Archives for September 2016


Cancer Stem Cells

If you want to cure cancer, you need to know about cancer stem cells. In my opinion the most important breakthrough in cancer research in the last decade has been the realization that standard cancer treatment protocols don’t work very well. They consisted of using surgery, radiotherapy and chemotherapy. Surgery is effective for early cancer. But radiotherapy and chemotherapy have been disappointing. Instead cancer immunotherapy has emerged as the missing link in the last 10 years. The full truth about cancer can only be understood, when we realize that most, if not all solid tumors are having their own cancer stem cells (CSC). In the past this was only recognized for leukemia, largely because of a lack of testing methods for solid tumors. We now have at least two methods of proving the existence of CSCs in solid tumors, as I will explain in more detail below. Using this new cancer stem cell concept, cancer can only be cured when the CSCs are eradicated.

New assays for cancer stem cells

Originally the concept of regular stem cells was proven in mice by radiating them and injecting bone marrow cells into them to rescue them. When the animals were sacrificed colonies were detected in their spleens that were of the same cell type as the injected stem cells. This new thinking revolutionized the treatment of leukemia. Bone marrow transplants were introduced that allowed in some cases a cure for leukemia. Presently there is a new wave of stem cell treatment applications for a variety of conditions.

With regard to developing an assay for cancer stem cells in solid tumors researchers took a strain of hairless mice that are known to be immune deficient (they lack thymus derived lymphocytes or T cells). They are officially called nude mice.

When human cancer stem cell samples are injected into them, they develop the original cancer of human origin, and they succumb to metastases. Histologically the tumors in these mice are the same as the original human cancer. Another mouse model was also shown to be equally effective in demonstrating CSC activity. The immune system of regular laboratory mice can be paralyzed with prior chemotherapy treatment. Using these chemotherapy pre-treated mice the CSC assay works very similar to the one using nude mice. If isolated cancer stem cells are injected into the nude mouse or immunosuppressed mouse model, cancer cells, such as prostate cancer cells will grow in a short time that look histologically the same as prostate cancer found in prostate biopsies from a man affected by prostate cancer.

Cancer stem cells in prostate cancer

Prostate cancer seems to originate from a cancer stem cell (CSC). The CSC has no androgenic receptors contrary to the majority of prostate cancer cells. This may be the reason why radiotherapy, hormone ablation and chemotherapy do not affect CSCs in prostate cancer. Ultimately this is the reason why the patient dies when the resistant CSCs multiply in the end stage.

One of the important new insights into cancer is that CSCs have the same surface antigen components as the cancer cells despite the difference in other receptors like hormone receptors. One of the techniques of killing prostate cancer is ablation cryotherapy using Argon applicators that freeze the cancer cells, followed by thawing them again. The interventional radiologist, Dr. Gary Onik was the inventor of this technique. Using temperature probes this can be controlled and is done at least twice. This will eliminate all prostate cancer including the prostate CSC. At the same time it will stimulate human T cells to recognize the cancer cell surface antigens as foreign and mount an immune reaction to eliminate any remaining cancer cells and all the CSCs. Prior to doing the cryotherapy the cancer cells were secreting substances that disabled the immune cells from recognizing prostate cancer as foreign cells. Now the cryosurgery does a double task: this therapy kills cancer cells and CSC and vaccinates patients against their specific tumors. This eradicates metastases and either cures the cancer or prolongs survival.

Irreversible electroporation and cancer stem cells

Another technique pioneered by Dr. Onik is the NanoKnife or irreversible electroporation (IRE). This is another tumor ablation method using high voltage electrical impulses that put nano-sized holes into cancer cells, but not into surrounding healthy tissue. Dr. Onik has been pioneering prostate cancer treatment, but he has also shown in liver cancer that this method can double the survival rate, compared to conventional treatment methods. Again, CSC and cancer cells are killed by this method and the released surface antigens of cancer cells stimulate the immune system to further the healing.

