What About Chemotherapy? - October 31, 2009

It's been almost three weeks since my last post, and nobody is complaining too much. And there are a few out there that like to read this blog, so I shall continue for your benefit. Blog stats indicate that about 30 folks hit this blog each day on average, and about a quarter of them stay for more than a few seconds. Some are harvesting the images, and a significant number stick around and read several pages. So for the silent minority out there, this blog's for you!

I get a couple of cancer news items emailed to me weekly, and one recently told of the discovery by a local university that glutamine also has a role in the long-established medical model that CANCER LOVES SUGAR. Some of the background and findings are interesting, and it does highlight the simple (but apparently not well-known) fact that cancer has a serious lust for sugar. Not just any sugar, mind you, but specifically glucose. I may discuss the simple chemistry of common sugars and starches and how they contribute to blood glucose in a future post. Today's post will focus on how blood glucose feeds cancer directly, and how a clever technique can use this fact to target chemotherapy to kill cancer cells without causing widespread damage in your system. Why discuss this here, when BCG is the treatment protocol I am using? Because when BCG fails, we need to be ready with something besides radical surgery to remove bladder, prostate, and lymph nodes in "yard sale" fashion. HK in Toronto and Ed B. in Washington state have both had serious reactions to BCG, so even our little bladder cancer fraternity of blog readers here yields a significant sample who are interested in an alternative. HK is at the mercy of the Canadian doctors and their system, but he might choose to venture abroad for alternatives. Ed B is already looking, just in case.

In my last post I disclosed the ten things I recommend to battle cancer, and I showed a logic model to support the multi-pronged approach. Number one on the list is to follow medical advice - preferably with research and a support team to back you up. Most people I encounter do this, and for the majority that is ALL that they do. The few that do anything more usually skip down to #9 and take some vitamins and/or supplements. The exercise nuts do #10, but they were all doing that before their cancer. In my opinion the second priority after allopathic medicine is to STOP EATING SUGAR and simple starches. Ironically this is both the easiest and the hardest thing in the world to do. Easy because you just have to say "No!" Difficult because sugar is in everything and human beings love it almost as much as cancer does. Let's look at the article I referenced initially from the Salt Lake Tribune and reprinted in its entirety below. Boldface type emphasis was added by me:

Tumors Hungry for Sugar
Huntsman Institute » Findings point to new ways to fight cancer.
By Brian Maffly, The Salt Lake Tribune
Updated: 08/24/2009 09:48:06 AM MDT

Utah biochemists have made a breakthrough in understanding how cancer cells feed on glucose, possibly paving the way for new drugs designed to starve cancer into submission.

Cancer cells use glucose in tandem with another crucial nutrient, the protein glutamine, an amino acid found in many foods, according to findings published this week by researchers at the Huntsman Cancer Institute. The findings could spur development of new chemotherapies that would stall tumor growth by deactivating cancer cells' ability to use glucose, said Don Ayer, a professor of oncological sciences whose lab published the research in the Proceedings of the National Academy of Science .

For decades, science has known that cancer cells suck up inordinate quantities of glucose, nature's ubiquitous biological fuel, in a process that quickly blows tiny tumors into deadly malignancies.

PET scans use cancer cells' high rate of glucose metabolism to build images of tumors. These cells also need glutamine, just like normal cells.

"It's absolutely clear you need both for tumor growth. They seem to need it more than other nutrients. If you deprive them of one or the other, tumors don't grow," Ayer said.

Mohan Kaadige, a postdoctoral researcher in Ayer's lab, spearheaded the study, whose co-authors include Ayer; Sadhaasivam Kamalanaadhan, also a member of the Ayer lab; and Ryan Looper, an assistant professor in the Department of Chemistry.

The lab's work, funded by the National Institutes of Health and the American Cancer Society, seeks to unlock the molecular mysteries associated with tumor proliferation.

"Research into the factors that regulate the metabolism and growth of cancer cells is still at an early stage," said Janet Shaw, a U. professor in the Department of Biochemistry and a former Huntsman researcher. "Dr. Ayer's discovery that glutamine and glucose utilization are linked is important because it identifies a number of new molecular targets that could be manipulated to interfere with the growth and survival of tumor cells."

This week's discovery builds on the lab's previous research identifying the role of MondoA, a protein that switches genes on and off, in tumorigenesis. This protein affects the gene TXNIP, which suppresses tumor growth by blocking glucose uptake into cancer cells. The Ayer team discovered that in the presence of glutamine, MondoA deactivates TXNIP. This is important because it suggests new ways to impede tumor growth.

