Cancer Treatments

Hope for cancer
ART OF HEALING
By DR AMIR FARID ISAHAK

Sunday May 3, 2009

A look at some cancer treatment methods that have yet to be proveBy clinical studies.


CANCER will always be a hot topic in health circles because the problem is increasing in magnitude, and we don’t seem to have satisfactory answers.

In the last two weeks, there were two articles in the star ( Supplements and cancer, Fit4Life, Sunday, April 19 and What’s up, doc?, Fit4Life, Sunday, April 26, 2009.) that reminded readers that there is insufficient evidence to rely on supplements to prevent cancer. The only proven effective ways are to stop smoking if you are a smoker, and to have vaccinations for hepatitis B (men and women) and cervical cancer (girls before becoming sexually active).

In the past, I have reported on new methods of treating cancer (eg the cytotron magnetic field therapy), which elicited some unfriendly comments from several oncologists who accused me of promoting unproven methods.

To avoid controversy, let me emphasise that what I would like to share with you today include some methods which are yet to be proven by clinical studies, but which offer hope for the future, and hope for the present for those who have advanced or terminal cancers after current proven methods failed to help or cure them. Some of these methods are already being utilised in cancer centres around the world and if proven effective, will hopefully be made available here soon; while others, even if proven, may not be offered here because of ethical reasons (eg the use of embryonic stem cells or their extracts).

The fruits of medical research carried out in non-English speaking countries often do not reach us promptly. Sometimes new methods tried in clinics or medical centres not affiliated to any university or research centre only become known to us through word of mouth. I hope this information, which I gathered from China and Ukraine, may be useful, especially to those with advanced cancer who have nothing else to hope from conventional methods.

Many Malaysians with advanced cancer have already gone to some cancer centres in China to avail themselves of these treatments. I have reviewed some of their reports and am impressed with the results. Some are in remission even though conventional treatment failed to destroy their cancers. One patient is a Malaysian lady with breast cancer that had spread to her pelvic bones and spine. A post-treatment PET scan showed that all the cancer primary and secondaries are gone.

It is too early to pronounce them as “cured” because we have to wait for five years of non-recurrence.

The individual methods may not be new, but the novel way these centres combine the various methods to defeat the cancer is probably the reason they succeeded where others failed.

As the treatments are extremely expensive, only those with advanced cancers and deep wallets have made the journey. I hope that as the treatments become more acceptable, the costs will come down and be accessible to more patients. It will be best, if the methods are proven effective as these early results indicate, that the treatments are made available here.

Chemoembolisation

This method is already in use in many countries, especially in treating liver cancer, but a cancer centre in GuangZhou, China, is using this to treat many types of cancer. Chemoembolisation involves the injection of one or more cancer drugs directly into the blood vessels directly nourishing the cancer tumour. This allows high concentration of drugs to be sent to the tumour without poisoning the rest of the body.

This centre uses combination chemotherapy to attack single or multiple tumours, and this technique also kills the cancer cells that may have spread nearby beyond the border of the tumour. These cells, if they survive, would result in “local recurrence” of the tumour after the primary growth is removed. However, this method is not very effective if the tumour is large, and will have to be repeated at intervals. This is the first step before targeting the destruction of the main tumour mass.

RAPI

This stands for Radio-Active Particle Implant, which is a form of brachytherapy. Using computer-guided imaging, small titanium (or other inert metals) capsules containing radioactive isotopes appropriate for the cancer-type are implanted into the tumour mass to completely eliminate the tumour.

Again, if the tumour is large, repeated implantations will be necessary. Brachytherapy is already widely used throughout the world. In this centre, it is done as part of a multi-step treatment protocol.

HIFU

If RAPI is not suitable for the patients, then High-Intensity Focussed Ultrasound is used to kill tumour cancer cells using heat generated by ultrasound. This method is increasingly being utilised in cancer therapy because it is non-invasive.

Whole body cancer cell clearance

This is the most difficult part of cancer therapy. Too often we know of cancer patients who have had their primary tumours successfully removed, including a wide margin of surrounding tissues (and often the whole breast in the case of breast cancer) only to have the cancer resurface some time later. The standard treatment for the prevention of local recurrence is by radiotherapy, and that of distant metastases is by chemotherapy. For certain cancers, anti-hormone therapy and immune modulators may be employed.

Below are several novel methods employed in some hospitals in China, and possibly elsewhere too.

