As an integrative physician with a focus on cancer treatment and prevention, I’m often asked about my opinions on chemotherapy. Given the potential risk of side effects and research findings that often conflict each other, patients consistently ask me, “Is chemotherapy the right choice?” This is certainly a complicated question, as there is no one-size-fits-all approach to treating cancer.
When certain chemo drugs were first introduced in the 1950s, it was a real breakthrough. However, despite our improved understanding of the disease, we’ve experienced diminishing returns in the decades that followed. Quite often, chemotherapy is given to a large number of patients, when statistics show that it will increase long-term survival only for a handful of people.
So the question isn’t whether chemotherapy is effective. The question is whether it’s effective enough. This is a simple question with a complex answer. Newer research has moved us beyond the cookbook recipe with one-size-fits-all chemotherapy choices just based on the organ or tissue site of the tumor. How a tumor responds to a specific therapy depends on its mutations. New research is finding that mutations vary even within the tumor itself. As a result, chemo may kill some of the cancer, but not all of it. Studies also have shown that chemo can force the cancer to evolve in order to escape treatment. Still other findings focus on cancer stem cells, which generate new tumors that are more resistant to chemotherapy.
The time has come to accept that current regimens, while effective in some cases, can too often have detrimental shortcomings. We need to do more to develop targeted, rational approaches that can help overcome cancer and more specifically, cancer resistance. We need to leverage our ability to rapidly sequence cancer genes as well as personal genes in order to find the cancer’s greatest vulnerabilities and, from there, create individualized treatment plans.
Fortunately, this is already happening with a number of companies offering various types of gene analysis and chemo-sensitivity testing. By understanding the genetic makeup of both the individual and the cancer, we can help determine whether a specific treatment will be effective. For example, if the gene topoisomerase 1 is overexpressed, the tumor will be sensitive to the drug irinotecan. If the gene topoisomerase 2 is overexpressed, the tumor will be sensitive to the drug doxorubicin.
We need to find ways to make existing treatments act more effectively, support metabolism and ramp up the body’s own cancer-killing systems. In other words, we need to remember that chemotherapy is taking place inside a very complex system. We need to address the system as a whole while targeting the cancer at the same time. Many studies are looking at specific botanical compounds which are showing great promise in their ability to enhance the effects of conventional therapies, support normal cellular health and reduce the side effects of chemotherapy and radiation. By using an integrative approach, benefits can be maximized and toxicity minimized.
Natural Ingredients Can Make Chemo More Effective
Cancer is known to cause a cell dysfunction that activates an enzyme called mTOR. When this happens, cancer cells that should experience apoptosis (programmed cell death) after treatments meant to cause their cellular death manage to survive. However, honokiol (a powerful antioxidant compound derived from magnolia bark) has been found in preclinical studies to inhibit the mTOR enzyme, thus making some chemotherapy more effective. (Metformin, a well-known anti-diabetes drug is also a potent mTOR inhibitor.)
We should also work to block agents in the body, like the problematic protein galectin-3, that enhance inflammation and fuel cancer growth. Research has confirmed that modified citrus pectin (MCP), derived from citrus peels, controls excess galectin-3 levels and helps to inhibit cancer growth and metastasis.
Importantly, modified citrus pectin also has demonstrated synergy in preclinical studies with certain chemotherapy drugs such as doxorubicin in prostate cancer cells and paclitaxel in ovarian cancer cells, showing promise as an ingredient in regimens that allow for less toxic dosages and better anti-cancer results. Data demonstrate that MCP can help to achieve these synergistic effects through its ability to bind and block excess galectin-3.
Antioxidants can also play a role. For example, patients whose genetic tests indicate that the tumor is “caveolin 1 negative” respond poorly to chemotherapy. However, if we introduce antioxidant compounds at high doses, the tumor tissue can become caveolin 1 positive and, as a result, respond to the chemo.
Antioxidant use during chemotherapy is a controversial topic, and the question of whether it is advisable can be tricky. Some chemotherapy regimens may be enhanced with use of antioxidants, while some could have reduced effectiveness. Undertaking any integrative program should be done under the careful guidance of an experienced practitioner.
We can help to optimize chemo’s therapeutic benefits and minimize side effects by adjusting different pathways to better fight cancer: Influencing metabolism, inflammation, oxidation, pH, glucose metabolism, immunity and circulation should all play a part. An integrative perspective offers a multi-layered approach, attacking cancer from as many integrative angles as possible, rather than relying solely on toxic compounds with marginal long-term benefits. However, new research in the field of integrative medicine is helping to guide the way to more effective, strategic ways to fight this all-too-common disease.