, and rehabilitation, as well as with other exercise interventions.
For the entire Review click here
Abstract
Monday, November 01, 2010
New Yorker Magazine Book Review: Cancer World The making of a modern disease
Alex Comments: Interesting Book Review.
The risk-factor world holds out hope for avoiding cancer while recruiting masses of us into the anxious state of the “precancerous.” The physician and historian Robert Aronowitz offers an acute illustration of the problem: a fifty-eight-year-old woman diagnosed with breast cancer has a lumpectomy, followed by local radiation and months of chemo. After that, she is put on the anti-estrogen Tamoxifen for five years. As she finishes that course of treatment, she weighs the decision whether to go on a different type of hormonal therapy and what type and frequency of M.R.I. or mammogram to get. She is an active member of a breast-cancer-survivor group, and she closely monitors the latest developments on the Web. Meanwhile, another woman, the same age, has not received a breast-cancer diagnosis. She has, however, taken supplementary estrogen pills for several years in connection with menopause, and her doctor now tells her to stop, because estrogen may constitute a risk factor for breast cancer. She has been getting annual mammograms since she was forty, and four years ago an abnormal mammogram was the occasion for an aspiration biopsy. This proved negative, but her anxiety increases. She surfs the Web for information about risk factors, and she is struck by direct advertisements for Tamoxifen to prevent the development of breast cancer, for which she now believes she is at serious risk. The first woman had cancer; the second woman does not have cancer. But their experiences eerily resemble each other.
Read more http://www.newyorker.com/arts/critics/books/2010/11/08/101108crbo_books_shapin?currentPage=all#ixzz142wUXaq8
Friday, October 29, 2010
The Safe and Efficacious Use of Chinese Herbs for Radiotherapy Patients (Part I)
Alex Comments: The following two newsletter posts I wrote prior to my own cancer diagnosis. Little did I know I was going to be receiving radiation myself. My friend, colleague and visionary, Ellen Rudolph directs the Life Cycle Health Center. I have been working with her for a few years.
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The Safe and Efficacious Use of Chinese Herbs for Radiotherapy Patients (Part I) Dear Doctors, Nurses, Caregivers, Patients and Friends: Previously we have referenced some of the numerous research studies from China demonstrating that integrating Chinese medicine--acupuncture, therapeutic exercise such as qi gong and tai qi, massage, diet therapies, and herbal medicine--with Western medicine benefits cancer patients more than either medicine on its own. This week, Alex Berks, licensed acupuncturist and Clinical Director of Oncology for Life Cycle Health Center, who has himself just completed active treatment for an aggressive soft tissue sarcoma, discusses how Chinese herbal medicine combined with conventional radiotherapy can be of tremendous value to cancer patients: While advances in the targeting of radiation therapy have vastly improved, allowing greater protection of surrounding tissue, radiation can still pose a significant challenge for some patients. Radiotherapy may damage fragile mucosal barriers in the lungs and intestines, injure salivary production, cause digestive problems, dryness, inflammation and even scorching of fragile tissues, depending on location, intensity and duration of the treatment. It can also injure the bone marrow. From a Chinese medicine perspective, radioactivity damages tissue, causes inflammation and oxidation and is considered a "toxic heat". Chinese medicine refers to cancer itself as a toxin. Radiotherapy is viewed as a toxin used to kill a toxin. "Rebalancing" is the core concept of Chinese medicine and forms the basis of the diagnostic system that allows for individuation of treatment based upon patterns that individuals express, not just their western disease diagnosis. For example, a person who has a "dry" constitutional type (think post menopause, for example) will have a more difficult time with radiation than a person who has more phlegm, or excess body weight or a more moist constitution. According to Chinese medicine, when the organ systems are in balance and qi (vital energy) and blood flow smoothly, it is much harder for disease to take root. Eating foods and taking herbs that are cool in nature, with moistening properties that mitigate toxic heat and activate and nourish the blood provides the natural balance for radiation toxicity and are generally recommended for radiation patients. Aloe is an example of a cool, moistening anti-inflammatory plant. It is used topically and internally to soothe burns and ease inflamed tissue. Patients undergoing radiation therapy may