Lymphocyte/NK cell transfusion

In this method, compatible blood from the closest relatives (parents, siblings) are collected and the lymphocytes are isolated. The NK (Natural Killer) cells, which are the body’s main cancer-fighting cells, are isolated, and the NK-rich fraction is transfused into the patient. This can be repeated at intervals.

Nano transfusion

Using nano-technology, it is possible to deliver minute radioactive atoms as well as chemotherapy molecules to cancer cells throughout the body, with minimal harm to normal cells. The radioactive isotope (eg strontium 89) and chemo-drug molecule are attached to iron atoms that are rapidly taken up by metastatic cancer cells. In this way cancer cells marauding in the body far away from their origin, including those that are undetectable by current tests, can be killed. The three-in-one (iron, isotope, chemo-drug) bullet is transfused as per normal fluid transfusion.

Maturation Factors (MF)

Cancer cells grow and multiply without proper differentiation or maturation. Differentiation refers to the process of becoming specific cell-types with specific functions. Maturation refers to undergoing a process of fully acquiring the ability to perform the specified function of that particular cell-type.
For example, the cells lining the uterus have a specific function of preparing for and supporting a pregnancy. In the menstruating young woman, they undergo a maturation cycle that makes them fully prepared to support the early embryo which has implanted. If there is no pregnancy, they die, and new cells repeat the cycle.

Proper differentiation and maturation are determined by genes, maturation and growth factors, hormones and nutrients. Infections, drugs and chemicals may interfere at any stage.

The current understanding about cancer is that cancerous stem cells are probably the real culprit we should go after. Other stem cells can replicate ad infinitum because they always produce one copy of themselves at each division, while the other cell begins the process of differentiation and maturation. The trouble with cancer stem cells is that they divide into two cells that do not differentiate, and do not mature. Thus they have abnormal behaviour, including having unstoppable growth, and being locally and distantly invasive.

Maturation factors are substances that hasten the differentiation and maturation process of young, new cells. When applied to cancer cells, they have been found to cause some differentiation and maturation of the cancer cells. They become less aggressive, with less local invasion and metastasis. With continued treatment, progressive maturation of succeeding generations means the cells lose their ability to multiply indefinitely, and will die through the normal process called apoptosis (programmed cell-death).

This therapy is also called “taming” of cancer because the cancer cells are not killed by the treatment, but are “tamed” into becoming less harmful, or even harmless, until they die naturally. If you remember, cytotron cancer therapy also does not kill the cancer cells directly, but stop their ability to divide until they die naturally. While cytotron therapy is best for localised tumours, MF can be injected to tame tumours in the entire body.

At present, the source for MF used is Ukraine, because the best source is embryonic stem cells (ESC), and most countries still ban ESC research due to ethical reasons. MF is actually a combination of many known growth factors, and possibly many yet to be identified factors present in the embryonic stem cells.

Please be reminded that some of the above is not yet proven therapy, but it offers hope for those who are desperate, and who can afford it.

I am sure there are many more exciting therapies for cancer and other diseases out there that we have yet to discover. If you know of any, please let me know and I will do my research on them, and if justified, will share the information in this column.

http://thestar.com.my/health/story.asp?file=/2009/5/3/health/3810234&sec=health

When liver meets cancer

By LIM WEY WEN
Sunday April 18, 2010

As the liver’s ability to regenerate itself makes it more difficult to detect liver cancer early, prevention is key.


IF the liver was a machine that exists in our modern world, it would be the embodiment of the perfect workhorse. It will be able to work 24/7 with little rest, juggle multiple tasks at the same time, and regenerate parts that are old or damaged so they will continue to work at peak performance, day in, day out.

And that’s not all. If there is a greater demand of its services, it’ll be ready to work harder to take on the challenge.

Datuk Dr Ibrahim Wahid ... While chronic infection with viruses such as
Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the more common causes
of liver cancer, chemicals that cause cancer (carcinogens) and alcohol can also cause it. 

 

But while the liver’s ability to regenerate itself when damaged can be a blessing, it can also be a curse, because when it has trouble recovering from damage, or coping with the demands placed on it, you can’t really feel it.

“The liver is an organ that does not complain very much until it is very, very late,” says Malaysian Liver Foundation chief executive officer Datuk Dr Nor Shahidah Khairullah. Because of that, patients with liver cancer often see their doctors in late stages of the disease, where treatment options are limited.

