Cancer Treatment in the United States: An Ongoing Travesty
Dr. Mark A. Rosenberg, Guest Writer
Dr. Mark A. Rosenberg
I am a medical doctor and cancer scientist and I regularly collaborate with other scientists around the world and in the United States. We are working on exciting therapies to treat and cure advanced stage cancer, and the results we are achieving are nothing short of remarkable.
The journey has not been easy, and it is forever ongoing. Here is my story.
Approximately 4 1/2 years ago, my mother, an avid smoker, came to me with chest pain. As the assistant director of Emergency Medicine at my hospital, I expedited her evaluation and discovered that she had lung cancer with metastases to her liver, spleen, adrenal glands and left hip. I knew that there were no standard treatments for her, so I began to research the literature. I quickly developed concepts followed by details regarding improving our current treatment for cancer. Having just completed my work on the development of a new drug for obesity, I put all of my other projects aside and immersed myself in the world of cancer research; and this is where my odyssey began.
I spent three weeks with minimal sleep, as I poured through all of the literature from the U.S., Asia, Europe, and Latin America. My goals were twofold; first I had to understand the mechanisms through which cancer progressed, and then I had to evaluate all therapies, both traditional (chemotherapy and radiation) and alternative. My first epiphany was startling. By the time cancer has become metastatic (spread from its primary origin to another part of the body), it has mutated into highly evolved growths which promote its own existence and progression. Simultaneously, these growths become highly impervious to destruction. Metastatic cancer is analogous to a resistant bacterium that grows unchecked after it has been exposed to every antibiotic known to man. What I found most interesting about these aggressive cancers, was the complexity involved with their evolution. These immortal cells have developed a countless number of mechanisms to allow for their own proliferation. Based on this finding, my next realization was intuitive. Using chemotherapy as a sole treatment for metastatic cancer was like trying to fend off a lion from attacking a child using a fly swatter, with one difference; the fly swatter won't kill the child.
Unfortunately, cancer swarmed through my mother too rapidly, and I was unable to save her. But she did not die in vane. My first patient after my mother's passing was a 47 year old woman with metastatic lung cancer to liver and spine. She was being treated at Fox Chase Cancer Center in Philadelphia with chemotherapy, but was not responding favorably. Her oncologist begged her not to seek alternative therapy. The patient's response was amusing, "What's he going to do, kill me?" So I began treating this patient with multiple off label drugs, to cut off as many "escape routes" for the cancer as possible. In addition, I began experimenting with extremely high dose intravenous vitamin C. After four months, the PET/CT scan revealed the patient was in complete remission. Astounding! I just treated a patient with metastatic cancer, who failed chemotherapy, and put her in remission without chemotherapy. There were many more patients to come. I discovered, to my regret, that most patients did not respond as well as my first patient.
I continued to scrutinize the literature. Why have we made no headway in treating advanced stage cancer? Obviously, we do not understand how cancer grows unchecked, or certainly we would be able to stop it. I re-read the American Cancer Society's definition of cancer. According to the ACS, cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. This definition rolled around in my mind for many sleepless nights. If this definition is correct, then we simply need to kill these abnormal cells. How many times have we taken the most aggressive cancer cells, grown them in a culture medium, and always found some cytotoxic chemotherapy drug to kill them. How many times have we injected the most aggressive cancer cells in mice, and completely eradicated them? Yet it doesn't seem to work in humans.
I awoke one morning at 3AM with perhaps my most important revelation. The ACS definition of cancer is incorrect. Cancer is actually the interaction between abnormal cells and its natural environment that results in uncontrolled cellular growth. That's why we can't just transfer cancer from one person to another or from one species to another or even from a culture medium to an animal. Cancer is cancer only when it lives with the environment from which it arose. It all made sense. There is constant communication between cancer cells and its environment. To eradicate cancer, one must attack the cells AND the environment. This requires multiple modalities, aimed at the cells, the environment, and the communication mechanisms.
I began treating patients with cancer vaccines and other forms of immunotherapy, along with many off-label drugs and natural substances. Some of the drugs that I used and developed were not FDA-approved and therefore had to be administered outside of the U.S.; most other countries allow the use of unapproved drugs for terminally-ill patients. The U.S. Supreme Court, in March of 2007, ruled that even terminally-ill individuals have no right to unapproved drugs. The results on my patients were nothing short of remarkable. I have not hurt one patient by leaving the U.S. and using unapproved drugs. On the contrary, I have extended both quality of life and lifespan. Most patients who make their way to my office have already failed chemotherapy and have been told to go home and enjoy their last few months. There is no greater satisfaction than crying with a beautiful forty year-old woman because her metastatic breast cancer to hips and spine is no longer seen on bone scan; or a vibrant sixty seven year-old man with metastases from his kidney to liver, lung, spine, and rib enters remission, after being told by his oncologist that he has perhaps 2 months to live. And this happens over and over, outside of the standard of care. So why do I have to run from my country to save people's lives? Because my country says that unless we have done randomized clinical trials, showing safety and efficacy, that costs hundreds of millions to billions of dollars, I can't use the drug. Who can afford these clinical trials? Pharmaceutical companies can.