Other solid tumors and cancer stem cells

In the last 10 years new methods have been developed to demonstrate the existence of CSCs in many solid tumors. Both the cryotherapy ablation method as well as the IRE method that stimulate the immune system in the sense of a cancer vaccination is not only effective in prostate cancer. It works for most solid tumors such as pancreatic cancer, liver cancer, melanoma, breast cancer, colon cancer and many more.

These new evolving cancer therapies are essentially avoiding the trap of chemotherapy and radiotherapy where only more resistant cancer cells are produced. By removing the original cancer with cryosurgery and/or IRE the immune system is specifically stimulated to recognize the surface antigens of the cancer cells and the CSCs at the same time. With this cancer vaccination process the CSCs are eliminated, and this prevents new cancer cell clones (metastases) from developing. Dr. Onik has recently treated incurable cancer patients and has a cure rate of about 30% (personal communication) in patients who previously would all have died. Others are partial cures, where patients live much longer than anticipated. Using these techniques it is possible in many cases to cure end stage cancer. This has been done with liver and pancreas cancer, cancers that are extremely difficult to treat otherwise.

Cancer Stem Cells

Cancer Stem Cells


Cancer seems to develop out of cancer stem cells that are abnormal cells with genetic mutations. They are resistant to chemotherapy and radiotherapy, but respond to surgery, to cryotherapy and to irreversible electroporation (IRE). The advantage of cryotherapy and IRE is that the tumor and the cancer stem cells are removed, but at the same time the killed cancer cells stimulate the immune system to produce cancer-fighting antibodies that kill metastases and any remaining cancer stem cells. Although initially shown to be effective in prostate cancer patients, this method has since been tested in terminal cancer patients with pancreatic cancer, melanoma, liver cancer, brain cancer and many more solid tumor types.

Cancer is a disease of the immune system, and it is only logical that immunotherapy will achieve successful treatment. Surgery can only be successful, if the entire tumor is removed, which in many cases is not possible. Radiotherapy leaves cancer cells behind that will become resistant to treatment. Chemotherapy has the dismal prospect of killing the immune system and ultimately the patient. It appears that cryotherapy (and/or IRE) and the associated immunotherapy are the way of future cancer treatments. This is the most important breakthrough in cancer research during the last ten years.

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Seven Steps To Live Over 100 Years

Forbes invited me to publish a blog I wrote for Quora, “Seven steps to live over 100 years”.

The topic of habits by people who live more than a hundred years has been reviewed many times in the media. It continues to be popular. Here are seven things you can do to stay healthy followed by an explanation why.

Seven steps to live over 100 years – step1: Stay active

You want to stay active every day, even if you retire. You want to move and keep your mind busy. Part of that is to do a daily formal exercise routine to keep those muscles toned, which will prevent falls in the future.

Explanation: when you keep your muscles toned and you move about, your balance organ and coordination remains sharp, you are less likely to fall and break a hip. 50% of those who sustain a hip fracture die.

Seven steps to live over 100 years – step 2: Eat a healthy diet

Eat a Mediterranean type diet or follow the Okinawan diet. These diets contain less meat (or no meat as in the Seventh Day Adventist diet), but lots of vegetables and fiber. This keeps your cholesterol down, your arteries open and your metabolism controlled, preventing diabetes. If you are not obese and you have no diabetes, you are going to be OK with your cardiovascular system for decades to come.

Explanation: Heart attacks are still on top of the mortality list. Avoid them and you got it made, if you want to make it to 100 and beyond. But we need to stay away from the poor fats and the obsession about eating beef. Red meat, if eaten too often gives you a higher risk of getting cancer and heart disease. So eat it only once a week at the most, the rest would be chicken, turkey meat or fish. Nothing wrong with a vegetarian meal, let’s say kidney beans or lentils on a day in between. This still gives you protein for your muscles, but spares you a heart attack.

Seven steps to live over 100 years – step 3: Take care of your teeth

Brush your teeth and floss every day. This will control the bacteria in your mouth and prevent leakage into your blood affecting your heart valves. Studies have shown that this prevents heart attacks.

