Cancer: Know your enemy
Written By: Dr. Adam McLeod, ND, BSc
Chemotherapy is an effective tool at killing cancer cells when it is used appropriately. The biggest challenge is knowing which drug is best suited for an individual’s cancer. Over the years we have learned that certain cancers tend to be more vulnerable to specific chemotherapies. This has resulted in specific protocols being assigned to patients in a “cookie cutter system”. For example, if you have hodgkins lymphoma you are given ABVD1. If you have non-hodgkins lymphoma you are given CHOP2. This model is currently the standard of care with cancer treatment but it is clear that this is not the most effective way to treat cancer.
It is true that certain cancers tend to be susceptible to certain chemotherapies but these generalizations are not universally correct. There is an incredible degree of variation between cancer cells in different people. Genetic variations are significant even between different cells within one tumour in an individual3. In fact, very often there is a protocol different than the standard chemotherapy regimen that would be more effective4. Unless tests are done there is no way of knowing which protocol will be the most effective. It is essential to run these tests first and have a clear rationale for the chemotherapy protocol rather than testing on the patient through trial and error.
There is no question that targeted cancer therapies are the future of oncology. It is very important for patients to realize that we already have the ability to do this. Personalized cancer therapy is available but it is rarely encouraged by oncologists due to the costs. Although these tests are often not covered, they can be done privately for approximately $4000.00.
The older chemotherapy protocols involve using extremely toxic compounds that target any cell which is growing rapidly. In recent years there have been major advances in drugs that target specific pathways in cancer cells5. Before using these targeted drugs effectively it is essential to know which targets the cancer cells are vulnerable to.
When a surgery or biopsy is performed on a cancerous mass it is essential that the sample be sent to a lab that runs these personalized genomic tests. The cancerous cells will be tested against hundreds of different types of chemotherapies and clear evidence will be obtained about which drugs the cancer is actually susceptible to. This vulnerability of the cancer is determined by an actual test on the cells rather than making generalizations based on the type of cancer. As these tests become more affordable it will inevitably become the future standard of care because it is so much more effective than the current standard model.
This is something that patients need to ask for before the surgery. You cannot ask for it to be done afterwards because the cells will not be adequately preserved. This service is rarely offered to patients and few are even aware that this is an option. You need to specifically ask for the cells to be sent to a lab that runs these tests.
Personalized cancer therapy gives patients many additional treatment options. If they do not tolerate the initial chemotherapy regimen well or if the cancer becomes resistant to the first line therapy, then there is a potential “Plan B” that is effective based on molecular evidence. By running this test it will give your oncologist data that justifies the use of a protocol, which may deviate from the current standard of care. The data will give a distinct molecular profile of the cancer that allows a customized treatment plan to be developed for you.
If this customized approach is something you are interested in doing make sure you speak to your oncologist. Any naturopathic doctor who works with oncology on a regular basis will also be familiar with these tests. Contact your local naturopathic doctor to see if this test is right for you.
He currently practices at his clinic in Vancouver, BC where he focuses on integrative oncology. http://www.yaletownnaturopathic.com
1) Bonadonna G, Zucali R, Monfardini S, De Lena M, Uslenghi C (1975). “Combination chemotherapy of Hodgkin’s disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide versus MOPP.”. Cancer 36 (1): 252–9
2) Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP (1993). “Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma.”. N Engl J Med 328 (14): 1002–6.
3) Ross, Douglas T., et al. “Systematic variation in gene expression patterns in human cancer cell lines.” Nature genetics 24.3 (2000): 227-235.
4) Strickland, Stephen A., et al. “Correlation of the microculture-kinetic drug-induced apoptosis assay with patient outcomes in initial treatment of adult acute myelocytic leukemia.” Leukemia & lymphoma 54.3 (2013): 528-534.
5) McDermott, Ultan, and Jeff Settleman. “Personalized cancer therapy with selective kinase inhibitors: an emerging paradigm in medical oncology.” Journal of Clinical Oncology 27.33 (2009): 5650-5659.