Introduction A few years ago after my father was diagnosed with pancreatic cancer, began to intensively research the different treatment options available - both traditional and alternative. I quickly found out that there was no traditional option that was effective for treating pancreatic cancer. So I began to look more deeply into alternative options since they held they only possible hope for recovery. In my research I did not find a magic bullet for pancreatic cancer, but I did come across a few alternative therapies which could document, to some small degree, pancreatic cancer survivors. While none of the research was definitive, finding survivors at all was surprising and certainly raised my interest in these alternatives. This page details the results of my research - I hope that you find it helpful. I would also say, that based on my research, if I were designing a treatment plan for pancreatic cancer, I would try a multidimensional approach as I describe in my alternative cancer options page. I am convinced that this type of program, incorporating different complementary elements (diet, supplements, exercise, meditation, etc) is a very powerful way to fight any chronic disease including cancer. If you have further questions on these treatment options, you may find more information in the different resources available on my cancer resource information page. I have especially found People Against Cancer and the book, The Alternative Medicine Definitive Guide to Cancer, to be very helpful. See the resource page for contact information. I should say here, so you know my intention in creating this option page, that I don't mean this listing of treatment options to be seen as a comprehensive list of alternative treatments for Pancreatic Cancer. Since there are so many alternative treatments out there, I tried to winnow them down by finding those that had some sort of specific evidence of helping PC patients survive. There are a lot of other well known alternatives - such as Essiac Tea, Ozone Therapy, the Bryzinski program, Burton's program, etc.- that may be of real interest to you as well, but just did not have any specific information as to their effectiveness with PC when I did my research. So I would urge you to read the books that are in my resource section for an overview for general options alternative cancer therapy options, and I really urge those interested in learning more to consider Alternative Medicine Program at People Against Cancer. These resources will give you a lot more information on general alternatives that may really interest you as well. I should also say, that I know some of the alternatives I discuss on this page are controversial, as are many of the alternatives out there for cancer therapy. My intent is not to vouch for those alternatives on this page, but instead to make information available so that people can have a place to start their investigations into alternatives and see if any make sense to them. So take all this information with a healthy bit of skepticism - I know I do for all information, whether traditional or alternative, that I come across on PC. But any information on any treatment that may have a benefit for PC survival interest me greatly, and I put those that I was able to get basic, credible information on this page. If any of these alternatives do interest you, I urge you to really investigate them to see if they make sense to you. Also, for more information check out our Pancreatic Cancer links page. 1. Nutrition and Pancreatic Cancer. As I researched, I became aware that nutrition seemed to be related to both the causes and perhaps the recovery from pancreatic cancer. In the summaries that follow you will find my review of the information on these different nutritionally based programs (Gerson diet, Gonzales diet, etc) that seemed to have had interesting results (i.e. survivors) for pancreatic cancer. In this summary, I wanted to share some of the information I ran across on the correlation between nutrition and the development of pancreatic cancer. In an article entitled "International Comparisons of Nutrition and Mortality from Pancreatic Cancer" (1991, Parviz Ghadirian, PH.D, et al, journal unknown, Vol 15, Issue 5), the authors look at the impact of three food items - eggs, milk, and meats - as well as on protein, fat, and total caloric intake of animal and vegetable sources. (Note: the authors also note the clearly established link between pancreatic cancer and cigarette smoking. They also mention that some studies have found a correlation between coffee, alcohol and sugar as well, but other studies have failed to confirm these findings) Their findings were somewhat of a revelation for me - they found A direct and significant correlation between mortality rates from cancer of the pancreas and per capita consumption of eggs, milk and meat... This correlation was stronger for calories derived from animal sources of food ...while consumption of vegetable calories correlated with decreased rates of mortality from pancreatic cancer. The average per capita intake of both total and animal fat was also directly correlated with mortality from cancer of the pancreas. This suggest that animal sources of calories, protein, and fat may play an important role in the etiology of pancreatic cancer. Looking country by country incidence of pancreatic cancer only served to underscore the idea that nutrition may play a key role in pancreatic cancer. "Countries at highest and lowest risk reflect a tenfold difference in the incidence rates (of pancreatic cancer)" While there might be a genetic explanation to this differential, another explanation would be the differing diets of the people in these countries. Based on this information, it seemed to me that there might be a great deal a person can do nutritionally and by changing their lifestyle