INTEGRATIVE CANCER TREATMENT CENTRE
The Centre for treating cancer and related diseases, including bleeding and clotting disorders, was established in 2017 at Saira Memorial Hospital, Model Town Extension, Lahore. The Centre, in addition to standard of care therapies, provides a whole range of therapeutic interventions which provide research proven advantages for cancer patients.
The Centre is overseen by Dr. Muhammad Arif, an American Board certified Oncologist/Hematologist, with vast experience of treating all forms of cancer. The patients have recourse to an integrative approach benefitting from the experience of a multi-disciplinary team including infectious disease physician, pain management services and nutritional support and interventions.
Apart from the conventional standard of care therapies the following treatments modalities are employed at the Centre:
REGIONAL HYPERTHERMIA – ONCOTHERMIA
At our Integrative Cancer Centre hyperthermia is administered to patients using state of the art machine manufactured by Oncotherm, Germany. This equipment is used to generate modulated radio frequency waves with a large electrode placed under the patient and another flexible electrode placed on the tumor area. A carrier frequency of 13.56 MHz is generated which heats up the malignant cells, within a temperature range 0f 40-43C, because of their higher conductivity as compared to normal cells. The normal cells are largely unharmed by the achieved temperatures.
Normally sessions last 60-90 minutes while the patient lies comfortably without feeling any effects of the heat generated as the body temperature remains essentially unchanged without any deviation in patients’ vital signs.
This treatment is increasingly applied for large number of tumors, including but not limited to, the following cancers:
- Tumors of the head and neck
- Brain tumors like glioblastoma
- Cervical carcinomas
- Hepatocellular carcinomas
- Renal Carcinoma
- Oesophageal Carcinoma
- Ovarian cancers
- Colorectal Cancers
- Ca Breast
- Ca stomach
- Pancreatic cancer
Mechanism of action of Regional Hyperthermia
Regional Hyperthermia (Oncothermia) impacts the cancer cells in a variety of ways by modifying factors that lead to tumor growth i.e. the tumor microenvironment, immune response and tumor vascularization and oxygen supply as explained below:
- Alterations in Cell membrane permeability
The heat causes changes in the cell membrane permeability and alters enzymatic activity and cellular structure inducing apoptosis. The increased cellular permeability also results in enhanced drug absorption thereby increasing its cytotoxic effects.
- Increased Tumor Oxygenation and Targeting of Cancer Stem Cells:
Another reason that despite recent advances in cancer treatment and management the overall survival is still limited and cures elusive, is the frequent relapses which are progressively more resistant and difficult to treat. A group of cells – the Cancer Stem Cells (CSC’s) – escape the effect of cytotoxic therapy owing to their location in hypoxic, under-perfused tumor areas and their relatively slower growth, becoming the primary drivers of the dreaded recurrences.
The increased vascularization and oxygenation of the tumor with Oncothermia therapy helps target tumor cells in the areas populated by CSC’s which are difficult to penetrate by conventional therapies. It also modifies the tumor friendly microenvironment by adversely affecting the up-regulated DNA repair pathways which protect the CSC’s genomes. These properties make Regional hyperthermia an ideal tool to employ, along with standard of care therapies, to prevent relapses.
- Oncothermia Induced Enhance Immune Response and effect on Heat Shock Proteins (HSP):
Oncothermia increases levels of Natural Killer Cells causing increased tumor growth inhibition. Additionally, it causes an enhancement of the antigenic foot print of the malignant cells which in turn facilitates their recognition by the immune system.
Oncothermia also triggers an up-regulation of Heat Shock Proteins (HSP’s) which precipitates un-binding of cellular proteins with consequent loss of function and cell death. Also the increased production of HSP’s and their release by necrotic tumor cells causes dendritic cell maturation resulting in a powerful systemic anti-tumor response.
Oncothermia, in conjunction with other integrative interventions and standard of care therapies results in clinically significant improvement in patient outcomes with decreased tumor burden and reduction of metastases with improved overall survival rates.
HYPERBARIC OXYGEN THERAPY (HBOT)
Abnormal tumor growth is known to create hypoxic areas in the tumor which promote progression of the disease. Hyperbaric Oxygen Therapy saturates the tumor with oxygen thus reversing the cancer promoting effects of tumor hypoxia. HBOT also produces Reactive Oxygen Species (ROS) which the cancer cells are not equipped to neutralize, resulting in apoptosis. Additionally, many complications arising in cancer patients like fatigue, anemia, non-healing wounds and chemo brain respond very favourably to HBOT.
In recent years a number of studies have been published in respected journals that firmly establish that HBOT, in combination with other standard of care therapies like radiation and chemotherapy, not only increases mean survival time as compared to controls, but also helps in improving quality of life.