Explanation: When I heard this first about 20 years ago, I found it strange. But the literature is clear: chronic gingivitis is associated with bacteria that grow on the gums and spread into your blood. They can then colonize your heart valves and even the lining of the arteries, particularly where there is already hardening of the arteries (arterial plaque). This can lead to heart valve disease like mitral valve disease or heart attacks.

Seven steps to live over 100 years – step 4: prevention of disease

See your physician right away if there is a new skin lesion or anything that is different on your body. Removal of early cancer and treatment of any early medical condition is always easier to treat than waiting until it is out of control. Particularly with cancer treatment at an early stage, which usually involves only a small surgical procedure, this will reward you with a ripe old age.

Explanation: I learnt this point in general practice. Patients who waited until small problems become big problems were always much worse off than patients who saw me for small problems that we could remedy at an early stage. As mentioned above this is particularly important in cancer cases, as usually stage 1 and 2 of a cancer is curable with surgery. Once you get lymph node metastases and distant metastases, the cancer is much more difficult to treat, if at all. This is a principle that is pretty much true for any disease. The prevention factor is huge. Make use of it!

Seven steps to live over 100 years – step 5: Lifestyle matters

Watch excesses like smoking (cut it out!), alcohol intake, and recreational drugs. Smoking causes heart attacks, strokes, and cancers, which shorten your life. Recreational drugs just interfere with your body chemistry and have side effects. Cut them out, if you cherish growing older than 100. Alcohol needs to be kept at a very low consumption, if you want to preserve your liver, which is your central metabolic organ. If you can’t handle moderation with alcohol consumption, cut it out. No one has died from not consuming alcohol.

Explanation: I have already explained why lifestyle choices matter. The alcohol question is one that will be discussed back and forth for centuries. There are cardiologists who tell you that men should drink 1 to 2 drinks per day and women 1 drink per day and we all live longer, because of prevention of heart disease. The wine industry makes sure that you will hear this cardiology rule. It is true that centenarians often drink one glass of red wine per day. But there are plenty of centenarians who never drank in their life. It is a matter of personal choice.

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

I did mention to avoid obesity under point 2 above, which is associated with metabolic syndrome and diabetes. Your ideal body mass index should be in the 21 to 22 range. You can achieve this by following the diets I mentioned above. You should cut out sugar and starchy foods.

Explanation: I have followed such a diet since 2001 and my body mass index is between 21 and 22. I grew up in Germany where an emphasis was put on sweets and starchy foods. Needless to say my modified Mediterranean diet deviates from the good old German diet significantly. I find healthy food very tasty.

Seven steps to live over 100 years – step 7: Sleep and hormones

Getting sleep regularly, having an optimistic outlook on life, and having good relationships help to keep the immune system strong and keep your hormones balanced. This in turn will keep you healthy emotionally and physically.


There are two comments I like to make. One is that when you have calm nerves, and your emotions are balanced, your stress hormones are controlled. We know that people who are laid back and easy going live longer. The type A personality is the one who gets a heart attack.

The other point is that hormones have running times. When they start missing, we get menopause or andropause. When we are in our 50’s it is time to have your hormones checked by a knowledgeable health practitioner (naturopath, anti-aging physician). At this point regular physicians are mostly uneducated about bioidentical hormone replacement. I mention this as in European studies it has been shown that replacement of missing hormones with bioidentical hormones resulted in more youthful lives. Life expectancy can be prolonged by 15 years using bioidentical hormones according to Dr. Hertoghe, an endocrinologist in Belgium.

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years


People have always been fascinated about the factors that lead to a healthy age above 100 years. I am suggesting that you concentrate on enjoying your life and keeping toxins out. Engage in some form of exercise or stay active all the time. Adopt a healthy diet. This is where perhaps most people go wrong. They think they can go on pouring junk foods and alcohol down their throats and never get heart disease or cancer. The truth is not quite like that. We do need to adopt a healthy diet like the Mediterranean diet. We also need to limit drinking to a healthy level. Replacing missing hormones with bioidentical ones will prolong your life as well. Given these recommendations, happy journey to 100 and beyond!