to diminish their risk of pancreatic cancer. And certainly there seemed to be no downside to these relatively simple changes - stop smoking, eat more vegetables, less animal products, and less fat. In fact these results seemed to be in concert with those Dr. Dean Ornish was finding for heart disease. So maybe a similar program would benefit not only people worried about getting pancreatic cancer but also those suffering from pancreatic cancer. And as I looked into pancreatic cancer more and more, I saw that nutritionally based approaches (see those below) had interesting results in general and specifically with pancreatic patients. These programs, to a greater or lesser degree, were producing survivors and that made me very interested. Based on this type of information I have become a full-fledged vegetarian - they call us vegans. It wasn't easy learning all the new skills I needed for cooking tasty vegetarian meals, but once I learned I came to really enjoy eating this way. Not only do I not feel deprived, but I also really love eating this way and I have found that other enjoy it when they eat in the way we do. If this is of interest to you, check out my Veggie Delights section of my Healthy Foundations site for tips and recipes. I originally learned about the Gerson diet through his book, "A Cancer Therapy, Results of 50 Case Studies", by Dr. Max Gerson. After reading the book, I contacted the Gerson Institute, which gave me the names of 3 long term survivors that I then immediately called. Their stories were pretty amazing – the one I interviewed on the show (I had a health radio show locally for a time) is a now 14-year survivor (as of August 2000). While program is very intensive (hourly juicing, tons of supplements, pancreatic enzymes, coffee enemas (to get the liver to detox they claim), etc.), I had not run across any program at that point in my research that had produced long term survivors who had not had any sort of previous treatment. Because of these survivors, and despite the difficulty with actually doing the program, and was and remain very interested in the Gerson program. I have put, an interview I did with this long term survivor, who only used the Gerson method, on my former radio show. If you need real player to listen you can download it for free. Are these types of survivor results typical for those Pancreatic patients who have tried the Gerson program? No, most patients who try the Gerson method are very advanced and don't have this type of long term survival. But from the physicians I spoke with as well as the survivors, the picture I get is that many patients enjoy better quality of life, perhaps significantly longer median survival (although this is the observation of the physicians, and I have not seen any hard proof to back up this observation), and there have been some long term survivors. Since long term survivors of any type, who have not had the Whipple procedure, are so rare, survivorship of any amount really perks up my interest and is the reason that I became interested in the Gerson method. When I first investigated the Gerson method in 1993 - 4, the lay of the land seemed pretty clear. At that time, the Gerson Institute (1-888-4-GERSON), which is the group headed by Dr. Gerson's daughter Charlotte Gerson, was working with, and had been in association with for 15 - 20 years, the CHIPSA Hospital in Tijuana, Mexico (1-877-424-4772). Unfortunately, the Gerson Institute had split off from CHIPSA since then, and since late 1999 has been affiliated with the Oasis Hospital also in Tijuana, Mexico (888-500-HOPE). Dr. Rogers, the medical director at CHIPSA, tells me that while they are no longer affiliated with the Gerson Institute, CHIPSA continues to offer the "pure" Gerson program, as well as the Gerson program in combination with other alternative therapies (such as Issels therapy, Coley Toxins, hyperbaric chamber, etc.). The Oasis Hospital offers the Gerson program as set forth by the Gerson Institute, and the physicians running the program are physicians who trained in this under Dr. Rogers. My concern, as always, is to look at which "Gerson" method or methods has been able, when used, to produce long term survivors. All of the survivors I talked with had been through the program at CHIPSA. And those couple that I have been able to talk with again recently all had just the straight Gerson therapy - they did not have any additional alternative treatments as part of their program. Dr. Rogers at CHIPSA tells me that they continue to offer the same Gerson program that these survivors had while at CHIPSA, but says that that often patients choose to integrate other therapies into the program as well. This is based on their research wing, the Gerson Research Organization, that those patients, of all cancer types, who added these additional therapies to the standard Gerson treatment had 28% better survival results (although to be honest, I am not exactly sure what they are quantifying with this 28% better result figure - median survival, long term, response in general - I just don't know). They do not have specific analysis of whether these additional treatments provided this sort of additional benefit as in regard to just Pancreatic Cancer patients. If you are interested in the Gerson program, where would I recommend? I have a very simple philosophy - I try to find what type of alternatives are producing survivors, and then see where this exact alternative is being offered. Since the survivors I talked with had all been to CHIPSA, and CHIPSA continues to offer the pure Gerson treatment as well has the physicians with by far the most experience in treating patients with the Gerson method, I would have to go with CHIPSA as the first alternative. This is not meant as any disparagement to the Oasis hospital or any other facility offering the Gerson