The Moon and the Stars and the “Sun’s Soup”

   Lately, in my practice, this soup kitchen talk has been coming up a lot so I think it is time to share a summary perspective.  Every now and then there seems to be an increased awareness of a particular item and the Sun’s Soup is the latest.

   Sun’s Soup  (AKA Selected Vegetables) refers to several different mixtures of vegetables and herbs that are currently being studied as possible cancer treatments.  Since the main properties of this soup combination are immune enhancement it is also being considered for other medical conditions, acquired immunodeficiency syndrome (AIDS) for example.  Many of the contents of the soup were chosen because previous research and traditional Chinese medicine suggested they contain anticancer phytochemicals including properties of protease inhibitors, plant sterols, and isoflavones.

   There are three main versions of this soup.  The original blend consists of the Shiitake mushroom, Mung beans, Hedyotis diffusa, and Scutellaria barbata (skullcap).  This version of the soup is currently not sold in the United States. Another type is a freeze-Dried Selected Vegetables (DSV).  This freeze-dried mixture of vegetables and herbs is sold in the United States as a dietary supplement and is said to contain this much greater blend of ingredients: Soybean, Shiitake mushroom, Mung bean, Red date, Scallion, Garlic, Leek, Lentils, (I’m getting hungry) Hawthorn fruit, Onion, Ginseng, Angelica, Licorice, Dandelion, Senega, Ginger, Olive, Sesame seed, and Parsley (wow!).  All of this is very high in antioxidant activity, so now we are back the concerns of drug-nutrient interaction.

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Low Dose Naltrexone (LDN): Miracle Cure or “Why Not” Drug?

     Naltrexone is a blocker of opioid receptors and is used in patients who have overdosed on narcotics, but at low doses, there is lab-based work, largely conducted by a single group, that suggests that low dose naltrexone can have immunostimulatory properties and even directly kill cancer cells by a process called apoptosis, a self-destruct program built into cells when they become too mutated (cancer cells that are growing and dividing can turn off this signal).  At websites like www.lowdosenaltrexone.org and www.ldninfo.org, there are descriptions of anecdotal reports of patients with various different cancers who have done well, attributed to the LDN.  To the credit of the people running these sites, there are caveats that these are not scientifically conducted trials.  That’s fine, but there are certainly some people writing on patient and caregiver-mediated online communities who are intimating that LDN is a miracle drug and using terms like cure for lung cancer.

   I don’t want to be a wet blanket, but I do think it’s important to inject a little caution here.  In my mind, LDN fits in with DCA or noni juice or many other proposed interventions that are viewed by some as a “why not?” intervention and others as a miracle treatment that is not being studied or addressed by the oncology medical community or pharmaceutical industry because of a supposed profit motive keeping those groups from wanting to cure cancer.   I and most people in the “allopathic”/standard medical pathway recognize that there is major interest in complementary and alternative medicine (CAM) approaches in the general population.  What’s not clear to me is whether the majority of people seeking CAM interventions are looking more for a complementary approach and generally accept conventional medicine strategies, or whether there is a significant portion of the people favoring LDN and other less established interventions because they have a fundamental distrust of the medical and pharmaceutical establishments and believe that the people with the power actually want to suppress the ideas that could cure cancer.

   As someone who really believes in knowing your source, I recognize that I’m speaking as someone from the medical establishment.  I also recognize that there is some reason for distrust of a lot of large establishments with the collapse of entire industries recently for good reason.  But even if you have that much distrust of the health care and pharmaceutical industries, I can’t understand why someone wouldn’t think that either the pharmaceutical company or physician with an actual cure for cancer wouldn’t be enticed by the fame and fortune that this would offer.   While I think there are several very reasonable arguments in discussing LDN or many other strategies that aren’t widely accepted in conventional medicine, in my opinion saying that the pharmaceutical industry and the medical establishment are withholding the cure for cancer devalues the discussion.

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Interview with Dr. Bufi on Supplements and Various Naturopathic Agents for Cancer

I recently sat down with Dr. Bufi to discuss several topics in complementary medicine for cancer patients, covering a range of topics from vitamins and supplements to some specific agents like resveratrol, noni juice, and melatonin.  Here are several highlights, along with a transcript:

or access via this link.

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Talking dirty? Not in my house!

