Dr Ou of the UCI Medical Center

Last night I attended a meeting near the UCI Medical Center. The speaker, Doctor Ou, is an Associate Clinical Professor at the school. He brought up some interesting facts.

• There are more deaths among women from lung cancer (70,490) than from breast cancer, ovarian cancer, cervical cancer, uterine cancer, vulva cancer, and vaginal cancer combined (68,290).

• There are tests for early detection of many forms of cancer (i.e. mamograms for breast cancer and PAP smears for cervical cancer), but there is no test for early detection of lung cancer.

• Because of the difficulty in detecting lung cancer at an early stage, it generally takes 25 years to manifest itself. Almost half of all new patients diagnosed are in the late stage (IIIB and IV) of the disease, making treatment unlikely to be successful.

• Those who smoke but quit at the age of 30 have more than double the chance of dying from lung cancer than those who have never smoked. Those who quit at age 50 have more than a six-fold lung cancer mortality rate.

• Women who never smoke are much more likely than men who have never smoked to develop lung cancer. This is more pronounced in the Asian countries than in Europe and the US, although it holds true in all geographic areas studied.

• Radon gas is the second leading cause of lung cancer. Produced by decaying uranium-238 in the soil, it is estimated that 8 million homes in the US have elevated levels of radon, primarily in Northern states.

• As with most diseases, genetic mutations have been identified as being involved with the development of lung cancer. Epidermal growth factor receptor (EGFR), when mutated, can cause the uncontrolled cell division known as cancer.

• A drug under study, Gefitinib, shows great promise in stopping some forms of lung cancer, but while it works extremely well in some patients, it does not work at all in others. Its effectiveness depends on the specific mutations in the EFGR gene. I will write more about Gefitinib in a future post.

Ripe Mango

In 2001, a study at the University of Florida indicated that Mangoes contain several cancer fighting components including carotinoids and phenolic compounds called polyphenols, both powerful antioxidants.

A more recent study funded by the National Mango Board and done at Texas A&M University’s AgriLife Research department determined that one class of these phenolic compounds, known as gallotannins, is particularly effective in killing breast cancer and colon cancer cells under laboratory conditions.

In the earlier study, mangoes were pureed and separated into a carotinoid portion and a portion heavy in phenolics.  While both portions inhibited cancer formation, the phenolic portion was shown to be more effective.  Some of the compounds were suspected of being unique to Mangoes and the results suggested that further studies were warranted.

This brings up the later study.  The husband and wife team of Dr. Susanne and Dr. Steve Talcott at Agrilife Research found that gallotannins were effective in slowing the growth of lung, prostate, and leukemia cancer cells, but were even more effective against breast and colon cancer.  The compounds actually caused the breast and colon cancer cells to stop multiplying and die in a form of cell suicide called apoptosis.

The gallotannins also prevented damaged cells, those showing precancerous signs, from developing further.  When the compounds were administered to normal, healthy cells, no harm was done.

Although the research was funded by the National Mango Board, there appears to be no reason to question the findings.

Of course, not all experiments performed in the laboratory pan out when used on human subjects.  But the results give hope that another, more natural alternative to widely prescribed cancer drugs may soon be offered to cancer victims.  Clinical trials may begin soon to determine the efficacy on human subjects.

In the meantime, eat more mangoes and drink tea, which is also high in gallotannins.

President Roosevelt

It was recently revealed that President Franklin Delano Roosevelt died as a result of melanoma, a cancer noted for its ability to spread or metastasize throughout the body.  A tumor in his brain from the metastasized cancer caused the previously reported stroke.

In a study done at the University of Queensland in Brisbane, Australia and in a second study done at the University of California, Los Angeles. research indicated that family history may be more important in gauging melanoma risk than the amount of sun exposure or other factors.

While our knowledge of melanoma has come a long way since the 1940s, it is still one of the deadliest forms of cancer.  This is because it can be influenced by several different genetic factors each of which must be dealt with by a different treatment.  Unless one knows the genetic code involved, one can’t know which treatment will be effective, assuming there is a treatment for a particular genetic mutation.

In a test of a new drug, PLX4032, 20 of 22 patients with a common form of melanoma, associated with a mutation of the BRAF gene, experienced a reduction of their tumors.  It is believed that about half of all melanomas are associated with this genetic mutation.

Administered twice a day by researchers at the Memorial Sloan-Kettering Cancer Center in New York, PLX4032 blocked the activity of the gene.  All of the patients in the study had the mutated gene and all had failed to respond to other treatments.