Crazy Food Trends

CNN wrote about strange, crazy food trends that seem to receive a following. I thought it would be interesting to analyze them medically and point out to the reader what’s right and what’s wrong.

Crazy food trend one: Ashwagandha

In India this herb, also known as Indian ginseng has been used as part of the Ayurvedic medicine for centuries.

At the 22nd Annual Anti-Aging (A4M) Las Vegas Conference in mid December 2014 Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She gave a comprehensive overview of what you can do to prevent Alzheimer’s disease.

Dr. Smith recommended many other supplements, which I will not explain in detail here: B vitamins, vitamin E and C, carnosine, acetyl-L-carnitine, boron, ginger, coenzyme Q-10 (or CoQ-10), curcumin, vinpocetine, zinc, grape seed extract, blueberry extract, Ashwagandha, glyceryl-phosphoryl-choline, SAMe, huperzine A and DMAE and others. She specifically pointed out that she felt Ashwagandha was very powerful. It helps people preserve their memory, more so than regular drugs that doctors prescribe.

When the benefits of taking CoQ-10 were discussed, Dr. Smith reminded the audience “whatever is good for the heart, is good for the brain”. She recommended reading Dr. Perlmutter’s book from which this phrase was borrowed (Ref. 1).

Ashwagandha is an herb with multifaceted effects. Here is a review by a doctor about the various effects of Ashwagandha.

It does not belong into foods; it should be used as a supplement, if your doctor agrees with it.

Crazy food trend two: astrologically farmed eggs

Picture biodynamic farming of eggs with the guidance of the moon. Now you are producing astrologically farmed eggs. The Hemsley sisters insist you should eat these astrologically farmed eggs for breakfast. I don’t buy into this. This is hokey! It smells like somebody is trying to lure money out of your pocket by trying to convince you that there is health benefit to “astrologically farmed eggs”. There isn’t.

What does make sense is to buy eggs that do not have antibiotic residue in them and that came from free-range hens. Yes, I buy organic eggs that are somewhat more expensive. If you like to buy organic omega-3 eggs, this would also be scientifically superior to ordinary hen eggs. There is also the difference of “free run” and “free range” hens. “Free run” does not give you any guarantee for a healthy product, as the birds live in crowded barns and are likely receiving medications to combat diseases. “Free range” birds are hens that have access to the outdoors, and there is less of the overcrowding that is common in a barn.

Crazy food trend three: Cordyceps

There are about 400 subspecies to these sac fungi. Cordyceps has been used in Chinese medicines to help as an aphrodisiac, help improve kidney function in the elderly and also with regard to some anticancer activity. There are very few clinical review papers to substantiate any of these claims; yet traditional medicine insists on using Cordyceps for these purposes. If you want to see a traditional Chinese doctor, do so on your own. But don’t consume food that is prepared with Cordyceps.

Gwyneth Paltrow’s morning smoothie cost more than 200$, so if anything, I would be more concerned about bankruptcy than real nutrition with this type of breakfast drink.

I have my doubts that Cordyceps that kill ants to sprout their spores in their corpses (see Wiki link above) could be of any objective benefit to humans.

Crazy food trend four: blue majik

Blue Majik is just another name for a common antioxidant, phycocyanin. It is derived from algae, Arthrospira platensis.It has some similarity with the green spirulina. But just because it seems fashionable right now, does not mean that it is superior to vitamin C as a cheap antioxidant or vitamin E. The creators of blue majik are cashing in on color effects and selling false hopes of better health. You can live very well without it.

