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CANCER Basics and Chermotherapy


CANCER basics & CHEMOTHERAPY- 11 pgs –


1/13/17  http://healthfully.org/rc/id16.html & long version rl/id4


Complying with laws, below reflects my views and is not a recommendation for others to follow. 


Key points:  Moved to NT-Summation-cancer-diet-fasting in diet > KD diet.


That all cancers have defective metabolisms because of mutations in their mitochondria.


While each cancer is unique, the norm is for the mitochondria to have lost the ability to metabolize fat and to metabolize glucose aerobically; via., the mitochondria make ATP by a fermentation process.


Without ATP cells soon die, thus cutting off glucose by dietary restriction will kill cancer


Since there are minor secondary sources of energy such as glutamine, the cancer will likely shrink due to apoptosis and become dormant thus requiring a life-long ketogenic diet.


An indolent cancer becomes metastatic because of fusion of their mitochondria to a microphage.


Because of damage to the immune system and side effects, I would forgo all chemotherapies that can’t cure.


I would use fasting and ketogenic diet prior to excision (at least 2 weeks of fasting prior). 


I would use diet and fasting for all cancers, reliance upon which depends on initially findings and lab reports on the tumor:  A likely metastatic neoplasm, even if local, such as small cell lung, requires maximum dietary treatment, a cancerous polyp removed from the colon minimal.   


[If the cancer is stage I-III, excision is sufficient unless there is a significant chance to there being distant clumps of cells (metastatic cells) such as with small cell lung cancer.[1]  Therefore, I would forgo for stage I-III chemotherapy, unless in clinical trials it can produce a cure in over 30% of metastatic cancers.] 


 


There is a reason why the war on cancer, started under President Nixon has very few bright spots, though of course pharma claims much more.  Maximizing profits is at conflict with understanding the disease. Preventing it, and when that fails curing it.  It is essential to understand the inroads made upon medical science by corporate medicine: Corporate medicine is market driven; medical science evidence driven.  These two approaches result in different explanations concerning cancer.  The goal here is to understand the general basic biology of cancer, and then its treatment options based quality scientific evidence—without market considerations.  What follows is based upon sound science with sources.  Marketing science is driven by profits, & thus promotes aggressive drug cocktail for everyone with cancer.  Prevent is given deceptive lip service.  With a couple exception, chemotherapy does more harm than good.  Pharma’s marketing ploys confirms Harvard Prof. Dr. Marcia Angell’s  observation that we have “the worst system we could imagine.”  To learn more read Marketing Science & Side Effects, and you will learn how doctors are taught by Pharma to be pill pushers, and why they are.  It is as Prof. Goldacre writes:  A perverse system produces perverse results.


“A benign tumor is a mass of cells (tumor) that lacks the ability to invade neighboring tissues or metastasize.  These characteristics are required for a tumor to be defined as cancerous and therefore benign tumors are non-cancerous.  Also, benign tumors generally have a slower growth rate than malignant tumors and the tumor cells are usually more differentiated (cells have normal features).  Benign tumors are typically surrounded by an outer surface (fibrous sheath of connective tissue) or remain with the epithelium.  Common examples of benign tumors include moles, colon polyps,[2] and uterine fibroids.   Although benign tumors will not metastasize or locally invade tissues, some types may still produce negative health effects…. [Some types of] benign tumors can become malignant….  invade adjacent tissues or spread to distant sites by metastasizing.  For this reason, benign tumors are not classed as cancer Wiki.  Bad pharma has blurred the distinction between benign and malignant by calling benign tumors “carcinoma”, then aggressively treat with surgery and chemotherapy.  Critics point out in journal articles the negative consequences of treating benign (small local) tumors of the breast prostate, thyroid cancers, and others tissues with adjunct chemotherapy following excision. Yet pharma ignores this and through their KOLs (Key Opinion Leaders) sets up guidelines for aggressive treatment which includes chemotherapy. Their KOLs write medical textbooks, run the clinical trials, and instruct physicians in mandated continuing education classes.  In this and other ways pharma shapes the practice of medicine.  One ways is that on an average over half the revenues in a cancer clinic is derived from the spread of the cost of a drug and what they receive for administering it in their office.  This topic is covered at Cancer long version and in the Journal of the British Medical Association, Nov. 2016, Cancer Drugs, Survival and Ethics.  This link is to a sampling of articles in leading journals on bad pharma.


With regulatory capture, the FDA often grants patents to drugs that are not in the best interest of the patient.  Moreover pharma’s role in the production of journal articles entails bias.  For Industry funded trials positive bias averaged 32% (range 11 to 69%) for clinical trials based on a comparison of the raw data submitted to the FDA to the journal articles.  And it is worse, FDA approval is flawed.  Surrogate endpoints of shrinkage of tumor and/or duration in which tumor doesn’t grow are used by the NIH in a very select population of terminal patients (younger patients who have not undergone prior chemotherapy).  Unfortunately those with no treatment if they have more than a year to live would do better than the chemo cohort.  This is because the cancer cells that have thrived during the chemo, now that the frail cells have been eliminated, are getting all the energy molecule glucose and tumors are very glucose hungry, up to 200 times more than a normal tissue--to be explained later.  Moreover, the quality of life is reduced based upon the often horrendous side effects.  And it gets worse, for it is the norm to use the chemo on those without metastatic cancer, and depending on type most have been cured by excision, thus no benefit from chemo.  More on this later under Hope’s Hypothesis.  Typically in those with terminal cancer it translates into an average life extension of 1 to 3 months—general the duration of the chemo therapy.  Once stopped the vigorous remaining tumors cells resume growing.  Not surprisingly, a 2015 study Published in the BMJ (one of the 5 top English medical journals) found that most cancer drugs in the real world population “do not increase survival”, at.  And it gets worse, industry funded studies are always biased in favor of industry.  A study which relied upon the raw data found all 74 clinical trials journal articles industry produced were biased; its average 32%.  It as Prof. Goldacre said, “The devil is in the details.”  This makes good advice and informed decision unlikely. 


