Interesting article on ALA and LDN

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Naturopathic Philosophy And Cancer Care

by Dr. Barry Wheeler, ND on January 7, 2010

Cancer Care & Naturopathic Medicine, By Dr. Barry Wheeler, ND

Important: The only treatment recognized by the FDA as a potential cure to cancer is surgery. The statements in this paper have not been evaluated by the FDA. This information is provided for educational purposes only. Furthermore, I do not treat cancer.

I treat people. My license as a Naturopath in Washington does not allow me to treat cancer, but I am happy to work with your oncologist.

In the Allopathic world, medicine is about turning things off. To alleviate eczema they give you cortisol that suppresses your immune system. To treat hypertension they give you beta blockers. In the treatment of cancer they are trying to shut down cell growth in the entire body.

They try to kill cells selectively but don’t trust the body to do it on its own. Clearly, the body is unable to destroy the cancer in its current state but perhaps there is another answer. Perhaps, the body only needs the right tools and it can repair itself.

In the Naturopathic world, we are about treating the cause. The cause of disease is that the body is no longer able to function correctly. Sometimes it does need some big guns such as cortisol and beta blockers but if you can give the body the tools to do what it was designed to do then the outcome will be empowering and not a “shut down.â€

To treat eczema the immune system may be dysregulated and by giving herbs that stimulate Th1 you may help the body self correct. To treat hypertension simple lifestyle changes can have a huge effect; stress reduction activities such as meditation can decrease blood pressure.

In the treatment of cancer, perhaps if you give the body what it needs to improve function to do its own natural scavenger activities it can repair itself. In this paper, I will discuss a novel emerging approach to cancer treatment that is distinctly different from many cancer treatments that are the standard of care today.

The body is continually seeking out cancer cells just as it does free radicals, scavenging them, and destroying them. This is the function of the immune system and antioxidant system, respectively, that is largely ignored by mainstream medicine. However, some doctors are having amazing success treating incurable cancer with this functional approach.

For whatever reason, the body may become overwhelmed with free radicals and cancer cells and be unable to perform its function. Free radical scavengers can become depleted as oxidation increases and, as I will discuss further, these free radical scavengers may have other roles such as regulation of cancer cells, which is an immune system function. This is only part of the novel treatment approach that I am discussing. The other part is the stimulation of the immune system to increase the ability of immune cells to destroy the cancer.

The following research I am going to discuss is about alpha-lipoic acid (ALA) and low dose naltrexone (LDN) that are being used for the treatment of cancer. These two substances serve as examples for what I believe naturopathic cancer care should be based on our philosophy that I have briefly outlined above. ALA can actually cause apoptosis of hepatoma cells. This occurs via the PTEN/Akt pathway where PTEN is activated and Akt is inhibited(1). The diverse uses of ALA are currently being researched beyond its uses as a potent antioxidant to reduce oxidative stress (16).

LDN alone can reverse signs and symptoms of B-cell lymphoma(2). LDN appears to stimulate the immune system to attack cancer by causing an increase in opioids receptors on tumor cells(3). It may also increase endorphin production and NK activity (17). Furthermore, LDN combined with other substances such as ALA, interleukin-2, or other chemotherapeutic agents may have a synergistic effect (3, 4, 5, 7).

Naltrexone has traditionally been used in alcohol and heroin abuse treatment, but is also used to treat cancer treatment related constipation as an opioid antagonist at higher doses (3, 8). It has even been used successfully in the treatment of polycystic ovary syndrome, possibly from weight loss or changes in opioidergic tone (11). Also, it has been used as an antipruritic for conditions such as eczema (12). When used at lower doses it may cause the body to increase opioid receptors on tumor cells(3). At higher doses it causes a complete blockade of opioid receptors.

There is a need for more research on the exact mechanism of LDN but in my review of research I found no evidence to indicate that the mechanism of action of LDN is to “shut down†anything. Naltrexone at higher doses may have a “shut down†effect. Naltrexone and LDN can both have side-effects such as nausea and abdominal pain.