It’s interesting how the cold and flu season seems to be getting a bit longer and longer…and longer. Some experts even claim it reaches beyond April into the month of May. Why is this? Perhaps there are a few little subtleties that have begun to rock the microscopic world. One of these might be the one thing you just cannot put down…your cell phone. Recent research shows your mobile cell phone could be a major health hazard. I would be especially mindful of this for those in any type of cancer treatment.
Millions of people use cell phones. Some statistics claim that cell phone usage has gone from about 34 million Americans in 1996 to more than 200 million in 2008. And most of these users have no idea that their very own cell phone is a bacteria breeding ground. If they do have an awareness to such they simply think, “Those are just my own bacteria, it can’t be that bad.”

According to one report, cell phones have been shown to be more contaminated than shoes, doorknobs, and even toilet seats. What? And most people never think twice about walking in a public restroom and then walking on their home or office carpet without first cleaning the soles of their shoes. Shoes transport a tremendous amount of bacteria and foul matter into homes and offices.

Actually, when you stop and think about the many places your cell phone goes, besides your pocket, purse or briefcase, you can begin to understand the big nature of the little beast. Some have reported findings that there are literally tens of thousands of live bacteria on each square inch of a cell phone. One type frequently found includes Staphylococcus aureus, or simply “Staph”, which can cause skin rash, pimples, pneumonia, and even meningitis.

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More uncharted waters before we even buy the boat…the Nina, the Pinta, and the Graviola

Greetings after Thanksgiving and a birthday (my 12 year old daughter — I overlook my own).

Graviola has the scientific name is annona muricata and it is part of the Annonaceae family. Common names are cherimoya, guanabana, soursop, sour sop, custard apple, and brazilian paw paw.

I would not take or recommend a graviola product or any graviola extract as a dietary supplement. We do not have any convincing proof of efficacy, dosage, concentration, purity, nor basic safety data on the graviola plant. It has already been associated with a risk of neurological problems similar to Parkinson’s disease as well as some other types of myeloneuropathy movement disorders. The toxicity of annonaceae on dopaminergic neurons is thought to be the role it plays in atypical Parkinson’s. The in vitro test tube studies are really a long way off from the necessary clinical trials to determine the safety and efficacy of graviola compounds in humans with cancer. I have yet to find any human studies of graviola for anything let alone cancer. And how do we know that the graviola available to the consumer is the same one actually used for the test tube studies? We do not. My understanding is that the leaves of a related tree that grows in the state of Florida were the ones actually used for the studies. The study tree for these claims is annona glabra or pond apple (not custard apple) fruit. Buying “stuff” on the internet or anywhere else may not actually be the “stuff.”

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Controversy around Chinese Herbal Medicine Wormwood (Artemisinin)

Last week one of the major Seattle newspapers ran an article about a Chinese herbal medicine called artemisinin, or wormwood. The impetus was that some local chemists at the University of Washington conclude based on theory and some lab work with cancer cells that this agent, which is used as a treatment for malaria, can also kill cancer cells. Excited about the prospects of developing a new treatment for cancer, they started a private company.

The first part of the article describes the miracle that artimisin represents against cancer, but the quotes are from lab folks who aren’t treating patients. None of the people praising this approach is an oncologist at the University of Washington/Seattle Cancer Care Alliance, which I think is rather telling.

The counterpoint is provided by Dan Labriola, a naturopath who has helped out here in the past. I was pleased that he provided the same kind of caution that I would, although I feel like I must sound like a broken record. He reminds readers that while this drug has been used for malaria, and some people are trying to obtain it as a treatment for cancer, there’s a big difference between cells or animals in the lab and actual patients, and that there isn’t any evidence that it’s helpful in people at this point. Moreover, there is a real risk that it could be harmful.

Finally, others have come to the same conclusion: the web pages about artemisinin from Memorial Sloan Kettering (here) and the American Cancer Society (here) also note that there is no evidence supporting using this against cancer, and that it can have potentially dangerous side effects. Fine for malaria, but it’s not a cancer treatment at this point.

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Bisphosphenol A and Health Risk: “Drinker Beware”

As far back as the 1930s, it has been suspected of being hazardous to humans. However, the use of Bisphenol A in consumer products never really hit the headlines until recently, when several governments began questioning its safety.

Bisphenol A products have been in commerce for more than 50 years, and its uses are numerous. Along with shatter-proof plastic, it is used to make polyesters (remember Disco?), epoxy resins (coatings on the inside of almost all food and beverage cans), PVC industrial plastics, baby bottles, water bottles (Nalgene), sports equipment, medical devices, CDs, various household electronics, and even flame retardants. In the United States, BPA is manufactured by General Electric, Dow Chemical Company, Bayer Material Science, Sunoco Chemicals, and Hexion Specialty Chemicals.