“Cancer (malignant neoplasm) is a broad spectrum of diseases involving improperly regulated cell growth.  For that cell growth to become life-threatening it must be capable of sufficient reproduction so as to disrupt essential bodily processes.  Over 80% of fatal cancers spread to more distant part of the body through the lymphatic or blood systems—some such as cerebral cancer destroy a vital organ, and others such as  liver, and pancreatic simply grow beyond the margins of the tissue into other organs.  With the exception of blood and lymphatic cancers, they form hard tumors.  One of the most important factors in classifying a tumor as benign or malignant is its invasive potential” Wiki.   A microscopic examination of a biopsy by itself is insufficient to prove that the tissue is malignant, for it doesn’t reveal the properties of being invasive and/or metastatic.  Lab reports often numerical grade the tissue based on shape of cells, the heterogeneity of cells in tumor to produce a probability rating.  Lab write up of a biopsy very often use cancerous and carcinoma though it should be prefixed with an adjective such as likely or unlike.  Cancerous can only be definitively determined with additional imagining, such as MRI and CAT scan.  Depending on lab findings, removal often is the best choice, and but subsequent chemotherapy often isn’t necessary.


Oncogenesis (carcinogenesis):  literally the creation of cancer. It is a process by which normal cells are transformed into cancer cells. According to the standard theory (which I no-longer hold), “there is a progression of changes at the cellular genetic and epigenetic [regulate the expression of other genes] that ultimately reprogram a cell to undergo uncontrolled cell division, thus forming a malignant mass.  Over 98% of potential mutations and epi-mutations will have no bearing on cancer” Wiki.  There are 3 theories of how a tumor becomes malignant (invasive).  It is important for me to understand which theory fits best the evidence, and also how cancers produce the energy molecule ATP, for as you shall see, it affects my treatment choices.


Three theories on conversion of a tumor into cancer:  Standard theory is that there are typically seven essential types of mutations such as the cell line becoming immortal, fooling the immune system, etc. necessary to convert a benign tumor.  The second theory is that the tumor signals stem cells to become involved, and they give the tumor cells the properties needed to become cancerous.  The third is similar but having the changes brought about by M2 macrophages.  It seems that the only essential mutation for a cancer occurs in the mitochondria, known as the Warburg Hypothesis (1924 observation) which limits the metabolism of glucose in the mitochondria to fermentation (anaerobic).  This I will develop at the end since it entails way to starve cancer by having the body switch to fat metabolism—now lacking in cancer cells.  Yes, starve cancer!


A)    Six-mutation theory:  This is the theory favored by pharma (and once I too with the aid of stem cells until Dec. 2016).  It holds that 6 mutations are necessary for a tumor to become invasive, and these gradually accumulate among the many other mutations in the cell’s nucleus DNA (see Scientific American, July 2003) .  The theory holds that random mutation, whose rate is increased through exposure to mutagenic substance, radiation, or other forms of stress, and/or if a gene which checks the reduction of DNA during mitosis is switched off or damaged, such as the P53, BRAC1, or BRAC2 genes—being the best known and studied.  Common mutations it is held as causes (1) the cell to replicate at a high rate, (2) fail to respond to signals to return to the normal rate,   (3) evasion of apoptosis signals (programmed cell dismantling), (4) angiogenesis (causing new blood vessel to nourish the expanding tumor, (5) to reproduce bypass the telomerase system which limits replication to about 50 division, (6) not appear as foreign to immune cells when the tumor cells break off and invade different tissue type and/or migrate to distant locations using the lymph or blood circulatory systems for transport.  To this, I would add is the ability to penetrate membranes which form barriers.  This explanation ignores other essential changes in a cancer:  (1) the loss of the ability for aerobic metabolism of glucose using an inefficient system producing lactate anaerobic fermentation, (2) deformed mitochondria (the vacuoles engines produce over 90 of the ATP used by the body for energy) being deformed, (4) the inability to metabolize fatty acids (fats) (3) the involvement of the mitochondria.  of For most tissues, 7 or more mutations are required to create a malignant tumor.  Less than 10% of all cancers involve inherited mutations, the remainder is a result of environmental factors and bad luck.  Over half the cancers are attributable to carcinogens.  Excluding skin cancer, only about half of all cancers prove fatal.    