As this treatment addresses the genetic code which causes the cells to divide uncontrollably and not the cell division itself, it does not result in the devastating side effects of chemotherapy.

While the report was promising, the therapy is not yet viewed as a cure.  It did, however, focus on the importance of addressing the genetic programming which causes the disease rather than the symptoms of the disease.

In the future, it is likely that new therapies focusing on genetics will be the answer to beating various forms of cancer, including melanoma.

If FDR had lived in the early decades of the 21st century and had the mutated BRAF gene form of melanoma, he might have stood a chance of surviving the disease.

Rapidly growing solid tumors create pockets without sufficient blood vessels. This makes them difficult to treat with chemotherapeutic drugs. The drugs, carried by blood, cannot get to the cells and resulting dead material cannot be removed by the body.

Cells in these pockets are deprived of oxygen and nutrients. This is known as Hypoxia. As there is an absense of oxygen, hypoxic pockets in tumors create a unique niche in which anaerobic bacteria can grow.

The oxygen deficient pockets can create an environment for dangerous bacteria such as staphylococcus, but they can also be used for a focused therapy to reduce tumors.

Shibin Zhou, M.D., of Johns Hopkins Ludwig Center for Cancer Genetics has developed an attenuated strain of Clostridium novi, an anaerobic bacteria, the spores of which can be injected intravenously.

These spores, which germinate and thrive in the oxygen deprived environment of the middle of the tumor, cause massive death of cancer cells leading to tumor regression.

The bacteria cannot grow in the presence of oxygen, so there is no toxic effect on healthy tissue. In addition to the destruction of the tumor, the bacterial infection elicits a potent antitumor immune response in the host, leading to possible long-term cures.

Dr. Zhou’s laboratory is working on next generation anaerobic bacterial agents to increase potency and combine them with other types of therapies used to kill cancer.

For non-small cell lung cancer, specific genetic factors have been determined to be the cause in about 5% of cases.  Recent advances in genetic research, combined with a new treatment, may turn a virtual death sentence into a manageable condition for those with this genetic characteristic.

A gene called Anaplastic Lymphoma kinase, more commonly known as the ALK gene, can combine with another gene or form a duplicate copy of itself.  When this happens, a relatively rare type of tumor can appear.

Presence of the ALK gene is determined by FISH testing which is also sometimes used to detect copies of the HER2 gene in breast cancer patients.

By administering a new oral drug called an “ALK inhibitor”, this type of lung cancer is not only stopped from growing, but appears to melt away.  The drug does not rid the body of the gene, so tumors can reappear, requiring additional future treatments… but the disease becomes manageable.

Five cancer centers worldwide participated in the first two trials of the drug, including the University of Colorado Cancer Center, one of the few places where the related FISH test can be performed.

23 people were treated in the initial studies and almost all of them had dramatic responses within short periods of time.

Ila Hegland, diagnosed nine years ago with stage 4 non-small cell lung cancer, was told she only had two years to live. After six weeks of treatment with the ALK inhibiting drug, no signs of the cancer could be found.

Third stage trials are now being performed and it is hoped that the treatment will be generally available in the near future.

Other forms of cancer are also tied to the ALK gene, including 10 to 15 percent of childhood non-hodgekin lymphomas and myofibroblastic tumors (sarcoma).  With further studies, perhaps the drug can be applied to these types of conditions as well.

Chemotherapy acts on rapidly dividing cells

As stated in previous posts, I have not been enthusiastic about the use of chemotherapy against cancer. Too much damage is done to other tissues and the patient may die from the treatment. That opinion may be about to change due to a report from researchers based in Sydney, Australia.

According to the report, non-reproducing bacterial cells can be produced and modified to target receptors specific to cancer cells. Different types of cancer have different types of receptors, so the bacterial cells must be specific for a given type of cancer.

These bacterial cells, not actually alive as they have no chromosomes, are known as minicells and can be “loaded” with various chemicals. Minicells are about 1/5 the size of normal cells and are capable of transporting highly toxic substances.

In a first round of treatment, minicells are infused with materials which reduce cancer cells’ resistance to chemo drugs. Injected into the body, these cells seek out the cancer cells and pretreat them. This step can be repeated as many times as necessary.

A second “wave” of minicells are infused with chemo drugs. When one of these minicells reaches a cancer cell, it attaches to the receptors on that cell and releases the toxin into the cell, causing the cancer cell to die.

