Jul
21
2018

Frequent Flying Can Increase Cancer Rates

A review article from June 25, 2018 discusses that frequent flying can increase cancer rates. A study showed that cancer of the breast, cervix, skin, thyroid and uterus are about twice as common in female stewardesses than in women at large. Also, gastrointestinal system cancers including cancer of the colon, stomach, esophagus, liver and pancreatic cancers are more common. This observation was true in both male and female flying personnel who engage in frequent flying. This publication comes from a scientific paper published on June 26, 2018.

Study of flight attendants

Patients from the National Health and Nutrition Examination Survey (NHANES) served as a control for flight attendants. This control group consisted of 2729 patients; they were of a similar socioeconomic status as the flight attendants. In contrast there were 5366 flight attendants with much higher cancer rates than normally expected. Specifically breast cancer had a 1.51-fold higher frequency than the control group. Melanoma had a frequency of 2.27-fold in comparison to controls, and non-melanoma cancers had a cancer rate of 4.09-fold when compared to controls. Non-melanoma cancer cases include basal cell and squamous cell carcinomas.

Cancer rates in pilots

In a meta-analysis of various studies it became obvious that pilots had 20% more prostate cancer than a non-pilot control group. However their mortality was not higher than controls.

In an interesting study spanning over 60 years Icelandic airline pilots underwent an analysis for cancer development.

83 cancers were registered. The general population (non-pilots) served as controls.  There was an increase of 2.42-fold for all cancers compared to controls. Prostate cancer was higher in these pilots by 2.57-fold. Malignant melanoma had a 9.88-fold increase in pilots in comparison to controls. The basal cell carcinomas in these pilots were 3.61-fold more common than the rates in the controls. With regard to basal cell carcinomas of the trunk there were 6.65-fold more of them in comparison to controls.

The difference between the pilots and the general population was likely due to the higher exposure to cosmic radiation. This is what the authors concluded.

How does cancer develop?

There are several ways cancer can develop. One of the known cancer causations is ionizing radiation. We know a lot about this from the atom bombs of WWII in Japan. There were many more thyroid cancers in children than were normal following the dropping of the atom bombs.

But diagnostic CT scans and X-rays are not without risk of cancer development either. There is a lag period of 10 to 20 years and even longer. But after this time the higher cancer rate becomes measurable. A person who had a CT scan done as a diagnostic test in childhood will still have a 25% higher cancer rate 15 years later. This is how powerful radiation of the DNA of our cells is despite inherent repair mechanisms that fight back to keep things normal.

Single cancers versus multiple cancers

It is interesting that female stewardesses and male pilots came down with a mix of various cancers. There were skin cancers, breast cancers, cancers of the prostate and many gastrointestinal cancers. The numbers were not big enough to show statistical significance for leukemia also being a likely cause of cancer from cosmic radiation.

If cosmic radiation was going through the body randomly hitting various DNA strands in all cell types, which could explain why a random number of cancers develop in those cells that got the highest exposure. The ones who got above average cancer were stewardesses and pilots who were longest on their jobs. A variety of cancers would develop from various tissues. This is exactly what the studies have shown.

There are frequent flyers like business travelers and vacation seeking retirees who will also be at a higher risk of developing cancer. The more they fly, the higher the risk.

Other causes of cancer

Cosmic radiation is only one cause of cancer. There are many other causes of cancer. If you smoke heavily or abuse alcohol this can cause genetic mutations of cells that can develop into cancer. There is a pathway to cancer, which consists of initiation, promotion and progression. After those initial hurdles the cancer cell will multiply and start metastasizing into other areas of the body.

Carcinogens can damage the DNA of cells. In the case of pollution carcinogens enter the body through the air. But consuming processed meat and red meat has a proven link to cancer development as well, namely colon cancer.

Diverse factors all can cause cancer

Chronic inflammation from chronic infections is also carcinogenic. Chronic gastritis is caused by H. pylori. After years of infection with this pathogen stomach cancer can develop. Hepatitis viruses that are chronically present in liver cells can be the cause of liver cancer. Human papilloma virus (HPV) is the cause for the development of cancer of the cervix. The majority of cancer is caused from the environment or by poor life styles. Only 5 to 10% of cancers are inherited.

Tumor suppressor genes are important in terms of resisting the development of cancer. The TP53 gene produces a protein that interferes with the multiplication of cancer cells. Cancer cells in turn can produce a protein that interferes with TP53 function. The end result is that it will interfere with the body’s immune system to produce killer T cells. This way the cancer has the upper hand. There are some herbs that have shown anti-cancer effects, such as curcumin. https://www.askdrray.com/curcumin-and-cancer/. As I explain in this blog, there are absorption problems with curcumin presently. It is not yet primetime for curcumin, but it could be once the absorption problems are overcome. Nevertheless the research surrounding curcumin is interesting.

Frequent Flying Can Increase Cancer Rates

Frequent Flying Can Increase Cancer Rates

Conclusion

Several interesting studies have shown that stewardesses, pilots and frequent airplane travellers have a higher risk of developing cancer. Research groups have been careful to control these studies for lifestyle factors and other causes of cancer. Exposure to cosmic radiation is the common culprit that is behind this cancer causation. There was a multitude of cancers rather than one single type of cancer in pilots and stewardesses. This makes it more plausible that it is indeed cosmic radiation that caused the cancer increase. But cancer development is complex, and I have summarized this briefly here. It is important to be aware of all the possible causes of cancer. This allows you to minimize your exposure to carcinogens. We all get exposure to carcinogens from pollution. In addition we get exposure to cosmic radiation according to how much time we spend flying to holiday destinations or on business trips. Be safe and be informed!

