On natural supplements and breast cancer

In bold prints are my comments on the newspaper article of the Oct 28th issue of the Philippine Daily Inquirer  about the press conference sponsored by the PSMO (Philippine Society of Medical Oncologists) called "Dietary Supplements in Cancer Treatment."

A well-informed cancer patient is an empowered patient. But the barrage of often-conflicting information sourced from the Internet can be overwhelming, and deciding which to believe can be paralyzing.

ON THE CONTRARY, CYBER INFORMATION HAS OPENED THE DOORS THAT WERE PREVIOUSLY CONFINED TO THE MEDICAL & SCIENTIFIC COMMUNITY AND HAS NOW ALLOWED THE PRINCIPAL STAKEHOLDERS TO ACTIVELY PARTICIPATE IN SEEKING THE TRUTH! PARALYZING FOR THE MULTI-BILLION DOLLAR CANCER INDUSTRY BUT EMPOWERING FOR THE GENERAL PUBLIC!

Green tea, malunggay oil, vitamin C, guyabano and even red wine are believed to have properties that can cure cancer. How true are the claims?

“I am telling you right now, guyabano is not an anti-cancer fruit,” said Dr. Ellie May Villegas, the feisty, petite vice president of the Philippine Society of Medical Oncology (PSMO).

IT MAY NOT BE A TRULY ANTI-CANCER FRUIT BUT IF IT EVEN ACTS AS A PLACEBO IN ADDRESSING NON-CANCEROUS SYMPTOMS, THEN WHY NOT? FURTHERMORE, IT CAN DO NO HARM.

“We rely only on evidence. Guyabano is not proven to kill cancer cells, and yet it is marketed as 10 times more potent than Adriamycin, a commonly used drug in chemotherapy. Adriamycin is a very potent anti-cancer drug. Why do you associate it with a fruit? They don’t even know what they’re saying.”

NOT TO SPEAK IN FAVOR OF GUYABANO BUT INSTEAD OF SHOOTING IT DOWN, SCIENTIFIC RESEARCH MUST BE DONE TO INVESTIGATE WHATEVER CURATIVE OR PREVENTIVE BENEFITS WHATEVER FRUIT OR HERB HAVE, NO MATTER HOW MINIMAL. BUT THEN, WHO WOULD FUND THE RESEARCH ON FRUITS, VEGETABLES AND HERBS WHEN THESE ARE WIDELY ACCESSIBLE TO THE PUBLIC WHILE DRUGS ARE NOT!

Confusion

In a press conference sponsored by PSMO called “Dietary Supplements in Cancer Treatment: Investigating the Claims,” Villegas said guyabano, also called Brazilian pawpaw, is confused with the pawpaw tree Asimina triloba (Annonaceae), known as the North American pawpaw.

The Asimina triloba fruit, which in no way resembles the guyabano, contains the natural compounds acetogenins that are proven to help regulate various types of cancers.

“When the North American pawpaw is taken with chemotherapy, patients and physicians noticed an above average amount of tumor shrinkage after the first treatment than normally expected with chemotherapy alone,” she said.

PSMO PRESIDENT Dr. Felycette Gay Lapus

Villegas was expressing concern over networking companies that profit from making bogus claims about natural cures.

CONCERN MUST NOT BE ON PROFITS OF NETWORKING COMPANIES BUT ON THE BENEFITS OF ANY SUPPLEMENT. TRUE THAT A LOT OF EXAGERATION IS DONE TO SELL THESE SUPPLEMENTS BUT THAT IS EXACTLY WHAT BUSINESS AND MARKETING IS ALL ABOUT! EVEN SODA IS BEING ADVERTISED TO HAVE VITAMIN C!  IT MATTERS NOT IF THE PHARMACEUTICAL INDUSTRY RAKES UP BILLIONS OF PROFITS FOR AS LONG AS THEIR DRUGS CAN CURE CANCER!

PSMO believes in the multidisciplinary approach: surgery, radiation, chemotherapy and, when proven safe and effective, dietary supplements to complement the treatment.

“With the proliferation of scientifically unsupported alternative cancer treatments, PSMO has established that there is a need to educate the public on how to address the cancer problem. We put together a position paper to help guide fellow oncologists, doctors and patients in making correct choices,” said PSMO president Dr. Felycette Gay Lapus.

