Assembly Line MedicineOctober 2014
By William Faloon
People fear cancer more than any other disease—and for good reason.
Upon diagnosis, a patient is often given several treatment choices. None guarantees a cure, but all tend to inflict pain, immobility, mutilation, debilitation, risk of secondary complications (like stroke), and risk of secondary cancers (like leukemia).
Enlightened individuals face a particular degree of anxiety. They’ve heard about less toxic treatments that may be more effective. They often worry they are missing out on a curative therapy because of constraints placed on physicians by today’s bureaucratic medical system that fosters inefficiency and mediocrity.
We at Life Extension® have long been aware of serious gaps that exist between what is discovered by cancer researchers and what is delivered to patients in the clinical oncology setting. When advanced cancer patients send us their medical records, we almost always identify treatment omissions that could have markedly improved odds of remission, improved survival, and even offered a cure.
One example is a drug called cimetidine. It functions via several mechanisms to inhibit metastasis and improves survival in colon cancer patients.1-8 In 2002, results from a clinical trial on patients with an aggressive form of colon cancer were published in the British Journal of Cancer. Compared to controls, 10-year survival improved by a remarkable 2.7-fold in the group receiving cimetidine.4
Life Extension® has been recommending cimetidine since 1985 for certain types of cancer. Not once have we had a cancer patient approach us who had been prescribed this nontoxic drug by their oncologist.
An oncologist is a physician who specializes in the diagnosis, evaluation, and treatment of those afflicted with cancer. Cancer patients rely on their oncologist to utilize the best therapies to meet their individual needs. Regrettably, “managed care” has diluted the quality of care provided by many oncologists.
In a stunning new development, a health insurance company is offering oncologists $350/month for each patient that is put on the company’s recommended regimen.9 This will enable the insurance company to control treatment-related expenses of cancer patients, who will be afforded less individualized, creative, and comprehensive care.
In this month’s issue, we reveal how to circumvent this backwards approach to cancer treatment.
Within 24 hours of you reading this article, 1,500 Americans will perish from cancer.10 There will be no sensational media accounts of these travesties, just more statistics to confirm the grim failure of mainstream medicine to find cures for this epidemic killer.
We at Life Extension® have never ignored the threat that cancer poses to healthy longevity. Yet many people today are in a state of denial, as if this insidious disease only afflicts others.
The news media redundantly covers details of traumatic deaths such as airline crashes and terrorist attacks. My reaction to these headline news stories is that the number of victims pales in comparison to the estimated 585,000 Americans that die from cancer every year.11
As I wrote in a 2004 article titled “Are You Afraid of Terrorists?” over 2.4 million Americans die each year mostly from age-related disease. Yet one terrorist attack dominates media coverage.12
So here we are 10 years later, and terrorists have killed less than 100 people in the United States. The death toll from cancer in that same time period is around 5.8 million. One could argue from a mathematical standpoint that violent death threats could be disregarded and resources instead poured into more efficient cancer research.
My personal views don’t directly relate to what you are about to read, but may help you understand how committed we are to eradicating cancer in the same way that smallpox was last century.
The Basics About Cancer Treatment
There are some basic rules about cancer that everyone should know.
When it comes to achieving a “cure,” the best opportunity exists at the time of first treatment. Once tumor cells have been exposed to initial therapies, or one’s immune system has been compromised by surgical trauma, a malignancycan proliferate out of control and resist secondary therapeutic attempts.13-20
The best shot for a cure thus involves an individualized, multipronged plan of action to:
- Eradicate the primary tumor;
- Decrease fuels that feed metastatic growth;
- Turn off stimuli that encourage cancer stem cell proliferation;
- Block the escape routes used by residual cancer cells.
Some people erroneously believe they must try to eradicate their tumor immediately. A more intelligent approach is to take the time needed to:
- Ensure that the stage or extent of the tumor is within the boundaries of any ablative therapy (such as surgery or radiation);
- Investigate every mechanism an individual’s cancer will use to ensure its survival;
- Then introduce agents into the treatment protocol to circumvent each of these tumor survival factors.
What I’m conveying here is that newly diagnosed cancer patients should take advantage of the relatively vulnerable nature of their “ treatment-naïve” tumor to implement a plan that addresses a wide range of escape routes that tumor cells utilize upon exposure to radiation, chemotherapy, hormone blockade, and even surgery.21-25 To provide real world examples of this strategy being put into action, you’re going to read about some remarkable case histories in this month’s issue.
Immune Status Should Be Assessed In All Cancer Patients
Once a tumor is established, it is difficult for the immune system to eradicate it.26-29 That’s why mainstream oncologists pay little attention to the immune status of their newly diagnosed patients. In other words, since bolstering immune function alone won’t cure cancer, oncologists mistakenly think it is not of major importance.
Newly diagnosed patients often present with poor immune status even before immune-damaging chemotherapy, radiation, and/or surgery are initiated.30-33
Optimizing immune function prior to initiation of cancer treatment can be a critical component of comprehensive therapy with curative intent.12,34-37 This involves in-depth immune profile blood testing and when indicated, precise administration of expensive drugs like interleukin-2,12,38-46 filgrastim (Neupogen®),47,48pegfilgrastim (Neulasta®),49-58 and/or sargramostim (Leukine®).59-62
Health insurance companies are trying to reduce the cost of cancer care and would rather patients not know about the need to optimize immune function before, during, and after toxic therapies are administered.63 The high cost of implementing comprehensive immune support is causing insurance companies to refuse to pay for it.