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Mar
03
2018

Foods That Can Protect You From Cancer

There are foods that can protect you from cancer. Generally speaking you want to remove cancer-producing substances from your diet. But diet is only part of your lifestyle that can contribute to cancer. I will list some of the more important dietary factors below and briefly also touch on important other factors.

Avoid burning your meat 

When you use the BBQ, avoid burning your meat. As a matter of fact it is a lot better to use a slow cooker at low heat, and cook the meat for a longer time. In this way you won’t create carcinogens, which are cancer-producing chemicals. Healthy Grilling Tips to Minimize Carcinogens in Your Food. This is particularly important for the red meats (like beef, lamb, bison or pork).

Sugar can cause cancer

You never thought that sugar and an overabundance of starchy foods can cause cancer, but they do. 5 Reasons Cancer and Sugar are Best Friends.  What is the reason for this? The answer is found in the metabolism of cancer cells. Cancer cells use 10- to 12-times more sugar for their metabolism than normal cells.  Over-consuming sugar is the worst thing a cancer patient can do. Replace sugar by stevia, which is a harmless sweetener. It does not lead to an insulin reaction. You need to avoid all other sugar substitutes as there are other health problems associated with them.

Avoid macaroni and cheese because of phthalates

Avoid macaroni and cheese: Phthalates are found in almost every sample of cheese powder used to manufacture macaroni and cheese. Phthalates can cause infertility and breast cancer. Toxic effects of the easily avoidable phthalates and parabens.

High fat diet

A high fat diet increases the risk for breast cancer: High-Fat Diet Increases Breast Cancer Risk, Study Finds. Limit your fat intake to about 10% of saturated fat. That is the recommendation of the FDA: New FDA Food Guidelines – Medical Articles by Dr. Ray. Increase your consumption of fish and seafood. Only one proviso: predator fish like shark, marlin, tilefish, swordfish and grouper are high in mercury. But wild salmon, sardines and oysters are low in mercury; so are shrimp and squid. Before You Buy Fish, Check This Mercury Level List.

Take high dose vitamin D3 supplements

In order to avoid cancer, take high dose vitamin D3 supplements to avoid cancer. Vitamin D3 in cancer prevention and therapy: the nutritional issue. Strong statistics exist showing that vitamin D3 is a powerful tool to lower your risk of developing cancer. Your family doctor should take a blood test called 25-hydroxy vitamin D level to monitor that you absorb enough vitamin D3. Some people absorb vitamin D3 slowly and fast absorbers absorb it more rapidly.  The only way how to find out how well your gut is absorbing vitamin D3, is by doing this blood test. It is now generally accepted that a good range of the 25-hydroxy vitamin D level is between 50 and 80 ng/ml.

Also curcumin 500 mg per day is good for cancer prevention. Turmeric | Cancer in general | Cancer Research UK.

Take enough fiber

Make sure you take enough fiber, which does not only reduce colorectal cancer, but also many other cancers. Foods for Cancer Prevention. North Americans are not consuming enough fiber. Vitamin D3 in cancer prevention and therapy: the nutritional issue.

Avoid processed meat

The World Health Organization has determined that processed meat is causing a lot of cancer. They labeled processed meat as a probable carcinogen. Processed meat causes colorectal cancer, pancreatic cancer and prostate cancer.

Moderate amounts of fruit and vegetables

Eat moderate amounts of fruit and vegetables. The claim in the past that fruit and vegetables would protect you from cancer is not as solid as it was thought of in the past. Newer research has shown that a basic intake of fruit and vegetables is needed for essential nutrients, but consuming more than that will NOT protect you from cancer. Fruit and vegetables and cancer risk. This is a case where eating more vegetables or fruit beyond a certain point will not do harm, but it will not protect you further from cancer.

Drink green tea or black tea

Drink green tea or black tea, sweetened with stevia for cancer prevention: Winter Beverages for Cancer Prevention. Green tea contains polyphenols and antioxidants. One of the antioxidants is called catechin, which prevents cell damage. The antioxidants help to prevent breast cancer, colorectal cancer and prostate cancer. In addition tea is heart healthy.

Avoid alcohol consumption 

Avoid alcohol consumption as much as possible to prevent cancer: Drinking Alcohol Really Does Raise Your Cancer Risk, Doctors Warn. We were indoctrinated by cardiologists that one glass of wine per day for women and two glasses of wine per day for men would be a prevention against heart attacks. But these relatively small amounts of alcohol do have an effect on causing cancer.  This British study showed that small amounts of alcohol indeed are cardioprotective. In contrast, these amounts and higher alcohol amounts can also cause cancer of the pharynx, larynx (voice box), esophagus, liver, breast, colon and pancreas.

Avoid too much red meat consumption

Beef, lamb and pork probably contribute to causing cancer according to the WHO. Use common sense, and eat more fish, chicken and turkey. Reduce your beef consumption. My grandmother said when I grew up in Germany that beef was a meal reserved for Sunday dinner only. The rest of the days we ate little in the way of meats, but lentils, beans, eggs or fish instead. Ask your grandmother, what she used to cook. Or ask your mother what she ate as a child.

Other lifestyle issues

Quit smoking, if you still do. This is by and large the biggest risk for developing lung cancer, throat cancer, esophageal cancer and pancreatic cancer. Watch your calorie intake: eat smaller meals more often. This way the production of your digestive juices will consume some calories and because you satisfied your hunger for foods, you will not gain weight. This will help prevent obesity and type 2 diabetes, both of which are established risks for developing cancer. Here is a review that shows you, which cancer types are caused by obesity: Obesity and Cancer . With regard to diabetes, there is a strong association with developing liver cancer, pancreas cancer and endometrial cancer (=uterine cancer). There is a lesser risk (only 1.2 to 1.5-fold) to develop colorectal cancer, breast cancer and bladder cancer. Diabetes and Cancer: A consensus report.