method. It is simply based on the fact that CHIPSA continues to offer the same program as used by the survivors I talked with, the same physician in charge, Dr. Rogers, continues to be in charged of the Gerson program at CHIPSA, and that he has the most experience with this Gerson program. If you are interested in CHIPSA for the Gerson program, you will have to decide for yourself what, if any, other alternative you would want to add into this basic Gerson program. A cautionary note on the Gerson program. Like others on this list (Gonzales program, Taylor diet, etc.) it demands a lot of the patient in terms of compliance. A patient will have all sorts of things to eat, great quantities of juice to drink, large amounts of pills to take, coffee enemas to perform, etc. Those that are diminished by the disease, or have had previous chemo, radiation, or surgery may not be able to either comply with this program, or may have to do it in a reduced form. According to Dr. Rogers, often those that have had surgery can do the full program as long as they have physically recovered from the surgery and don't have any sort of problems complying with the program. However, those with chemo and radiation may have to do a lighter version of the program. It all depends on the person's physical strength and immune system, ability of that person to eat, drink, take pills, and do the other cleansing rituals. At CHIPSA, they do treat patients with the Gerson method even while they continue with such drugs as Gemzar. My dad never pursued any of these options due to his limitations in this area, and each pancreatic patient will have to access for themselves their ability to comply with the rigors of these programs. I should also say, that while I would strongly recommend that those interested in the Gerson program should go to a medical facility and learn it there, both CHIPSA and the Gerson Institute offer books and tapes which you can buy to learn the program on your own. In my discussions with the survivors, though, they all recommended going to Mexico since they were able to spend a few weeks learning the program, which made if easy to continue with the program once they returned home. Compliance is definitely one of the most difficult aspects of the Gerson method, and it sounds like it is much easier to learn it and be compliant if the patient actually goes and learns it at a medical facility. For those who instead choose to learn it at home, the physicians warn me that they will need the help of their families and friends to learn the Gerson program since it is so difficult to pick up on your own. Back to top 3. The Gonzales Program.
Update March 9, 2007 - The National Cancer Institute Clinical Trial on the Gonzales method is closed, but the report has yet to be issued. You can see that parameters for the trial at
National Cancer Institute Information on the Gonzales Trial. Dr. Nicholas Gonzales ((212-213-3337) Dr. Gonzalez's web site) is a New York city based physician who has for years been developing using a diet/supplement/detoxification treatment for pancreatic cancer. Due to the stunning results of the pilot study Dr. Gonzales published in the Spring of 1999, his office receives many more patients seeking treatment than he can currently treat. For Pancreatic Cancer, he has decided to only treating patients who have never had a course of chemotherapy or radiation treatment. Dr. Gonzales told me this decision was based on the facts that in his clinical experience, while those patients already having had chemo or radiation might have benefited from his methods in terms of longevity, he never had a long term Pancreatic Cancer survivor who had previously undergone chemo or radiation. This was due, in his belief, to such factors as the disease progressing quickly during the chemo and radiation treatment times, the immune system being adversely affected by chemo, etc. So in terms of marshalling his resources, his current policy is that while he will take other types of cancer patients who have had chemo and radiation, he only takes those Pancreatic Cancer patients who have not had previous chemo and radiation treatment. If you have not had previous treatment of this sort, I should warn you, though, that Dr. Gonzales still takes only a portion of those qualifying Pancreatic patients who come to see him. I am not aware of how he chooses out of this patient pool those patients that he will see, but again his point of view is that since he can only treat a portion of the patients seeking him out due to his limited resources, he takes those which he thinks will most benefit and respond to his treatments. I tell you this so you will have an understanding of his selection process before you see him and try to enroll as a patient. This treatment has three components: a special diet (mainly vegetarian with lots of juicing, although some eggs, milk products, and fish are allowed), supplementation with nutrients and lots of pancreatic and other enzymes (up to 130 - 160 capsules of enzymes alone a day), and cleansing components such as twice daily coffee enemas. Like the Gerson diet, this program is very extensive and requires a great deal of time, effort and will to comply with its many demands. In addition, prospective patients should be warned that I have been told, by very reliable sources, that Dr. Gonzales chooses to treat some pancreatic patients and not others - and does not give his reasons why a patient is not accepted for treatment. But while you weigh these different factors when considering the Gonzales program, you should also consider the results that this program, and its descendant the Kelley program, have shown for nonoperable pancreatic patients. These results (which are detailed below) have been stunning. For Kelley's program, those 5 who were compliant median survival was 9 years. For those