There is some evidence that naltrexone, not LDN, may block opioids that are inhibitory to some cancer cells such as head and neck cancer (9). Thus, naltrexone at high doses may be tumorigenic for some types of cancer. However, a study of opioid growth factor, naltrexone, and other opioid related drugs found that these substance alter cancer growth and death through a mechanism other than apoptosis shown by staining of TUNEL and Annexin V and for necrotic factors (10). This study included pancreatic and head and neck cancer cell lines. This evidence supports a very important case study that I am highlighting in this discussion regarding a patient with terminal pancreatic cancer, ALA, and LDN.

In 2002, a male patient was diagnosed with terminal pancreatic cancer (3). His doctors told him it was untreatable and he would likely only live a few months. However, this patient was still alive in 2006 when the case paper was written. The treatment he received was intravenous ALA and LDN. He also received some basic antioxidant herbal support and lifestyle and diet advice. The patient was very compliant and when they tried to discontinue his treatment his symptoms of pancreatic cancer that he had prior to the LDN and ALA returned. He has been able to return to his occupation and maintains himself symptom free with this treatment plan.

The mechanism is a combination of immune system support via reflex stimulation of opioid receptor production via partial receptor blockade and free radical scavenging. Oddly enough, while LDN may increase NK activity, lipoic acid may inhibit NK activity by decreasing interferon gamma synthesis (18). Thus, more research is needed on the combination of LDN and ALA, but this case study and reports from the doctors who treated this patient that they have other patients with similar results is very promising. More research is needed but when there are no other treatment options available, especially in the case of pancreatic cancer, this is an important treatment option to consider.

Other research on naltrexone is showing that it may a wide array of uses. One study showed that it can decrease neurotoxic side-effects of cancer treatment with IFN alpha (14). Another study showed that naltrexone can be used to inhibit colon cancer (13). ALA may be chemopreventative for intestinal tumors but may increase the risk for breat tumors (15). More reserach is needed on the possibility of ALA increasing patients’ risk for breast cancer.

Prevention is an important part of Naturopathic Medicine. The use of ALA as a chemopreventative for intestinal cancer is complex and needs more research, particularly in terms of its mechanism.

Luckily, as Naturopaths we learn to treat the whole person and would not generally only give a patient ALA and no other antioxidants or therapies. Careful evaluation of family history would direct us away from ALA possibly if a person has a strong history of breast cancer. Also, we may give ALA in conjunction with other therapies that decrease the risk for breast cancer if the person has no identifiable risks for breast cancer.

The problem with many studies is that they do not address the holistic approach that we take with our patients. There are some study designs that accomplish this but can be very complex.

Another philosophy used by naturopathic doctors is doctor as teacher. This implies that it is our duty to educate patients about natural medicine in order to empower them. This may involve education about lifestyle, diseases, treatments, and PARQ. This is not distinct to naturopathic medicine but in terms of the level of education that we often achieve it is unique.

First do no harm is another value that is not distinct to naturopathic medicine. This can be very complicated in the treatment of cancer, which often involves a large degree of harm when the standard of care is applied. An argument can be made that the degree of harm of a chemotherapy or radiation therapy is less than the degree of harm caused by the cancer (death) and therefore is permissible. As Naturopathic Physicians we can assist patients undergoing these harmful treatments, thereby minimizing harm.

My experience thus far in the treatment of cancer has involved one patient. Several years ago the patient was diagnosed with prostate cancer and had his prostate removed. He also received some form of chemotherapy. This was over five years ago that he was diagnosed and now his PSA is rising but still below 2.0.

In this case we are using high dose vitamin C intravenously with the idea that the ascorbic acid at high doses is preferentially taken up by the cancer cells and due to its high concentration destroys the cells. The patient has been able to maintain his PSA at a steady state without any symptoms using this therapy. This therapy may or may not be a functional approach in terms of what I have discussed in this paper.