B)   Role of Stem cells theory:  A way to explain the properties of a cancer without so many mutations.  There must be some, otherwise there wouldn’t be a benign tumors consisting of what once was normal cells.  Most significant are mutations that diminish the ability of cells to produce an exact copy of the parent cell DNA.  This increases the lineage’s number of mutation typically about 10 fold.  In the stem-cell theory, stem cells in their reproductive-healing role then step in to convert some of the tumor’s benign cells to cancerous cells. An April 2006 article in Scientific American and another in July (also at) claimed that stem cells were what was turning a cancer into metastatic phase.[3]  On stem cells Wiki:  “they are  undifferentiated  biological cells, that can differentiate into specialized cells and can divide through mitosis to produce more stem cells, which are found in various tissues.  In adult organisms, stem cells and progenitor cells act as a repair system for the body, replenishing adult tissues. Stem cells maintain the normal turnover of regenerative organs, such as blood, skin, or intestinal tissues.  Stem cells possess two properties:  self-renewal (to maintain through cell division the undifferentiated state) and potency (to give rise to any mature cell type).  Induced pluripotent, these are not adult stem cells, but rather adult cells (e.g. epithelial cells) reprogrammed to give rise to pluripotent capabilities of forming more than one type of tissue.  progenitor cell is a biological cell that, like a stem cell, has a tendency to differentiate into a specific type of cell, but is already more specific than a stem cell and is pushed to differentiate into its "target" cell… and can divide only a limited number of times.”  The occasional finding of stem cells in malignant tumors, and the heterogeneity of cells in most malignant tumors is held to demonstrates their role:  it fit the evidence; but a neat theory was shot down by facts, some below. 


C)   Role of type tumor associated macrophages[4] (TAM):  This is similar to the stem-cell hypothesis only the role is filled by macrophages; the supporting evidence is strongest (the extent of this evidence is to be found at a review journal article link to my published version, on line, and summarized 2012 Allevena.  Contrary to expectations, in malignancies, tumour-associated macrophages (TAM) promote disease progression by supporting cancer cell survival, proliferation and invasion. TAM and related myeloid cells…. also promote tumour angiogenesis and suppress adaptive immune responses.  Dr. Seyfried in his lecture points that experiments show that the DNA from the nucleus of cancer isn’t the cause of the cancer, but rather the mutations in the mitochondria which cause inefficient glucose metabolism. In experiments by inserting the mitochondria of a cancer cell into a normal cell, that cell will become cancerous—a event that won’t happen if the DNA of the cancerous cell is inserted.  Macrophages which are immune cells which engulf foreign substances including bacteria and viruses, help dispose of the products of cell apoptosis, and stimulate the growth of new tissue in the repair process on very rare occasions will attach to a tumor and acquire the defective mitochondria of the cancerous tumor.  This will turn the macrophage into a cancer cell.  In established tumours, TAM resemble M2-like macrophages… in the context of a growing tumour they may favour disease progression. [42,50–54]. Cancer-related inflammation is now recognized as a hallmark of cancer [55,56]. Macrophages are key initiators of the subtle chronic inflammation present in the tumour microenvironment, as they are major producers of inflammatory mediators.  IL-6 is a key growth-regulating and anti-apoptotic cytokine, having tumour-inducing activities on both malignant and stromal cells.  In mouse models of colitis, IL-6 is produced mainly by macrophages in response to intestinal injury and in an NF-kB-dependent manner.  Tumour cells exploit the ECM degradation mediated by TAM to invade locally, penetrate into vessels and disseminate to give distant metastasis. The chemokine CCL18 produced by TAM has been shown recently to play a critical role in promoting breast cancer invasiveness by activating tumour cell adherence to ECM. Tumour macrophages have the ability to suppress the adaptive immune response, thus contributing directly to the phenomenon of immune evasion of cancer. in the majority of human tumours high numbers of infiltrating TAM have been associated significantly with advanced tumours and poor patient prognosis [11,15,42,111],  TAM are present in large numbers in tumour tissues and are key promoters of cancer-related inflammation.” Summary article 2012 Supra.  The six mutation theory and the role of stem cells fall far short in evidence to TAM.




[1] As of now I don’t know enough about lymphomas and leukemias to predict the effects of energy restriction. 

[2] "Most hyperplastic polyps are found in the distal colon and rectum.[3].  They have no malignant potential, [3] which means that they are no more likely than normal tissue to eventually become a cancer” Wiki.  See also Controversy about removing benign bowel lesions.

[3] “Only a small subset of tumor cells has the power to proliferate and expand… share treats with stem cells….  Spring forth from regulator failures in damaged stem cells… cancer treatments must target cancer-stem cells” at p, 42 As per above, not stem cells but TAM in which macrophage has turned on certain oncogenic genes in the tumor. 

[4] Macrophages are large immune cells which function to clean up cell debris, engulf foreign substance, microbes, cancer cells, stimulate immune system, decrease immune reaction, encourage repair (M2 macrophage)  signal for other immune cells



On treatment and prognosis is about the typical, common cancers 


For the 5 common cancers (lung, colorectal, breast, prostate & pancreatic), 3 of them if assumed not metastatic on initial diagnosis can be successfully be treated by excision (over 70% at 10 years will not have died from that cancer).  Two of them small cell lung cancer (the most common type) and prostate over 90% die in the first 2 years.  Pancreatic cancer is locally invasive and cannot be entirely removed by surgery, and small cell lung cancer has metastasized by the time it can be seen with imaging.  For each there type of cancer there is a bell curve of variation for rate of growth.  Rate of growth can only be determined on subsequent imaging.