who participated in the Gonzales' pilot study of 11 patients, 81% survived 1 year, 45% survived 2 years, and 36% survived 3 years - 2 are still alive after 3.5 years and 4.5 years (see full text of this study on Dr. Gonzalez's web site). These results easily exceed the results usually found for nonresectable pancreatic cancer patients (survival of 4 - 6 months) and are easily among the best verifiable results for any therapy for pancreatic cancer. Dr. Gonzales has posted case studies of some of his patients who have responded to his regimen on his website. While he has case studies for a variety of different cancers, he has posted 5 patient case studies that had pancreatic cancer. You can find these at Dr. Gonzales Pancreatic Cancer Patient Case Studies . It is pretty unusual to find these kind of documented case studies on Pancreatic survivors - mostly you will hear anectodal stories of survival, but hardly ever do you see these kind of detailed case studies. And to see 5 survivors of this type of longevity is also very unusual (from 5 1/2 to 15 years). I find this all very interesting, and I was very excited about the study that the National Cancer Institute (NCI) had put together to test the Gonzales method in doing a full fledged, randomized study (vs. standard care with the drug Gemcitabine). Again, this was quite unusual and showed me a lot about Dr. Gonzales. It is something for an "alternative" treatment to subject itself to this type of scientific scrutiny, and I commend Dr. Gonzales for putting his treatment to this sort of test. As of now, no results have been published on this trial - and no further updates show on the NCI trial database. I did call the lead physician's office for the study in March 2007, that of Dr. John Chabot, but they didn't provide me with any information on when the results of the study would be published. Background Study of Dr. Kelley's program Dr. Gonzales then went on to analyze one specific form of cancer to analyze in depth. He chose pancreatic cancer since it is so morbid and survival results of any kind would be significant. All patients with pancreatic cancer who saw Dr. Kelley between 1974 and 1982 were reviewed which indentified 22 who had pancreatic cancer. Upon examination, these 22 patients broke down into three groups: 10 who never followed the program, 7 who followed the program sporadically or partially, and 5 who followed completely. The survival statistics for these three groups was stunning. Median survival for the 10 who never followed the program was 67 days, for the 7 who followed partially was 233 days, and for those following completely was 9 years. That's right, 9 years. When I first read this study I could not believe these results, and even years later they still stun me. While these results are very small and certainly not definitive, this type of survival by any pancreatic cancer patients in any sort of treatment protocol is just floored me. The only other results that I have yet seen of this type of survival is the Gerson program, where I have personally talked with 3 survivors. Unfortunately, the Gerson clinic does not track all its patients so it is not clear whether this type of survival commonplace in the Gerson diet (although I certainly find any survival for nonresectable pancreatic patients significant and find the Gerson diet an important alternative to consider). Recent Study 4.Bovine and Shark cartilage. I ran across a study in the Journal of Biological Response Modifiers, Vol. 4, No. 6, 1985, that was titled "The Treatment of Human Cancer with Agents Prepared from Bovine Cartilage", pp. 551. I will be posting this on the web site. It had some very interesting results for the few pancreatic patients on the protocol. Of 3 in the study, one had complete response, one had complete response with liver failure causing death (that’s why Gerson started doing the coffee enemas - he also was getting response but their livers were failing until he instituted the enemas), and one partial response who died of unrelated pneumonia. In addition, I talked with another patient’s wife – her husband had tried chemo, radiation, etc and the tumors were unaffected. As a last hope they tried the bovine cartilage and within 6 months the pancreatic tumors were gone. The treatment protocol is 9g a day (split into 3 doses if possible, or whenever they can) and now the cartilage is generally available in the health food stores. (VitaCarte - on the web at Vita Carte). As to shark cartilage, Dr. Prudden, the original researcher of bovine cartilage and the guy who taught Dr. Lane about cartilage, had very strong opinions about its efficacy. First you have to use a tremendous amount - sometimes 10 as much as bovine. Second there is little good research on shark, and none particular to pancreatic that I came across. Third, he claimed that shark was not ground small enough to be used in enema form - it was too large to be absorbed by the body. And this is often the preferred method of delivery since you have to take huge amounts. Also the relatively large expense in contrast to bovine or other alternatives discussed here. If you are still interested, I would try to find out specifically if shark has helped pancreatic patients and talk with them. I called one of Prudden's bovine patients and talked with his wife. This man's pancreatic cancer disappeared after taking bovine (I believe that within a few months he was noticeably better and within 6 months it was gone from the scans). Prudden believes that you need to take bovine for 3 - months to be able to see if it is of benefit, my dad only got in 2 before he became so sick he had to be hospitalized for the final time. Back to top 5. Macrobiotic Diet. There was also that study on Macrobiotic diet and nutritionally linked cancers (pancreatic cancers, metastatic prostate cancers, and