Cancer cocktails — or, more scientifically, combination molecular targeted therapies — are currently considered the most promising avenue for curing or prolonging the lives of many people with cancer. The potential is so encouraging that recent news stories have recounted how patients are working on their own to mix therapies they think might work — getting different prescriptions from different doctors or even going on-line for so-called expert assistance. The temptation to “do it yourself” is understandable because even the distant possibility of remission or cure gives hope to someone who may be running out of options and precious time — while for others, taking the matter into one’s own hands seems like it might be the best route for a faster, more effective cure. I asked two well-known oncologists, Jeremy R. Geffen, MD, a leading expert in integrative medicine and oncology (which combines state-of-the-art conventional cancer treatments with safe and effective complementary therapies) and founder of Geffen Visions International in Boulder, Colorado, and Roy S. Herbst, MD, a professor and researcher at the University of Texas MD Anderson Cancer Center in Houston, whether this is ever a good idea, considering the plethora of reliable as well as unfounded information available on the Internet.
PROMISING TREATMENT OR RISKY BUSINESS?
Over the past two decades, the use of molecularly targeted drugs that kill tumor cells with minimal side effects has significantly improved the survival and quality of life for many cancer patients. While few of these targeted drugs can cure cancer on their own, combinations of them, often used together with standard chemotherapy, can be highly effective. In fact, combination therapies have become conventional treatment in many cases, including for some kinds of colon cancer and non-Hodgkin’s lymphoma.
However, physicians generally only prescribe combination therapies that have been proven safe and effective in carefully controlled clinical trials — and, frustratingly, the drug approval process for combination therapies is even slower than for single drugs. While doctors can prescribe drugs or combinations of drugs that haven’t been formally approved for a specific condition, most avoid doing so, and for good reasons. “There are potentially serious consequences involved in giving patients unapproved drugs or unapproved drug combinations,” said Dr. Geffen. “There are also significant ethical as well as medical-legal concerns. While understandable and appropriate, these concerns are nonetheless part of the day-to-day challenge of practicing oncology in today’s health care environment.”
That’s why some patients end up taking matters into their own hands, researching their options and finding different doctors to prescribe different drugs without disclosing what they are already taking. However, taking unapproved combinations of anticancer agents is a risky endeavor. The greatest risk, of course, is the possibility of adverse drug-to-drug interactions. “It’s unpredictable at best, and can be harmful — or potentially even fatal — at worst,” said Dr. Geffen.
DIETARY SUPPLEMENTS AND CANCER DRUGS
Another version of the same story involves dietary supplements such as vitamins, minerals and herbs taken in combination with cancer therapies. According to the National Center for Complementary and Alternative Medicine (NCCAM), studies show that significant numbers of cancer patients are using complementary and alternative medicine (CAM) therapies as part of their cancer regimen. Others take supplements to reduce the side effects of their chemotherapies and boost their immune systems. Many of these herbs, such as ginger, flaxseed and ginseng, have been proven clinically effective in treating the symptoms of cancer and the side effects of drugs. Yet, though they are available without prescriptions, Dr. Geffen warns there are risks involved in combining natural substances with chemotherapy. “The amount of reliable, scientifically rigorous information on the safety of these substances is relatively small,” said Dr. Geffen. “Some herbs can indeed lower the toxicity of chemotherapy drugs — but they may also simultaneously lower the drugs’ effectiveness. Ironically, some herbs can potentially increase the toxicity of chemotherapy, which could actually make people feel worse.”
A variety of herbs and botanical supplements can interfere with the way cancer drugs work by altering how the drugs are metabolized in the liver or transported out of cancer cells. “These are two mechanisms that explain why combining natural substances with chemotherapy can be a risky proposition,” said Dr. Geffen. “There are likely even more mechanisms that we don’t fully understand yet, which is why more research is needed and why patients should be cautious about this.”
MAKE DECISIONS BASED ON KNOWLEDGE, ?NOT FEAR
When it comes to do-it-yourself cancer cocktails, both Dr. Geffen and Dr. Herbst advise patients to “work with your oncologist and make informed, intelligent choices.” In other words, let thoughtful, intelligent discussion between patient and doctor be the guide. Here are some of their suggestions on how to make sure you are getting access to the best of what’s available:
• First, find an oncologist who is in sync with you, including how aggressively you want to fight your disease. “Work with an oncologist who has extensive experience in treating your particular cancer,” said Dr. Herbst. “By doing that, you could either learn about an early Phase I clinical trial to join or take the best combination of other drugs from studies that have proven effectiveness.”
• Ask your oncologist if he/she is willing to work with the latest combination therapies or a drug (chemotherapy or non-chemotherapy) that is currently being explored “off-label” to treat the cancer, if this offers hope for your particular diagnosis. “Oncologists will combine drugs for you — that’s what they’re trained to do,” said Dr. Herbst. “But these cocktails need to be rational combinations, they must be based on the findings of clinical data, even off-label.” Mixing a personalized cancer cocktail should only be done with a physician.
• If necessary, consider traveling to a major cancer center that is currently doing research with your particular kind of cancer. “I encourage people to seek out major cancer centers to look at new cancer treatments, where they may be able to join an early clinical trial program and can potentially get on drugs that have more activity and less toxicity,” says Dr. Herbst. You can find the latest information on early Phase I clinical trials or drugs being studied to treat your particular cancer from the National Cancer Institute at http://www.cancer.gov/clinicaltrials/search.
• Don’t fall prey to people who claim they can concoct a cancer cocktail for you. “On the Internet there are people who advertise that they can help you design a cancer cocktail — but you want to go where the data is, and where the clinical trials are,” said Dr. Herbst. “Until you know through exploring the research that something is better, it’s safer to stick to what has already been proven safe and effective. There are many drugs that people thought would be better, but by Phase III we learn that they are actually worse.”
• Consider adding a naturopathic perspective to your care. You’ve heard this before from Daily Health News contributing editor, Andrew L. Rubman, ND, who frequently recommends that naturopathic physicians be added to a patient’s medical team in order to provide wellness-building advice. Some cancer centers now have naturopathic physicians in their practices in order to help address these issues.
The future remains promising for many cancer patients and for cancer cocktails, said Dr. Herbst. “Currently, in the general population, we’re treating cancer based on what’s already known about a particular cancer, and we may use some combinations that work together in a so-called cocktail,” he said. “In the future, cancer cocktails will be custom-mixed for each individual patient based on the composition of his or her specific tumor.”
But remember, these “mixes” aren’t to be taken lightly based on something you read on a blog. It is understandable that when faced with a challenging circumstance like cancer, people may want to explore or even take desperate measures. In certain cases, risk-taking may even seem a logical choice. However, Dr. Geffen stresses that, “to maximize the chance for success, it is essential for patients and loved ones to make decisions based on knowledge and understanding, in partnership with their physician, rather than based on fear.”