"If you don't have glutamine, the cell is short-circuited due to a lack of glucose, which halts the growth of the tumor cell," Ayer said.

The next step is to learn how the Mondo protein works in relationship with glutamine.

"If you can modify the metabolism of the tumor cell you can have a benefit. This is not a new idea," Ayer said. "If we can figure out how glutamine signals to Mondo, that has quite a bit of chemotherapeutic potential."

Were it developed, a drug that blocks glucose uptake would not likely choke off normal cell growth, as many cancer chemotherapy drugs currently do because of their toxicity.

"Tumor cells seem to be addicted to glucose. Normal cells are not. They grow at a slower rate and if you challenge them with nutrient deprivation they can be more flexible," Ayer said.

Ayer emphasized that his lab's findings shed no light on dietary impacts on tumor growth. Glutamine is the most common amino acid in our bodies and glucose levels are tightly regulated by our endocrine system, regardless of sugar consumption.

So here I am recommending something directly disputed by the last paragraph above. While it is true that the endocrine system "tightly regulates" blood glucose, Dr. Ayer is taking a very simplistic view of things. The endocrine system does indeed strive to keep blood glucose at a constant level, but it is not successful except when looking at the average. There are spikes in blood glucose (temporary hyperglycemia) as well as dips (temporary hypoglycemia). My approach #2 is to avoid eating things that make a your blood glucose spike, washing cancer in a bath of its favorite food. Sure there is enough blood glucose on average to allow cancer to survive, but why do anything to supercharge it by flooding your blood with glucose to be easily snagged by cancer cells?

Insulin Potentiation Therapy (IPT)

Perhaps something more could be done to exploit this trait of cancer cells. By using insulin a doctor can also regulate the blood sugar of a patient. Seems like we could just drop the blood sugar down until the cancer dies, and then all would be well. As simple and elegant as this approach might be, it will also kill the patient! The Utah researchers in the article above noted a connection with glutamine, and hope to devise a new treatment after more research. Some of us don't have that long to wait, and there is some good news. There is an existing treatment, permitted to be used in the United States (and nearly everywhere else), that exploits the cancer-sugar relationship by using insulin to regulate blood glucose along with low doses of conventional chemotherapy. This mechanism is called Insulin Potentiation Therapy, or IPT. Some prefer to call it by the slightly more familiar-feeling name of Low Dose Chemotherapy. The theory behind this protocol is to carefully lower a patient's blood sugar to induce starvation in cancer cells, which respond by sending out "wide open" feelers (aka insulin receptors) to take any glucose that comes along. This process is very short - maybe 10 minutes to lower the level to a minimum safe one, then maintain for five minutes - 15 minutes total. Then the doctor injects a low dose of chemotherapy drugs followed by an intravenous bag of glucose solution. The cancer in its greed for sugar also absorbs a disproportionate amount of the chemo drugs, causing the desired effect of cancer cell mortality. All with far fewer side effects than a full dose of chemo will give, preserving immune system function to deal with fighting cancer recurrences.

Many established medical organizations in the United States have denounced IPT, primarily because of the lack of rigorous, peer-reviewed studies to substantiate its effects. There are also some criticisms of the expense associated with the treatment, but to be fair, even the most egregious charges are smaller than the routine costs of conventional chemotherapy. In any case, one could try IPT for effect and follow with full dose chemo if needed. So there is little risk in trying IPT first. And it is very important, especially with Stage 3 and 4 cancers, that IPT be tried BEFORE conventional chemo, because the destructive effects of full dose chemo on the immune system makes it nearly impossible for the body to safeguard itself from a relapse of cancer.

Again, I am not doing IPT now. If the BCG continues to work (along with the other nine things I am doing), I never will need to try IPT. But if BCG fails, it will likely be the very next thing I investigate. If you are looking for an alternative to BCG for bladder cancer or full dose chemotherapy for any other cancer, take a hard look at IPT. More information and a list of practitioners worldwide can be found in this link: IPTQ.com

In the meantime, despite Dr. Ayer's fatalistic advice above to eat what you please, I shall continue to avoid sugar in all its forms to prevent glucose spikes. This is a real struggle, as sugar in some form is included as an ingredient in nearly everything, both prepackaged and prepared in restaurants. But if you take the attitude that sugar is deadly poison and work hard to avoid it, you can be successful. Sugar is beautiful, seductive, and addictive. And it tastes good, too! So tasty and so seductive. We have to ask ourselves, is sugar good enough to die for?