Life Over Cancer Blog

Antioxidants as Pro-oxidants

When is an antioxidant not an antioxidant?  This curious question was explored in a scientific poster that Dr. Block presented at the 10th International Conference of the Society for Integrative Oncology (SIO), held October 20-22 of this year. The answer to the question was suggested in the title of the poster, “Antioxidants as pro-oxidants in cancer cells.”  What, you might ask, is a pro-oxidant?  As the name suggests, it’s the opposite of an antioxidant!  Antioxidants neutralize free radicals, while pro-oxidants stimulate and produce free radicals, or, in scientific jargon, reactive oxygen species (ROS).

Why are we interested in producing free radicals in cancer cells?  Isn’t this the opposite of what we want to do?  And why would an antioxidant suddenly turn into a pro-oxidant when you put it into a cancer cell?  Actually, it’s well known that many antioxidants can act as pro-oxidants – this fact even appears in Wikipedia!  However, the Wikipedia discussion of antioxidants overlooks some new data that are coming to light about pro-oxidants and antioxidants as they relate to cancer treatment. 

The Block Center to present at SIO Conference

The Block Center will be giving four presentations at the upcoming Society for Integrative Oncology’s (SIO) 10th Annual Conference, October 20-22, in Vancouver, BC.

The mission of the Society is to advance evidence-based, comprehensive, integrative healthcare to improve the lives of people affected by cancer. Dr. Block has been a member of the Society since its first year of existence, has served on its Board, is a member of its Clinical Practice Committee, and was the Chair of the Scientific Program at its 8th Annual Conference, held in Cleveland in 2011. He regularly gives presentations and poster sessions at Society meetings. These are the Block Center’s four presentations:  

Antioxidants as prooxidants in cancer cells. Keith I. Block, MD, Charlotte Gyllenhaal, PhD, N Mark Mead, MS. Poster session # 96. Sunday, October 20.

Case reports on cancer patients using Anvirzel, a defined extract of Nerium oleander. Keith I Block, MD; Charlotte Gyllenhaal, PhD; Robert Newman, PhD. Oral presentation, # 97. Sunday, October 20. 

Workshop: Integrating Dietary Supplements into Cancer Care: Fish Oil. Keith I. Block, MD. Sunday, October 20. 

Workshop: A Practical Look at Current Clinic and Business Models for Academic and Private Integrative Oncology Centers, and What the Future Portends: Block Center for Integrative Cancer Treatment. Keith I. Block, MD. Tuesday, October 22. 

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

Ask Dr. Block: Reishi, Spirulina & Chlorella

Can a patient take reishi together with spirulina and chlorella? Is there potentially harmful interaction between the three supplements?

No, there is no evidence of a harmful interaction. According to Natural Medicines Comprehensive Database, none of these supplements is likely to interact with other herbal medicines. However, it is important to note that each of these compounds have immune stimulating properties, relating to different aspects of immune defense. In theory, someone who has an autoimmune disease, or who is taking immunosuppressant drugs, using all three together could potentially upregulate immune activation and thus, might be problematic.

For more information on The Block Center for Integrative Cancer Treatment, visit BlockMD.com.

12-Year Study Shows Doubling of Life Expectancy

EVANSTON, IL – A 12-year study conducted by the Block Center for Integrative Cancer Treatment has shown a doubling of life expectancy for a group of 90 metastatic breast cancer patients. The results were published in the July/August issue of The Breast Journal. The women, diagnosed before 1998, participated in a comprehensive clinical program that combined conventional treatments—surgery, chemotherapy, and radiation—with individualized nutrition and supplementation, as well as fitness and mind-spirit regimens.

Through the 1990s, median survival reported in metastatic breast cancer research ranged on average from 12 to 24 months. Median survival for Block Center consecutive case series patients was 38 months, and their five- year survival was 27%, versus 17% for comparison patients. Published literature on populations with more favorable prognostic factors treated in conventional clinics showed median survivals of 20 to 23 months. 

Survival of metastatic breast cancer patients at the Block Center was approximately double that of comparison populations, and possibly even higher compared to several randomized trials published during this period. It would appear that the advantage relative to just conventional treatment alone stems from the individually- tailored nutritional, nutraceutical, exercise and psychosocial interventions in the Center’s program.

In addition to age and occurrence of relapses several other factors, not typically assessed in conventional settings, can impact survival in breast cancer patients, among them: body weight, psychosocial distress with elevated catecholamines, cortisol, inflammatory and oxidative mediators, diet and physical activity. Randomized trials of single-agent therapies or one-dimensional interventions appear inadequate to address this complexity, and there is a need for new clinical models to research and test whole systems interventions, such as the integrative care program at the Block Center.