Pollution can also be a factor in causing cancer: How air pollution can cause cancer. If you can move to a less polluted city, do so.

Foods That Can Protect You From Cancer

Foods That Can Protect You From Cancer

Conclusion

As shown above there is strong evidence that certain foods can cause cancer. Others, including supplements like curcumin and vitamin D3, can help prevent cancer. If we avoid as many of the known cancer producing foods and eat more of the healthy foods that do not cause cancer, our cancer risk will decline significantly. In addition, if you quit smoking, avoid pollution as much as possible, reduce your alcohol intake and watch your calorie intake to prevent obesity and type 2 diabetes, you will move into the low-risk cancer group. We all need to work on this on an ongoing basis.

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Jun
17
2017

Prostate Cancer Treatment Is Often Inadequate

Prostate cancer treatment is often inadequate when you follow the advice of conventional physicians. The gold standard for prostate cancer treatment is a radical prostatectomy. Below I am explaining that this often leads to recurrences of prostate cancer in the order of 25 to 35% when physicians follow patients for up to 10-years. There is, however, another method of diagnosing and treating prostate cancer, which reduces the recurrence rate to only 6% at 10 years of follow-up. I will first explain the process of the initial assessment of prostate cancer, and then describe different treatment modalities.

Which prostate cancer biopsy method is superior?

Standard biopsy method

The standard biopsy method consists of 6 to 16 random biopsies via the transrectal approach. However, this approach has two downfalls. One is the danger of infection. The rectum is full of E. coli bacteria, which then can spread into the bloodstream. This can cause septicemia in 1 out of 200 biopsies, which is a medical emergency. The treatment consists of with high doses of antibiotics. The second problem is that the standard biopsy method misses 25 to 35% of prostate cancers. But it may take up to 10 years to show up as a prostate cancer recurrence. A careful study by the John Hopkins University, Cleveland, OH still showed a 23% recurrence after 10 years. Conventional specialists tend to downplay this long-term risk, but all of the publications that I have reviewed in my book show similar poor long-term results.

3-dimensional mapping biopsy

The interventional radiologist, Dr. Gary Onik from Ft. Lauderdale, invented the 3-dimensional mapping biopsy. In this case the specialist inserts needles through a brachytherapy grid over the perineum, the skin between the scrotum and the anus. The physician disinfects the area thoroughly, which eliminates the risk of infection with placement of the needles. The patient is under a general anesthetic, and the specialist inserts between 60 and 90 biopsy needles through the perineum into the prostate gland depending on the prostate gland size. The physician probes the entire prostate gland using biopsy needles, and this procedure does not miss any area of cancer. The surgeon can observe the procedure through a transrectal ultrasound (TRUS) probe. He labels the biopsies carefully and keeps track of them, so he can enter the results from the pathologist on a map, (hence the name mapping biopsy).

Better resolution with 3-dimensional biopsies versus TRUS guided rectal biopsies

The end result is like a geographical image of the areas where tests picked up prostate cancer. It is a computer generated ultrasound image of the patient’s prostate gland with overlaying histology results. Because of the higher number of biopsy needles used with mapping biopsies the resolution is much better in comparison to the TRUS guided rectal biopsies. It also tells the treating physician exactly the location of the cancer, which is important, if there is a plan to treat with ablative cryotherapy. Dr. Onik has published a 10-year follow-up of 70 prostate cancer patients treated in this way. 100% of the prostate cancer patients who had cryotherapy survived. 94% were completely free from any recurring prostate cancer. 6% had recurrent disease. These kinds of statistics are unheard of with other treatment modalities. The patients’ ages were between 45 and 77 years at the time of surgery.

My own personal experience with prostate cancer

As I have explained in my book entitled “Prostate Cancer Unmasked”, I was diagnosed with prostate cancer in early 2016. An elevation of my blood PSA (prostate specific antigen) tests started the search for the optimal prostate cancer treatment. I started reviewing the medical literature to see what was the most optimal survival with the least possible side effects. This is how I came across the name of Dr. Gary Onik who has been a pioneer of prostate cancer research for decades. The extremely low prostate cancer relapse data after 10 years of follow-up impressed me. I decided to receive a treatment by him in Ft. Lauderdale, FLA. I had the 3-D prostate biopsy involving 96 biopsy needles (due to an enlarged prostate gland, called prostate hypertrophy).

Ablation cryotherapy

One month later he treated me with ablation cryotherapy, which is the equivalent of a lumpectomy for breast cancer in women. Since then (Aug. 17, 2016) my 3 monthly PSA levels have stayed extremely low meaning that there is no recurrence of prostate cancer. I also have tested negative using the Oncoblot test, an extremely sensitive cancer test that had been positive prior to the prostate cancer surgery.

Combination treatment with ablation cryotherapy and IRE surgery

Dr. Onik told me that he wanted to use two procedures simultaneously in my case to treat my lesions optimally. His concern was the neurovascular bundles that cross through the outer aspect of each lobe of the prostate to the penis. The ablation cryotherapy could destroy them, if he came too close to them, which would result in sexual problems. On the other hand he needed to treat the prostate cancer until all of the cancer cells were dead. The surface antigens would still be intact and would stimulate my immune system to destroy any remaining prostate tumor cells. Dr. Onik has done extensive research regarding the immune response in prostate cancer patients and he was working on a publication in end-stage cancer patients.

There was a second procedure, FDA approved 4 years ago, namely IRE surgery.

IRE surgery

Another technique pioneered by Dr. Onik is the NanoKnife or irreversible electroporation (IRE surgery).