benefit from many herbs in the Chinese medicine pharmacopeia that have cooling and moistening properties and that target specific organs. As radiation damage accumulates over the course of treatment and in its aftermath, lingering toxic heat depletes the moistening properties of the blood (a Chinese medicine concept) and injures the mechanisms of energy production (excessive oxidation and inflammation). If the body cannot successfully compensate for this then opportunistic infections and inflammation can injure vital organs, possibly leading to long term damage and secondary cancers. Applying Chinese medicine diagnostic principles and appropriate treatment at each stage is a way to help prevent this degeneration and many side-effects. In summary, Chinese herbal medicine can be combined efficaciously and safely to improve and prevent side effects of treatment, as well as preserve long term vitality and survival. To achieve maximum benefit, patients should commence herbal treatment 1 week before starting radiotherapy and continue for at least 6 months after treatment. Please consult with a trained Chinese Medicine practitioner who is knowledgeable in the integrative support of cancer recovery, such as our team at Life Cycle Health Center. In good health, Alex Berks, L.Ac., Clinical Director, Oncology and Ellen Rudolph, Executive Director, Life Cycle Health Center | Resources and Studies Showing Benefits of Chinese Herbal Medicine for Radiotherapy Side EffectsIntegrative medicine has been practiced in China for 50+ years. 77 year-old Dr. Zhang Dai-zhao, a well-known oncologist in China who is currently chief physician and doctoral supervisor at China-Japan Friendship Hospital in Beijing has been engaged in preventing and treating tumors with integrative medicine for over 40 years. He is one of the leading authorities on the usage of integrative medicine to relieve the side effects of cancer treatment and has focused his research and practice on improving the quality of life for tumor patients by increasing the survival rates and lessening side effects from radiation and chemotherapy. The 2007 English translation of his book, An Integrated Clinical Approach with Chinese Medicine: Alleviating the Side Effects of Cancer Treatment (2nd Edition People's Medical Publishing House), is an invaluable resource for clinicians who are involved in the management of cancer. It focuses on using modern diagnostic methods and Chinese medical treatment to address the undesirable, adverse effects of radiation therapy, chemotherapy and other treatment modalities. His book cites cites studies that demonstrate the value of Chinese Herbal Medicine (CHM) in conjunction with radiotherapy (RT) to improve survival rates, lessen the impact of depletion of white blood cells, and improve a patient's ability to complete the full course of radiotherapy treatment. 1. This study, from page 22, reported by the Chinese Academy of Medical Sciences, included 197 nasopharyngeal cancer patients who were treated with Chinese Herbal Medicine (CHM) plus radiotherapy (RT), compared to radiotherapy alone. Survival Rate
Disappearance of the tumor
Cause of Death - primary lesion relapse or metastatic lesions
The combined therapy group had more than double the 5-year survival compared to the radiotherapy alone group. The tumor was killed in more patients in the combined therapy group and the remote metastasis rate was less in the combined group. 2. In a study looking at the efficacy of herbs to prevent and treat side effects of radiation therapy, 71 patients were an active treatment group with herbs and radiation. The control group was given a placebo herbal formula plus radiation. Results showed that 84.5% of patients were able to finish the full course of radiotherapy versus 63.3% in the control group. (Neither the type of cancer nor the staging was not revealed.) 3. In another small study, white blood cell counts did not go as low in a combined treated group as they did with radiotherapy alone. One particular formula, Fu Zheng Xiao Formula (FZZX) was shown to moderate T-lymphocyte subset to enhance radiotherapy efficacy. 4. Another combined herb-radiation study was conducted with nasopharyngeal cancer patients who continued taking herbs for 6 months after radiation was finished. The 5-year survival rate was 75%. The authors indicate that Chinese medicine combined with radiation improved the effectiveness of radiation therapy while minimizing its toxicty in both the short and long term. There was no mention of a control group in this study. 5. Rat studies have shown improved efficacy of white blood cell counts and survival rate when radiation and herbs were combined. Interestingly, survival rates were even higher in the rats that were given the herbal mixture 1 week before beginning treatment with radiation. |
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