As the mini-cells only attach to the cancer cells, the rest of the body is essentially unaffected. This means no damage is done to other tissues and the side effects experienced with systemic chemotherapy administration methods are absent.

By only delivering the chemo drugs to where they are needed, this delivery method reduces the amount of chemo needed, lowering the cost and the need for hospitalization in many cases.

Developed by EnGeneIC and applied to mice and dogs so far, human trials will be started shortly. If all goes well, this will be a huge and exciting advance in the fight against cancer.

Metastatic tumor cells produce proteins that encourage tumor growth and attract feeder blood vessels wherever they attach in other organs. Non-metastatic tumors produce a protein called prosaposin that stimulates the production of p53 in surrounding connective tissue. P53 suppresses the production of blood vessels needed to support tumors.

High levels of prosuposin are secreted by non-metastatic, localized prostate and breast tumors while very little of the protein is produced by metastatic ones.

By injecting prosuposin into mice with highly metastatic tumor cells, the researchers reported that lung metastases were reduced by 80% and lymph node metastases disappeared altogether. The treated mice lived 30% longer than those who did not receive the injections.

The results indicate that prosuposin, or derivatives that stimulate p53 activity may be an effective way to inhibit the metastatic process in humans, halting the spread of a cancer.

The study was released online in the Proceedings of the National Academy of Sciences.

Ginger reduces nausea from chemotherapy

Those who know me know that I am not a strong advocate of chemotherapy. If it does end up being the treatment chosen, anything which reduces the side effects should be implemented. I have already written about fasting to reduce chemo related damage.

Dr. Julie Ryan, Ph.D., of the University of Rochester medical Center in Rochester, New York led the study on 644 cancer patients, most of whom had breast cancer. All complained of nausea early on and were treated with standard 5-HT3 receptor antagonist antiemetics (anti-nausea drugs).

These patients were divided into four groups, one each taking 0.5, 1.0, and 1.5 grams of ginger daily, and the fourth group taking a placebo. All doses were administered as capsules.

Four times a day the patients recorded their levels of nausea on a seven point scale, from no nausea to extremely nauseous. While all patients reported high levels of nausea immediately after chemotherapy, the three groups taking ginger reported within hours feeling 40% less nauseated than those taking the placebo. Interestingly, the lower doses appeared to be more effective than the highest dose.

Results were presented to the American Society of Clinical Oncology.

lymphoma who drink wine on a regular basis are less likely to suffer a relapse or death.

Xuesong Han, a doctoral candidate in cancer epidemiology

Wine helps against Non-Hodgekins Lymphoma

at the Yale School of Public Health, led the study which analyzed 546 women with non-Hodgekins lymphoma. The results were presented at the 100th annual meeting of the American Association for Cancer Research.

The longer a woman drank, the lower her chances of a relapse or death. Those who drank for at least 25 years prior to diagnosis were 26 percent less likely to relapse or to develop secondary cancers and 33 percent less likely to die than those who did not drink wine.

76 percent of women who drank at least 12 glasses of wine over their lifetime were alive five years after diagnosis versus 68 percent of those who drank none.

The best outcomes were found among patients with diffuse large B-cell lymphoma. These women had a 40 to 50 percent reduced risk of death which rose to 60 percent if they had drunk wine the previous 25 years.

Other alcoholic beverages such as beer or liquor had no effect on lymphoma risk, relapse, or secondary cancer.

More and more evidence suggests wine contains chemicals that promote good health.

A team led by Professor Vic Morris at the Institute of Food Research in Norwich, Britain took pectin, a carbohydrate, and broke it down by heat into small non-branched chains of simple sugar known as modified citrus pectin.

One of these fragments has been shown to induce apoptosis (cell death) in multiple Myeloma cells which were resistant to other treatments.  It does this by binding to and inhibiting galectin 3, a protein known to play a role in all stages of cancer progression.

By binding to receptors on cancer cells, some fragments prevent the cells from penetrating nearby healthy tissue, causing the cancer cells to circulate in the blood stream until they die.  This inhibits the spread of the disease.  Tests were performed on rats injected with melanoma and human prostate cancer cells.

It is not known, but suspected by studies, that unmodified pectin found naturally in unprocessed fruits and vegetables can fight cancer.  Natural sources of pectin include citrus fruits, blackcurrants, apples, plums, carrots, and potatoes.  Most processed pectin comes from citrus peels and apple pulp.