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A Real-World Case History: Fighting Pancreatic Cancer With ISCA's Personalized Treatment Program

October 2014

By Michael Downey

Fighting Pancreatic Cancer With ISCA’s Personalized Treatment Program  

Pancreatic cancer will kill almost 40,000 Americans this year. Survival time is often measured in months. Five-year survival rates for patients with advanced disease are less than 4%.

Incidence of pancreatic cancer has been increasing as the population ages. More effective treatments are desperately needed.

Desperate is exactly how prostate cancer patient Paul D. felt when he was diagnosed with pancreatic cancer. Having worked successfully with the International Strategic Cancer Alliance (ISCA) to explore treatment alternatives for his prostate cancer, he turned once again to the organization to see if they could offer anything against this latest dreaded and deadly disease.

We report here on this remarkable case history whereby Paul’s pancreatic tumor markers were dramatically reduced and survival extended, without the patient having to endure the grueling agonies of conventional chemotherapy.

When Paul was diagnosed with stage IV pancreatic cancer at the age of 69, his family was devastated. He had successfully lived with prostate cancer for almost 15 years. But the prognosis for those diagnosed with pancreatic cancer is poor. When the disease is this far advanced, the patient’s projected life span is often measured in months, with steadily deteriorating quality-of-life.

Conventional therapies offered little hope. Rather than simply accept what seemed inevitable, and with the support of his family doctor, Paul and his family reached out to the International Strategic Cancer Alliance (ISCA) to see if there were any viable options for treatment. ISCA agreed to accept his case.

“When Paul was first diagnosed, it felt like things were completely out of control. We were in a state of shock, and we were searching frantically for anything that might offer some hope,” recalled Paul’s wife Rae. “Even though we were familiar with the medical system, Paul’s diagnosis plunged us into a state of chaos and disorganization. We felt completely overwhelmed by the lack of options available for treatment.”

The First Steps

ISCA CEO Örn Adalsteinsson, PhD, arranged a conference call that included himself, Paul’s family, and the oncologist, Dr. Stephen Strum, also an ISCA colleague, who had treated Paul for prostate cancer. “That call changed everything,” said Paul. “Rather than guessing about the tumor or possible treatments, ISCA’s staff took a step back to ensure we fully understood the diagnosis before we did anything. In that hour, we went from panic to a plan.”

The plan was clear:

  1. Have an expert review the CT and ultrasound images that were used for diagnosis.
  2. Find a skilled surgeon to conduct a liver biopsy. This would allow a definitive diagnosis, staging, and chemo-sensitivity assays.
  3. Identify pancreatic cancer centers of excellence around North America that could offer effective treatment options.
  4. Start treatment.

“It would take weeks for Paul to see a specialist in our area, and we knew we just didn’t have that much time. So we started searching online. But the amount of information available on the Internet is vast, and we’re not medical experts,” said Rae, “Without ISCA, we could never have accessed the qualified specialists Paul needed in the limited time we had. He was weakening daily and we needed help—fast.” ISCA reached into its network of medical experts and quickly narrowed the field of specialists that could deliver the care Paul needed on the short timeline his deteriorating condition dictated.

Because he had worked with ISCA for his prostate cancer, much of Paul’s medical history had already been accumulated. The advanced electronic medical record developed by ISCA personnel enables any medical professional to efficiently track every aspect of Paul’s condition and quickly initiate a response when disease progression is detected.

As Paul underwent a biopsy and PET/CT scan, the ISCA team continued to seek an oncologist with expertise in—and novel approaches to—difficult-to-treat cancers. The oncologist ISCA found in the US is a pioneer in the use of low-dose chemotherapy, also known as metronomic dosing, which proved extremely effective for Paul. After a two-hour consultation with the oncologist and a call to another patient who has been cancer-free seven years after being diagnosed with pancreatic cancer, Paul admitted: “The decision was obvious.”

Throughout Paul’s case, the ISCA team has monitored treatments and conducted regular reviews of the results. ISCA tracked all tests, including PET scans, and recommended novel, non-chemo compounds, such as Immune26® (i26®), which are efficacious in many cancer patients and act by minimizing treatment side effects. i26® is a functional food protein system that helps establish a balanced environment within the gut, thus promoting immunity. “When Paul was at his lowest points, the i26® was the only thing he could take,” remarked Rae.

 
Table 1: List Of 20 Treatment Modifications  

The Challenges

Pancreatic cancer treatment has not had many improvements over the last 40 or 50 years. In most cases, by the time it’s diagnosed, it is at an advanced stage. Although there is a surgical option called the Whipple procedure, it is lengthy, complex, and best performed by a surgeon experienced with the technique. By the time most people are diagnosed with pancreatic cancer, their condition makes them poor candidates for surgery.

“One thing that many people don’t understand is that you don’t have time,” maintained Paul. “With life-threatening cancers, you need to act quickly. You can’t wait a month to see your doctor and then wait weeks or months to start treatment. If you are diagnosed with a serious cancer, you need to do something right now. Because of ISCA’s help navigating the medical system, less than a week after our first conference call, I was having a biopsy.”

To give you an idea of how poor Paul’s prognosis was, on the day he was diagnosed in October 2012, his pancreatic tumor marker (CA19-9) was over 45,000. By November 28, the day he started chemotherapy, it was 218,000. Normal range is less than 34. As of writing this article, that tumor marker is about 197.

The oncologist ISCA recommended uses a series of low-dose chemo infusions along with heavy-duty nutritional support. Treatment has been ongoing, and side effects have been manageable. Overall Paul’s quality of life has been good. In August 2013, a FDG- PET/CT found the tumor was greatly reduced and that metastases to Paul’s liver had calcified and were inactive. A subsequent FDG-PET/CT in June 2014 showed continued response to treatment.