FIVE KEY FACTORS AFFECTING PROGNOSIS (the benign tumor that a TAM has converted into a cancer:  


 One factor is the stage I-IV, which is based upon the degree of invasiveness of the cell line and size of cancer.  A larger tumor, spread to adjacent tissue, or is found in lymph nodes is more likely to have undergone the changes involving TAM and become metastatic (lethal).   For an example 5-year survival of breast cancer, if greater than 5 cm 65%, for less than 2 cm 96%—tissue of origin makes only a small difference.  Each tissue type percentage figures is different. How fast the cancer invades adjacent tissue and spreading through the tissue of origin can only be determined by a successive examinations months apart.  Second, is the primary tissue.  Each tissue has its own prognosis.  Pancreas has 3 common primary tissues; however, all tissues produce a very high percentage of aggressive malignancies (the 5-year survival rate is 2%).  The third is the variation in cells within the tumor the more likely a M2 obtained a mitochondria from the tumor that will cause the mitochondria to become caner.  And if it still is mutating at a higher, the less like that all the cancer sell will be removed or respond to dietary restriction or radiation.  Fourth is the degree of differentiation from the tissue of origin.  The closer the tumor resembles the parent tissue the more likely is it that it won’t be cancerous or if cancerous will be indolent and thus easy to cure with excision and diet.  The complex processes involving many genes, their control mechanism, the also way the M2 macrophages (TAM) and other immune cells respond to the benign and later malignant tumors, all this makes each cancer unique.  Fifth, the presences and involvement of M2 macrophages.  But for a few experimental settings, the lack of awareness entails that lab reports don’t contain this information.


On Staging: While the stage of cancer development is important as to survival (success of excision in curing cancer) the early detection yields no survival benefit.  Yes finding a cancer early doesn’t improve the patient’s chances versus findi later.  Theory behind early detection is that the clock is running, and at some point the cancer will have a mutation that will allow to spread to distant tissues.  Allow me to explain, if it is really a cancer, not a benign in situ tumor, then by the time it has gone invaded other tissues, it has already done a fusion with a macrophage, and what properties that tumor has gained have determined it properties; viz., weather the cancer is deadly or not.  So removing a pea size tumor is already too late if mitochondria fusion has occurred.  Only a certain percentage of fusions are deadly, and that percentage is determined by the tissue type.  Some tissues have most of the cancers progress slowly while others like small cell lung tissue are very likely metastatic rapid growth. This theory of early detection was shot down in the fifties when a program of screen with X-rays was adopted. Since death typically occurs within 9 months, answers to this question was in hand by the end of the second year.  The program was stopped because there wasn’t a statistically significant benefit.  It was in an era when most trials were ran by a university, even those funded by pharma, their further involvement was minimal.  That has all changed with the changes made by the Republicans during Reagan’s administration.  Others like breast cancers are in between.  Thus a so called breast cancer of 2 cm or less has only a 4% chance of killing the woman; while one of 5 cm has a 35% chance.  The point is that with a regular checkup only 11% of the metastatic cancers haven’t progressed from small to 5 cm.  Some of those are indolent and the new colonies will take years to show up, but most aren’t.  Early discovery doesn’t change the nature of the cancer.  This has again been confirmed with breast cancer.  The harm done by early detection, treating tumors that aren’t cancer.  In a study published in 2017 in the BMJ, article drawing attention to the article published in the Annals of internal Medicine found that one in 3 women was over-diagnosed (a polite way of saying they didn’t have cancer, just a benign tumor).  Seventeen years of organised breast screening in Denmark has not reduced the incidence of advanced tumours but has markedly increased the incidence of non-advanced tumours [not cancer] and ductal carcinoma in situ” BMJ, 2017.   This is the same for other detection methods which lead to a biopsy.  I was diagnosed with prostate cancer based on a biopsy in 2006, and didn’t go back for further screening after reading the lab report which call it “carcinoma”.  The percentages were the same for biopsy following a high PSA as for mammogram.  Millions have had their lives shortened by treating a phantom cancer:  they poison called chemotherapy, made all the worse by chemical castration (block estradiol or testosterone).  But pharma who miss-educates doctors benefits.


FOUR KEY PROBLEMS WITH MOST CHEMOTHERAPIES, LACK OF SELECTIVITY, DEPRESSION OF IMMUNE SYSTEM, SUMPRESSION OF TUMOR GROWTH SHORT-TERM DOES NOT PRODUCE A CURE, DEVELOPMENT OF RESISTANCE AND ELIMINATION OF WEAKER MALIGNANT CELLS:  1) Cancer cells are nearly identically to body cell; their genes and thus proteins are identical.  Thus unless the tissue type can be eliminated without dire consequences (as with testicular cancer) it is unlikely that the chemo will produce a cure.  Thus very few chemotherapies harm only cancerous tissues.  2) The common cancer drugs function by blocking functions vital to cells and tissues (and thus the patient) such as the production of new blood vessels, cellular reproduction, etc.  “Thus chemotherapy also harms normal cells especially those that divide rapidly, most notably in the bone marrow,  digestive tract, and hair follicles.  This results in the most common side-effects of chemotherapy:  myelo-suppression    (decreased production of blood cells, hence also immuno-suppression),  mucositis (inflammation of the lining  of the digestive tract), and  alopecia (hair loss).  Virtually all chemotherapeutic regimens can cause depression of the immune system, often by paralysing the bone marrow and leading to a decrease of white blood cellsred blood cells, and platelets Wiki.  Thus since macrophages have vital functions to develop a chemo to suppress their functions would soon prove fatal.   This explains why chemo therapies (with a few exceptions) can be given only short term, and often not continuously but every week or two for a couple of months.  3) The surrogate endpoint of tumor shrinkage and progress-free period is used by the FDA for drug approval.  This is a very low hurdle that can extend the life of a terminal patient near death a few weeks or months, but doesn’t translate into benefit for patients whose death from cancer is a year or more out, or who were cured by surgery.[1]  Causing damage throughout the body is why most chemotherapies are given only short term intermittently (such as biweekly) and stopped after a couple of months.  They at best for the terminal patient near death prolongs life on average 2 months for metastatic cancers.[2]  This explains why there is a lack of long-term studies with the end point of death for those with stage I, III, and III cancers.[3]  And if stage IV, I wouldn’t want to have the decline of my health in my last few months.  4) If the chemo proves toxic to the weaker malignant cells, those that survive are both resistant to the chemo, and now are not competing with the weaker tumor cells for the limited supply of glucose, their energy molecule.  Thus once the chemo has stopped the malignant cell typically then reproduce at an accelerated rate.  Moreover since the immune system often plays a key role in suppressing a cancer, to weaken the immune system for many also contributes to the growth and spread of the cancer.  If I was likely to be cured by excision or radiation, the use of chemo subsequent or prior is a choice I would never make--see Hope’s hypothesis below.   A recent of new drugs (2003 to 2013) showed them on an average no better than old drugs at Jan 4, 2017. Of course pharma exaggerates the benefits and downplays the side effects.  