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 this procedure on prostate cancer patients, but he has also shown in liver cancer that these methods can double the survival rates, compared to conventional treatment methods. This method kills cancer cells, and the released surface antigens of cancer cells stimulate the immune system to further the healing. The interesting finding in Dr. Onik’s past research regarding the IRE surgery showed that the neurovascular bundle shows no damage from the IRE surgery within the prostate. With the two lesions in my right prostate lobe Dr. Onik wanted to use mainly IRE surgery, because they were in closer proximity to the neurovascular bundle.

Summary regarding mapping biopsy and prostate surgery

There are several points that impressed me with ablation cryotherapy.

Mapping biopsy

It starts with the mapping biopsy, which gives an exact histological picture of any prostate cancer in your prostate. This provides the roadmap for the surgeon to treat any lesions within the prostate with ablation cryotherapy that the biopsy located. During the biopsies there is transrectal ultrasound guidance (TRUS) using a rectal probe. This helps to locate the cancer 3- dimensionally.

Ablation cryotherapy

Like the mapping biopsy the physician does the ablation cryotherapy under general anesthetic. He treats the same lesions from the mapping biopsy with special Argon sounds, and temperature probes measure the temperature to make sure that the freezing action was long enough to destroy the tumor. This is repeated one more time to be certain that all cancer cells are killed.

IRE or also called NanoKnife

For cancer lesions too close to the neurovascular bundle to be removed with cryotherapy, the surgeon can use the alternative, IRE or also called NanoKnife. It had been researched in dogs and later in humans that it will  eradicate cancer cells, but not normal cells. It also does not attack the neurovascular bundle. Between the two procedures the entire cancer within the prostate can be removed safely.

Erectile dysfunction is only temporary

This means that the side effects are much less than with conventional prostate surgery. The erectile dysfunction is only temporary for 3 to 5 months, but Cialis and/or Viagra can be titrated to achieve normal sex until your own erections come back. There is no effect on the rectum and no sign of bladder leakage. Problems urinating are only temporary in the beginning and can be overcome with self-catheterization or with an indwelling catheter for a period of time. The end result is that the patient is back to normal, and the prostate cancer is removed.

Prostate Cancer Treatment Is Often Inadequate

Prostate Cancer Treatment Is Often Inadequate

Conclusion

I compared all of the other prostate cancer procedures to ablation cryotherapy. My conclusion was that ablation cryotherapy was the best solution for me. It is straightforward, cancer specific and works with the least amount of damage to the normal surrounding tissue. The 10-year survival was 100% with a tumor free rate of 94%. There is another advantage: anytime the PSA is elevated in the follow-up blood tests, the mapping biopsy can be repeated. If there is a recurrent cancer, the treating physician can repeat the ablation cryotherapy again.

Reference: https://www.amazon.com/Prostate-Cancer-Unmasked-Ray-Schilling/dp/1542880661

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Apr
29
2017

Cancer By Chance

A new theory talks about cancer by chance. In other words, it likely is mostly bad luck when cancer develops. Mathematician Cristian Tomasetti and cancer geneticist Bert Vogelstein of Johns Hopkins University in Baltimore, Maryland developed a new model of cancer development. They found that stem cells in different organ systems divide at different rates. The faster they go through cycles of cell divisions, the higher the chances of a mutation. The mutations happen in the genetic material and can lead to cancer. Dr. Vogelstein applied this model to 32 different cancer types and found the following.

  • 66% of cancers: cancer-promoting mutations develop by chance during cell division in various organs
  • 29% of cancers are due to environmental causes
  • 5% of cancers are inherited

Stem cells in organs can turn into cancer by chance

Key to the new theory of “cancer by chance” is that cancer likely is developing from stem cells in different organs. Different stem cells have different rates of stem cell divisions.

With respect to pancreatic cancer that 5% were due to genetic factors, 18% were from environmental factors (smoking) and 77% came from chance mutations. The Cancer Research UK database provided this data.

Environmental factors and random mutations in prostate cancer

For prostate cancer the rate of spontaneous mutations is 95%. From all of the cancer statistics it is clear that about 1/3 of cancers are due to either environmental or inherited factors, but 2/3 of all cancers are due to random mutations (“bad luck mutations”). They pointed out this fact in their first publication.

With the second publication, as mentioned in the beginning, Vogelstein and Tomasetti concentrated on 17 common cancers in 69 countries. They searched 423 international cancer databases. Again they found that the more stem cells divided in an organ, the more random mutations occurred. This caused cancers in that organ.

Cancer frequency related to stem cell divisions in organs

Here are a few examples for lifetime stem cell divisions:

  • Colon: 6,000 cell divisions in stem cells of the colon
  • Breast: 300 cell divisions in breast stem cells
  • Lung: only 6 cell divisions in lung stem cells

Colon cancer is very common because of the high stem cell division rate. But they also looked at environmental factors. For instance, lung cancer is rare in non-smokers because stem cells in lungs divide slowly. However, the carcinogens from cigarette smoke add a huge environmental risk. The end result: there is more lung cancer in smokers. Vogelstein said that with every stem cell division there is the creation of three new cell mutations because the body has a “poor copying machine”. During meiosis DNA breaks can occur that lead to mutations. Once they occurred, future cell divisions will maintain the copy.

Environmental factors versus cancer by chance

In the first paper the medical community was critical about how the authors had put too much emphasis on the finding that two third of cancer would occur randomly. So in the second paper Vogelstein and Tomasetti mentioned quite a bit how a change of the environment can change the final outcome of developing cancer.

This is also reflected in this summary from the CNN.

They mentioned that one mutation is not enough to cause cancer. You need three or four such mutations. As we get older there is a higher likelihood that we accumulate this number of mutations, and cancer can develop. But if we exercise, stop smoking and avoid red meat, this can contribute to a much healthier environment in the dividing stem cells. In this case we may not accumulate enough stem cell mutations in our lifetime to come down with cancer.