Bisphenol A has become controversial because it mimics estrogen and thus could induce hormonal responses. Laboratory animal experiments in the 1930s showed the first evidence of the estrogen activity from Bisphenol A. However, it was not until 1997 that adverse effects of even low-dose exposure were first reported. Since then more than 100 studies have been published with health concerns about Bisphenol A.

Various BPA animal studies have stated the following:

-Bisphenol A can disrupt the endocrine system affecting the way in which glands and hormones interact. Even low doses of Bisphenol A can mimic the body’s own hormones and possibly cause negative health effects. Long term low dose exposure may create chronic toxicity in humans. Bisphenol A has been known to leach from the plastic lining of canned foods and plastics that contain acidic or high-temperature liquids. While most exposure is through diet, exposure can also occur through air and through skin.

-Studies have demonstrated carcinogenic effects and possible neurotoxicity at low doses ,as well as a possible linked to obesity by triggering fat-cell activity.

-The U.S. Environmental Protection Agency and the International Agency for Research on Cancer have yet to evaluate Bisphenol A for carcinogenic activity.

Of course some toxicologists and some regulatory agencies have criticized low-dose toxicity studies, especially when Bisphenol A is injected directly into animals since human exposure is mainly through ingestion. Some studies (funded by the chemical industry) have found no evidence of adverse effects from low dose exposure. And a recent 2008 study concluded that blood levels of Bisphenol A in neonatal mice (cute little baby mouse) are the same whether it is injected or ingested.

The first study of the BPA effects on humans was published in September 2008 by Iain Lang and colleagues in the Journal of the American Medical Association (article link here). The study of about 1,500 people assessed exposure by looking at BPA levels in urine. The authors found that high Bisphenol A levels were markedly associated with diabetes, heart disease, and abnormally high levels of some liver enzymes. An editorial in the same JAMA issue (here) states that while this preliminary study needs confirmation and cannot show cause, there is a model here for equivalent effects in animal studies. This adds a great deal of biological probability to the results reported by Lang and colleagues.

Despite a soil half-life of only 1 to 10 days, it is an ever-present pollutant. According to Environment Canada, an initial assessment shows that over time even low levels of BPA can harm fish and organisms. Studies also indicate that it can currently be found in some municipal wastewater.

There are seven classes of plastics used in packaging applications. Type 7 plastics (sometimes identified with the letters “PC” near the recycling symbol) are made from Bisphenol A. Some type 3 plastics with BPA are PVC piping that is popular for household plumbing. When these plastics are exposed to hot liquids, Bisphenol A leaches out rapidly. The Types 1 (PET), 2 (HDPE), 4 (LDPE), 5 (polypropylene), and 6 (polystyrene) plastic products do not contain Bisphenol A so leaching into food or beverages is not a worry.

Some type 7 and type 3 plastics may leach BPA and will have their three arrow triangle with the number 7 or 3 inside the triangle. This symbol is located somewhere on the plastic, usually the bottom of the container.

There are some main points to help decrease BPA concerns:

1. Discard clear plastic baby bottles. Research that says there are problems point to the effect of the estrogen-like BPA on children as the most significant.
2. Tin cans are often lined in plastic BPA and sit around a long time, so discard older cans especially tomatoes and other acidic fruits.
3. Do not plastic bottles for hot drinks.
4. Replace your BPA bottle with a BPA free one, particularly if pregnant or pre-pubescent.
6. Use only BPA free water jugs.
7. Get a filter and use city tap water in lieu of drinking bottled water.

Don’t worry about polycarbonates in non-food related products like CDs and DVDs but do keep them out of the mouths of babes.

This issue remains controversial, however. The plastics industry and the maker of Nalgene bottles say there are no ill health effects with BPA. According to Chemistry World, the FDA maintains that there is no reason to ban or restrict the use of BPA in food or drink containers because human exposure levels to the chemical from these sources is too low to have any adverse effects. There is concern that the Food and Drug Administration’s policies on BPA are entirely dependent on two studies’ that were both funded by a subsidiary of the American Chemistry Council, and they represents plastic resins manufacturers.

So…debate continues on what is the safe limit of this BPA compound. Within the United States, an exposure of up to 50 µg/kg/day (50 parts per billion (ppb)/day) is considered safe by the Environmental Protection Agency. The term plastics covers a range of synthetic or semi-synthetic organic condensation or polymer products that can be molded or extruded into objects or films or fibers. The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people.

For the most part, we know the animal studies raise concerns and the human studies show exposure but no true effects…yet?