Evolution works for the survival of the most vigorous cancer cells.  This is why in most cases when a cancer returns the same treatment is not repeated, or if repeated has little positive effect.  The very high rate of mutation for most aggressive cancer gives an evolutionary resistance that entails survival of some of the cells during chemotherapy.  (That is why the greater the variation in appearance seen under a microscope of the tumor cells is associated with an increased risk of the cancer proving to be metastatic.)  Thus for a chemotherapy that reduces tumor size, some of the cells will survive, and continue to reproduce.  “Those resistant cells reproduce at the highest rate will make up most of the new tumor.… Over a sufficiently long period of time there always are metastases that share little with their tumor of origin…. But the sad reality is that the current cure rates for metastatic-disease still sit where they have been throughout the history of humankind—in a neighborhood near zero” (Slipping Past Cancer’s Barriers, Mauro Ferrari, American Scientist, Vol. 101, p. 430 12/2013).  These three issues entail that for nearly all chemotherapies entail the net result is not in the best interest of the patient. 


THE PROBLEM OF DESTROYING CELLS THAT HAVE ALL OF THAT PERSON’S GENES:  A metastatic cancer is as stated a line of cells from a person’s body that have undergone mutations in the mitochondria the result of reactive chemical the products of metabolism and glycation that disables its ability to metabolize fats and glucose aerobically.  (Mitochondria have their own genes.)  The macrophages in a rare fusion process acquire the abnormal mitochondria with its genes to become cancerous.  Instead of growth of lung tissue to repair damage from an accident or infection, the mitochondria now function like aberrant lung tissue.  This cancer is from that person’s body cells with all its genes.  How can a chemical destroy those body cells without also destroy other lung cells, or other tissue throughout the body?  It can’t.  Consider how different a bacteria is or the protozoan Malaria from human cells, different in many ways, yet there isn’t for Malaria a chemotherapy that will destroy the disease.  And with bacteria, the antibiotics must be given in low dose so as not to kill the patient.  The antibiotic only helps the immune system destroy the bacteria generally by slowing the reproduction of the bacteria.  Once the immune system is damaged by chemotherapy, survival is shortened if the cancer turns out NOT to be metastatic, or if metastatic and indolent.  How much is a guess because population data banks are not open to the academic community; these include records by major insurers and hospital chains such as Kaiser, and by our government (Veterans Hospitals). Informed consent requires the patient and being given valid figures on the endpoint results of all causes of death and side effect in a real world population, and his oncologist needs access to these figures for giving advice.  But pharma, the global trillion dollar gorilla is very good at market.


What of cancer cells which no longer are held in check by white blood cells, as they once were before TAM modified it in a way that permits the cancer cells to spread to distant tissues.  The chemo must somehow destroy the cancer without now the aid of the white blood cells; it can’t.  Oncologist use the term “survival” to sell patients on a poison that for most chemotherapies extends life of a terminal patient under 3 months; that is not “survival”, only modest extension of the patient’s suffering.  The poison is used short term because if it is used continuously it will kill the patient.  And even short term, most patients have a major reduction in the quality of life.  If oncologist weren’t merchants of false hope, and patients knew the meaning of their use of “survival”, most would refuse chemotherapy.


SHOULD CHEMOTHERAPY BE GIVEN TO A STAGE I, II, OR III CANCER?  Typical 5 year survival for breast cancer  is 97% for stage I, 85% for stage II, and 65% for stage III.[4]  (The very higher survival rate for stage 1 comes from treating many benign tumors, called malignant).  If chemotherapy is given to those who will remain cancer free, it is life shortening and affects quality of life.  This negative effect is very significant in cancers of the prostate and breast because of hormone blocking (castrating) drugs are included in the chemotherapy.  Yes, sex hormones not only increase libido, but also promote health, which is why pharma and the NIH do tobacco science to claim the opposite (see Natural HRT and Testosterone links).  Without estrogen, total morality was double at 10 years.  Moreover, if the surgery misses some of the cancer, the chemo won’t destroy that tumor.  Once observed it can be removed.  If the cancer has evolved to be metastatic in the interim period, it would have with or without the chemo.  Chemo, since it can’t destroy the missed tumor it doesn’t change the course of events.  Thus for stage III breast cancer (cancer found in nearby lymph nodes), 65% of patients must endure chemotherapy when they don’t need it and its horrible side effects, which persist for years for about 40%.  And for the 35% who will die of cancer, they are gaining nothing but side effects.  Since they are not near death, the cancer is more likely to be more aggressive now that the febrile tumor cells have been eliminated, and all the glucose absorbed is used by the surviving cells.  Rather than treat every one, it would be better to treat only those who have progressed to stage IV (metastatic) cancer if they want to be poisoned.  And given the small benefit of chemo, why prolong the illness with costly treatment that lowers the quality of life?  Yes, pharma is very good at marketing