A large health insurance company is offering oncologists $350/month per patient as a reward to channel treatment towards the insurance company’s “recommended regimen.” We believe this will result in cancer patients dying sooner and using up fewer resources in the process.8 Oncologists following these cookbook protocols will be able to squeeze far more patients into their hurried schedules.
Under this new scheme whereby oncologists are paid $350/month for each patient placed on the “recommended regimen,” insurance companies benefit financially, while patients are largely confined to chemo drug protocols that provide relatively minimal survival improvement in treating metastatic disease.
Impact Of Surgery On Immune Function
The first line of defense against malignancy is our natural killer cells (NK). Young individuals have high levels of functional natural killer immune cells, but this declines with aging.64-72
Natural killer cells originate in the bone marrow (like other immune cells) and go through a maturation process that enables them to participate in early control of microbial infections and cancers.73-76
In a study examining NK cell activity in women shortly after surgery for breast cancer, it was reported that low levels of NK cell activity were associated with an increased risk of death from breast cancer.77 In fact, reduced NK cell activity was a better predictor of survival than the actual stage of the cancer itself. In another study, colon cancer patients with reduced NK cell activity before surgery had a 350% increased risk of metastasis during the following 31 months.78
The likelihood of surgery-induced metastasis requires a cancer patient’s immune system to be highly active and vigilant in seeking out and destroying renegade tumor cells immediately before, during, and after surgery. Numerous studies document that cancer surgery results in substantial reduction in NK cell activity.79-82 In one investigation, NK cell activity in women having surgery for breast cancer was reduced by over 50% on the first day after surgery.81 A group of researchers stated that, “We therefore believe that shortly after surgery, even transitory immune dysfunction might permit neoplasms [cancer] to enter the next stage of development and eventually form sizable metastases.”80
We know cancer surgery reduces NK activity. This means that NK cell activity becomes impaired when it is most needed to fight metastasis. With that said, the preoperative and perioperative periods present a window of opportunity to actively strengthen immune function by enhancing NK cell activity. Fortunately, validated interventions to enhance NK cell activity are available to the person undergoing cancer surgery.
While there are nutrients that can boost NK function, many cancer patients would benefit enormously with individualized courses of drugs like interleukin-2 (IL-2) and Leukine®.
IL-2 directly promotes NK function,83-85 while Leukine® induces bone marrow production of macrophages.86-88 Since these drugs are expensive, insurance companies will often refuse to pay for them as they are not approved by the FDA for the creative interventions that published studies show may be effective.
How Off-Label Drugs Save Lives
In the world of conventional oncology, FDA-approved drugs are routinely and legally prescribed for “unapproved uses” to better treat the disease.89,90 This is often referred to as using drugs “off-label.”
A 2008 study found that eight out of 10 oncologists surveyed had used drugs off-label.91 Studies have reported that about half of the chemotherapy drugs prescribed are for conditions not listed on the FDA-approved drug label.92 The National Cancer Institute has stated, “Frequently the standard of care for a particular type or stage of cancer involves the off-label use of one or more drugs.”92
Off-label drug use in many cases is the genesis of innovation. It enables oncologists to use their training and experience to design creative therapeutic protocols based on new scientific findings. When favorable results are found, the protocol may be published in medical journals so that other oncologists can emulate the treatment successes.
The problem for health insurance companies is that cancer drugs are outlandishly priced, sometimes costing over $100,000 each per patient.93-95 Insurance companies don’t want to bear the costs associated with creatively designed treatments. They want to limit their expenses by confining oncologists to chemo drugs that provide relatively little survival improvement in advanced-stage cancers.63
This helps explain why one insurance company is offering oncologists $350/month per patient to not prescribe drugs beyond the insurance company’s “recommended regimen.”96
Other health insurance companies are doing it differently by reimbursing oncologists less money when they prescribe newer, more expensive cancer drugs.97
Not All Off-Label Drugs Are Expensive
Some of the most effective off-label drugs are affordable out-of-pocket (without insurance company involvement). The problem occurs when oncologists are being paid ($350/month) to only offer an insurance company’s “recommended regimen.” This creates a disincentive to utilize Herculean initiatives to ensure their patients receive every therapy that could optimize outcomes with the goal of inducing a complete remission; in other words, the complete disappearance of all manifestations of the cancer.
From our review of the scientific literature spanning decades, many cancer patients would benefit by taking aspirin98-100 and the antidiabetic drug metformin.101-115 Aspirin of course is readily accessible, but cancer patients are unlikely to use it if their oncologist does not recommend it.
Metformin requires a prescription, and if the insurance company catches the oncologist prescribing metformin, which is not part of the “recommended regimen,” the oncologist might lose the $350/month stipend for that patient.
Even the use of aspirin requires the oncologist’s involvement as chemo patients whose platelet count is reduced to fewer than 100 x 10E3/uL are at risk for hemorrhage.116-119 Under these circumstances, aspirin should be deferred until platelet counts are restored.
There are numerous off-label drugs effective against certain cancers (such as COX-2 inhibitors, certain statins, hormone modulators, etc.) that require a prescription, yet we are rapidly regressing to a system where medical decision making is dictated by insurance company cost mandates and not physician dedication and experience.