If you haven’t heard, the latest news that is keeping oncologists up at night and dancing in the streets is using metronomic chemotherapy for cancer in people and pets. I am sure they are quietly saying, “It’s about time.”
At a time when people are running away from chemotherapy like a dog from a skunk, oncologist are breathing a big sigh and leaping at the opportunity to accept the latest (and greatest?) approach to cancer.
Metronomic chemotherapy is basically using lower dosages of chemotherapy drugs on a more consistent basis than the previous chemotherapy protocols. What I find particularly interesting, research claims its success by comparing it to the failures of the current, standard protocol for chemotherapy. Doesn’t bode well for those patients receiving the regular protocol.
The standard protocol for chemotherapy is based on a rational theory that simply states, “The higher dosage, the better.” Oncologists give maximum dosages of the strongest drugs in order to kill the cancer cells. This is referred to as maximum tolerated dose or MTD. Unfortunately, this comes with a boat load of side effects including killing normal body cells in the process along with intense side-effects that make the patient ill as well as potentially killing them. But, we have to take the bad with the good if we want to get rid of that cancer.
The latest research indicates that the standard protocols using MTD, that have been used for the past 40 years, yes, 40 years, may actually be causing more cancer cells to generate, potentially leading to recurrence with cancer cells that are more dangerous than the ones being treated. A recent article from the NIH states, “The introduction of the maximum tolerated dose (mtd) in usual treatment protocols made necessary the imposition of rest periods between cycles of therapy—a practice that not only involves re-growth of tumour cells, but also growth of selected clones resistant to the therapy. Hence, the therapeutic success obtained during the first cycles of treatment reverts in the direction of growth of more malignant metastatic tumours with no therapeutic response.”
If we look at standard chemotherapy protocols it is not hard to see what typically happened. Patients were given chemotherapy for most cancers, whether research indicated that the cancer responded to chemotherapy or not. It was the only “trump card” that the oncologist had to play against the cancer. Some patients went into remission, some, due to side effects, had to stop the treatment, some died from the treatment and some made it through the treatment but did not put the cancer into remission. So, what happened to the patients that did not go into remission. Often, they were given options for “experimental” protocols.
Some of these experimental protocols stayed along the pathway of maximum dosage, better results, so they increased the dosages even more. They would remove the patients bone marrow, inject chemotherapy drugs at dosages 2-3 times the maximum dosages recommended and then replace the bone marrow cells. Unfortunately, many patients died from this protocol, including my best friend’s wife because the high dosage of the chemotherapy drugs wiped out the liver and kidneys. The patients that lived had no better results than the adopted protocols.
So, now we move forward with the latest protocol that relies on the new theory, “Less is best.” We must emphasize that this protocol is considered a “novel” protocol by the FDA, meaning that there is not enough research to consider it an established protocol, meaning that we don’t know anything more than what is on paper. That makes me feel warm and fuzzy.
From an observation perspective, it is easy to look at what is perceived as great benefits. The lower dosages are not making the patients acutely ill as often and that has to be good. But, does that mean there are no side effects and does it mean that it will be successful? We don’t know yet.
Metronomic chemotherapy goes against the standard protocol regarding killing cancer cells. The theory is that instead, it acts as an anti-angiogenesis protocol. Angiogenesis is a term that describes the ability for a cancer to produce its own blood supply to feed itself during rapid growth. Anything that inhibits the blood supply to the tumor will slow growth and potentially starve the cancer. This is not a new theory, as this knowledge has been around for many years. Many other drugs thought to have this benefit have been tried and none have been accepted to the point of rendering the standard protocol obsolete.
The hiccup in the theory of anti-angiogenesis is that the body actually needs its angiogenesis capabilities, but, just not to the cancer. Does this mean that if the drugs affect angiogenesis on the entire body and not just the cancer, that it might cause harm? Seems so. Sort of like the MTD not being specific for the cancer. Still too early to know.
I am also a bit concerned about oncologist sending home chemotherapy drugs to be administered by the public. About 25 years ago, research indicated that handling some chemotherapy drugs was dangerous to doctors, nurses and technicians. Strict FDA standards were devised to prevent toxicities due to these exposures. Vented hoods were needed for handling and other safety protocols were mandated. This is why most vet clinics stopped doing chemotherapy in-hospital and sent their patients to the oncologist, where they had the safety devices to administer the drugs. I wonder how this is being handled?
Beyond all of the potential pitfalls in the latest theory by oncologists the fact still remains that chemotherapy does not heal. It cannot heal because it does not address the most fundamental of all questions, “What caused the cancer?” Conventional medicine does not address this question, so the best that we can hope for is that chemotherapy is a treatment that will hopefully put the patient into remission until it returns again. Is this a good thing? Certainly, if it is safe. But, other options, especially those that do address the underlying cause, should never be discounted.