The jury is still out in some circles and has long gone home in others. I’m switching back to glass.

Be good to yourself,
Dr. Bufi

Detox Diets: What Makes Sense for Cancer Patients?

Some cancer patients want to do some kind of detox plan. I am not sure if it is the time of year or just the economy (perhaps both) but this detox issue seems to be cycling back again. Most or all of you have heard me say this before, “Part of my job is to protect you, part of my job is to prevent any type of supplement reaction with any type of cancer treatment.” Understanding mechanisms of detoxification and understand limitations for cancer patients require some basic guidelines.

A narrow definition of detox would be the reduction of the toxic properties of a poisonous substance or simply a biotransformation. A popular definition is enhancement of waste elimination by inducing the release of accumulated toxins from the tissues and facilitation of their subsequent removal from the body. This of course assumes that toxins may build up when elimination can not keep up with production of cellular wastes or absorption of toxins. Most people want to detox after acute or long-term exposure to toxic substances like heavy metals such as mercury or lead, exposure to solvents, long term prescription medications, drug and/or alcohol detoxification. In addition, toxins of daily 21st century life like pesticides, pollution, exogenous hormones, or my relatives back in New York (just kidding Johnny!). The overall goal with all of this is to clean up, get back on track, lose weight, improve skin tone, increase energy, promote longevity, decrease risk of all sorts of disease.

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“Natural Hormone Therapy” for Women: Summary of the Evidence for Safety

    Many women have turned to natural forms of hormone replacement for menopause since learning that conventional hormone replacement therapy (HRT) may increase their risks of breast cancer and other health problems.  Most women have assumed that “natural” or “bio-identical” HRT is safer than conventional HRT. However, recent research has shown that this is not the case, and that – in fact – the risks are probably similar.

Bio-Identical Hormone Replacement Therapy
   Bio-identical HRT refers to products that are derivatives of plant extracts and are modified to be chemically similar to hormones naturally produced in the body. They are often compounded into custom formulations that combine the three major types of estrogen – estriol, estradiol and estrone – in varying proportions. These preparations are marketed under a number of trade names including Bi-Est and Tri-Est.

Other bio-identical HRT products have names without estrogen-like words in the title, yet they still contain estrogen. Additionally, some natural hormone replacement therapies include a “bio-identical” form of progesterone called “oral micronized progesterone,” or OMP. Women who have not had a hysterectomy are frequently advised to take progesterone along with estrogen.

None of these bio-identical preparations has been well-studied for safety and efficacy, but they are promoted as safe and effective in the popular media. Read the rest of this entry »

Complementary and Alternative Medicine: Intro to Evidence-Based Guidelines

The American College of Chest Physicians (ACCP) recently published multiple papers of evidence-based guidelines for many aspects of lung cancer, and among these was a provocative one about complementary and alternative medicines (CAM)(abstract here). These guidelines are novel because they attempt to compile the evidence about CAM, a broad topic about which there is a great deal of interest but not nearly enough clinical trials or evidence. Among the first points is that complementary and alternative are two different things, with complementary really being defined, as the name implies, as an adjunct combined with the current standard “mainstream” treatments, primarily given to minimize side effects and integrate to enhance patient well-being. In contrast, alternative approaches tend to either be unproven or even disproved strategies that are often promoted instead of mainstream treatments for cancer. The latter are far more problematic for oncologists, because it is often detrimental to the health of patients to delay or refuse standard treatments for cancer altogether. Complementary treatments are often eventually tested, sometimes found to be beneficial, and then combined with chemo, radiation, and other standard anticancer approaches as part of an “integrated oncology program”. Alternative medical approaches are less commonly subjected to clinical trials and have not, as a rule, been demonstrated as beneficial if they have been tested. Alternative therapies are more commonly aggressively promoted as a biologically active easy cure in lieu of standard and better tested treatments.

One key principle is that CAM in one form or another is commonly used by patients, estimated at about 50%, and up to about 75% if prayer specifically for health reasons is included; moreover, much of the research suggests that use of CAM approaches has increasing (full text article here). Because of that, one of the recommendations is that physicians specifically ask patients about their use of CAM.

The guidelines include commentary on topics ranging from acupuncture, for which there are actually a number of studies on it as a treatment for pain or nausea, to massage therapy, vitamins and herbal supplements, massage therapy, bioenergy fields, and other work. I’ll cover these topics in my next several posts, and I’ll invite Dr. Labriola to provide his commentary in order to add further information that may support or refute my input.