Hope For Cancer

There are basically 2 ways of increasing immune capability– we can either confer“passive immunity” or stimulate“active immunity” . When children nurse breast milk, they receive antibodies from their mother which travel (undigested) into their bloodstream. This confers upon the infant immunity against those germs that the mother is immune to– but only until the child is weaned. This “temporary” immunity is basically being borrowed from someone else, without stimulating the child’s own immune system, and so is called “passive immunity” . If an adult is exposed to Hepatitis-A at an unsanitary restaurant, they go to their doctor for a shot of “gamma globulin” – that is pooled antibody from people who have successfully fought hepatitis- A in the past. This “passive immunity” is enough (if given at the right time) to kill the hepatitis-A germ in our exposed adult. After a few weeks, this temporary immunity will be lost, so if the adult is exposed again they will require another dose of gamma globulin.In contrast, when a child receives vaccinations (e.g. polio, mumps, measles, tetanus) they are being exposed to either a killed germ or a weakened living one. This stimulates their immune system to recognize that germ, and start to produce protective“antibody” against it. The T-helper memory cells can recall for years, or even a decade, what that germ’s protein coat looked like, and what the right antibody was to combat it. Since we are stimulating the child’s own immune system, this defence is called “active immunity”, and will be long-lasting. As adults, if we sustain a deep injury with a soiled object, and we have not had a tetanus shot in ~10 years, we are given “tetanus immune globulin” to confer passive immunity for the current injury, and also “tetanus toxoid” to stimulate active immunity for the future. Thus a person may receive both types of“immune therapy” . Immune therapy may be very “specific”, only meant to combat one type of germ, or it may be “general”, to boost the entire immune system to a higher level of functioning. Adjusting the immune system’s functioning, up or down, is called “immune modulation” . If one removes immune system cells and stimulates them in the laboratory to become more effective against a particular antigen, this is called“Adoptive Immunotherapy” .

Understanding how immune therapy works for germs also helps us understand it’s use for cancer. Passive, Active, and “Adoptive” immunotherapy can be utilized to help cure cancer . An example of using passive immunity would be manufacturing (“cloning”) monoclonal antibodies to a particular cancer’s protein coat, and then injecting them into the patient. These antibodies would (hopefully) gravitate and join exclusively to the tumor cells, and thus be extremely specific. Once coated, the cancer cells would be easily identifiable as foreign to other WBCs, and be quickly destroyed by an “immunocompetent” individual. Eventually the monoclonal antibodies would be all used up, degraded by the liver, or themselves targeted by the immune system as being “foreign”. Since the patient themselves would not produce any more, this would be temporary, passive immunity.

An example of stimulating active immunity is when the BCG vaccine (used as a test for tuberculosis) is injected in the patient– it prompts a strong, non-specific immune response. We are basically flooding the immune system with a foreign antigen, and it gears both to start producing antibody (humoral immunity) and to engulf the foreign antigen by“phagocytosis” (cell eating– cellular immunity). Fluids around the tumor can actually be dranken up by the process of“pinocytosis” (cell drinking). Thus, the immune system cells can literally gobble up the BCG antigen. The patient’s immune system will remember the BCG vaccine, and if it encounters it again will quickly make antibodies to it– thus it is nearly permanent, active immunity (it is “nearly permanent” since eventually the long lived T-memory cells will die off).

The BCG vaccine, used for bladder cancer, is non-specific, but other tumor vaccines are specific for their particular targets. A classic example of this is the “melanoma vaccine”, made up from the TILs of patients who have mounted a successful immune response to melanoma. If this vaccine is then injected into another patient, it can “teach” their immune system how to fight melanoma– this is stimulating active immunity against the melanoma itself. Theoretically, this treatment should have no significant side effects against any normal cell, just boost the immune response (as seen by the TILs around the tumor).

Adoptive Immunotherapy is used when NK cells or TILs are removed from the region of the tumor, and worked with in the laboratoy. They are given “mitogens” which cause them to divide (undergo “clonal expansion”) as well as lymphokines like interleuken-2 to activate them. Once they are plentiful and active, they are injected back into the patients tumor and/or bloodstream, where they will hunt down cancer cells and kill them. This is then using a combination of natural active immunity (the patient’s own response to the tumor) and passive immunity (artificially multiplying and implanting an immune response) to treat cancer.

The main drawback of all of the above therapies is that their effects tend to be temporary and non-curative if used alone.Cancer cells have a nascent genetic “intelligence” which allows them to overcome therapies which should theoretically decimate them . Of course, billions of cancer cells are killed by surgery, radiation, chemotherapy, hormonal therapy, and immunotherapy, but the problem lies with those few that remain, and are the strongest and best able to re-establish the tumor. We previously said that immune therapy is much more successful at killing small numbers of individual cancer cells than attacking large tumors. It is the principle therapy in killing “micrometastasis” of tumors prior to seeding the cancer to distant body areas. The current key to cure cancer is by using MULTI-MODALITY therapy, that is attacking the cancer from many different vantage points simultaneously, not allowing it time to develop resistance. A careful strategy of conventional therapy is required to help ensure that the immune system is not being too supressed to help cure the cancer. No single therapy today cures anything but the earliest cancer . Immunotherapy is crucial in a successful campaign, since it is the ONLY known therapy (within normal tissue tolerance) capable of annihilating the last, stongest, cancer cells.

This is just an excerpt from our Complete Cancer Treatment Transcript. Much more, including latest treatments, can be sent to you by email when you order the complete transcript at a nominal cost.

