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Oncology Update: Case Studies in Alternative Treatments of Advanced Stage Cancers

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Oncology Update: Case Studies in Alternative Treatments of Advanced Stage Cancers Oncology update: Case studies in alternative treatments of advanced stage cancers Dr. Ralf Kleef, MD Dr. Virender Sodhi, MD (Ayurved) ND Introductions Dr. Ralf Kleef, MD Dr. Virender Sodhi, MD (Ayurved) ND • Board certified in general • Board certified MD (Ayurved) in medicine, oncology, and 1980 naturopathic medicine in 1994 • Ayurvedic Medical professor until • Post doctoral researcher at 1986 Memorial Sloan-Kettering Cancer • Became first Ayurvedic and Center Naturopathic physician in the • Headed commission of experts to United stated in 1988 fever therapy of cancer at NIH • Envisioned and formed Ayush • Began medical practice and Herbs, Inc to bring Ayurvedic research in Vienne, Austria in medicines to the West in 1989. 1998 • Practicing at Ayurvedic & • Serves as a sworn court certified Naturopathic Medical Clinic in Expert for Hyperthemia and Bellevue, Washington with a Complementary Medicine in focus in Oncology. Autstria Update on Alternative Oncology • In 2020, we are seeing a boom in research validating often ignored or overlooked techniques for treating late stage cancers. • In America, much of this research isn’t being widely disseminated or utilized. – The NIH states: “a number of challenges must be overcome before hyperthermia can be considered a standard treatment for cancer” • A 2020 study is finding Homeopahy as an Add-On therapy may prolong survival and improve quality of life. What does Late-Stage management really mean? • Cure? • Remission? • What is the Quality of Life? • Are the patient’s goals considered? – “ I want to see my child get married” – “I want to just be able to lie flat on a bed” – “I want to feel ready should something happen” What are the options? • When things are not working, or are not optimal: patients and providers have choices: – Wait and see. – Explore new research: • Hyperthermia • low dose immunotherapy • metronomic chemotherapy – Switch “medical lenses” • Homeopathy • Traditional Chinese Medicine • Ayurveda Ayurveda A 5,000 year old science of life Ayu = Life Ved = Science The Goal of Ayurveda To treat disease To maintain optimal physical, mental, emotional and spiritual health. To fulfill the primary desires of: (DHARM) - Religious satisfaction (ARTH) - Financial stability (KAMA) - Procreative instinct (MOKSHA) - A balance physical, mental, emotional and spiritual body Ayurvedic Fundamentals • The Dosha – Ayurveda’s understanding of phenotype and genotype Vata + Pitta Vata + Kapha Kapha + Pitta – 3 Primary: Vata, Pitta, Kapha. Tridoshic/ Vata-Pitta-Kapha • Looks at the whole person, and looking for places of strengths and places of weakness. • Crucial to understanding one’s self, and thus maximizing quality of life through harmony. Ayurveda’s Primary Approaches Nutrition Lifestyle Panchakarma Herbal Therapies Nutritional Therapy • Many people eat • Food choices are not the improper foods for their only thing modified body • Food habits are also – Ayurveda utilizes the changed: Dosha understanding to – When food is eaten make targeted – With whom food are eaten recommendations. – Amount of food in one sitting – Help patients eat right for their body. Examples of Dietary Therapies • Generalized Dosha Specific Recommendations: (for all Dosha) • Kapha – Eat fruits and vegetables that are seasonally available – Tends towards sluggish digestion, constipation, bowel – Create a plant based diet. blockages. – Reduce consumption of meat – Need to be warmed up: warm foods, astringent foods – Eat meals in a scheduled way are best. – Eliminate unnecessary sugars from the diet Avoid sweets, avoid dairy and red meat as these will • Spices – putrefy in the digestive tract and could lead to – Spices and flavorings are adjusted for each Dosha type carcinogens. – They are often medicine herbs in their own right. – They help enhance digestion and elimination to – Vegetables: leafy greens, bitter melon. Also Legumes prevent carcinogenesis within the digestive tract and and tofu for protein. body. • Pitta Examples • – Tends towards diarrhea, undigested food in stools, – Trikatu- a mix of black pepper, long pepper, and ginger powders, assists in activating epithelial cells in the itchy rectum. intestines, assists in breaking down fats – Avoid red meat, acidic foods, and hot spices. – Cumin-balances pitta in the gut and increases – Moderate dairy, eat lean proteins and enjoy juicy absorption of nutrients fruits. – Honey- scrapes Kapha from the body and modulates allergens • Vata – Tends towards a weaker digestion (gas, bloated easily) – Only eat cooked foods to support digestion – Increase dairy such as yogurt – Moist, heavy, and warming foods are best. Lifestyle Overview Applications • Daily routine can change the • Yoga health of individuals for the – Research supports yoga reduces better Insomnia, pain, fatigue, anxiety, depression and improves quality of • Proper waking and sleeping life. schedules reduce stress and • Meditation allows the body to heal – Improves immune function, • Yoga brings balance to body in increases circulating endorphins. – Improves emotional processing of using movement cancer diagnosis • Breathing exercises not only • Breathing Practices ease the mind, but detoxify – Increase immune activity the body using the breath – Improves sleep quality • Meditations allows the mind – Improves patient’s perception of to check in with the body quality of life Danhauer SC, Addington EL, Sohl SJ, Chaoul A, Cohen L. Review of yoga therapy during cancer treatment. Support Care Cancer. 2017;25(4):1357-1372. doi:10.1007/s00520-016-3556-9. Dhruva, A., Miaskowski, C., Abrams, D., Acree, M., Cooper, B., Goodman, S., & Hecht, F. M. (2012). Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial. Journal of alternative and complementary medicine (New York, N.Y.), 18(5), 473–479. Hardoerfer, K., & Jentschke, E. (2018). Effect of Yoga Therapy on Symptoms of Anxiety in Cancer Patients. Oncology research and treatment, 41(9), 526–532. Fouladbakhsh JM, Stommel M. Gender, Symptom Experience, and Use of Complementary and Alternative Medicine Practices Among Cancer Survivors in the U.S. Cancer Population. Oncol Nurs Forum. 2010;37(1):E7-E15. doi:10.1188/10.ONF.E7-E15. Panchakarma (PK) • A long-term detoxification process utilizing patient specific diet and multiple purging practices. • Goal: Remove years of toxins that have accumulated in the body. • Rational: Moves excess doshas and agitates them so that they can be expelled into the digestive system, sweat glands, and urinary system • After PK treatments, foods are gradually reintroduced, and what remain of doshic imbalances is re-evaluated PK Methods • Vamana • Basti – Emesis-removes toxins – Enema- removes toxins from the upper gut from the colon • Virechina • Rakta mokshina – Intestinal cleansing- – Blood donation if removes toxins from the needed- removes toxins lower gut from the blood • Nasya • Detox is accompanied – provides herbs through the nasal passages, reaching by body treatments: the brain directly – Massage, shirodhara, sweat therapy Herbal Therapies • Ayurveda in inextricably linked to herbal therapies to treat disease and promote health. • Science continues to elucidate the mechanisms by which different herbs heal different conditions. • Ayurvedic practioners incorporate new plants (“Western” herbs) because they are able to learn in the modern era how to apply them using Ayurvedic philosophy as well. Ashwagandha • Withania somnifora has been shown to target and eliminate several cancer cell lines in vitro (see figure)4 • Has been shown to reduce colon cancer cell is mouse studies2 • Prostate cancer cells respond quickly to ashwagandha but cancer markers also improve1 Roy R V., Suman S, Das TP, Luevano JE, Damodaran C. Withaferin a, a steroidal lactone from withania somnifera, induces mitotic catastrophe and growth arrest in prostate cancer cells. J Nat Prod. 2013;76(10):1909-1915. doi:10.1021/np400441f. Muralikrishnan G, Dinda AK, Shakeel F. Immunomodulatory effects of Withania somnifera on azoxymethane induced experimental colon cancer in mice. Immunol Invest. 2010;39(7):688-698. doi:10.3109/08820139.2010.487083. Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol. 1998;62(3):209-214. doi:10.1016/S0378-8741(98)00039-7. Yadav B, Bajaj A, Saxena M, Saxena AK. In Vitro Anticancer Activity of the Root, Stem and Leaves of Withania Somnifera against Various Human Cancer Cell Lines. Indian J Pharm Sci. 2010;72(5):659-663. doi:10.4103/0250-474X.78543. Emblica officianalis • Shown to downregulate pro- oncogene expression in ovarian cancer cells while upregulating inhibitors of oncogene transcription 1. De A, Powers B, De A, et al. Emblica officinalis extract downregulates pro-angiogenic molecules via upregulation of cellular and exosomal miR-375 in human ovarian cancer Azadirachta indica • Regulates macrophage inflammatory characteristics in tumor cores • Regulates the immune system in the cancer microenvironment as well as systemically 1. Goswami KK, Sarkar M, Ghosh S, et al. Neem leaf glycoprotein regulates function of tumor associated M2 macrophages in hypoxic tumor core: Critical role of IL-10/STAT3 signaling. MlIl 2016 80 1 10 d i 10 1016/j li 2016 10 008 Mistletoe • Clinical trial showed that mistletoe not only improved quality of life, but also reduced inflammation when compared against common chemotherapy. • Improved survival and case study improvement . 1. Piao BK, Wang YX, Xie
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