Crazy food trend five: cannabis

When I heard that people are starting to mix cannabis into foods, I was reminded about a story I heard from one of my patients in the mid 1980’s who worked in the shipyards of North Vancouver. One day he saw some cookies on a tray in the lunchroom. A co-worker offered some to him and he ate it. After 5 minutes his head started pounding with an excruciating headache and he became nauseous. Shortly after he vomited and started getting a rapid heartbeat. His co-workers laughed and told him that they were special cookies laced with marijuana.

I suspect that whoever baked these cookies used a higher dose of marijuana and my patient experienced a marijuana overdose.

This example illustrates that cannabis has special properties that affect the body.

In the brain it binds to cannabinoid receptors. These are not only present in brain tissue, but also in lungs, liver and kidneys. Even the immune cells have cannabinoid receptors.

There may be a place for chronic pain patients under the guidance of a physician to get medical marijuana. But keep cannabis away from your food. Don’t consume it! You have no idea what you are doing to your body that is full of receptors for cannabis. If cannabis is used like a drug, it should be prescribed by a doctor and taken according to doctor’s orders. Like with any drug there will be effects and also side effects.

Crazy Food Trends

Crazy Food Trends


Out of five crazy foods reviewed there are only 2 that merit consideration, but not mixed into food. These are Ashwagandha as a supplement (part of memory loss prevention and others) and cannabis for chronic pain. A physician should supervise both. The remainders are fashion crazes. Unfortunately many people will fall for these fashion trends and lose a lot of money. This will make someone who peddles these items very rich. Is this what you want to do: throw your money out and toss it right into the pocket a huckster? Rethink what you want to do. You may just want to buy organic eggs from chickens that happily scratch away in a farmyard. This is very much down to earth, and nothing “astronomically farmed” is needed.


Ref 1: David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

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Hidden Cause Of Depression

About 15.7 million Americans suffer from depression every year, but there remains a hidden cause of depression.

Not everybody responds well to antidepressant medicine. Only 30 to 50% of depressed people respond to antidepressants. There are two blood tests many physicians do not know and therefore fail to order: homocysteine blood levels and 5-methylfolate levels (5-MTHF).

Homocysteine as a hidden cause of depression

In 2004 a research group studied 924 middle-aged men. They noted that those men who fell into the highest third of homocysteine levels had a two-fold higher risk of being depressed than those who fell into the lower third of homocysteine levels. Other studies showed that SAMe, a nutrient that is required to build up mood enhancing neurotransmitters was sadly lacking in depressed people. In addition, folate levels were also found to be low in depressed people.

Having found this association between lack of nutrients and depression offered new opportunities to treat depression. Two studies examined the effect of taking 5-methylfolate on the effect of antidepressants. The result was astounding: in one study 7% of patients taking an antidepressant experienced improvement of their depression when assessed with a standard depression score. However, the same group improved their depression by 19% when 5-methylfolate was given in addition to the antidepressant.

Patients with the most severe depression on antidepressants had a 16% improvement of their depression. Adding 5-methylfolate to the antidepressant caused a 40% overall improvement in these severely depressed people, 24% more than without this simple vitamin supplement.

There is other evidence that patients with depression recover faster in the presence of 5-methylfolate. Moderately depressed patients recovered within 231 days on antidepressants alone, but in only 177 days when 5-methylfolate was present as well. The most severely depressed patients recovered within 150 days with antidepressants alone, but recovered within only 85 days on 5-methylfolate and the antidepressant.

Hidden cause of depression and Alzheimer’s disease

The story is getting more involved. Depression is related to proper balance of neurotransmitters that can be influenced by antidepressants and 5-methylfolate. But new research showed that Alzheimer’s disease (dementia) patients with cognitive decline have elevated homocysteine blood levels. A study in the New England Journal of medicine in 2002 found that after 8 years of observation more than 75% of them were diagnosed with Alzheimer’s disease. When blood homocysteine levels exceeded 14 micromole per liter the risk of Alzheimer’s had doubled compared to those with normal homocysteine levels. The researchers concluded that homocysteine is an important risk factor for the development of Alzheimer’s diseases and dementia, although it is not the only one.