Hope’s Hypothesis (pharma’s deceptive logic):  that chemo could make me a survivor.  Chemotherapy in clinical trials doesn’t have a placebo group.  It is given to terminal patients, thus avoiding long-term following with its side effects.  Remission is measured by imaging observations of the tumors size.  Typically the tumor stops growing or shrinks for 3 months.  Suppose the average death occurs at 12 months and that 20% die in 3 months; and 5% are live 2 years—the length of the trial.  That does not prove that a few patients had an atypical positive response to the drugs.  Rather a few patients had indolent metastatic cancer and would have lived that long without the chemo.  In the 60s, prior to chemo some survived for years with metastatic cancer.  Today the patients receiving a poisonous cocktail (typically 3 drugs) some will die from side effects such as opportunist diseases for stage II and III, and many also for stage I, even when the literature cautions against aggressive treatment.  These patients believe that the chemo will destroy all the cancer missed by surgery, and the oncologist promotes this belief.  Moreover, the horrible side effects will be downplayed.  Instead the oncologist sells Hope Hypothesis; pharma makes billions; and the patients suffer.  The evidence basis always is biased in favor or pharma.  For an account of trial distortions read Bad Pharma by Dr. Ben Goldacre.  Pharma’s clinical trials are not about uncovering side effects or indolent metastatic cancer, but about marketing.  I certainly would fall for Hope’s Hypothesis, unless the cancer I had could be for some be cured based upon clear published evidence.  Remission isn’t a cure!


IF CHEMO CAN’T CURE METASTATIC CANCER, THEN IT CAN’T CURE INDOLENT CANCER.  They are essentially the same but for the ability to fool the immune system. There is not an atypical positive response for a subgroup; those terminal patients have an indolent form of the cancer.  The term “Survival” applied to chemo means “delays death” a few months.  Like soldiers, doctors are believers, thus they sell their faith in chemo.


 


 Side effects:  because chemotherapy consists of chemicals that blocks essential processes, major side effects are the norm.  Among the effects, an assortment of sickness symptom (nausea, pain, weakness, etc.) that is sufficient for about half to modify or forgo full treatment.   There is a significant mortality risk because of suppression of the production of red and white blood cells.  Typhlitis is an intestinal infection with a “very poor prognosis”.    Anemia and bleeding are blood suppression consequence along with fatigue.  Long-term consequences include weakness and fatigue, an increased risk for new cancers, heart attack, infertility, & damage to the heart, kidney, liver, intestines, hearing, brain, skin, and other organs.  Chemo brain (PCCI) is a significant cognitive dysfunction; for some “lasting 10 years or more” Wiki,   A 1980 study of various cancers found, “…this was surprising, due to the fact that a majority of the drugs administered in this study are known to not cross the blood brain barrier (BBB)…  Commonly describe as affecting vision, memory, coordination, attention, understanding…”  Other studies have added a psychiatric dimension.  In a 2013 summation of imaging studies both brain volume and neural activities were down--both short and long-term.  Increased mortality is grossly under reported, only cancer deaths are counted, quality of life reduced and years lost.  




[1] Most stage I. II, & III cancers are cured by excision; commonly estimated at 85% or more according to several journal articles. 

[2] If we dropped the few cancers that lives are saved (testicular, some leukemia-s and lymphomas) the average would be 2 months.

[3] As mentioned prior bias is the norm for pharma-funded studies.  For example those who die during the period of chemo treatment are doped out of the study as too those who drop out because of severe side effects, and their side effects are not included in the journal article.  Moreover, the post-marketing studies (after a patent has been granted) are of the lowest quality.  Read Ben Goldacre’s Bad Pharm and Marcia Angell How Drug Companies Deceive Us—and on YouTube.  

 

[4] Stage I is local, stage II is invading adjacent tissue, and stage III is also found in lymph nodes; stage IV is metastatic, found in other tissues such as the liver, bone, brain, etc. 



Ketogenic diet has shown to prolong life.  First proposed by Otto Warburg, Nobel Laureate, in 1924, and his thesis updated in 1966, and it is still current—there were 4 books on his work published in book form—see amazon.com.   Book 5 of the series, Metabolism of Cancer, is an updated version of his 1966 book.  Studies published since 2005 have shown that the Warburg effect, indeed, might lead to a promising approach in the treatment of solid tumors”: Wiki.  Research on the Ketogenic diet for treating cancer progresses at a snail’s pace because of lack of funding and FDA opposition to approving clinical trials.  (see Targeting Energy Metabolism in Brain Cancer 21 min lecture by Prof Thomas Seyfried’s research at https://www.youtube.com/watch?v=sBjnWfT8HbQ&hd=1 and his  Cancer as a Metabolic Disease


 