THE NEED IS TO EDUCATE THE PUBLIC ON THE CAUSES OF BREAST CANCER AND NOT ON SURGERY, CHEMOTHERAPY AND RADIATION. THE MEDICAL APPROACH IS NOT NECESSARILY THE CORRECT CHOICE. WHAT MATTERS MOST IS THE PATIENT’S FULLY INFORMED DECISION AND NOT THE DOCTOR'S. THIS IS THE REASON FOR THE PROLIFERATION OF WHATEVER ANTI-CANCER SUPPLEMENTS – BECAUSE PEOPLE DO NOT WANT TO GET CANCER AND FOR THOSE AFFLICTED WITH CANCER, THE FEAR OF MEDICAL APPROACHES HAVE BEEN MOUNTING DUE TO THE FAILURE OF MEDICAL SCIENCE TO CURE CANCER.

Scientific evidence

In a PowerPoint presentation, Villegas said commonly used supplements not supported by high-level scientific evidence include homeopathic products, high doses of oral multivitamin supplements, vitamin C + collagen, high doses of oral vitamin C, oral stem cell enhancers/fibroblast growth factor enhancers, ozone therapy (IV), and heavy metal chelation therapy that removes heavy metal toxins supposed to cause cancer.

“Randomized controlled trials in advanced cancer patients taking 10 grams per day of oral vitamin C did not demonstrate any significant benefits. These can, in fact, interfere with the action of chemotherapy and radiation therapy. That’s why we always advise our patients to tell us what they’re taking,” Villegas said.

ON THE OTHER HAND, CHEMO AND RADIATION RENDERS NATURAL SUPPLEMENTS USELESS! IN FACT, TO APPEASE PATIENTS IN COMPLYING WITH TOXIC AND INVASIVE TREATMENTS, SUPPLEMENTS ARE BEING ALLOWED AS SUPPOSED COMPLIMENTARY MEASURES. BUT THE TRUTH IS THAT CONVENTIONAL AND NON-CONVENTIONAL APPROACHES CANNOT EXIST ALONSIDE EACH OTHER.

Villegas said that metabolic therapies such as nutritional therapies, Gerson Regimen, Kelley Therapy, Gonzalez Regimen, Contreras Therapy and Manner Therapy—also known as detoxification/cleansing regimens—do not work.

They can even cause nutritional deficiencies, she said, while some entail potentially toxic doses of supplements or agents. Coffee enemas, for instance, can cause sepsis, dangerous electrolyte deficiencies, and even death.

“The colon or large intestine is there for the stool to pass through. Why do you have to clean an organ that is supposed to be dirty? It is supposed to facilitate the removal of toxins via the stool. The American Cancer Society strongly urges cancer patients not to seek treatment with metabolic therapies. No published evidence supports their claims,” she said.

UNFORTUNATELY, VILLEGAS IS HIGHLY UNINFORMED AND MISEDUCATED. HAD SHE ATTENDED THE WORLD CONFERENCES ON BREAST CANCER IN CANADA SINCE 1997, SHE WOULD HAVE NOT HAVE STOOD HER GROUND. IN FACT, THE AMERICAN CANCER SOCIETY IS A VERY POOR AND BIASED SOURCE OF INFORMATION.

Lactic acidosis

Commonly used supplements supported by very limited scientific evidence, but not enough to suggest use, include transfer factor, malunggay oil, intravenous hydrogen peroxide, mangosteen extract pills, guyabano extract pills and resveratrol/grapeseed extract (provided they are not used with Tamoxifen).

AGAIN, THERE HAVE BEEN NUMEROUS SCIENTIFIC EVIDENCES WHICH ARE NOW SLOWLY BUT SURELY ENTERING MEDICAL JOURNAL IN NORTH AMERICA AND EUROPE. THE BREAST CANCER DRUG, AVASTIN CARRIED SCIENTIFIC EVIDENCE WHEN IT WAS RELEASED TO THE MARKET, ONLY TO BE PULLED OUT BY THE US FDA BECAUSE IT WAS LATER FOUND TO BE INEFFECTIVE!

“We cannot promote malunggay oil to be used as an anticancer agent because this has never been used on humans. What you can eat in a diet, eat it. Do not put it in a capsule or tea,” she said.

HUH? AND THE FOOD CAPSULES TAKEN BY ASTRONAUTS IN SPACE IS NOT NUTRITIOUS? HELLO, THERE IS SUCH A THING AS FOOD TECHNOLOGY!

  

Severe lactic acidosis was reported with mangosteen juice daily for 12 months, and patients eventually died not from their cancers, but from the lactic acidosis from mangosteen, Villegas said. Mangosteen may also interfere with certain chemotherapy drugs, and must be used with caution by diabetics due to its high sugar content.

