There was a lively discussion at the recent International Conference on Holistic Healing for Breast Cancer in Kuala Lumpur organised by Cansurvive Malaysia. I was privileged to be involved in the event as session moderator, panellist as well as speaker.
Being a conference on holistic healing, there were speakers with a wide range of expertise and perspectives (from Ayurveda to modern medicine to Vasthu to yoga). What I would like to share here is something I did not have the opportunity to elaborate on during the panel discussion due to time constraints.
When it comes to cancer, the main worries include: What are the causes? Why is the incidence rising? What are the treatment options? And why do most cancer patients still die despite advancements in medical science and the trillions spent on cancer research?
We were fortunate to have Datuk Dr Suseela Nair as a speaker and panellist. She is a senior breast surgeon with much knowledge and experience in managing breast cancer patients, at least from the surgical perspective.
It would not have been a balanced discussion if only the complementary health practitioners were there. Even though I am a medical doctor, my interest in cancer management is in the role of nutritional therapy and qigong.
It would have been even better if we also had an oncologist on board. However, attempts to get an oncologist to be involved in the Cansurvive conferences in the last two years have been futile. We may be luckier next year.
I would like to invite readers to contemplate the dilemma of the overall failure of the gold-standard medical treatments in the management of cancer. Why do I say that it has been a failure? Let me refresh you with findings published in several of the top medical journals on the usefulness of chemotherapy for cancer:
Clinical Oncology (2004)16:549-560): Overall, chemotherapy contributes just over 2 per cent to improved survival in cancer patients in Australia and the US. Currently, eight years later, this conclusion has not been refuted.
Journal of the National Cancer Institute of NIH (USA), Sept 1993: Chemotherapy helped only 7 per cent of patients in terms of "durable response" and prolonging survival.
Lancet, 1991, Vol. 337, p. 901: "Many oncologists recommend chemotherapy for almost any type of cancer, with a faith that is unshaken by the almost constant failures." - Dr Albert Braverman, Medical Oncology in the 90s
Followers of this column would also know that I had a close-up experience of this failure when my own sister died of breast cancer last year after undergoing all the surgery, radiotherapy, chemotherapy, and smart-drug therapy her doctors recommended. It is one of many recurring stories of cancer patients dying,F despite the best of what modern medicine can offer.
I am not saying that there have been no success stories, but the statistics (as published in the medical journals and reported regularly by the authorities) tell us that overall, cancer treatment has failed. For example, last year there were about 230,000 new cases of lung cancer in the US (arguably the most advanced in medical science), with about 160,000 deaths. For breast cancer, it was 230,000 new cases with 40,000 deaths.
Why is this so when we always read fantastic reports on new chemo or smart drugs that show improved survival rates?
To understand the whole picture, you need to understand simple statistics and how results can be presented to look good.
For example, a new drug is claimed to give 25 per cent longer survival rate than the current best drug. That sounds impressive indeed, until you look into the details and discover that the survival rate using the previous drug was four months, and the new drug gives five months (one month longer = 25 per cent improvement).
There are also the potentially dangerous side effects that the new drug may cause, which may further make it unbeneficial. And the newer drugs are usually more expensive.
In fact, this has been the typical snail-paced advancement in the development of new drugs for cancer therapy. Of course, many small steps would eventually equal a big step, but the progress has been painfully slow, in spite of the trillions spent over many decades on research.
The bevacizumab story
In 2008, the "smart" drug bevacizumab received "fast-track" approval as a treatment for metastatic breast cancer from the US Food and Drug Administration (FDA) because of reported improved survival rates. It became the "hot" drug for those who could afford it (RM7,000-15,000 per month, depending on subsidy received), even though the side effects can sometimes be severe (eg hypertension, bleeding and intestinal perforations).
In November 2011, the FDA revoked the approval for its use in breast cancer because follow-up studies showed that women taking the drug did not live longer than those not taking it. Many oncologists refused to follow this, and continued prescribing it to their breast cancer patients.
Many patients also trusted their oncologists and willingly continued with the hope for better survival. In fact, because of this hope, there is a movement to demand that the FDA reverse its decision.
In July 2012, The Cochrane Database of Systemic Reviews (one of the most respected independent reviewers of research data) published results of their review of all the seven randomised controlled studies on bevacizumab. It found that bevacizumab neither prolongs the lives of breast cancer patients, nor improves their quality of life.
Researchers found that patients who took bevacizumab along with their chemotherapy treatments survived about two to six weeks longer than those who took a placebo with their chemotherapy - but the difference between the groups could have been due to chance or factors other than the drug, according to the study.
The drug is still approved as a treatment for colon cancer and certain types of lung cancer and brain cancer in the US, and still approved for breast cancer in UK. It is still used for breast cancer by many oncologists.
I relate this story to illustrate that the trust put on evidence-based medicine is very high, but when it proves contrary to their expectations, even doctors ignore the evidence.
There have been other drugs that were withdrawn after more comprehensive studies negated the initial studies that led to their approval.
The apigenin story
Apigenin is a bioflavonoid found in many fruits and veggies (eg celery, parsley). Since 2005, studies (on cancer cells and cancers grown in live rats) have shown that apigenin induces cancer cell death (apoptosis), and shrinks the tumours of several types of cancer with minimal or no side effects.
Earlier this year, a University of Missouri study on rats showed apigenin to be effective in shrinking aggressive human breast cancer tumours stimulated by a progestin ( medroxy progesterone acetate is a progestin or synthetic progestagen hormone commonly found in female hormone replacement therapy drugs).
However, unlike bevacizumab, which was relentlessly researched and received "fast-track" approval, the research on apigenin is likely to stop here, despite the encouraging results. The reasons, as stated by researcher Salman Hyder, are as follows: "Clinical trials of apigenin with humans could start tomorrow, but we have to wait for medical doctors to carry out that next step... but finding funding for clinical testing of apigenin in humans may be difficult... since apigenin is easily extracted from plants, pharmaceutical companies don't stand to profit from the treatment; hence, the industry won't put money into studying something you can grow in your garden."
The nutritional therapy story
Sadly, many potential nutritional therapies for cancer remain at the "unproven" stage because nobody is interested to proceed with expensive human clinical trials, even though lab and animal studies have proven them to be effective.
Until randomised controlled human trials are done, no valid claims/conclusions can be made, and the treatment method cannot be accepted widely. So many nutrients with good lab study results are abandoned without sufficient clinical trials, eg fucoidan (brown seaweed extract) and ß-glucan.
Smart drugs vs nutritional therapy
The basic difference in the approach to fighting cancer between the two contrasting methods is this:
Chemotherapy (and smart drugs) attempts to damage/kill cancer cells, but also damage/kill normal cells, including the defence/immune cells that are required to fight the cancer and infections.
The challenge is to reduce the "collateral damage", which is often severe, and even fatal.
Nutritional therapy has three aims:
·Provide general nutritional support in the situation of poor appetite and undernutrition/cachexia (especially if undergoing chemo/radiotherapy).
·Empower the defence/immune cells to fight the cancer.
·Directly damage/kill cancer cells (eg by causing apoptosis) just as the chemo drugs do, but without harming normal cells.
My opinion is that the concept of fighting cancer the chemotherapy way is wrong. That is why finding the perfect chemo drug (kills cancer effectively, with no or minimal side effects) will be a neverending story. We have better hope if we spend the trillions researching the nutritional therapies that have shown promising results thus far. In other words, we have been betting on the wrong horse.
It is my fervent belief that the definitive answer to cancer is in nutritional therapy, and not chemotherapy, and not even the so-called "smart" drugs.