Recommendations:  For treatment and diagnosis a teach hospital is best.  Become knowledgeable.  Given marketing bias in practice of medicine, in guidelines, in journals, and in textbooks, start with a search of the critical journal articles concerning treatment and diagnosis.  Time counts; have a biopsy as soon as possible.  Read carefully the results concerning the abnormality of the tissue and size of tumor. The term cancer, malignant, and carcinoma can only properly be applied if the tumor has spread outside the tissue of origin.  The greater the abnormality of the cells, the greater the risk,[1] and the more likely it will be called malignant though it is benign.  If the risk is substantial that the local tumor will evolve into cancer, have it removed.  Remember that time increases the risk of an indolent cancer becoming aggressive, and/or metastatic.  If chemotherapy is recommended, submit to it only when major benefits are clearly documented, and deduct for bias, which is the norm.  Don’t rely upon treatment guidelines, they are based upon marketing science  written by pharma’s KOLs; so too is the advice of the oncologist whose continuing education is given by pharma.  Published articles have an average bias of 32%.  Only for a few cancers does chemotherapy save lives, the rest are not curative (see hope’s hypothesis above), nor does chemo prevent a missed indolent cancer from becoming aggressive or metastatic.  If it is not curable and you want to endure the horrific side effects, then see if an in vitro chemo-sensitivity testing[2] is available.  If you feel that you must, because of family pressures endure chemo, ask the oncologist not to give you the maximum dose.  And remember that on an average the oncologist makes over half is his income from administering chemo in his office.  He is bill at a discount rate for the treatment cocktail well below what he bills the insurance company.   In the majority of cases aspirin is the best prophylactic, and best treatment because it activates necrosis factor NF-B.  Read Aspirin, & Aspirin's Cancer Protection. Take 975 mg of aspirin daily for the first 5 years.  If aspirin irritates your stomach take Tums and avoid protein pump inhibitors.  If acid indigestion is severe, check for the Pylori bacteria, which cause most ulcers.  For reducing risk of cancer take 325 or 650 mg daily.  JK has taken aspirin since 1992, an average of 650 mg, and this has reduced his cancer risk over 50%.  Testosterone and natural estrogen moderately reduce risk of certain cancers.  Remember that business ethics is driven by profits, and pharma is very good at marketing in our corporatist world.    Vitamin C has both protects against developing cancer and increases survival of the terminal patient.  I recommend following the treatment used by Linus Pauling  (see previous paragraph) on terminal patients whose immune system hasn’t been compromised with chemotherapy.  Pauling used 10 grams daily, and extended the life of the terminal patients from an average of 50 days to 250 days—without the horrific side effects. 


       


 


CHEMO CAN’T CURE METASTATIC CANCER, THUS IT CAN’T CURE INDOLENT CANCER.  They are essentially the same but for the ability to fool the immune system. There is not an atypical positive response for a subgroup; those terminal patients have an indolent form of the cancer.  The term “Survival” applied to chemo means “delays death” a few months.  Like soldiers, doctors are believers, thus they sell their faith in chemo.


 


 


It puzzles me why so many people are concerned about GMO foods, pesticides, food additives, and yet take several chemicals from their doctor, herbal products from there health food store, and expose themselves to the chemical in hair conditioners, laundry products, and so on.    In general paleo peoples don’t take daily pills and cancer is very rare among tribal elders.   




[1] In some tissues (prostate, thyroid, breast, cervix, and colon) the removal of low-grade benign tumor often causes more harm than good. Preventing screening has been turned in a cash baby for pharma though guidelines that push chemotherapy. 

[2] Like the testing of an antibiotic on a patient’s bacterial culture, the chemotherapy should be tested on an in vitro tumor samples.  With most in vitro testing, some cells will survive because they have mutated in a way that makes them resistant to chemotherapy.   