other nutritionally linked cancers) at Tulane ("Hypothesis: Dietary Management May Improve Survival from Nutritionally Linked Cancers Based on Analysis of Representative Cases, Journal of the American College of Nutrition, Vol. 12, No. 3, 209-226 (1993) Published by the American College of Nutrition). I will be putting this up on the web site as well. The results were very intriguing: they found that "The retrospective study of pancreatic patients disclosed that 1-year survival was higher among those who modified their diet than in those for whom there was no evidence as to diet alteration". Mean survival for the 23 patients was 17 months, vs. 6 months for the control group. Median survival was 13 vs. 3 months for the controls. The actual case histories of the patients using the macrobiotic diet were fascinating. In one instance, the patient had survived 7 years when hospitalized for fever and abdominal pain. The patient died during surgery, and upon autopsy they found that the cancer was still on the head of the pancreas, but it had not increased in size over the years. Case 2 offered a similar type of result. There the patient showed no progression of the cancer for the 5 years of using the diet. However upon resumption of his standard diet the cancer seemed to spread and he died 2 years late. Patient 3 practiced the macrobiotic diet as well as chemo and monoclonal therapies. After 9 years he was in excellent health and no mass could be defined in the pancreas. Finally in case no. 4, the patient had basically no conventional therapy but went on the macrobiotic diet. After 5 years he remained in good health, while a CT scan after 3 years showed that the tumor was still present. My read on these results is that in general, when the macrobiotic diet was effective for pancreatic patients, the diet seemed to just keep the cancer from growing. The patient who deviated from the diet saw his cancer progress. For those intrigued by these results, there is also a book or two out by Drs who used this diet to overcome their pancreatic cancer. For more info contact the Kushi institute - it is the main center for macrobiotics in the US, or phone is 413-623-5741. Back to top 6.Alternative Medicine Program at People Against Cancer. I found Frank Weiwel at People against Cancer, a nonprofit cancer information group, to be of great help in understanding options and getting information. (515-972-4444). They also have a program where they look at a patients medical records and a) do a search and prepare a very detailed report on the various traditional and alternative options that are applicable, b) send the information to selected alt. Practitioners for their input on whether their treatments might offer some benefit, and c) Frank then has a phone consult with the patient, their family and their physician, if the physician is interested, going through the material and answering all questions. I found him to be a font of information and the program was very helpful for us in understanding the alternatives that were available. The cost of the program is $350 or so – less costly ($25 or so) is joining to get their newsletter, booklists, etc. Back to top 7. Dr. Taylor's Metabolic Assessment Program. Frank Weiwel, mentioned above, has told me that he believes that the treatment program offered by Dr. Taylor (Dr. Taylor's Metabolic Assessment Program web page) should also be considered by pancreatic patients. Although Dr. Taylor has not published any studies on his methods, Frank says he is getting very interesting results. This program is not just specifically cancer oriented, although many people using it are cancer patients. It involves giving a blood sample for analysis and filling out a detailed question sheet. They use some high tech way of analyzing the blood as well as analyzing the questionnaire to determine where each individual specifics nutritional needs are. So unlike the other programs discussed above, Dr. Taylor ends up giving each patient an individually tailored program based on their specific need - at least in theory. I have no specific knowledge of this program nor have I talked with any patients. If you are interested, I suggest contacting People Against Cancer - they may want you to sign up for the alternative medicine program to discuss these kinds of things in detail. Dr Taylor's # is (217) 525-6843. Back to top 8.Vitamin C. In 1989, Dr A. Hoffer in conjunction with Dr. Linus Pauling published a very interesting study on the efficacy for Vitamin C and cancer. It was based on Hoffer's work with cancer patients in Canada. He was a therapist who saw mainly terminal patients who were referred because of depression, etc. As part of his treatment, he offered up Pauling's idea of very large doses of Vitamin C (from 3 grams to 40 grams - averaging 12 grams) 3 times a day. They later analyzed the results of using vitamin c for 123 patients - 31 who did not follow the regime, and 92 who did. The results, if legitimate, are astounding. The mean survival time for those who did not follow the regime was 5.7 months. For those who did take the vitamin c, 20% were poor responders with a mean survival of 10 months, while 80% were good responders with a mean survival of 122 months (or 20 times longer). The specific results for pancreatic patients were also interesting, if rather limited. There were 5 pancreatic patients in the study - 1 who did not use vitamin c, and 4 who did. The patient not using vitamin c died after 1 month. Of the four who took vitamin c, two had minimal or no benefit - one died after 2 months and the other after 9 months. But of the other two, both were still alive and well at the time of the study - one surviving 37 months and one 137 months. I was very intrigued to see these results - to find 2 out of 5 pancreatic patients surviving, with one as long as 137 months, after