Source(s): ?
Jeremy R. Geffen, MD, is president of Geffen Visions International, Inc., and director of integrative oncology of P4 Healthcare and Caring4Cancer.com. Dr. Geffen lectures widely about integrative medicine and comprehensive cancer care, and has testified before the United States Congress as an expert witness on integrative medicine and oncology. Dr. Geffen is author of The Journey Through Cancer: Healing and Transforming the Whole Person (Three Rivers Press). For more information visit http://www.geffenvisions.com.
Roy S. Herbst, MD, PhD, is professor of medicine and professor of cancer biology at the University of Texas, MD Anderson Cancer Center in Houston. Dr. Herbst’s research focus is on the diagnosis and treatment of lung cancers, and his research program is focused on the biology and therapy of lung cancer metastasis. Dr. Herbst has worked to develop a clinical/translational research program designed to test new therapies preclinically and then rapidly introduce them to the clinic to be studied in a scientific fashion using surrogate endpoints of tissue biopsy and imaging studies.

Al

AL

Pierre and Joanne, love the joke and the quote!

I have to admit that after reading 3-5 political comments here – sometimes – I welcome some change i.e. alien banter, AH history lessons, jokes, whatever…Sotomayor is in as far as I’m concerned, I pay no attention to background noise from naysayers, so I’m finished with that subject : ) I’m onto this: what are we going to do about all those white haired white guys in the house and congress, have you watched C-span to follow your fave piece of legislature? Holy cow…! Where are all the real people i.e. women and OTW and OTFO (other than freakin’ old!) wtf???

Ok, gotta get this day goin’ on now, enough dawdling with my latte and this blog, think I’ll go see who’s mad at me over at my own blog, tee hee…

Luv, Zen Lill

Quote for the day:

“Whatever you give a woman, she’s going to multiply. If you give her sperm, she’ll give you a baby.

If you give her a house, she’ll give you a home. If you give her groceries, she’ll give you a meal.

If you give her a smile, she’ll give you her heart. She multiplies and enlarges what is given to her.

So – if you give her any crap, you will receive a ton of shit.”

Joanne