There is a problem with prostate cancer as indicated in this German summary of Vogelstein and Tomasetti’s work.

Xenoestrogens in the environment of the US

Japanese men have an extremely low rate of prostate cancer, namely 1/25th of the rate in the US. When Japanese men immigrate to the US, it does not take long before their risk is the same as that of US men. This is a classical case of the importance of environmental factors in cancer causation. Song Wu has pointed out in a publication in Nature that in his opinion Vogelstein and Tomasetti did not pay enough attention to extrinsic (environmental) factors in the causation of cancers.

This could explain the prostate cancer conundrum just mentioned. There may be more xenoestrogens in the environment in the US when compared to Japan, and this may have caused the additional prostate cancers when Japanese men moved to the US. Xenoestrogens are estrogen-like hormones in the environment, which can cause prostate cancer.

Prevention undermines “cancer by chance”

The role of prevention is likely larger than previously estimated. Now that we know that on average 2/3 of all cancers are due to chance mutations, it is important to realize that prevention and early detection play an enormous role.

Only stage 1 and 2 cancers tend to get cured

Most cancers are only curable in stage 1 and stage 2 out of 4 stages. And this is only the case when the surgeon removes the stem cell cancer mutations along with the clone of cancer cells.

For lung cancer: stop smoking!

In terms of reducing the risk for lung cancer this means to stop smoking.

Prevent colon cancer with colonoscopies

With colon cancer it means having regular colonoscopies to remove suspicious polyps.

Mapping biopsy and cryoablation therapy for prostate cancer

For prostate cancer it means to do a mapping biopsy and to do cryoablation therapy, which has a prostate cancer vaccination effect as well

Some cancers are more difficult to diagnose, but Oncoblot test may help

Not all cancers can be diagnosed early. Pancreatic cancer is such a difficult to diagnose cancer. But screening methods have been developed that are more sensitive and very specific such as the Oncoblot test.  With this test even cancer of the pancreas can be diagnosed years before it would be clinically detectable.

Avoiding inflammation avoids cancer

We do know that chronic inflammation can lead to cancer. It makes sense therefore to start with an anti-inflammatory diet like the Mediterranean diet. Fish oil is also anti-inflammatory.

Cancer prevention through regular exercise

Add to this regular exercise, as we know it reduces the risk for cancer development and strengthens your heart and lungs.

Vitamin D3 reduces cancer rates

Vitamin D3 can reduce cancer risks in both males and females. When vitamin D3 was given and blood 25-hydroxyvitamin D levels were above 40 ng/ml, the breast cancer rate was reduced by 71% compared to a low vitamin D3 group. Similarly in men the prostate cancer rate dropped by 71% with vitamin D3 supplementation.  There is more good news with vitamin D3. You can read about it in the link.

Cancer By Chance

Cancer By Chance

Conclusion

The causes of cancer have always been by chance, by environmental exposure and by inheritance. In recent years more detail about this has come to the forefront. Now we know that the majority of cancers develop by chance, but this does not mean we should sit back and do nothing. The PAP test with early diagnosis of cancer of the cervix and early treatment has almost eradicated this cancer. HPV vaccinations have added to the armamentarium. Colonoscopies have reduced the incidence of colon cancer, but only through screening at regular intervals. The PSA test has enabled men to check for prostate cancer, and early treatment for this is quite successful. More knowledge is available now than in the past about cancer prevention through supplements and lifestyle.

Nature is cruel and wants to knock us off, as we get older. The only alternative we have is to fight back as follows: reducing environmental causes, increasing preventative steps and going for early treatment, when cancer is diagnosed.

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Mar
11
2017

Obesity And Diabetes Can Cause Cancer

Dr. Nalini Chilkov gave a talk about how obesity and diabetes can cause cancer. The original title was “Integrative Cancer Care, Increased Rates of Cancer and Cancer Mortality Associated with Obesity and Insulin Resistance, Nutraceutical and Botanical Interventions”. She presented her talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended.

In the following I will present a brief summary of her lecture.

Obesity is a major risk factor for cancer

Obesity causes 14% of all cancer deaths in men and 20% of cancer deaths in women.  This link explains this in more detail. The following 15 cancers related to obesity in terms of causation. They are: colon cancer, gastric cancer, gallbladder cancer, ovarian cancer, breast cancer, liver cancer, uterine cancer, endometrial cancer, rectal cancer, pancreatic cancer, cervical cancer, non-Hodgkin’s lymphoma, renal cancer, multiple myeloma and esophageal cancer.

The American Society of Clinical Oncology reported about a meta-analysis involving 82 studies. This involved more than 200,000 women with breast cancer. The researchers compared premenopausal and postmenopausal women who were obese or normal weight. Premenopausal, obese breast cancer women had a 75% increase in mortality compared to the normal weight breast cancer group. In comparison with the normal weight group the postmenopausal group of obese breast cancer women showed a 34% increase of mortality.

With obese prostate cancer patients there is a similar observation. Obese patients have a more aggressive prostate cancer on the Gleason score and the cancer is in a more advanced stage at the time of diagnosis.

Diabetes increases mortality from cancer

Obesity is a common risk factor for both cancer and diabetes. But diabetes by itself is also increasing mortality of several cancers. In a consensus report details of the relationship between cancer and diabetes have been discussed in detail. The following cancers have been identified to have an increased risk of diabetes: pancreatic, gastric, esophageal, colorectal, liver, gallbladder, breast, ovarian, endometrial, cervical, urinary bladder, renal, multiple myeloma and non-Hodgkin’s lymphoma.