being considered terminal was, to say the least, extremely surprising and unusual. Back to top 9. Hydrazine Sulfate. This is quite controversial and I have heard recently that this drug may not be readily available as it was when we used it. The reason we were very interested in Hydrazine Sulfate is its reported success in some clinical trial in stopping the wasting away (Cachexia) that is such a problem with Pancreatic Cancer patients. The controversy is that some trials have been very positive, and some have not been - and there has been a great deal written on both sides as to which trials were properly done and really were valid. You can get some background on this controversy at Dr. Ralph Moss's Article on Hydrazine Sulfate. We decided, due to my Father's rapid weight loss, to try Hydrazine, and the results were pretty amazing. While he had lost 25 pounds or so before starting Hydrazine in just a couple of months, he did not lose more than 5 pounds more after starting Hydrazine over the remainder of his life (until his last week of hospitalization). While I don't believe Hydrazine had any particular impact on the progression of his disease, it did allow him to keep on his weight and strength to a degree the hospital had never seen in a Pancreatic Cancer patient. This meant a lot to the family at the end - for he was able to talk with people and spend time with the family when he was hospitalized and this was really important time for a lot of the family. When I later asked the Drs for their opinion, they were unanimous that they also believed that Hydrazine was the only explanation for his keeping his weight on since they had never seen this kind of thing in a Pancreatic Cancer patient before. I know that the FDA has been looking at Hydrazine Sulfate, and in reviewing the web it does seem that it may no longer be readily available in the U.S. It is legal in Canada, though, I am told - and one website I ran across that did have it for sale was Life Energy Distributor. There are a lot of does and don'ts when taking Hydrazine, and the protocol was developed by Dr. Gold of the Syracuse Cancer Research Institute - 315-472-6616. They work only with physicians or other healthy professionals, though, so you would need to have your physician contact them in order to get the protocol and find out if your physician can prescribe Hydrazine. But I did find a a copy of the Protocol on the web. I'm afraid that I can't vouch for it being upto date and accurate, but it does seem to be the same protocol that we used back in 1994 - except it does not explicitly state that you are supposed to have periods off the drug in order to make sure that the drug does not cause pernitious anemia, the one significant side affect that I am aware of associated with the drug. But if these rest periods are followed, I believe that there is very minimal risk of this particular problem. It is really important to read this over and make sure that you are able to follow the protocol - both to make sure that Hydrazine may work for you, and also to make sure that you don't have any significant side affect. Of course the best would be to have your physician work with the Syracuse Cancer Research Institute to make sure that you are following the protocol correctly and that it is being used in the safest most effective manner. We were lucky and our family physician was open to this and coordinated with Syracuse Cancer Research Institute - hopefully you can find a compassionate physician who will also help you in this way. Back to top 10."Designer Chemo" through Testing Cancer Cells by Rational Therapeutics. This one is a bit unusual for me to write about, considering the pain and anguish I saw my father go through with his chemo regime and the fact that no chemo regime has ever shown any real benefit for pancreatic patients. However, in the course of our radio show I interviewed Dr. Robert Nagourney of Rational Therapeutics who is doing something very different with chemo. The interview can be found at Nagourney interview. He has developed special test for testing a patients own cancer cells - I won't bore you with the details but it essentially test the cancer cells against a wide variety of chemo and herbal combinations (60+) in the test tube to see which, if any, promote cell death in these cells. This is a very different approach and gives a patient a kind of designer chemo result that hopefully has a much better chance of working on that patients own cells. I talked with him yesterday about pancreatic cancer and he believed that it is more treatable than normally believed and has had some success in treating patients. He mentioned one man that is two years under the regime they put together for him and I saw an interview with another patient of his who had survived for some time. Some traditional oncologist are not supportive of this way of determining a chemo regime, while others have a real interest in working with this type of approach. I know that they have had a bit of success with pancreatic cancer, and with other supposedly terminal cases. You can go there for the testing or send the cells to them - it does require a biopsy of the cancer so they would have live cells to work with. Their number is 562-989-6455. Back to top 11.Orathecin (formerly known as Rubitecan) click here for latest information on their clinicals trials Orathecin is a new drug under clinical trial for use with pancreatic patients. Orathecin, or known as Rubitecan, has been getting some attention due to some results Phase III trials by the company SuperGen. Supergen is still in the process of conducting randomized Clinical Trials for patients with advanced pancreatic cancer. For further information and eligibility requirements call: Super Gen at (925) 560 0100, and tell the operater you are interested in information about any trials for