AGAIN, VEGETABLE AND FRUIT JUICES ARE EVALUATED ON HOW THEY INTERFERE WITH DRUGS! SO WHY ARE NATURAL FOODS VIEWED FROM THE PERSPECTIVE OF CHEMO? BUT OF COURSE, DIABETIC CASES HAVE RESTRICTED FOOD INTAKES – AND SO ALSO DO HYPERTENSION, OBESITY, PREGNANCY AND ALL OTHER HEALTH CONDITIONS!

Resveratrol, which can be found in red wine, is also consumed as a dietary supplement for its purported antioxidant and anti-inflammatory properties.

“Because resveratrol exhibits estrogen-like properties and activates transcription by both the estrogen and androgen receptors that lead to stimulation of cancer cell proliferation, patients with hormone-sensitive cancer should use it with caution,” she said.

ALL SUPPLEMENTS JUST LIKE DRUGS ARE TAKEN FOR THEIR RESPECTIVE INDICATIONS AND ACTIONS. THIS IS THE REASON WHY THERE CAN BE NO ONE SUPPLEMENT FOR ALL INDICATIONS AND AILMENTS.

It may also protect against chemotherapy-induced cardiotoxicity, although more studies are needed to confirm its effect on humans, Villegas said.

“I caution breast cancer patients taking Tamoxifen not to take these supplements with resveratrol or grapeseed,” she said.

DO NOT TAKE TAMOXIFEN IN THE VERY FIRST PLACE! TAMOXIFEN CAN EVEN LEAD TO SECONDARY CANCERS!

Scientifically supported

Among the commonly used supplements supported by high-level scientific evidence are CoQ10 (decreases cardiotoxicity in Anthracycline chemotherapy); R-alpha lipolic acid (decreases neuropathy); American ginseng, rhodiola, ashwanga (decreases fatigue); calcium citrate/carbonate (bone support); ferrous sulphate (anemia support); vitamin B12 (anemia support for gastropathy and post-gastric resection in patients with B12 deficiency); whey protein/L-glutamine and branched chain amino acids (protein support for patients undergoing surgery); and polyglycoplex (viscuous fiber for patients needing weight loss and modulation of body mass index).

As for omega-3 fatty acids, although studies on their role in cancer prevention are inconclusive, Villegas said, they may reduce colon cancer risk, improve immune response in patients with colorectal cancer, and are associated with reduced occurrence of renal cell carcinoma in women.

Fish oil supplementation may reduce the risk of breast cancer, she said, although high-blood concentration of omega-3 is associated with increased risk of prostate cancer.

Other commonly used supplements supported by high-level scientific evidence include vitamin D, beta glucans, bio-available curcumin, green tea, pomegranate, acetogenin molecules and bio-available silymarin phytosome.

SO NOW THERE ARE SUPPLEMENTS THAT ARE SCIENTIFICALLY SUPPORTED? OH WELL, LET THE PUBLIC WAIT AND SUFFER UNTIL SCIENCE COMES TO THE PUBLIC’S RESCUE WAITING FOR SCIENTIFIC BREAKTHROUGHS IN CANCER CURE. BUT WHEN YOU HAVE CANCER, YOU CAN NOT WAIT! ONE WILL HAVE TO DECIDE WHAT ROUTE TO TAKE. 

Safe, efficacious

“We’re not saying no to supplements. We just want to direct patients to those which work and how to safely combine them in a complementary fashion with chemotherapy drugs in a safe and efficacious manner,” said Dr. Omid Etemadi, a board-certified integrative medicine doctor who trained at the National Cancer Institute in the US.

Etemadi said no supplement has been shown to cure cancer on its own.

YES, NO SUPPLEMENT CAN CURE ON ITS OWN. AS A MATTER OF FACT, CANCER HAS NO CURE. ONE THING FOR SURE THOUGH, CHEMOTHERAPY WILL MAKE MATTERS WORSE. AND BY THE WAY, TRAINING IN THE US NATIONAL CANCER INSTITUTE DOES NOT MAKE ONE A GURU.

“There are anecdotal reports, case reports that patients have been cured through very significant lifestyle changes, but these are very rare—more the exception than the rule. More than 99.9 percent of them will not benefit from diet and supplement alone,” he said.

I BEG TO STRONGLY DISAGREE!

He said surgery may cure stage 1 cancer, while surgery or radiation with chemotherapy or targeted therapy may cure stage 2.

IN MANY INSTANCES, STAGE 1 CANCER CAN DO EVEN WITHOUT SURGERY AND WILL EVEN BE AGGRAVATED WITH RADIATION AND CHEMO.

“For stage 3 and 4, we prolong the lives of patients if we use standard care. The cancer doesn’t completely regress, but it doesn’t grow anymore.”