A meta-analysis suggests that cancer patients who are diabetic have a 1.41-fold increased risk of dying compared to those cancer patients who have normal blood sugars. Dr. Chilkov explained in detail what the various mechanism are that account for the faster cancer growth in obese and diabetic patients. High insulin levels is one of the risk factors, so is IGF-1, an insulin-like growth factor. The aromatase enzyme in fatty tissue turns male type hormones into estrogen, which also can stimulate cancer growth.

Carbohydrate restriction diet to prevent obesity

Low carb diets like the Mediterranean diet, the ketogenic diet and the Atkins diet will drop blood insulin and lactate levels. Cancer size and cancer growth are related to insulin and lactate levels. A low carb diet can reduce insulin-mediated uptake of sugar into cancer cells.

Research has shown that cancer metabolism slows down when a 10%-20% carb/high protein diet is consumed by the patient. This reduces the amount of sugar that is taken up by cancer cells. It also reduces insulin, so there is less cancer growth. A ketogenic diet is a more strict way to restrict carbohydrates. Intermittent fasting is also a useful method to reduce carbohydrate intake.

Here is an interesting study that illustrates the power of intermittent fasting. The study involved 2413 patients with early breast cancer who were followed for 7 years. Those breast cancer patients, who consistently did not eat anything between dinner and breakfast for 13 hours or more, had a 36% lower risk of having a cancer recurrence. There was also a 21% lower risk of dying from breast cancer when fasting was done for 13 hours or more overnight.

Supplements to prevent obesity, diabetes and cancer

A low carb diet and in some cases even a ketogenic diet is beneficial as a baseline. A regular exercise program is also useful for general fitness building and cardiovascular strengthening. In addition Dr. Chilkov recommended the following supplements.

  1. To reduce inflammation in the body, Dr. Chilkov recommended taking 2000 to 6000 mg of omega-3 fatty acids per day (molecularly distilled fish oil).
  2. Berberine 500 to 1000 mg three times daily. Dr. Chilkov said that Berberine has anti-cancer properties, improves insulin sensitivity and reduces absorption of sugars in the intestinal tract.
  3. Curcumin inhibits cancer cell division, invasion and metastatic spread through interaction with multiple cell signalling proteins. Several researchers showed that curcumin could lower blood sugar levels by stimulating insulin production from beta cells in the pancreas. Triglycerides, leptins and inflammation in fat cells are also lowered by curcumin. Insulin sensitivity increases through the action of curcumin. Dr. Chilkov recommended 300 mg/day of curcumin for 3 months.
  4. Resveratrol, the bioflavonoid from red wine is a powerful anti-inflammatory. This antioxidant has several other effects, which make it challenging to measure each effect by itself. This group of investigators managed to simultaneously measure these effects. They found that resveratrol lowered the C-reactive protein by 26% and tumor necrosis factor-alpha by 19.8%. Resveratrol also decreased fasting blood sugar and insulin; in addition it reduced hemoglobin A1C and insulin resistance. The recommended daily dose of resveratrol is 1000 to 5000 mg.
  5. Green tea catechins (EGCG) help to normalize the glucose and insulin metabolism. The dosage recommended was 1-3 grams per day.
  6. Reishi mushroom (Ganoderma lucidum) contain polysaccharides with antidiabetic and antiobesity effects. They make gut bacteria produce three types of short-chain fatty acids that control body weight and insulin sensitivity.
Obesity And Diabetes Can Cause Cancer

Obesity And Diabetes Can Cause Cancer

Conclusion

Obesity is a risk factor not only for diabetes, but also for cancer. Chronically elevated blood sugars, increased fasting insulin levels and increased IGF1 levels can cause cancer. In addition they can stimulate tumor growth and increase cancer mortality. It is for this reason that the health care provider should screen all diabetics for cancer. In her talk Dr. Nalini Chilkov gave clear guidelines what supplements will be beneficial to reduce the risk of obesity and diabetes as well as cancer. Start with a healthy, balanced diet. Add an exercise program. Then consider some of the above-mentioned supplements to reduce your risk for cancer, diabetes and obesity.

Feb
25
2017

Heart Health Improves With Hormone Replacement

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

First of all, estrogens are the main female hormone in women that protects them from heart attacks.

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. Postmenopausal women who do estrogen replacement therapy (ERT) are helping to reduce their heart attack rates.

Difference between oral and transdermal estrogen replacement

The liver metabolizes estrogen taken by mouth. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained using many slides how estrogen prevents heart attacks. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. The production of Premarin involved pregnant mares. In other words, it is not human estrogen and it does not fit the human estrogen receptors. Also the liver metabolizes estrogen taken as tablet form, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. Postmenopausal women on ERT reduce their physical and emotional stress response compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. No proinflammatory metabolites occur in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. There was an increase of venous thromboembolism in women who took oral estrogen.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Furthermore, progesterone is the second most important female hormone, the importance of which has been neglected in the past. Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Finally, testosterone is the third sex hormone that is present in women. In men it is the main hormone, but women benefit from just a small amounts of it for libido, clarity of thought and muscle endurance.

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician replaces first with bioidentical estrogen; only then does he consider replacing missing testosterone in women. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone ca cause high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone can cause diabetes and metabolic syndrome, which in turn can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. This may be due to rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Researchers sh0wed that bioidentical testosterone does not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

The adrenal glands produce the hormone dehydroepiandrosterone (DHEA). It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial.

Hormone effects on heart muscle

Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart. Physicians can  use them therapeutically in chronic heart failure patients. When people age, their hormone glands will produce less hormones, but blood tests will show this. Replacing hormones that are missing can add years of active life. Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

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Sep
24
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).