Hyperbaric Oxygen Therapy entails administration of 100% pure oxygen at 1.5 times the normal atmospheric pressure after putting the patient in specially designed oxygen chamber for 60-90 minutes. This increases the plasma oxygen saturation, independent of the haemoglobin oxygen saturation, leading to reduction in tumor hypoxia.
At our Integrative Cancer Treatment Centre we offer HBOT as a non-toxic adjuvant therapy to standard care for patients with systemic metastatic disease.
INSULIN POTENTIATION THERAPY – LOW DOSE CHEMOTHERAPY
This protocol entails intravenous injection of a small dose of insulin inducing mild hypoglycemia in the patient followed by chemotherapy injection. While standard chemotherapeutic agents are employed in this protocol, the dose is 5-20% of the normal dosages. On conclusion of the chemotherapy drug the hypoglycemia is reversed by glucose given by IV injection or orally. At these low dosages of the cytotoxic agents the normal healthy cells are spared any extensive damage, with resultant minimal side effects, as most of the chemotherapy drug is selectively taken up by cancer cells owing to their much higher number of surface insulin receptors as compared to normal cells.
Another advantage of this unique protocol is that the patient can be given three or four chemotherapeutic agents having different cytotoxic modes of action. This decreases the incidence of drug resistance apart from improving cancer cell death.
At Saira Memorial Hospital we have been using this protocol with excellent response for the last two years. It is also especially useful as a palliative tool in advance disease where conventional dose chemotherapy, or other invasive interventions, are not possible because of the patient’s general health. Such patients see a substantive improvement in quality of life because of lessening of the disease load. This protocol is being used extensively in European clinics not only as a palliative tool, but also in patients who refuse to, or are unable to, undergo chemotherapy for any reason.
REPURPOSED DRUGS IN ONCOLOGY (REDO) PROTOCOLS
ReDo project is an international collaboration of researchers and clinicians working as a not-for-profit group. It entails use of existing drugs, being used for decades for various common diseases, to treat cancer patients. These common medicines have a long established record of safety and low toxicity. The ReDO database has identified 270 such drugs which offer research established therapeutic advantages for cancer patients.
Most of these drugs are off-patent and extremely low cost and include commonly used drugs like anti-malarials, NSAIDs, antibiotics, lipophilic statins, anti-parasitics and anti-fungals. While these drugs can be used with existing chemotherapeutic agents, they remain effective when used alone or in different ReDO combinations.
These drugs, used for their off-label indication in cancer, demonstrate a host of anti-cancer actions including, but not limited to following:
- Stimulation of immune system
- Inhibit Cell-cycle progression
- Facilitate Apoptosis
- Target Cancer Stem cells
- Inhibit microtubulin formation
- Block metabolic pathways of cancer cells
- Rectify abnormal cancer cell signaling
- Increase response to chemotherapy and radiation
- Decrease uptake of glucose by cancer cells
- Cause membrane disruption
- Inhibit HER-2 activity
One of the most useful action of repurposed drugs is their ability to target the various metabolic pathways of the cancer stem cells. All cancer cells exhibit extreme metabolic flexibility. While normal cells mainly depend on glucose dependent oxidative phosphorylation for their energy needs, the cancer cells can, in absence of glucose, switch to aerobic glycolysis, fatty acid oxidation or use of glutamine and other amino acid as fuels. Repurposed drugs, by varying mechanisms of action, target all these metabolic pathways – and the abnormal cellular signaling – resulting in cellular apoptosis.
At Saira Memorial Hospital Integrative Cancer Treatment Centre these drugs are used routinely in conjunction with standard of care chemotherapeutic agents, or alone in various combinations, to treat a wide variety of cancers. In patients who have developed multi-drug resistance to standard of care therapies the repurposed drugs are particularly effective in helping to reduce the resistance with potential for improved outcomes.
HIGH DOSE PARENTERAL ASCORBATE THERAPY (IV VITAMIN C)
Parenteral Ascorbate as an unorthodox therapy for cancer has clinically proven efficacy and safety record. Linus Pauling, known as the father of modern biochemistry and a double Nobel Laureate, advocated its use. He published a number of case studies attesting to benefits of vitamin C especially in patients with advanced, unresponsive disease. Other researchers, unfortunately, failed to replicate Pauling’s results because of the low dosage used in their experiments. This, combined with the fact that the anticancer mechanism of action attributed to vitamin C by Pauling was not validated scientifically, did not help establish IV vitamin C as a supportive therapy along with standard of care.
A number of physicians and scientists persisted with their research and it is now clinically established, scientific fact that usage of vitamin C intravenously in high dosages has multiple benefits for cancer patients.
Cancer cells preferably accumulate Vitamin C as compared to normal cells. High concentration of Vit. C results in production of hydrogen peroxide, which acts as a pro-oxidant with creation of Reactive Oxygen Species (ROS). Cancer cells lack or are deficient in anti-oxidants enzymes like Catalase and particularly glutathione and fail to neutralize hydrogen peroxide resulting in cellular apoptosis. .