"New cancer drugs are routinely approved for extending survival for 2 to 3 months,” said Dr. Keith I. Block, medical and scientific director of the Block Center. “There currently is no drug that has demonstrated the potential to double the life expectancy of metastatic breast cancer patients, as evidenced in these findings. These data are another compelling argument for conducting further research into an integrative treatment model for cancer.

“Our statistics were derived from our community-based patient population. While our group was comparable on major prognostic factors, we had a higher proportion of relapsed and younger patients (the median age at onset of metastasis was 46 years) than the comparison patients, which usually means a poorer prognosis. One would have expected worse survival rates, but that is the opposite of what we saw.”

“This is the first time that treatment outcomes using integrative cancer therapy for this disease have been documented,” Dr. Block said. “The survival times for our population were substantially higher than for patients who received conventional treatment alone.”

Dr. Azra Raza, Director of the Myelodysplatic Syndrome Center, St. Vincent’s Comprehensive Cancer Center, New York, characterized the Block Center’s comprehensive, integrative program as “superior….This evidence- based integrative approach should serve as a wake-up call for oncologists to overcome their obsession with treating cancer as an isolated target, but rather pay attention to the cancer patient whose own faculties need to be harnessed as agencies to win this war.”

Citation: Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer, Block KI, Gyllenhaal C, Tripathy D, Freels S , Mead MN, Block PB, Steinmann WC, Robert A. Newman RA, & Shoham J. The Breast Journal, 2009, 15(4), pp 357-366.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

 

Ask Dr. Block: Chronomodulated Chemotherapy

What is chronomodulated chemotherapy and who should consider this approach to treatment?

There are nine specific "clock-related" genes in our brainstems that control our time-dependent biological functions, including sleeping and eating patterns, heart rate, body temperature, and hormone production. Similarly, cancer cells also have time controls; they divide and rest at different times of any given day. While rest and division also occur among healthy cells, their timing differs from that of cancer cells.

We can take advantage of this by administering the drugs at the specific time when cancer cells divide, and are more vulnerable to cell death, and when healthy cells are at rest, and least sensitive to toxicity from chemotherapy. Research demonstrates chronotherapy not only improves treatment tolerance, but can improve response and survival as well. In fact, the literature contains studies showing that chronomodulated chemotherapy can even allow for patients who previously needed to discontinue a chemotherapy protocol - either because it was ineffective, became ineffective prematurely, or was too debilitating to tolerate - and benefit from that identical drug protocol when it was administered via chronomodulated chemotherapy. 

Gold standard research supports the use of chronomodulated chemotherapy. For example, for metastatic colon cancer patients, studies show that administering chemotherapy at the optimal time can halve toxicity and double treatment response. For advanced metastatic ovarian cancer, a study in the journal Cancer reported that optimal timing of chemotherapy can reduce toxic side effects by 50 percent and quadruple five-year survival. This is a four-fold improvement! (Four times as many patients were alive at the five year mark). The same study demonstrated a 75 percent reduction in the need to cut the treatment dose! 

Chronotherapy at the Block Center
I brought this technology to the U.S. from Europe in the mid 1990s, hoping to improve treatment tolerance among my patients, ultimately enhancing the benefits we were seeing from the integrative approach to treatment we were already providing (In fact, studies suggest that 1/3 of patients discontinue chemotherapy treatment prematurely due to the debilitating physical and psychological consequences). 

At the Block Center, we were implementing nutritional strategies and supplement formulations that could help diminish the side effects of chemotherapy – and my research team and I were conducting ongoing studies – when I came across the chronobiology evidence that sleep and activity cycles along with the timing of drug infusions were all clock dependent. The extensive research that demonstrated decreased toxicity and improved survival with the use of chronotherapy persuaded me that we needed to bring this technology to our patients as soon as possible. 

At the Block Center, we administer chronotherapy using a portable, computerized pump, small enough to fit in a fanny pack. The infusion of the chemotherapy drug resembles a sine wave curve, it starts infusing quite slowly, and ratchets up in carefully programmed stages. It slowly increases to the middle point of the cycle where it peaks, meaning the drug will be infused at its highest rate, and then slowly ratchets back down in an exact mirror image to its ascending slope. When the drug dosage reaches zero, the cycle is complete.

Though there are currently over 40 major centers in Europe that participate in cooperative research using this method of chemo administration, there are less than a handful of clinics in the U.S. that implement it. Why is this? Currently, cancer treatment in our country is scheduled at the convenience of the hospital, medical center, treating physician, etc., not at the optimal time for the patient. In addition, the complexity of the technology would require training and incur additional expenses to the treating facility that would not be covered by insurance. 