Methylation pathway defects as a hidden cause of depression

40% of the population is defective in one or more genes that control the so-called methylation pathway in each of our cells (Ref. 1). This can slow down the metabolism of brain cells including the synthesis of certain neurotransmitters. At the same time it can cause the rising of homocysteine, which is then a useful marker for methylation defects. Another marker is the 5-methyl folate level, which, when low, indicates a deficiency in methyl donors including 5-methylfolate (5-MTHF).

Mental illness is an area where epigenetic factors play an important role. Depression that responds only partially or not at all to SSRI’s (antidepressants) often responds to L-methylfolate, a simple supplement from the health food store as a supplement. Similar epigenetic approaches can be used to treat psychosis, schizophrenia, bipolar disorder and Alzheimer’s disease.

Other illnesses due to methylation defects

Dr. Rozakis mentioned that 92% of migraine sufferers have a defective methylation pathway involving histamine overproduction and they can be helped with a histamine-restricted diet (Ref.2).

Autism, ADHD (hyperactivity) and learning disabilities are other diseases where methylation pathway defects are present. Every patient with autism should be checked for methylation pathway defects, and appropriate supplements and diet restrictions can help in normalizing the child’s metabolic defects. DAN physicians (“defeat autism now”) are well versed in this and should be consulted.

S-adenosylmethionine (SAMe) defects are another type of methylation defect, which is associated with certain liver, colon and gastric cancers.

Dr. Rozakis went on to say that methylation defects lead to disbalances between T and B cells of the immune system and are important in autoimmune diseases like lupus or rheumatoid arthritis.

Methylation defects can also cause autoimmune thyroiditis and type 1 diabetes. They can also cause cardiac disease by raising homocysteine levels, which causes dysfunction of the lining of arteries and premature heart attacks.

Epigenetic factors through global methylation defects from vitamin B2, B6 and B12 deficiency can cause many different cancers. Hypomethylation is the most common DNA defect of cancer cells.

With skin diseases it has come to light that atopic dermatitis, eczema, psoriasis, scleroderma and vitiligo are related to methylation.

When we age, certain hormones are gradually missing, which leads to menopause and andropause. This leads to impaired cell function, elevated cholesterol, arthritis, constipation, depression, low sex drive, elevated blood pressure, insomnia, irritable bowel syndrome and fatigue. Replace the missing hormones with bioidentical ones, and symptoms will normalize.

Tests and treatment for hidden cause of depression

It is important for a physician to test patients for homocysteine levels once per year. As we age, we tend to lose some of the methylation pathway enzymes, which can result in an increase of homocysteine in the blood. A normal homocysteine level is less than 7 to 8 micromoles per liter. This is lower than the commonly recommended 15 micromoles per liter.

If the homocysteine level is too high, the treatment consists of methionine containing foods like dairy products and meat. Methionine, an essential amino acid, functions as a donor of methyl groups, which will normalize the methylation pathway defect and allow the homocysteine level in the blood to decrease. Research studies have been using 1000 to 5000 micrograms of 5-methyl folate daily to reduce homocysteine. Other B vitamins are necessary to reduce homocysteine, like vitamin B2, B6 and B12 in addition to 5-MTHF.

Hidden Cause Of Depression

Hidden Cause Of Depression


Depression and several other illnesses that are related to methylation pathway defects can be caused by a lack of 5-MTHF resulting in high homocysteine blood levels. It is important for elderly patients to be checked for homocysteine blood levels once per year to prevent depression, Alzheimer’s disease, migraines and a number of other illnesses mentioned above.

Once a methylation pathway defect has been identified, it is relatively easy to treat the patient with a proper methionine rich diet and 5-MTHF supplements as well as other B vitamins as discussed. It can prevent a lot of disability and human suffering.


Ref.1: William J. Walsh, PhD: “Nutrient Power. Heal your biochemistry and heal your brain”. Skyhorse Publishing, 2014.

Ref. 2:

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