Pancreatic Cancer. Click here to see clinical trials still enrolling for Orathecin. SuperGen released a press release on their results for the Phase III of their clinical trials regarding Orathecin versus 5-FU in pancreatic cancer patients with progressive disease following treatment with gemcitabine. SuperGen has also issued a press release on Orathecin plus gemcitabine as first-line combination therapy for advanced pancreatic cancer patients who have not undergone chemotherapy. . Beyond these press release results, so far information on results has been scant. According to preliminary results on phase II studies on Rubitecan provided by the original developer of the drug, the Stehlin Foundation, they were getting some positive response. The type of response they cite, while significant in pancreatic cancer types of cases, is certainly far from recovery. In summary, for their 61 patients they 33% responders (with a 16.2 median survival time), 30% stable (median survival of 9.7 months) and 37% nonresponder (5.9 months median survival). Now I'm not knocking these results, my dad would have killed for 16.2 months, I personally looked to find what types of treatments, if any, produced actual long term survival. Historical research into Orathecin: Back in September 1998, I talked with the person in charge of the trial program at SuperGen. At that time, he cautioned that SuperGen didn't necessarily agree with the Stehlin Foundation's findings of efficacy; he looks at their data in a more conservative view and under criteria that SuperGen will be using in its FDA application for Rubitecan. His specific point of difference from Stehlin is that while they define response as anything over a 10% reduction in tumor size, under World Health Organization guidelines and those that he is using in his FDA filings, response is defined as 50% and over response. Under this criteria, he estimated that there was a 10% response rate with the other people (categorized as responders by Stehlin) falling into the stable category. He wanted to emphasize, however, that he believes the drug is still has the potential to be more effective that gemcitabine, the drug recently approved by the FDA and sold by Eli Lilly under the trade name Gemzar. For instance, he said that the mean time of treatment for patients for Rubitecan was 11 months, which indicated that the oncologist believed it was beneficial. He said in his experience oncologist will stop using a particular medication within a month or two if it has no beneficial purpose. I should caution that from this information it is unclear the type of side affects or their severity from Rubitecan. Originally these types of drugs were rejected years ago because of the severity of their toxicity. These second generation drugs are less toxic I guess since there is this renewed interest in them, but from an abstract that SuperGen sent me on the efficacy of Rubitecan for ovarian cancer on 34 patients, they mention "Grade or = 3 hematologic side effects included 23% anemia, 20% neutropenia, 7% thrombocytopenia. Non-hematologic side effects included 70% grade 2 and 20% grade 3 nausea; 20% grade 2 and 20% grade 3 vomiting; 20% grade 2 and 13% grade 3 diarrhea; 10% grade 2 chemical cystiris; and 10% grade 1 alpaca.... Gastrointestinal toxicity was the main clinical problem in managing these patients." Each person has to weigh the possible benefits of this drug against these possible side affects, as well as the possibility that these side affects (especially nausea and Gastrointestinal toxicity) may make it impossible to do any other alternative forms of treatment. That was true in my father's case - his extreme GI trouble caused by the chemo and radiation made it very difficult for him to eat or take pills and thus made any sort of nutritional therapy almost impossible to do. I hope this helps in evaluating Rubitecan. Also I have not looked at the actual data or talked to patients to see what types of side affects, if any there were of this treatment. I did talk with Dr. Nagourney (see above) to see if he tested for this substance, and while he doesn't for this specific type of Camptothecin, he has tested cells using a drug in this general class of drugs called topoisomerase inhibitors. Back to top I just received this update on the original trials on RFS2000 by the Stehlin Foundation (before the rights were sold to SuperGen). I am with the Stehlin Foundation for Cancer Research and am involved in the pancreatic study that we reported on in Internationl Journal of Oncology. I noticed that you stated that 16 months was not your ultimate goal in survival of patients responding to RFS2000 (rubitecin or 9-nitrocamptothecin). It is not ours either, and we an encouraging update on our survival statistics. We now have 10 patients that have survived over 24 months. This is 10 out of the entire 107 patients that were entered into the study, or 10 out of 60 patients who were able to complete 8 weeks or more of treatment with 9NC. I feel that these are pretty impressive statistics. 9 out of these 10 patients continue to survive, with a range that is now over 53 months. Also you stated some toxicity statistics from treatment of 9nc from an ovarian study done at M.D. Anderson. It should be pointed out that these were StageIV patients who had already failed treatment with Taxol and cis-Platinum treatm! ent. This is a very agressive and toxic regimen. As noted in our paper, the overall toxicity from treatment with 9NC is relatively mild. We have several patients who have been on drug continuously for over 24 months and are maintaining very good quality of life. Thank you for your interest in this terrible disease, and the hosting of this web site. I know that many people benefit from you sharing the experience that you had with your father and the knowledge that you have gained in it's treatment. Back to top