Cancer stem cells which normally escape cytotoxic therapy and also become resistant to treatment have a glycolytic phenotype and are vulnerable to high doses of intravenous vitamin C acting as a glycolysis inhibitor. This effect of Vit C on cancer stem cells (CSC’s) is of particular importance in treating cancer.
At our Centre we use various ReDo medicines, which have anti-stem cell action, in conjunction with high dose intravenous ascorbate. This synergistic combination of ReDO+IV Vit C serves as a particular lethal metabolic strategy to eradicate cancer stem cells with remarkably no toxic side effects.
WHOLE BODY HYPERTHERMIA
This treatment modality is a modern scientific application of the one of the oldest healing method. A healthy body responds to illness and inflammation with increase in body temperature. This serves to enhance the body immune response with upgradation of all cellular components of the immune system, particularly resulting in lymphocytic migration to the inflammation and malignant tumor sites. Also the cancer cellular walls are particularly susceptible to higher temperatures causing their disruption.
The Whole Body Hyperthermia also serves to increase the tumor vascularization and oxygenation which, apart from causing direct cellular stress, results in improved delivery of cytotoxic agents to the tumors with enhanced response to conventional therapies.
At our Cancer Centre whole body hyperthermia is administered with European manufactured Heckel-HT3000 using patented technology based on Hydrosun irradiators producing water-filtered infrared rays (wIRA). An exclusive feature of wIRA is its property of penetrating the deeper tissues without adversely affecting the skin. This permits to use higher intensities to rapidly raise the core body temperature, with increased effectiveness, without damaging the skin.
The patient is made to lie inside a specially designed chamber with the wIRA Irradiators arranged over exposed upper part of the body with further infrared emitters placed over the leg and foot region. The vital functions are constantly monitored with dedicated monitor and include body core temperature, pulse rate, ECG, respiratory rate and non-invasive blood pressure measurement.
This modality is used as a supportive therapy for nearly all types of cancers along with standard of care therapies and serves to improve patient outcomes. Additionally, this therapy module is being increasingly used in a host of other diseases including auto-immune disorders, respiratory disorders including asthma, bronchitis and pulmonary fibrosis and chronic infections and inflammatory processes.
USE OF IMMUNE-RESPONSE ENHANCING STANDARDIZED HERBAL EXTRACTS AND SUPPLEMENTS & DIETARY SUPPORT
According to current research nearly 80% of all cancer can be traced back to poor nutrition, unhealthy life style and environmental toxins. An optimally nourished body with a healthy immune system is equipped by nature to deal with these toxins and detoxifies our bodies keeping it in a state of health. It is only when the immune system is weakened that the cancer cells find an opportunity to multiply and cause disease.
At our Centre we guide the patients to modify their diets and refrain from foods that produce inflammation in the body and drive cancer growth. These include all processed foods and foods containing artificial additives, colouring and flavouring agents. These harmful foods are replaced by natural unprocessed foods, herbs, vegetables and fruits which contain specific phytonutrients providing protection against cancer and have the ability to interrupt and, in some cases, reverse the course of disease.
Additionally, the patients are given a comprehensive cocktail of enzymes, minerals and standardized herbs and vitamins which clinical research has proven to have direct anticancer activity, with varying modes of action, apart from immune enhancing effects.
The objectives of the dietary interventions and supplementation are:
To make the body less acidic and more alkaline – The immune system works better in an alkaline environment.
Strengthening of the immune system and improving the body’s natural self healing ability – As described earlier the cancer cells only gain a foothold in the body when the immune system is weakened and compromised. Our dietary programme is designed to restore and upgrade the disease fighting ability of the immune system.
Reducing the amount of inflammation in the body – Inflammation is the precursor of all disease states. High sugar intake and high insulin levels promote inflammation in the body. We specifically aim to reduce sugar and insulin levels in the body.
Increasing the efficiency of the detoxification system of the body – Toxins accumulate in the body when the body organs responsible for eliminating toxins are performing sub-optimally. Liver and intestines are the primary organs for elimination apart from the lymphatic system, skin and kidneys. With this program the detox ability of the body is repaired and restored.
Prevention of metabolic changes that cause cellular mutations that lead to cancer and providing antioxidant protection improving body’s ability to fight cancer causing free radicals – Vegetables and fruits have a host of phytonutrients with anti-oxidant and immune boosting action. Incorporating these natural foods in the diet prevents pre-cancerous metabolic changes and also enhance the body’s ability to destroy free radicals which can lead to cancerous changes in the body.
Improving the digestive system so there is better absorption and utilization of nutrients – It is the chronic inflammation of the digestive tract, because of processed pro-inflammatory foods, that leads to faulty absorption of nutrients and deprives the body of the elements it needs to perform its protective and reconstructive functions. The special supplements and dietary programme serves to restore the integrity of the patients’ digestive system which is inevitably compromised due to cytotoxic drugs.