“(Liver cancer) is dangerous because the liver is our powerhouse, when it comes to internal organs,” Dr Nor Shahidah says. “It stores all your energy and vitamins, nourishes you by manufacturing amino acids (building blocks of proteins), secretes hormones and bile, and helps to emulsify the fats in your body. So, it’s an organ that is virtually life itself.”

The good news is that many liver cancers can be prevented. However, not many people know that.
So, to create more awareness about the disease and its treatments, Dr Nor Shahidah and Malaysian Oncological Society president Datuk Dr Mohd Ibrahim Wahid shares with Fit4Life the following insights.

How do the cells in the liver become cancerous?

When the DNA of normal liver cells are damaged, cell mechanisms can repair it to some extent. However, when the damage is too severe, the cells will die, and new cells will be formed to take their place.

Sometimes these processes can go wrong, says Dr Mohd Ibrahim.

When they go wrong, the cells that are repaired or regenerated may contain DNA that is different from normal cells. So, unlike normal cells that grow, multiply, and eventually die in a tightly controlled manner, these new cells can now multiply freely. And when they get old or damaged, they don’t die, as they should. This will cause the extra cells to accumulate into a mass of tissue called a growth, nodule, or tumour.

While some of these growths, nodules, or tumours are benign (they do not grow and multiply aggressively, invade surrounding tissues or travel to other parts of the body), some of them, which are malignant or cancerous, do.

What are the types of liver cancer?

If the cancer starts in the cells of the liver, it is called primary liver cancer. However, the four types of primary liver cancer are categorised according to the types of cells that become cancerous first.

The most common form of liver cancer (hepatocellular carcinoma) begins in hepatocytes, the main type of cells in the liver. Others begin in the cells in the bile duct (cholangiocarcinoma), and very rarely, blood vessels in the liver (angiosarcoma or hemangiosarcoma). When it happens to children under the age of four, it’s called hepatoblastoma.

What are the causes?

Most of the causes of liver cancer are those that cause long term damage to liver cells. As acute infections such as Hepatitis A do not affect the liver in the long term, it does not result in chronic liver disease, hence it is not a risk factor for liver cancer.

While chronic infection of viruses such as Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the more common causes of liver cancer, chemicals that cause cancer (carcinogens) and alcohol can also cause it, says Dr Mohd Ibrahim. However, in most of Asia, chronic HBV infection is the main cause of liver cancer.

You will also have a higher risk of developing liver cancer if you smoke, are obese, diabetic, or have a history of cirrhosis (when your liver has been scarred by chronic disease).

Are there any early symptoms?

Before looking at the symptoms, it is good to note that liver cancer affects more men than women, usually in their 40s to 50s. Worldwide, men who are diagnosed with liver cancer outnumber women three to one.

Unfortunately, many people do not experience signs or symptoms in the early stages of liver cancer, says Dr Nor Shahidah.

But as the cancer progresses, some may notice some of the following symptoms:

·Weight loss
·An ongoing lack of appetite
·Feeling very full even after a small meal
·A hard lump on the right side just below the rib cage
·Pain around the right shoulder blade
·Yellow-green colour to the skin and eyes (jaundice)
·Discomfort or pain in the upper abdomen on the right side
·Unusual tiredness
·Nausea

As these symptoms are non-specific and can be caused by many health problems other than liver cancer, it is always wise to consult your doctor to have them checked out.

Are blood tests useful in detecting early liver cancer?

Blood tests, like liver function tests (which tests for proteins produced by the liver and enzymes found in the liver) and tumour markers can be used to detect changes in the liver that may indicate the presence of liver cancer. However, they are not very reliable, says Dr Mohd Ibrahim.

As the test results could be influenced by other factors as well, most of the time, a doctor needs to investigate the abnormal blood test results further with ultrasounds, MRI, and CT scans, or biopsies to determine the presence of a cancerous growth in the liver.

Who do you see when your blood tests are abnormal?

“It depends on the type of blood test,” says Dr Nor Shahidah. If they are liver function tests, all doctors should be able to advise you. But if they are serology tests for hepatitis infections, your doctor might refer you to another doctor who specialises in liver diseases (hepatologist).

Also, if your doctor suspects you may have liver cancer, he or she will also refer you to a cancer specialist (oncologist).

Nevertheless, your best bet is to visit your family doctor or a general practitioner first, because he or she will be able to treat you or advise you on which doctor to see next, whether it is a hepatologist or oncologist.