New testing methods for cancer stem cells

In the past cancer researchers thought that cancer stem cells were only present in 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. Researchers then sacrificed the animals. They found colonies in their spleens that were of the same cell type as the injected stem cells. This new thinking revolutionized the treatment of leukemia. In some cases bone marrow transplants could cure 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 known to be immune deficient.  They lack thymus derived lymphocytes or T cells. They are officially called nude mice.

Two methods of proving that cancer stem cells exist

When researchers injected human cancer stem cell samples into them, they developed the original cancer of human origin, and they succumbed to metastases. Histologically the tumors in these mice are the same as the original human cancer. Another mouse model is equally effective in demonstrating CSC activity. Prior chemotherapy treatment paralyzes the immune system of regular laboratory mice. Using these chemotherapy pre-treated mice the CSC assay works very similar to the one using nude mice. Following injection of isolated cancer stem cells into the nude mouse or immunosuppressed mouse model, cancer cells, such as prostate cancer cells will grow in a short time. They 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.

Ablation cryotherapy to kill prostate cancer cells and CSC

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. With the help of temperature probes the freezing process can be controlled. 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, this method kills the CSC and cancer cells. 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.

Cancer vaccination process with cryosurgery and/or IRE

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

Conclusion

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 surgeon can remove the tumor and the cancer stem cells. At the same time the dead cancer cells stimulate the immune system to produce cancer-fighting antibodies. These kill any metastases and any remaining cancer stem cells. Initially cancer researchers proved this method to be effective in prostate cancer patients. But since then a few researchers tested this method also in terminal cancer patients with pancreatic cancer, melanoma, liver cancer, brain cancer and many more solid tumor types.

Cancer as a disease of the immune system

Cancer is a disease of the immune system, and it is only logical that immunotherapy will achieve successful treatment. Surgery is only successful, when the surgeon can remove the entire tumor. In many cases this 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.

Aug
27
2016

New Prostate Cancer Treatment

The June issue of Life Extension reviewed a new prostate cancer treatment. Prostate cancer affects about 180,000 men per year and 28,000 die every year from prostate cancer metastases. Dr. Gary Onik, interventional radiologist in Ft. Lauderdale, FL, developed a new prostate cancer treatment protocol. Two years ago he published a medical paper regarding a group of 70 prostate cancer patients following his treatment 10 years after their surgery.

New prostate cancer treatment protocol

Usually it is a rising prostate specific antigen test (PSA) that tells the treating physician that not all is well with the patient’s prostate gland. In the last two years a new more specific and very sensitive genetic screening test has been developed, called Oncoblot test. If this is positive for prostate cancer, it is almost as good as a prostate biopsy that shows the cancer cells directly. But at this point the medical profession does not accept the Oncoblot test as being proven reliable.

3-dimensional mapping biopsy replaces gold standard

A transrectal prostate biopsy was the “gold standard” for the last several decades. However, 14 years back Dr. Onik decided to develop a more meaningful and more reliable prostate mapping biopsy. With this 3-dimensional mapping biopsy the examiner inserts many biopsy needles through the perineum, the skin between the base of the scrotum and the anus. The physician records the location of the needles carefully and sends the biopsy samples to the pathologist for histological analysis. When the results come back, he records the biopsy results as a 3-dimensional image of the prostate cancer on a computer screen. This becomes the basis for the next step in the treatment protocol.

Cryotherapy replaces robotic prostatectomy 

The surgeon introduces cooling probes through the perineum and places them exactly to the cancer location from the prior prostate mapping. It is this closely controlled placement of the treatment probes that ensures a much higher treatment success rate compared to the “gold standard” of the robotic prostatectomy (removal of the prostate gland).

PSA helps to spot recurrent prostate cancer

The physician follows his patient with PSA blood tests at 3-monthly intervals until the level is low and stable. Should there be any rise in PSA the patient undergoes another prostate mapping biopsy. The surgeon may have to repeat the cryoablation therapy until the PSA is low or negative again.

10-year follow-up of 70 men with prostate ablation therapy

Dr. Onik followed 70 prostate cancer patients using the above protocol for a total of 10 years. The patient’s age was between 45 and 77 years at he time of surgery. 66 of Dr. Onik’s patients survived until the end of 10 years. The four who passed away, died of causes other than prostate cancer making the “disease-specific” survival rate 100%. PSA stability occurred in 89% of the patients.

High risk and low risk survival data with new prostate cancer treatment

Prostate cancer patients can be classified into high-risk, medium-risk and low-risk. It is a composite score from the histological characteristics of the cancer, the Gleason score (a measure of how aggressive the cancer is), the stage (based on the extend of the cancer) and the height of the PSA level.

Using conventional treatment (prostatectomy) long-term follow-up data show that low-risk patients have a disease free survival of 85%, while high-risk prostate cancer patients have a success rate of only 45%.

In contrast to this Dr. Onik’s protocol achieved a biochemical disease-free survival of 90% for low-risk patients, 88% for medium-risk patients and 89% for high-risk patients. Surprisingly there seems to be no difference with regard to the long-term outcome of any of the risk levels. This is unique for the Onik method of focal cryoablation therapy.

What is focal cryoablation therapy, the new prostate cancer treatment?

The prostate cancer is frozen much like a wart is frozen by liquid nitrogen treatment in the doctor’s office. In the case of prostate cancer ablation liquid Argon is used for freezing. The physician controls the temperature of the application closely using heat probes to ensure adequate freezing. The surgeon introduces the special cooling probes to the cancer areas as per the prostate mapping procedure. He does the freeze/thawing three times. This way he achieves a 100% kill of all of the cancer cells at the time of the procedure. The surgeon individualizes the  treatment for every patient according to his condition.