Health care practitioners and their governing bodies (American Medical Association, State Boards of Medicine, FDA, and of course, the pharmaceutical industry), have knowingly allowed and even promoted the continued use of an ineffective treatment strategy (chemotherapy) for advanced stage cancer for over two decades. This strategy has caused the needless suffering and premature deaths of millions of children, women, and men. Most of us have witnessed an acquaintance, friend, or loved one with advanced cancer, fail to respond to chemotherapy, and eventually succumb. Oncologists are generally forthright with their patients and frequently explain that for stage IV cancer, chemotherapy is palliative, and may slightly extend survival over doing nothing. Those same oncologists will also tell their patients not to seek any "alternative" regimens. According to the oncologists, there is no proof that alternative regimens are effective, so don't waste your remaining time or money. If we already have proof that chemotherapy is palliative, why should we fear trying something else? Do we, in fact, have proof?
A study was published in the British journal, Clinical Oncology, in December, 2004, entitled, "The Contribution of Cytotoxic Chemotherapy to 5-Year Survival in Adult Malignancies." The authors, one medical oncologist and two radiation oncologists, analyzed the results of all randomized clinical trials performed in the U.S. and Australia, that reported a statistically significant increase in 5-year survival due to the use of chemotherapy in adult malignancies. The trials that were analyzed were performed between 1990 and 2004. The authors' conclusions were the following:
- Contribution to 5-year survival in Australia was 2.3%
- Contribution to 5-year survival in US was 2.1%
- Median survival in lung cancer has increased by 2 months in the past 20 years
- Overall survival benefit of less than 5% has been achieved in the adjuvant treatment of breast, colon, and head and neck cancers.
These results caused significant tumult overseas, but we heard few rumblings in the U.S. Most oncologists that I have interviewed were unaware of the study. Overseas proponents of chemotherapy argued vehemently that the statistical analysis was incorrect, and that the contribution to 5-year survival was closer to 4%. I think most of us would concede the 4% or even 5%. After reading studies such as this, and watching family and friends quickly succumb to cancer despite the "best" of care, it should be blatantly obvious to all that the current standard of care for advanced stage cancer, chemotherapy, is insufficient.
If chemotherapy has not been effective for all of these years, why is it still standard of care? Although an entire book can be dedicated to dealing with this issue, I will briefly address this question. Studies performed and funded by the pharmaceutical industry, generally dictate to the medical community what drugs are considered appropriate therapy for a specific disorder. Since the pharmaceutical industry continues to develop and study additional chemotherapy drugs, it continues to be mainstream therapy. Why does this industry continue to devote research to chemotherapy? A chemotherapeutic drug that has shown in a study to increase survival by 2-3 months, may be a multi-billion dollar per year drug. On the other hand, studying natural substances or developing techniques for stimulating immune function (immunotherapy) are generally monetarily worthless. Bottom line – if you can't patent a new drug, it's not financially worth pursuing. An example of this is the work of Dr. Nobuto Yamamoto. Dr. Yamamoto discovered that cancer cells can prevent an attack from macrophages (a type of white blood cell) by secreting a substance that inactivates another substance called Gc macrophage activating factor (GcMAF). Dr. Yamamoto discovered how to circumvent this issue by synthesizing his own GcMAF. He states in his peer-reviewed journal article, that he cured every patient with cancer that he had treated. Sounds exciting! But… there is an issue. GcMAF is naturally produced in the body, so a patent cannot be obtained on the substance. This may explain why his exciting studies have generated little to no interest by the pharmaceutical industry.
Why don't oncologists consider other treatments instead or in addition to chemotherapy? Oncologists simply have no training regarding cancer treatment other than surgery, radiation, and chemotherapy. In addition, like most physicians today, they are extremely busy. They see patients all day, and if they have an hour to spare, they pick up a "peer-reviewed" journal and read. What's in that "peer-reviewed" journal; pages and pages of pharmaceutical-funded drug studies. If an oncologist steps outside the box, and deviates from "standard of care," he is considered unorthodox and is viewed as a pariah. Also, approximately 2/3 of an oncologist's income comes from the administration of chemotherapy. In summation, oncologists are merely pawns in the system, manipulated by the pharmaceutical industry. Not only don't they know anything other than chemotherapy for advanced cancer, they truly don't even know that there is another form of treatment that may be efficacious.