As is evident from the above discussion, hormones stimulate the origination and propagation of certain cancers by giving a message for cells to reproduce, including cancerous ones. Preventing hormone release by destroying the pertinent gland, or giving counter-acting acting hormones thus turns off the message for these cells to divide. Unfortunately, once a cancer starts, it is rare to be cured by hormonal shutoff alone, but it is often slowed down by removing the stimulating hormone . However, newer studies are showing that appropriate “hormonal therapy” may help cure early cancers in conjunction with other treatments, or extend life in advanced cancers. Since hormones are naturally occurring substances that deliver specific messages, we often expect less side effects (“toxicity”) than other conventional treatments. Although hormones do not have the poisonous side effects of excessive chemotherapy or radiation, they do have side effects when adjusted (“modulated”) to help a cancer patient, as discussed below.

What are the Hormonal Adjustments used in Cancer Therapy?

There are basically 3 ways of modulating hormones– by doingsurgery to remove the hormone producing gland, by givingradiation treatments to the gland to lower hormone production, and/or by givingdrugs which either counteract the cancer-stimulating hormone (work in opposition to it) or damage the glands ability to produce the offending hormone. Drugs are being used more for this as they are discovered.

Surgery is the oldest therapy for modifying hormones, and is still done (though not as frequently as in the past). The surest, simplest way of modifying the amount of testosterone a man in making is by cutting off his testicles(“orchiectomy”) . This is often the least expensive way and least dependent upon the patient following future instructions. Note that the actual operation preserves the scrotal sac, the testicles are cut out and plastic or metal “balls” can be sewn into the sac to preserve the appearance and weight of testicles. The surgery can be done under general or spinal anesthesia. The operation takes only an hour or so, with about 3 days recovery time. There is 1% chance of operative death, and 10% risk of infection or other complications. Obviously, a man will be rendered infertile (“sterile”) and lose libido immediately. The biggest problem with castration alone for reducing testosterone is that some androgens (about 5%) are still made in the adrenal glands and body fat. Thus, a prostate cancer can continue to grow under some androgen stimulation, albeit more slowly. Another problem is the psycho-social issues involved in being castrated. Thus male castration alone is seldom used today for prostate cancer, although it was common in the past.

Female castration can also be done by removing the ovaries (“oophorectomy” ) under general or spinal anesthesia; an incision is made into the lower abdomen and the uterus and fallopian tubes are usually removed also. The complete operation is called “Modified Radical Hysterectomy with Bilateral Salpingo-Oophorectomy” or “TAH-BSO” for short. There is about 2% operative death rate, 10% infection rate, and 10% risk of other serious complications including heart attack, stroke, or blood clots in the lungs (“pulmonary embolism”). Recovery time is about 1 week, with the tissues being 75% back to normal strength at 3 weeks; at this point heavy lifting is again possible. The operation was commonly done for cancers of the breast, uterus and ovaries, with the primary aim of reducing estrogen production. Obviously, it induces an immediate menopause with mood changes, hot flashes, and long term bone weakening and heightened risk of heart attack. The main problem with female castration alone is similar to that of male castration– the adrenal glands and body fat continue to produce estrogens. If additional drugs are not given to block this other estrogen, the cancer will continue to be stimulated, albeit more slowly. Again, female castration is seldom used alone today for estrogen-sensitive cancers.

Another gland destruction which can reduce both male and female hormones, and relieve pain from advanced cancer is“pituitary ablation” . Ablation means destroying the gland, and it can often be done by inserting an instrument up through the nose, breaking through the thin bone at the base of the midbrain, and mashing the pituitary. This procedure is called a “trans-sphenoidal pituitary ablation”, and is relatively safe. Complications include destruction of needed pituitary hormones (i.e. thyroid hormone and adrenocorticotropic hormone) which will require replacement therapy. Problems with this operation include an infection risk of 5%, and a 10% risk of blood clots, bleeding, or drainage of the brain-cushioning cerebral-spinal fluid

(“CSF”) out of the nose (“rhinorrhea”). Besides for the latter problem, the risks of doing an open brain procedure (“craniotomy”) with with neurosurgery are about twice as high. In practice, pituitary ablation today is reserved for tumors of the pituitary unresponsive to radiation, or possibly for severe pain from metastatic cancer.

Another hormone producing gland that is surgically removed for treatment is the thyroid– the operation is called a“thyroidectomy” and is done under general anesthesia. It is important to remove and re-implant the four parathyroid glands, so that parathyroid hormone continues to be produced– these are often placed into the forearm. The operation carries a 2% death risk, and 15% risk of complications including infection, blood clots, heart attack, stroke or pneumonia. Obviously, thyroid hormone (thyroxine) will need to be forever replaced, by fortunately it comes as a simple pill taken daily. If the lower thyroid is also removed (for medullary carcinoma of the thyroid) calcitonin may also require replacement, it comes as an injection (“Calcimar”) which can be given under the skin several times per week.

For “insulinomas” and “glucagonaomas” of the pancreas, “gastinonomas” of the stomach , “vipomas” of the intestines, and “pheochromocytomas” of the adrenal glands, simple surgery to remove the hormone producing tumor is usually curative. Hormone levels should be carefully monitored afterwards by an endocrinologist, with appropriate replacement therapy if they drop too low.

This is just an excerpt from our Complete Cancer Treatment Transcript. Much more, including latest treatments, can be sent to you by email when you order the complete transcript at a nominal cost.