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Summary

Chemotherapy drugs have a high rate of treatment failure. Twenty years of clinical trials using chemotherapy on advanced lung cancer patients yielded survival improvement of only 2 months. While new chemotherapy regimens appear to be improving survival, when these same regimens are tested on a wider range of cancer patients, the results have been disappointing. Oncologists at a single institution may obtain a 40-50% response rate in a tightly controlled study, but when these same chemotherapy drugs are administered in a real world setting, the response rates decline to only 17-27%.

New approaches beyond chemotherapy are required. There have been few clinical trials however, to determine if adjuvant approaches actually improve survival in cancer patients. In fairness, it should be pointed out that lymphomas (Hodgkin's, non-Hodgkin's, and Burkitt's), myeloma, hairy cell leukemia, and chronic lymphocytic and certain other types of leukemia are all responding better to chemotherapy than 30 years ago. Also, depending on the timing of treatment, certain institutions are achieving better results with breast and early-stage lung cancers.

Our objective in conveying this large body of data is to provide chemotherapy patients with a better opportunity to beat cancer and minimize toxic side effects. We advocate that you follow a protocol based on a wide range of individual considerations, including the results of chemosensitivity and immunohistochemistry testing recommended at the beginning of this protocol. Information on your tumor cells obtained by these tests will help determine therapies most likely to work for you. In addition to these tumor cell tests, and based on your particular medical situation, you and your healthcare team will need to design a program specific to your needs and tolerances. The following is an outline of the steps described in this protocol:

  1. Decide on an appropriate chemotherapy regimen. Chemosensitivity and immunohistochemistry tumor cell tests can help you and your physician make a more informed decision.
  2. Based on tumor type, consider asking your physician to prescribe a COX-2 inhibiting drug, such as Lodine.
  3. Based on findings from the immunohistochemistry test, if your tumor expresses the K-Ras oncogene, consider high-dose statin drug therapy such as lovastatin (80 mg a day).
  4. The following supplements might help block growth signals used by cancer cells to escape eradication by chemotherapy. These supplements have also displayed antiangiogenesis properties. Some of these supplements may be best initiated 3 weeks after cessation of chemotherapy if one believes that antioxidants will protect cancer cells from the effects of chemotherapy drug(s):
    • Soy Extract (40% isoflavones), five 675-mg capsules taken 4 times a day. Note that isoflavones from soy have antioxidant properties.
    • Curcumin (as highly absorbed BCM-95®), 400-800 mg daily.

      Warning: Use caution when combining curcumin with other chemotherapy drugs. Do not take curcumin with the chemotherapy drugs Irinotecan, Camptosar, or CPT-11. Watch for NSAID-like side effects such as gastric ulceration because curcumin is a COX-2 inhibitor. Do not take curcumin if you have a biliary tract obstruction. Also note that curcumin is a potent antioxidant.

    • Green tea extract, two-three 725-mg capsules with meals. Each capsule should be standardized to provide a minimum of 200 mg of epigallocatechin gallate (EGCG). It is the EGCG fraction of green tea that has shown the most active anticancer effects. These are available in a decaffeinated form for persons who are sensitive to caffeine or who want to take the less stimulating decaffeinated green tea extract capsules in the evening dose. Note that green tea is a potent antioxidant.
  5. To possibly enhance the efficacy of certain chemotherapy drugs:
    • Fish oil, 4000-8000 mg daily of a fish oil concentrate supplying up to 2800 mg EPA and 2000 mg DHA.
    • Panax Ginseng, 200-600 mg daily standardized to contain 4-7% ginsenosides.
    • Quercetin, 1000-3000 mg daily.
    • Sulforaphane, 400-1600 mg daily of a  broccoli extract.
    • L-theanine, five 100 mg capsules twice a day.
  6. The following natural supplements may reduce side effects and healthy tissue damage caused by chemotherapy. All of these supplements except shark liver oil, PSK, and astragalus are potent antioxidants:
    • Vitamin E, 400 IU a day of vitamin E succinate
    • Vitamin C, 4000-12,000 mg throughout the day.
    • Astragalus, 2000-4000 mg daily.
    • Blueberry, 900-1800 mg daily.
    • Coenzyme Q10 (as ubiquinol), 100-300 mg daily. (Refer to cautions about CoQ10 and chemotherapy.)
    • Melatonin, 3-50 mg at bedtime. Dose may be reduced after chemotherapy ends if too much morning drowsiness occurs. After several months, most cancer patients take 3-20 mg of melatonin at bedtime.
    • PSK (from the mushroom Coriolus versicolor), 3 g daily
    • Se-methylselenocysteine (SeMSC), 200-400 mcg daily.
    • Whey protein concentrate isolate, 30-60 grams, in divided doses, daily.

      Note: Cancer patients undergoing chemotherapy should consider taking whey protein concentrate at least 10 days before beginning therapy and during therapy and then continuing with the whey protein for at least 30 days after completion of the therapy.

    • Shark liver oil, 200 mg alkyglycerols, 5 capsules daily for 30 days.
    • Digestive enzyme capsules may reduce the gas and bloating associated with high soy intake.
  7. Ask your oncologist to consider prescribing immune-enhancing drugs suggested in this protocol, such as Leukine and alpha interferon or IL-2 (along with a retinoid drug).

For more information on specific types of cancer, see the following protocols: Breast Cancer, Cancer Radiation Therapy, Cancer Surgery, Colorectal Cancer, Leukemia, Lymphoma, Pancreatic Cancer, and Prostate Cancer.

Additional Information on Cancer Treatment

After reading this protocol, please refer to Cancer Treatment: The Critical Factors. It contains important additional information for the chemotherapy patient that we do not want to duplicate in this protocol section.

For More Information

U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health National Cancer Institute, Bethesda, MD 20892 and NIH Publication No. 94-1136.