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Health Protocols

Cancer Treatment: The Critical Factors

Step Two: Determine Sensitivity or Resistance to Chemotherapy

When a person is prescribed a treatment for their cancer, they might assume that the treatment was chosen based on the uniqueness of their cancer. For instance, when a woman with early-stage breast cancer is told that her chemotherapy treatment regimen will consist of the drugs doxorubicin (Adriamycin), Cytoxan, and Taxol (ACT), she might think this treatment was individually tailored for her cancer. In actuality, ACT is a standard chemotherapy protocol given to breast cancer patients. This "one-size-fits-all" approach to breast cancer treatment would work well if superior results were obtained from this routine practice. Sadly, this has not been the case.

The "one-size-fits-all" approach to prescribing chemotherapy has failed to improve survival for the vast majority of women with breast cancer. In a shocking study of women with breast cancer over the age of 50 who had cancer present in their lymph nodes, standard chemotherapy regimens were shown to increase 10-year survival by only 3%.2,3 Other studies have determined that standard chemotherapy does not improve survival in women with estrogen-receptor positive breast cancer.4,5

A critical flaw of the "one-size-fits-all" approach rests in treating all breast cancers as if they are one in the same. Although traditional oncology does make distinctions in a few obvious qualities, such as size of the cancer, lymph node status, and estrogen receptor status, we now know there can be substantial individual differences in cancer cell genetics among those with "similar" breast cancers. These differences can dramatically influence the response to treatment. A powerful illustration of the lack of appreciation for individual differences in cancer treatment was clearly revealed in a landmark study published in the New England Journal of Medicine in 2007. Researchers compared women with lymph node positive breast cancer who received ACT chemotherapy to those who did not receive chemotherapy.6 Their HER2 status was also determined—which refers to a genetic characteristic of the cancer. The researchers discovered that the group of women who were HER2 negative and estrogen receptor positive did not benefit at all from taking Taxol. The ramifications of this study are immense, as a large percentage of women with breast cancer fall into this category. In recognition of the failure of Taxol to benefit this large group of women with breast cancer, oncologist Anne Moore, M.D., Professor of Clinical Medicine at the Weill Medical College of Cornell University in New York stated, "The days of 'one size fits all' therapy for patients with breast cancer are coming to an end."7

A further indictment of the "one-size-fits-all" approach was prominently displayed in a study published in the Journal of the National Cancer Institute in 2008. In this investigation,8 scientists measured the effectiveness of an anthracycline-based chemotherapy regimen in 5,354 women with early-stage breast cancer. Anthracyclines are a class of chemotherapy drugs of which Adriamycin is a key member. The scientists determined that women with early-stage breast cancer who were HER2 negative derived absolutely no benefit from taking Adriamycin or other anthracycline drugs. Given that approximately 80% of breast cancers are HER2 negative,7 these results suggest that only one of five women with breast cancer may benefit from these drugs that have considerable toxicity associated with their use. For example, in a large-scale study, 5% of patients treated with Adriamycin developed congestive heart failure.9

Breast cancer is not the only type of cancer in which resistance to chemotherapy may impair treatment; in fact, all cancers may display interindividual variability in chemosensitivity. For example, assessing expression of a chemoresistance protein (IGFBP2) in leukemia patients helped identify those who were likely to respond to standard chemotherapy, and those who were not.10

If chemotherapy is being considered, it is crucial to ascertain which chemotherapy drugs will have the highest probability of being effective against your particular cancer. A company called Nagourney Cancer Institute performs chemo-sensitivity testing on your living cancer cells to determine how your cancer cells respond when exposed to various drugs in the laboratory.

Nagourney Cancer Institute was founded in 1993 by Dr. Robert Nagourney, a prominent hematologist and oncologist. Nagourney Cancer Institute pioneers cancer therapies specifically tailored for each individual patient, and is a leader in individualized cancer strategies. With no financial ties to outside healthcare organizations, recommendations are made without financial bias.

Nagourney Cancer Institute develops and provides cancer therapy recommendations that have been designed scientifically for each patient. Following the collection of living cancer cells obtained at the time of biopsy or surgery, Nagourney Cancer Institute performs an ex-vivo analysis of programmed cell death (EVA-PCD) functional profile on your tumor sample to measure drug activity (sensitivity and resistance). Ex-vivo analyses mean your living tumor cells are maintained outside of your body for the purpose of determining which drug or drug combination most effectively induces cell death in the laboratory. Each patient is highly individualized with regard to his or her sensitivity to chemotherapy drugs. Your responsiveness to chemotherapy is as unique as your fingerprints. Therefore, this test will help to determine which drug(s) will be most effective for you. Nagourney Cancer Institute will then make a treatment recommendation based on these findings.

Nagourney Cancer Institute provides custom-tailored, assay-directed therapy based on your tumor response in the laboratory. This eliminates much of the guesswork prior to your undergoing the potentially toxic side effects of chemotherapy regimens that could prove to be of little value against your cancer.

Contact information for Nagourney Cancer Institute:

Nagourney Cancer Institute
750 East 29th Street
Long Beach, CA 90806
Telephone: (562) 989-6455

How to Implement Step Two

Contact Nagourney Cancer Institute so that your surgeon can follow the precise instructions required to send a living specimen of your tumor for chemo- sensitivity testing. It is important that your surgeon carefully coordinate with Nagourney Cancer Institute in order to ensure your cells arrive in a viable condition. You may have to pay for this test yourself because your insurance may not reimburse for it. Please note that this test may not be of benefit to all cancer patients. While it provides a basis for improved treatment, not all cancers are effectively treated with current therapies.