JK’s Hope’s Hypothesis--Positive Choices


In 1924 Otto Warburg one of the leading biochemists of the 20th century and Nobel Laurette published his findings that cancers have abnormal glucose metabolism and abnormal mitochondria.  Since as described above cancer is dependent essentially on glucose fermentation, I would starve the cancer.  I would start with a water fast[1] of 14 days or longer. At the end of the fast, I would go on a ketogenic diet and even limit fiber.[2]  Protein limited to 25-35 grams a day to prevent loss of muscle mass.  The amino acid glutamine is another fuel for cancer, thus the low protein diet.  With its calories limited, for mot the growth stops and the cancer shrinks.  How effective depends to a large extent on how crippled the mitochondria is, and if some can still metabolize fat to some extent.  I would also become current on the latest work on diet.  Currently work is being done to limit glutamine (another functional metabolic substrate), and supply cancer with a optical isomer of glucose that it can’t metabolize.  It would be a high fat diet since cancer with their defective mitochondria can’t metabolize fats.  Hyperbolic oxygen has also been shown to promote the death of cancer cells.  I would also have the tumor removed as soon as possible.  I would be less aggressive in staving the cancer if it was a local stage 1 cancer with a favorable biopsy report.  Assuming it is stage 2 or in a tissue that has a high mortality rate, I would adhere strictly to the diet and go on repeated fasts using fat for energy or try alternate day fasting.  I would also take 2 grams of aspirin daily.  Aspirin has the highest cure rate of all chemotherapies for stage I, II, and III, and aspirin prevents cancer.  (Oncologists hear a much different account at pharma’s continuing education classes.)  Breast cancer survival is up 66% by stimulating necrosis factor TNF; colon cancer survival up 74%, & others for stages I, II & III; but does not increase survival of metastatic cancer, yet should lengthen survival.  Aspirin reduces risk of cancer evolving into a fatal cancer by its effect upon 3 bodily defenses: as a COX-2 inhibitor, upon nitrous oxide (NO) system of endothelial cells, and stimulation of the body’s system for destruction of abnormal cells (apoptosis).  Aspirin increases survival of glandular, blood, & epithelial cancers.  Also aspirin reduces the risk for most cancers by promoting various necrosis factors and inhibition of JNK which “regulates several important cellular functions including cell growth, differentiation, survival and apoptosis” Wiki.  Risk various tissues:   reduction of63% colon, 39% breast, 36% lung, and 39% prostate cancer, also for esophageal 73%, stomach 62%, and ovarian cancer 47%” also Hodgkin's disease, and adult leukemia, melanoma 55%.  Other studies have shown that aspirin promotes the death of abnormal cells through the natural mechanism of apoptosis by stimulating tumor necrosis factor NF-B, by p38 & JNK.  Long term, but low dose is insufficient because of drug tolerance.  Moreover the increase risk of ulcer is in the US Physician’s Study 1 per 1780 patient years with 325 bi-daily.  At dose of 975 mg daily, the ulcer risk is about 1 per 300 patient years.  In the Physician’s Study the rate of heart attack was reduced 44%.   With higher dose of 325 mg daily, it has an inhibitory effect upon atherosclerosis that would be statistically significant after 3 years-- and also its inhibitory effect upon cancer.  The positive results in journal articles are based on general population studies.  For example a study published in 1991 on cancer prevention based on lifestyle of 662,424 adults found that those who took 16 or more aspirin a month had a 50% reduction in colon-cancer deaths (measured 1982-88).   Similar study using nurses found similar benefits for breast prevention & survival.  Pharma of course doesn’t fund clinical trials for aspirin except to “demonstrate” its risk and ineffectiveness.  The positive information sits in journals, while pharma friendly organizations using marketing studies produce treatment guidelines on cancer and prevention of heart attacks which warn about the grave risk of stomach bleeds that counters the modest benefits of low dose aspirin; a message repeated in continuing education classes.  I would also take testosterone (and if a woman estradiol with progesterone) since the sex hormones like other steroid promote healing.  One study found HRT subsequent to breast cancer resulted in a substantial reduction in cancer mortality.  This is what I would do and advise my wife to do.




[1] This would include tea with lemon juice and possible bone broth (See Fung, Obesity Code P. 265)

[2] As much as half the calories from fiber are made available through the metabolism by intestinal bacteria.  Though it doesn’t raise insulin because of low quantity it supplies glucose to the cancer.  



4. Cancer articles at rcdm

***** Targeting Energy Metabolism in Brain Cancer 21 min, 113,000 views by Prof Thomas Seyfried, leading research to audience of fellow scientists on how to starve cancer which depends on glucose metabolism and thus cause its apoptosis through ketogenic diet. Cancer cells have damaged mitochondria that metabolized glucose & glutamine-- read his Cancer as a Metabolic Disease s. https://www.youtube.com/watch?v=sBjnWfT8HbQ&hd=1 Excellent

*****Cancer as a Mitochondrial Metabolic Disease, 60 min, 13,000 views by Prof Thomas Seyfried, similar to the above, but with more such as the role of macrophages, more on diet, glutamine, and how current standard treatment kills their patients. https://www.youtube.com/watch?v=dm_ob5u9FdM Excellent

***** The Ketogenic Diet and Cancer 152,000 views, 30 minutes Dr. Dewitt radiologist recommends intermittent fasting, with 8 hour window for eating and ketogenic diet, critical of the standard care & pharma; a polished lecture covering all the essentials https://www.youtube.com/watch?v=Q9socQcwPIs Excellent.

*****How the Cancer Industry Deceives You with Cancer Drugs: 87 minutes, 69,000 views, quality documentary for a wide audience, also covers the role of FDA and the results of regulatory capture. How industry is into treating not curing, & how promising treatments are blocked for profits https://www.youtube.com/watch?v=uX8saD8fATw  Very good

*****The Ketogenic Diet and Cancer: Teaching an Old Dog New Tricks, 59 min 5900 views Prof. Colin Champ, to an educated professional audience at a conference.  Full of slides and information, he has done his work on the topic, very effective https://www.youtube.com/watch?v=gIKVsHbW1yQ Excellent

 

How to Heal from Cancer & Prevention 40 min,153,255 views, John Bergman MD , good intentions, appropriately critical of chemotherapy,  sincere, sometime cherry picking, weak on science with causal errors, buys into the organic prevention and cure,  its wrong, at least it is not chemo poison  https://www.youtube.com/watch?v=IjhbxT0T9Sk  so-so

Fasting, Safe & Effective Use of an Ancient Healing Therapy, 55 min, 5,900 vies, Michael Kalper MD, nice guy giving boring lecture with a promotion for his clinic and need for medical supervision.  Like most of the talking under fasting on YouTube, weak science https://www.youtube.com/watch?v=m92Y12lpl6Y&t=32s Skip

Starving cancer, 10 minutes 138,000 views, Prof Dominic D’Agostino, TEDx lecture works with Dr. Seyfried, talks first about hyperbolic oxygen causing epileptic seizure in deep sea divers, then ketogenic diet prevent epileptic seizures, and his work on hyperbolic oxygen to damage cancer cells while sparing healthy cells, and an rat model which showed that this combination workedhttps://www.youtube.com/watch?v=3fM9o72ykww&t=526s Very good

 


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Disclaimer:  The information, facts, and opinions provided here is not a substitute for professional advice.  It only indicates what JK believes, does, or would do.  Always consult your primary care physician for medical advice, diagnosis, and treatment.