The benefit of using high dose vitamin C is that the side-effects are minimal. The downside is that it may not be effective enough. However, for this patient to receive another round of chemotherapy would be very detrimental to his health. Furthermore, he refuses to undergo traditional chemotherapy again. This is an issue that can cause some legal problems because if the patient is refusing to receive standard of care treatment for cancer you may be considered negligent if your treatment is unsuccessful.

As the disease progresses the patient may become more and more unable to comprehend what is going in their body due to anemia or other pathological factors which effect the functioning of their brain. If you are concerned that you may need to “firing†a patient it is better to do it early on before the disease progresses so far that it is truly untreatable by mainstream oncology protocols.

There are many other modalities that Naturopaths are using to treat cancer. These modalities include homeopathy, nutrition, energetic medicine, physical medicine, and herbs. My personal belief is that a multi-factorial approach is necessary in the treatment of any disease. I have studied applied kinesiology and feel that by asking the body what it wants or needs you can truly heal someone.

Using manual muscle testing as a diagnostic tool I can take the patient on a healing journey. The layers of disease are peeled away like an onion. At one time the patient may need a homeopathic remedy and a spinal manipulation. At another time the patient may need intravenous therapy. I prefer this approach because it is not just guess and test. The muscle tester is responsible for ensuring that they are testing the muscles correctly and that the treatments performed make sense with the patient’s disease presentation. Correlating muscle test with blood tests and other diagnostic procedures is essential.

In conclusion, there are many ways to treat cancer naturopathically. The main discussion of this paper has been alpha lipoic acid and low-dose naltrexone. These are promising agents for the treatment of cancer, particularly pancreatic cancer. The evidence available shows that they are more in line with naturopathic philosophy and values than other chemotherapeutic agents.

Certainly, there are many other forms of medicine that are being used to treat cancer than those discussed in this paper. Unfortunately, there is a powerful factor, money, that drives much of the research that is currently being conducted on cancer treatments. The birth of oncology from chemical warfare is disturbing. Hopefully, as the public become more aware of the disparity of money spent of drug research in comparison to searching for environmental causes of cancer there will be a shift.

The growing number of cancers in this country is oddly noted at the same time that there is a growing number of novel chemicals being developed and disseminated into our environment. High volt power lines over childrens’ schools produce powerful electromagnetic frequencies that children were not exposed to 100 years ago. Cellular phones produce microwaves that people were not exposed to 50 years ago. People are consuming their weight in white sugar on a yearly basis. We cannot ignore these potential factors in the development of cancer.

While we must help to treat individuals who have cancer, it is our duty to help prevent cancer. In the State of Washington I am only licensed to complimentary therapies in conjunction with standard of care delivered by an oncologist. I am always happy to talk to your oncologist. Please feel free to contact me at (425) 516-5500.

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1. Alpha-lipoic acid induces apoptosis in hepatoma cells via the PTEN/Akt pathway. Shi DY, Liu HL, Stern JS, Yu PZ, Liu SL. Department of Biochemistry, Shanghai Medical College of Fudan University, Free Radical Research Center of Fudan University, Shanghai 200032, PR China. cyshi@...2. Reversal of signs and symptoms of a B-cell lymphoma in a patient using only low-dose naltrexone. Berkson BM, Rubin DM, Berkson AJ. Integrative Medical Center of New Mexico, Las Cruces, USA. PMID: 17761642 [PubMed – indexed for MEDLINE.3. The long-term survival of a patient with pancreatic cancer with metastases to the liver after treatment with the intravenous alpha-lipoic acid/low-dose naltrexone protocol. Berkson BM, Rubin DM, Berkson AJ. Integrative Medical Center of New Mexico and New Mexico State University, Las Cruces.4. A new neuroimmunotherapeutic strategy of subcutaneous low-dose interleukin-2 plus