These impressive results were achieved with a synergistic program of both conventional and advanced therapies. They can be seen in the Tumor Marker graph on page 78 titled CA19-9 Vs Months From Diagnosis, which shows the decline of the tumor marker. Three other patients receiving treatment for pancreatic cancer at the same clinic are also experiencing similar results.

During this time, 20 different treatment modifications were made where the type of chemotherapy, dosage, and timing were adjusted based on tumor response to the treatment and ISCA’s Electronic Medical Data Log feedback. These events are highlighted in Table 1 (above) with a date stamp for each event. (They are also shown as triangle tick marks in the bottom part of the Tumor Marker graph below.)

With ISCA, the focus is on the needs of the patient, not the boundaries of the medical system, which can be confusing and hard to navigate. According to Rae, “ISCA’s concern is serving the individual. Whatever Paul’s need was—finding an oncologist, sourcing an FDG-PET/CT, getting a second opinion, or cardiology—ISCA always connected us with competent medical professionals who met Paul’s needs. Not only did the ISCA team find good treatment options for Paul, they helped us understand what we needed to know to make sound decisions about his care.”

Table 2: Treatments Over 21 Months

The chronology over the 21-month period shows how treatment modifications were able to achieve tumor marker reduction. These treatments included:

  • Taxol®-Gemzar®, with Interferon alfa-2b (IFN alfa-2b)
  • 5-FU with Leukine® (recombinant granulocyte-macrophage colony-stimulating factor, GM-CSF)
  • Paclitaxel, Oxaliplatin, Leucovorin, 5-FU
  • Tarceva®

Paul’s Condition Today

Paul was diagnosed with stage IV pancreatic cancer in October 2012. His prognosis with conventional therapy was about six months. His oncologist believes that without treatment, he would likely have been dead by Christmas of that year. Using ISCA’s resources and expertise, Paul’s condition turned out quite different.

Twenty-two months after he was diagnosed, Paul continues to receive chemotherapy, but is very much alive and doing well as of August 2014.

“Paul’s ECOG Score (refer to top of next column for description of the ECOG Score) is 1, which I think reflects the improved physical changes from the early months of pancreatic cancer before and after diagnosis, as well as the positive effects of chemotherapy,” observed Rae. “For the past 10 days he has been down on the floor for five minutes daily doing one or two pushups. Depending on the day, he walks anywhere from six to 14 blocks. His appetite is good and his weight remains stable at what it was when he was in his 20s. We make a point of going for coffee daily and we visit regularly with friends. This is in contrast to his health in late 2012 and early 2013, when he needed elevated seating to be able to stand, ate less than a half cup of food at mealtimes, struggled to manage his personal care, and needed assistance for everything else.” Paul is not cured, but is living with his cancer.

Table 2 at left shows some of the chemo treatments that were administered, all in low doses and most with immune support. Paul and his oncologist monitor his overall health, as well as the tumor markers.*

* Editor’s Note: We at Life Extension® understand the time urgency when combatting pancreatic cancer, which kills some victims only weeks after diagnosis. We reiterate our long-standing position that a comprehensive, individualized treatment plan must first be in place. Typical terminal pancreatic cancer patients are offered chemotherapy drugs that add several months of survival. The problem is that once treatment-naïve cancer cells become refractory to standard chemo protocols, they are usually resistant to further interventions. Had it not been for the relationship that Paul already had with ISCA, he likely would have been administered conventional chemotherapy, which would likely have deprived ISCA of the opportunity to successfully utilize more progressive approaches.

The ECOG Score

The Eastern Cooperative Oncology Group (ECOG) score, published by Oken, et al. in 1982, runs from 0 to 5, with 0 denoting perfect health and 5 death. Here are what the numbers mean:

  • 0 – Asymptomatic. (Fully active, able to carry on all predisease activities without restriction.)
  • 1 – Symptomatic but completely ambulatory. (Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, such as light housework or office work.)
  • 2 – Symptomatic, <50% in bed during the day. (Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours.)
  • 3 – Symptomatic, >50% in bed, but not bedbound. (Capable of only limited self-care, confined to bed or chair 50% or more of waking hours.)
  • 4 – Bedbound. (Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair.)
  • 5 – Death.

Adjuvant Treatments

Paul’s treatments were also supported at different stages in his program with advice on diet, adjuvants, and natural supplements. The regimen of i26® maintained daily throughout the period played a key role in mitigating treatment side effects. Along with i26®, additional support included supplements such as:

  • Dichloroacetate (DCA)
  • Super Bio-Curcumin®
  • Green Tea Leaf Extract
  • Melatonin
  • Milk Thistle
  • Fish Oil
  • Acetyl-L-Carnitine (ALC)
  • Benfotiamine
  • Boswellia
  • BroccoMax®
  • CoQ10
  • Vitamins and Minerals
  • Cissus quadrangularis
 
Paul’s Pancreatic Tumor Marker CA19-9 Over A Period of 21 Months  

Summary

“We had to make a decision after I was diagnosed and it was going to be a life-changing decision, but it would have been life-changing either way!” said Paul.

ISCA CEO Örn Adalsteinsson noted, “In late-stage cancer cases like Paul’s, multiple resources have to be pulled together quickly to find the optimum treatment plan. But this is just the start of the journey. Many additions and modifications have to be made along the way as dictated by the feedback from the medical data and most important, the patient.”

Paul recalled, “There were some days when I thought it was going to be game over. I threw the ISCA team a few curveballs, but they never gave up.”

Paul will likely remain an ISCA client for the rest of his life, or until there is clear evidence of a cure. The ISCA team has empowered Paul to fight one of the deadliest cancers, giving him back quality-of-life years.

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