So what is optimal treatment for an individual with advanced stage cancer? The answer to this question, as I have personally learned in my practice, is to use everything that works. Unlike the pharmaceutical method, one size does not fit all. What works for one patient's cancer may not work for the next. Because the mechanism of progression of cancer is extremely complex and multifaceted, one must often treat with many different modalities. In addition, not only is every cancer genetically unique, but it's constantly changing; cancer is a dynamic disease because of constant mutations. The idea of treating everyone with the same cancer, using the same chemotherapy, is absurd to any cancer scientist. One should not even use chemotherapy without knowing the genetics of the cancer. This explains why some patients get no benefit from chemotherapy, and some get a temporary response; it's pot luck. If you are lucky enough to get chemotherapy that fits your cancer, you may get a temporary response. Why don't we do genetic testing on all cancer patients? Once again, it comes down to money. Doing genetic testing on all cancer patients would be as cost-effective as making a different dose of blood pressure medicine for every individual in the country.
Here is an abbreviated summary of the drugs and modalities that I use in my treatment of advanced stage cancer.
- Immunotherapy; to stimulate the innate immune system;
- Coley's toxins consists of heat-killed bacteria that stimulate the innate immune system to attack abnormal cells, including cancer. GcMAF is a macrophage activating factor that is normally inhibited by cancer cells.
- Interleukin-2 is a substance produced by the body that stimulates production of cytotoxic T cells, which can kill cancer cells.
- Whole body hyperthermia is a process where the patient is warmed to a temperature of up to 104 degrees Fahrenheit. Increased temperature stimulates increased innate immune function.
- Glycolytic inhibitors; DCA, or dichloroacetate inhibits the cancer cells' ability to utilize sugar, while promoting normal mitochondrial oxidative phosphorylation (cancer cells that use oxidative phosphorylation are more susceptible to being destroyed).
- Matrix metalloproteinase inhibitor; cancer cells "dig in" by secreting an enzyme that breaks down tissue. Low dose doxycycline inhibits release of this enzyme.
- Angiogenesis inhibitors; tumors can not grow without sprouting new vessels. Vessel formation is dependent on adequate amounts of copper; if copper is depleted, tumors can not develop more blood vessels. Ammonium tetrathiomolybdate, chelates copper, thereby inhibiting angiogenesis.
- Cancer cell cytotoxic agents; vitamin C, at high doses intravenously, when used with vitamin K3 at a ratio of 100:1, is preferentially cytotoxic to cancer cells, while leaving normal cells unharmed.
- Mitosis inhibitors; cancer cells divide rapidly through a process called mitosis. Mitosis occurs through a process known as spindle formation. During spindle formation, spindles pull the chromosomes to opposite sides of the cell, in preparation for cell division. Noscapine, an opioid agonist binds to the spindles, inhibiting mitosis.
- Aromatase inhibitors; research has shown that several cancers, including breast, cervical, uterine, lung, and colorectal, often fuel their growth through the production of estrogen. Aromatase inhibitors block production of estrogen.
- IGF-1; IGF-1, or insulin-like growth factor-1 is a growth factor that often fuels cancer growth. Octreotide inhibits the production of IGF-1.
- GnRh agonists; GnRh agonists, or gonadotropin releasing hormone agonists may inhibit cancer in 2 ways. GnRh inhibits production of the sex steroids; if the cancer is dependent on sex steroids, GnRh will slow cancer growth. In addition, many cancers have receptors for GnRh, which when stimulated, inhibit cancer growth.
- Many other drugs and natural supplements are often used as well, depending on the specifics of the patients' cancer.
Using all of the above modalities, I have been able to cut off many pathways of cancer growth, often converting an acutely progressive disease, into a stable, chronic disease.
What will it take to awaken the masses? What will it take to educate the medical professionals that advanced stage cancer can be treated as a chronic disease right now? I do not know the answer to this question; if I knew, I would already be doing it. I am saddened by our laws that are based on monetary gain over and above health. I am saddened that most health care practitioners don't even know that this is occurring. In the meantime, I continue on my journey, with the minority of physicians who care to make a difference, no matter what the consequences.
Mark A. Rosenberg, M.D.
President, The Institute for Healthy Aging
Program Director, Integrative Cancer Fellowship
Dr. Rosenberg will be teaching a Fellowship for the American Academy of Anti-Aging Medicine. A4M offers a variety of Fellowships created to equip doctors and other health care providers with extensive knowledge, best practices and tools to put to work in their practices immediately, offering their patients cutting edge treatment.
For more information contact A4M Fellowships
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