Are surgery and chemotherapy the only treatment options for liver cancer?

No. Although surgery to remove the cancer is still the main method of treatment, many liver cancer patients could not be operated upon. Often, when the cancer is diagnosed too late, the cancer has spread to a large area of the liver, or has occurred in too many sites. Sometimes, it’s just a matter of the cancer growing too close to an important artery.

For these patients, doctors may consider starving the cancer to death by cutting off the blood supply through a procedure called embolisation.

And if embolisation is not possible, doctors may consider killing the cancer by freezing (cryoablation), heating (radiofrequency ablation) or damaging it with chemicals (chemotherapy).

In the year 2008, the Malaysian Ministry of Health had approved the use of a drug initially licensed for the treatment of kidney cancer (sorafenib) as a treatment for liver cancer that could not be operated upon.

However, it is not easily accessible to many liver cancer patients due to its cost.

Therefore, to make sorafenib more accesible to patients, its maker has collaborated with the Malaysian Liver Foundation in a programme that allows eligible patients to purchase two months supply of the drug and get the rest of the year’s supply free.

How do I prevent liver cancer?

As chronic hepatitis B infection is the main cause of liver cancer here in Asia, the best way to prevent it is to get vaccinated against it, says Dr Nor Shahidah.

But what if you are already infected with the HBV or HCV? The answer is to get your liver monitored regularly (about every six months) by your doctor to detect liver cancer early if it develops. (Not all people who are infected with the viruses develop liver cancer.)

Of course, by reducing all other risk factors, including obesity, diabetes, smoking, and alcohol consumption, you will also reduce your chances of developing liver cancer.

> For more information about liver cancer, please visit the Malaysian Liver Foundation website at www.liver.org.my.

http://thestar.com.my/health/story.asp?file=/2010/4/18/health/6057041&sec=health

New hope for liver transplant patients

by MARTYN HALLE, Daily Mail

Last updated at 12:12 18 October 2005


Scientists have developed a treatment that could save the lives of hundreds of people needing liver transplants - they have discovered how patients can 'regrow' their own livers.

New treatment regenerates liver

During the new procedure, doctors remove healthy cells from a patient's own liver, grow them for up to a week in a laboratory - and then infuse them back into the liver. There, they continue to multiply.

At present, there is no way of keeping alive critically ill liver patients for long enough to receive a transplant if one is not available immediately.

There is also an enormous demand for livers, and doctors say that is likely to increase dramatically because of rising rates of obesity, heart disease and hepatitis C.

Doctors have struggled for years to grow enough liver cells in the laboratory to save seriously ill patients.

But researchers have employed a relatively new surgical technique that allows the new liver cells to grow rapidly when put back into the liver.

The method, embolisation, has already been used to help patients with liver cancer grow more liver cells after surgery to remove their tumours.

Surgeons cut off some of the blood supply of the liver where the cells are infused, and this forces that part of the liver to work rapidly to make new cells.


Trial with liver failure babies due

So far, only animal trials have taken place, involving the removal of cells. But human trials are expected to start in the next few weeks on new-born babies with major liver failure who might otherwise die.

Results of the research were reported yesterday at the conference of the United European Gastroenterology Conference in Copenhagen by doctors from the Hospital St Antoine in Paris.

Dr Andrew Burroughs, a liver specialist at London's Royal Free Hospital, said: "This is a really exciting development which opens up the possibility that soon the majority of patients will not need a donor liver transplant.

"We are desperately short of donor livers and often lose patients because an organ cannot be found in time.

"There are also patients we would like to put on the transplant list but cannot because of the shortage of organs. So patients are prioritised for transplant."

The number of donor organs becoming available in the UK is less than half the rate of many other European countries. Italy and Spain have among the highest donor liver rates.

A growing number of patients developing liver failure suffer from obesity and heart disease. The damage is caused by a build-up of cholesterol.

Dr Burroughs says: "The popular misconception is that the majority of patients with liver failure are alcoholics. Patients with diseased and damaged livers due to alcohol abuse form a large number of those needing transplant, but they are in a minority.

"The benefit of using a patient's own liver cells to regrow their liver is that they not only avoid transplant, but also would not need to spend the rest of their lives on anti-rejection drugs.

"We also know that even those who have successful liver transplants may - after 15 or 20 years - need a new liver. Growing and infusing liver cells would get round those difficulties."

http://www.dailymail.co.uk/health/article-365757/New-hope-liver-transplant-patients.html