However, the potential impact to reduce toxicity, improve response to treatment and even boost survival, makes the need to broaden access to this approach essential. Consider the fact that few if any drugs have improved survival by more than 18 weeks over the past two decades. Then realize that chronomodulating chemotherapy can improve outcomes in many studies by years. Thus, all patients deserve this no-risk/high-benefit approach to chemotherapy. It is my hope that one day chronomodulated chemotherapy will be widely available in this country, as it is outside the U.S.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

Ask Dr. Block: Tracking Progress

How do you track the progress of integrative cancer treatments at your center? What tests and measurements do you follow?

The primary tests that we use the standard medical assessments including, but not limited to, tumor markers, CT scans, PET-CT Scans and monitoring of physical symptoms. These are absolutely necessary to make sure your treatment plan is favorably impacting your disease.

We also provide some more innovative testing not generally part of a conventional workup. These are laboratory tests that assess your biochemical terrain by analyzing a number of terrain factors, such as inflammation, oxidation, glycemia, immunity, blood coagulation and stress hormones. The results provide our physicians and dietitians the information needed to individualize and personalize both a diet and supplement program to help create a cancer inhibitory environment. Terrain factors are reevaluated 2-3 times per year for patients with active cancers and recommendations are modified as needed.

We also provide an integrative lifestyle assessment. This is a series of questionnaires and in-office tests that evaluate lifestyle, diet, overall distress, body composition and parameters of physical activity, such as cardiac endurance, flexibility and strength. These assessments are regularly reviewed to provide support and counsel on an ongoing basis. Additionally, we perform comprehensive molecular tumor tissue analysis. Since cancer is a function of multiple gene related defects, this testing allows us the ability to select pharmaceutical and nutritional strategies to more precisely impact tumor targets affecting your disease.

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

Healing Power of the Terrain: Blood Circulation

In the last in our series on the “terrain,” we’ll take a look at Blood Circulation.

When you are healthy, your blood is neither too thin nor too thick. If it becomes too viscous, it is in a state of hypercoagulation. This can happen when you have cancer: tumors cause clot-forming platelets to become overactive, and they stimulate production of a protein called fibrin, which kits blood cells together and thus makes the blood “sticky.” If your blood becomes too fluid or “thin,” on the other hand, it is in a state of hypocoagulation. This can happen from a loss of platelets, impairment in liver function, or use of anticoagulants, either pharmaceutical or nutritional. Too few platelets or their loss of “stickiness” can lead to capillary leakage or a full-blown hemorrhage. Both hypercoagulation and hypocoagulation are problematic. The first raises the risk of thrombi and embolisms and can promote tumor progression and metastasis. The second can lead to uncontrolled bleeding. These conditions are especially dangerous for cancer patients, because they have an impact on several aspects of your disease. 

Healing Power of the Terrain: Glycemia

Tumors are gluttons for glucose. They consume this blood sugar at a rate ten to fifty times higher than normal tissues. PET scans, which detect glucose consumption, have shown that the higher the rate of glucose accumulation in cancer cells, the more aggressive the tumor – that is, the more invasive and likely to metastasize it is.

In addition, having high levels of blood glucose – as diabetics do – can make you more susceptible to several different cancers and lead to a worse outcome if you do develop cancer. However, even without diabetes, small elevations in glucose or insulin can wreak havoc on your health and fuel malignancy. Patients who have what’s called pre-diabetes (blood sugar levels that are high but not high enough to be diabetes) or metabolic syndrome (a precursor to type 2 diabetes) have abnormally high blood sugar. They also tend to have elevated levels of insulin because of what is called “insulin resistance.” Insulin is the molecule that transports glucose into muscle, brain and other tissue. In insulin resistance, cells block the entry of glucose. When this happens, blood levels of both insulin and glucose increase in a futile attempt to overcome that resistance.

Healing Power of the Terrain: Immune Surveillance

Though there are a few intriguing experimental research approaches, an all-natural immune-based cure for cancer is for now still more dream than reality. However, this is not to say that you can’t enlist your immune system in your battle against cancer. In Life Over Cancer, Dr. Block details his recommendations for an “immune support program.” At the foundation of this self-care program is, of course, the Life Over Cancer diet. Here are a few additional recommendations that can help support immune function: 

Core Nutritional Needs and How to Meet Them

March is National Nutrition Month, a month focusing on the importance of making informed food choices and developing sound eating and physical activity habits. 

We know that diet affects cancer both directly and indirectly. This food selection guide will help you choose specific foods and food groups that help alter your internal biochemistry from cancer-promoting to cancer-inhibiting, based on your core nutritional needs.

Need: Cancer-Fighting Phytochemicals

Recommendation: Eat a rainbow of vegetables, emphasizing brightly colored ones (pigments contain cancer-fighting phytochemicals), leafy greens, and cruciferous vegetables such as broccoli, onions, and garlic. Choose locally grown and organic whenever possible. Try to get a mix of root vegetables, leafy green vegetables, and sea vegetables. Fruits should be limited to no more than two or three servings per day.