Endstage Pancreatic Cancer: Prolonging survival through complimentary and alternative nutritional interventions.
the uncontrolled growth of cells within the pancreas; either within the exocrine or endocrine cells. (American Cancer Society)
Exocrine tumors form in ducts of the pancreas,[adenocarcinomas] and make up 95% of cases.
Endocrine tumors [neuroendocrine] make up 5% of pancreatic cancers, more commonly referred to as islet cell tumors or pancreatic neuroendocrine tumors (NETs).
RISK FACTORS
- Age
- Race (more common in African Americans)
- Gender (more common in men than women)
- Religious background
- Obesity
- Chronic inflammation of the pancreas (pancreatitis)
- Diabetes
- Family history of syndromes that increase cancer risk
- Family history of pancreatic cancer
- Cigarette smoking*
*Johns Hopkins Medicine (2016) reports one in four cases is caused by cigarette smoking and it is currently the leading preventable cause of pancreatic cancer.
STAGES
DIAGNOSIS
Signs and symptoms are not typically seen until stages III or IV, hence the disease is often undetected or undiagnosed until later stages - hence poor survival rates.
Stage IV pancreatic cancer has a five-year survival rate of 1%.
Once the tumors have metastasized, surgery is no longer a viable option, and patients typically turn to others forms of allopathic treatment.
SURGICAL & OTHER TREATMENT
- Pancreatoduodenectomy ("Whipple") - removal of pancreatic tumor on the head of the pancreas.
- Laparoscopic surgery - removal of pancreatic tumor located on the tail of the pancreas.
- Radiation - high-energy beams administered externally in order to destroy cancer cells.
- Chemotherapy - oral or IV drug administration.
- Chemoradiation
- Doctors prescribing additional, strong, narcotics for pain management.
- Clinical trials
- Vaccine
SIGNS, SYMPTOMS, & COMPLICATIONS
(Primarily seen in advanced stages III or IV)
- Weight loss
- Nausea and vomiting (often side effect of chemo)
- Pain or discomfort in stomach or abdominal region
- Loss of appetite
- Altered pancreas functioning, lack of digestive fluids produced
PRIORITIZE THE GOAL OF TREATMENT IN PANCREATIC CANCER - TO PROLONG SURVIVAL AND MAINTAIN OR IMPROVE THE QUALITY OF LIFE FOR THE PATIENT.
HYPOTHESIS
Based on the research present and available, and a vast history of chemotherapy, radiation, and surgical treatments for pancreatic cancer, while there is no cure, the implementation of nutritional therapies in collaboration with allopathic treatments can greatly improve the quality of life and prolong survival in patients with end-stage pancreatic cancer. These specific therapies include fish oil supplementation, vitamin D supplementation, and following a ketogenic diet. These results rely on patient compliance, minimized or eliminated bias, and practitioner collaboration.
INTERVENTIONS IN THE RESEARCH
Cruciferous vegetable consumption - cabbage, broccoli, cauliflower.
- Enhanced cancer cell sensitivity to chemotherapy treatments, reduced tumor growth.
- Specific to pancreatic ductal adenocarcinoma.
- Freeze-dried broccoli root in capsule form administered to patients with advanced pancreatic cancer undergoing palliative chemotherapy.
- Lozanovski, 2014, Biomed Central Trials.
Fulvic acid - highly active carbon, hydrogen, and oxygen molecule. Results in maximum bio-availability, allowing molecules to move through a cell membrane with little difficulty.
- Increases retention, absorption, and utilization of nutrients in food, vitamins, and supplements.
- Promotes the body's ability to repair itself.
- Studies show anti-inflammatory properties in acne, eczema, bacterial, fungal, & viral infections.
- Dr. D. Nuzum, 2015, The Truth About Cancer.
3-bromopyruvate - a [very controversial] small molecule anti-cancer agent synthesized for complementary treatment programs.
- Inhibits glycolysis in order to starve tumor cells of glucose and cellular energy - based on the belief that normal, healthy cells will remain unaffected due to their low reliance on glucose for survival in comparison with cancer cells.
- Majority of administration occurs in Europe
- Few U.S. clinics offer 2bp in conjunction with various other alternative treatments: vitamin C, glutathione, exercise with oxygen therapy, dietary counseling, juicing, hyperthermia therapy, etc.
- Dayspring Cancer Clinic, Scottsdale Arizona, 2016.
- Pedersen & Ko, Johns Hopkins Medicine, 2012.