Comparison of focal ablation treatment with traditional prostatectomy

After 5 years of prostate mapping biopsies Dr. Onik published a study where he looked at 180 men who had been diagnosed with prostate cancer on one side of the prostate gland by standard rectal biopsies. When he did mapping biopsies involving the whole prostate gland he noticed the following:

  • 61.1 % (110 patients) had cancer on both sides of the prostate
  • 22.7 % (41 patients) who had been classified having a cancer with a low-grade score increased to an intermediate-grade score
  • 19.4 % (35 patients) had cancer growth in very close proximity to either nerve bundles or blood vessels.

69.4% of those patients who had been diagnosed as having only low-grade, one-sided tumors were found to have more extensive cancers. With the previous classification they were thought to need only active surveillance (also known as “watchful waiting”).

3-dimensional mapping biopsies have a greater resolution than blind rectal biopsies

But with the detailed mapping biopsy results things looked different. They had at least one finding that reclassified their disease to requiring a more aggressive cancer treatment protocol. Other physicians have found the same thing when looking at these patients with more sensitive MRI scans. The prostate cancers were more extensive than when depicted with simple MRI scans. In some patients where areas on one side of the prostate seemed free of cancer using traditional MRI’s, now showed cancer on both sides using the more sensitive MRI scanners. Also using blind rectal biopsies, which is the standard technique that most radiologists use, can often miss prostate cancers that are found with sensitive MRI scanners or Dr. Onik’s mapping biopsy.

Complication rate with new prostate cancer treatment

Very low recurrence rate following ablation cryotherapy

The recurrence rate of prostate cancer treated with cryotherapy ablation therapy after 10 years was only 4%. Compare this to a study where prostate cancer was treated with radiotherapy. After 10 years the biochemical disease free survival for low risk patients was 78%, for medium risk 78% and for high risk 62%. This translates into cancer recurrences of between 22% and 38% depending on the risk stratification. The so-called golden standard procedure (robotic prostatectomy) showed the following: in a study that went on for 5 years there was a 28% overall recurrence rate. When the margins of the prostatectomy were examined, the following amounts of cancer had remained: 23% for low risk patients, 29% for medium risks and 42% for high risks.

No urinary incontinence

Urinary continence was maintained in 100% of the cases meaning that the nerves going through the prostate gland were preserved.

Low rate of sexual problems after 10 years

Only 6% of patients treated with ablation therapy had problems with sex 10 years after the procedure. This compares favorably with the other treatment modalities that have much higher rates of sexual problems.

Overall patients tolerate cryoablation therapy very well and the procedure removes tumor tissue exactly where the 3-D mapping biopsy findings showed the prostate cancer  location. This helps the patients’ survival rates.

Conventional treatment failures versus the new prostate cancer treatment

What are the reasons for treatment failures with conventional prostate cancer?

Blind prostate cancer biopsies are generally trans-rectal procedures. They lead to infections of the prostate, in rare cases even to blood poisoning (septicemia), but they often miss cancers that mapping biopsies detect. Rectal biopsies require only 8 to 16 biopsies. They are blind, the physician does not know exactly where the biopsies came from. In contrast, the doctor keeps track carefully with mapping biopsies where the biopsies originated from. The doctor also sends them separately to the pathologist. With the mapping biopsy 60 to 90 biopsies are taken depending on the size of the prostate gland. There is a much higher resolution of the area where the prostate cancer is located. This helps the physician where to focus the cryoablation treatment.

Poor diagnostic tests lead to poor outcomes with conventional prostatectomy

Poor diagnostic tests prior to cancer surgery lead to missed prostate cancer removal, which in turn lead to recurrences. With a “Total prostatectomy” (robotic prostatectomy) the physician removes only 70% of the prostatic tissue. This leaves chunks of prostatic tissue behind. This is the reason why undiagnosed prostate cancer can regrow. This explains the poor 5-year follow-up results of 23% to 42% recurrence rates after the “gold standard prostatectomy”.

Mapping biopsy depicts the entire prostate gland

Only the mapping biopsy that depicts the entire prostate gland (the physician does it with the perineally approach to prevent infection) can show exactly the cancer location. The subsequent surgery consists of the removal of the cancer in its entirety.

Immune stimulation with cryoablation therapy

The cryoablation therapy is likely stimulating the immune system to send killer T cells to help with the destruction of any remaining cancer cells. This may partially explain the low 10-year recurrence rate of only 4%.

New Prostate Cancer Treatment

New Prostate Cancer Treatment

Conclusion

Dr. Onik, an interventional radiologist from Ft. Lauderdale, FL, has developed a new focal ablative prostate cancer treatment. He showed in a study going on for 10 years that it is superior to either radiotherapy or robotic prostatectomy. Baby boomers are aging and prostate cancer is a disease of aging men. This new treatment modality  arrived just in time to help men with the diagnosis of prostate cancer. Physicians expect their patients to have prostate cancer when their PSA value rises above 4 or 5. Instead of taking a risk of blood poisoning with E. coli or developing prostatitis from the transrectal biopsy approach, the patient may want to consider having the 3-dimensional mapping biopsy done by Dr. Onik in Ft. Lauderdale.

Perineal approach with cryotherapy for prostate cancer

The surgeon does the procedure through the perineal approach, which shows the exact location of the cancer. This method uses cryotherapy probes with liquid Argon to treat the cancer is focally. This is similar to a lumpectomy in a woman with early breast cancer. Cancer recurrence rates at 10 years were only 4%. The good news is that the surgeon can repeat a mapping biopsy of the prostate, if rising PSA levels should occur in the future. This shows whether there is a cancer recurrence, and this can be treated again with cryotherapy. Very likely more physicians will embrace this method in the future, as several centers are in the planning stage in the United States. They will very likely replace a “gold standard” of prostate cancer treatment that is less than perfect.