December 6, 1999 First, as they explained, the biologic "glue" is injected into the tumor and forms a kind of receptacle so that when the radiation is then injected, in very high doses up to 2,000,000 rads, the radiation is confined solely to the tumor. By using this method, they have been able to put in these high doses without any side affects (including, they tell me, no damage to the pancreas' function).The 98% success level that they mentioned in the story was not 98% survival for those pancreatic patients treated, but that in their study so far (they are doing a phase II trial now), 98% of the time they were able to kill the localize tumor in the pancreas. Unfortunately, since pancreatic cancer is usually diagnosed so late, killing this primary tumor does not necessarily impact on a patients survival. But the results they have reported so far are, I believe, very interesting - approximately 30% of patients alive at one year and there are several long-term survivors. Median survival statistics are not yet available.This treatment is available to pancreatic cancer patients currently, even while the clinical trial is in porgies. Thus, for those interested, if they don't qualify for the clinical trial, they can still get the treatment at his clinic (they tell me pancreatic patients, due to the nature of the disease, begin treatment within a couple of days of coming to the clinic). Note: ). Infusional brachytherapy using P32, the actual name of this treatment, is FDA approved and reimbursed by Medicare. From the online NCI information on this clinical trial, 2 centers in the USA participating in this clinical trial: Northside Hospital Cancer Center, Atlanta, Georgia, 30342-1611, United States; Recruiting Clinical Trials Office - Northside Hospital Cancer Center 404-303-3355 and Center for Molecular Medicine, Garden City, New York, 11530, United States; Recruiting Stanley E. Order, MD, ScD, FACR 516-222-5190. I don't know if these centers or physicians offer this treatment for patients in general like Dr. Order does or not. Back to top
Dr. Bernard Bihari((212) 929-4196), a Harvard trained physician, has come up with some interesting results for the use of low doses of the drug Naltrexone (LDN) and cancer. Specifically, he has treated a small number of Pancreatic Cancer patients (I believe 5 or so), but his site claims that there have been two apparent remissions for those PC patients who have used LDN. You can learn more about LDN at his website Low Dose Naltrexone - see the page entitled LDN and Cancer. Back to top
The name Radiosurgery is a bit of a misnomer. There is no surgery involved, instead it is a new and allegedly more advanced, safer, and more effective way of doing radiation therapy. You can read about at the Staten Island University Hospital Staten Island University Hospital website - click on the Radiation Oncology link on the left.. I found out, though, in reading their material that it is important to pay close attention to the language being used when claims are being made about the effectiveness of a medical treatment. Here, for instance, the center claims that a success rate of 99% ("over 99% of primary pancreas cancers currently have been successfully controlled in the treated area at Staten Island University Hospital with Body Radiosurgery") for the treatment of tumors of the pancreas. But on closer reading, they define the term "successfully controlled" as the "cessation of growth, shrinkage or disappearance of the treated lesion". I tend to view success, though, as survival, and here the benefits so far have been much more down to earth. In a paper published by one of the physicians from the Radiosurgery center, Dr. Gil Lederman states that "For those undergoing chemotherapy treatment the median survival was 9.8 months and the one year survival rate or the percentage of patients alive twelve months after diagnosis was 25%. In contrast, the 45 patients treated with body radiosurgery and followed at least a year, showed that of all patients treated the median survival was 10.6 months and at one year 44% were alive. This is more than a 70% improvement over chemotherapy alone!"You can read Dr. Lederman's complete article at the Staten Island University Hospital site - click on the link for Radiation Oncology on the left, and then on the main Radiation Oncology/Radiosurgery page, click on the link to "Other Cancers and Treatments". On this page you will find a link for "Pancreas Cancer", and this page has Dr. Lederman's article. So while radiosurgery may show survival benefits versus chemotherapy, these results are a far cry from what many may have interpreted a 99% success rate to mean. All one can say is that from their work so far, radiosurgery may be a more effective alternative than these types of chemotherapy in terms of mean survival and 1 year survival. In addition, radiosurgery may have less side affects than the standard types of radiation due to its more pinpoint nature. But I view this also as a cautionary tale. It is important to remember that the scientific community uses common place terms as terms of art, and that a common term like "success" may have a very different meaning in the scientific community than we layman would ever guess. In this case, 99% success did not mean 99% of the patients were cured - which many laypeople might wrongly assume that it meant. Instead, the 99% rate of "success" meant only that the treatment affected the tumors growth in some way, but did not suggest that the cancer was in any way "cured". Instead, some marginal benefit versus chemotherapy is all that has been found so far. So beware - investigate any such claims that seem to good to be true to make sure you understand how these terms are being defined so you can understand what types of specific claims are being made. Back to top |