the long-acting opioid antagonist naltrexone in metastatic cancer patients progressing on interleukin-2 alone. Lissoni P, Malugani F, Bordin V, Conti A, Maestroni G, Tancini G. Division of Radiation Oncology, S. Gerardo Hospital, Monza, Milan, Italy.5. Neuroimmunotherapy of untreatable metastatic solid tumors with subcutaneous low-dose interleukin-2, melatonin and naltrexone: modulation of interleukin-2-induced antitumor immunity by blocking the opioid system. Lissoni P, Malugani F, Malysheva O, Kozlov V, Laudon M, Conti A, Maestroni G. Division of Radiation Oncology, S. Gerardo Hospital, 20052 Monza (Milan), Italy.7. Synergistic effects of methylnaltrexone with 5-fluorouracil and bevacizumab on inhibition of vascular endothelial growth factor-induced angiogenesis. Singleton PA, JG, Moss J. Department of Medicine, University of Chicago, Chicago, Illinois, USA.8. Cancer-related constipation. J. San Diego Hospice

& Palliative Care, San Diego, San Diego, CA 92103, USA. jathomas@...9. Opioid growth factor (OGF) inhibits the progression of human squamous cell carcinoma of the head and neck transplanted into nude mice. McLaughlin PJ, Levin RJ, Zagon IS. Departments of Neuroscience and Anatomy, The Milton S Hershey Medical Center, The Pennsylvania State University, 500 University Drive, Room C3727, Hershey, PA 17033-0850, USA. pxm9@...10. Opioids and the apoptotic pathway in human cancer cells. Zagon IS, McLaughlin PJ. Department of Neuroscience and Anatomy, The Milton S. Hershey Medical Center, The Pennsylvania State University, College of Medicine, 500 University Drive, H-109, Hershey, PA 17033, USA. iszl@...11. Effect of long-term naltrexone treatment on endocrine profile, clinical features, and insulin sensitivity in obese women with polycystic ovary syndrome. Fruzzetti F, Bersi C, Parrini D, Ricci C, Genazzani AR.

Department of Reproductive Medicine and Child Development, Section of Gynecology and Obstetrics, University of Pisa, Pisa, Italy. ffruzzi@...12. Naltrexone: a case report of pruritus from an antipruritic. Sullivan JR, A. Department of Dermatology, Royal Newcastle Hospital, Newcastle, New South Wales, Australia.13. Inhibition of human colon cancer by intermittent opioid receptor blockade with naltrexone. Hytrek SD, McLaughlin PJ, Lang CM, Zagon IS. Department of Comparative Medicine, Pennsylvania State University, College of Medicine, Hershey 17033, USA.14. Treatment of neurotoxic side effects of interferon-alpha with naltrexone. Valentine AD, Meyers CA, Talpaz M. Department of Neuro-Oncology, University of Texas M.D. Cancer Center, Houston, USA.15. Intestinal tumour chemoprevention with the antioxidant lipoic acid stimulates the growth of breast cancer. Rossi C, Di Lena A, La Sorda R, Lattanzio R,

Antolini L, Patassini C, Piantelli M, Alberti S. Animal Care Unit, Consorzio Negri Sud, SM Imbaro (Chieti), Italy.16. Lipoic acid as a potential therapy for chronic diseases associated with oxidative stress. AR, Shenvi SV, Widlansky M, Suh JH, Hagen TM. Dept. of Biochemistry and Biophysics and the Linus ing Institute, 571 Weniger Hall, Oregon State University, Corvallis, Oregon 97331, USA.17. Enhancement of natural cytotoxicity by beta-endorphin. Mathews PM, Froelich CJ, Sibbitt WL Jr, Bankhurst AD. The Journal of Immunology, Vol 130, Issue 4 1658-1662, Copyright © 1983 by American Association of Immunologists.18. Lipoic acid stimulates cAMP production via the EP2 and EP4 prostanoid receptors and inhibits IFN gamma synthesis and cellular cytotoxicity in NK cells. Salinthone S, Schillace RV, Marracci GH, Bourdette DN, Carr DW. Portland Veterans Affairs Medical Center and Department of Neurology, Oregon Health

& Science University, Portland, OR 97239, USA.

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