GcMAF - protein [vitamin D-binding protein-derived macrophage activating factor]
- Rebuild a depressed immune system
- Inhibits angiogenesis
- Activates macrophages, leading to cancer cell destruction
- Apoptosis within cancer cells
- Reverts cancer cells back to healthy original state, reducing likelihood of metastasizing
- Increases ATP production in mitochondria
- Destroys neuropathic pain and stress induced by oxaliplatin (chemotherapy drug)
- Thyer, 2013, American Journal of Immunology
Fish Oil - oral EPA/DHA supplements may have a significant effect on reducing weight loss in patients with pancreatic cancer by modulating aspects of the inflammatory response.
Proteolytic Enzymes - enzymes that digest proteins, have anti-inflammatory properties, and provide immune support
- Nicholas Gonzalez (proteolytic enzymes paired with diet, nutritional supplements, detox procedures.
- Clinical practice, 9 patients surviving one year (81%), 5 surviving two years (45%), and 4 surviving three years at the time of reporting.
- Gonzalez, 1999, Nutrition and Cancer.
Ketogenic Diet - high fat intake, moderate protein intake, minimal carb intake to activate ketosis within the body, utilizing fat as a fuel source instead of glucose
- Enhances mitochondrial oxidative metabolism while limiting glucose consumption to increase metabolic stress in cancer cells vs. normal cells
- Slow growth rate of tumors; which are reliant on glucose for survival as well as metastasis.
- Enhances patient responsiveness to chemotherapy, improving or relieving normal tissue side effects.
- May see improved weight maintenance or weight gain.
- Safe, inexpensive, noninvasive, easy to implement, has been shown to improve emotional functioning, reduce insomnia.
- Allen, 2014, Redox Biology
TRENDS IN THE RESEARCH
In 2008, a NHIS reported 65% of respondents who had ever been diagnosed with cancer had used complementary approaches. And up to 77% of those individuals never disclose in their use or interest in CAM to their primary care physician or doctor due to concerns that they will react negatively or dismiss their questions.
National Institute of Health National Center for Complementary and Integrative Health
Consistencies in research for alternative, complementary, and nutritional therapies for pancreatic cancer.
- Limited in quantity of studies for repetition in treatment success.
- Very low total number of participants.
- Difficulty with compliance and retention.
- Controls not properly applied, or at all.
- Funding not available for all necessary resources or expenses.
- BIAS.
...although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be dangerous. As you consider your options, look for 'red flags' that might suggest fraud. Does the method promise to cure all or most cancers? Are you told not to have regular medical treatments? Is the treatment a 'secret' that requires you to visit certain providers... Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known), which can help you make an informed decision.
American Cancer Society's Website: "Pancreatic Care Treatment"
While some scientific evidence exists regarding some CAM therapies, for most there is little evidence to support their effectiveness. Well-designed scientific studies are needed to determine if CAM therapies are safe and whether they work for the diseases or medical conditions for which they are used. CAM therapies are not regulated by the FDA. Their reported benefits are often unproven.
Pancreatic Cancer Action Network Website
Alternative treatments listed as potential options for pancreatic cancer by the Mayo Clinic (2016):
...art therapy, exercise, meditation, music therapy, relaxation exercises, and spirituality.
COMMUNITY HEALTH PROGRAM
Implementing a Ketogenic Diet for patients with advanced stage pancreatic cancer, who have previously or are currently undergoing allopathic care.
- DOCTOR-to-PATIENT education/communication.
- DOCTOR-to-NUTRITIONIST networking.
- Family support and education in assisting with planning/shopping/prepping/enforcing.
- Monitor diet for minimum period of 12 weeks (must follow for 8 weeks to be considered significant in results).
- Measure changes in weight, tumor size, tumor growth, and metastasis, as well as evaluated with a QOLS.
TAKING ACTION TO PREVENT
- Moving towards preventative health care
- Emphasizing the dangers of smoking cigarettes
- Encouraging frequent testing for those with family history
- Monitoring dietary choices and maintaining appropriate weight
- Affordability of health care - both allopathic and CAM
TREATING PANCREATIC CANCER
- Apply nutritional support - primary goal to prevent significant weight loss, appetite depletion
- Educate patients on complementary and alternative options that may prolong survival or improve quality of life - for both patient AND family
- Palliative care centers
- Implement Ketogenic Diet - offer meal plans, educational support, and assistance to family members for shopping and preparation
BRIDGE THE GAP BETWEEN CONVENTIONAL AND CAM PROFESSIONALS
The goal is not to CURE pancreatic cancer, but to prolong survival, improve nutritional status and quality of life.