PROLONG LIFE? MORE OF EITHER HASTEN DEATH OR PROLONG UNDUE SUFFERING.

“Dietary supplements may help reduce the side effects of standard care, may help survival rate and prevent cancer recurrence. But I would not recommend that patients use them alone,” said Etemadi.

SURGERY, CHEMOTHERAPY AND RADIATION WILL NOT HELP SURVIVAL RATES NOR PREVENT RECURRENCE.

Read more: http://lifestyle.inquirer.net/133877/guyabano-and-supplements-alone-wont-beat-cancer-doctors-say#ixzz2jC2v5v00

Angelina Jolie's Personal Choice

On May 15th, I was called by a major TV network inquiring if the PBCN had a similar case like Angelina Jollie. When I replied that we know of no cases of prophylactic mastectomy, the TV researcher then asked if we knew of any scheduled case of mastectomy who they could interview. I told her to best contact any major hospital because for sure, they would have mastectomy cases. Then on May 21st, I was invited and accepted a live early morning TV interview to publicly air the PBCN's view on the matter. The entire TV staff and crew listened intently as I spoke and even another guest of the Department of Health promoting one of their many health programs kept nodding. Because of the public interest generated, I was interviewed live the next day over a radio program. Following were my main points:

1. Breast removal for preventive purposes is not a guarantee or assurance that breast cancer will be prevented. In fact this option belongs to the age-old Halsted era when it was said by prominent surgeons that to prevent breast cancer, it would be best to simply remove the breasts of a female the moment she is born. "no breast - no breast cancer." The truth is that breast cancer can develop even without breasts because it is a hormonal disease that does not exempt flat-breasted women or lesbians.

2. In the Philippine setting, most if not all females value and treasure their breasts and in fact will not just agree to breast removals. Note that majority of women place their hands on their chest whenever they bend so as not to expose the cleavage of their breasts, wear shirts when swimming and do not wear clothes which easily expose their breasts. This cultural practice will withstand medical options for breast removals just for preventive purposes.

3. Regardless of hereditary risk factors or genetic dispositions to breast cancer, there are non-invasive options that are kinder that will not permanently damage a woman's self-esteem - avoiding and eliminating known environmental risk factors and causes of breast cancer!

4. Angelina Jollie does NOT represent the common woman NOR can she be made an example to follow. Personalities remain to be media materials and their individual choices or views can not and should not influence the general public as being even close to the truth. Her personal life does not even have to be discussed to see why she is very far from being like you, your daughter, your sister or your mother.

5. A woman with the stature of like Angelina can do anything with her body and still maintain her status and even increase her public image just as others have done - change the color of one's skin, tatoo one's entire body or even change gender. Definitely not the case with most women who live ordinary lives. And not every woman has a Brad Pitt by her side!

6. Lastly, my own wife was diagnosed with late stage breast cancer when our youngest daughter was only five years of age.  Because it takes 5 to 10 years before the first symptoms of breast cancer are manifested, our daughter was definitely conceived when her mother already had breast cancer! Our daughter is genetically predisposed - in vitro! So does that mean that our daughter, now aged 18 will have to loose both her breasts to prevent her from getting the disease that took away her mother at an early age? NO WAY! There are other ways of preventing a woman from getting breast cancer no matter the genetic predisposition!

Breast surgeon Shelley Hwang, MD, chief of breast surgery and professor of surgery at Duke University Medical Center and Duke Cancer Institute, who did not treat Jolie, when interviewed by WebMD stated the following salient points:

1. Only about 5% of all breast cancers are in women who have this genetic mutation.

2. Most breast cancer experts would agree that the choice is really the patient's to make, and I really want to emphasize, it is a choice.

3. The women who should absolutely consider genetic testing are those who themselves have had a triple-negative breast cancer, the kind associated with BRCA mutations, at an early age, under 45, people who have had both ovarian and breast cancer in family members, and people who have breast cancer in the family and are of Ashkenazi Jewish descent.

Breast cancer does not have to happen

March 3^rd would have marked my 40^th year with Rosa who passed away in 2000, a month after her 48^th birthday. Rosa died 4 years after she was medically diagnosed with breast cancer at age 44.

That morning, I received the journal of a woman who died 10 years after her diagnosis of breast cancer at age 50. In the afternoon, I received a call from a 41 year old woman whose breast tumor had already burst and was seeking assistance. In one day, I faced two cases which I have become most familiar with in my more that 15 years of breast cancer advocacy. Two different cases which mirror the unacceptable breast cancer epidemic situation in our country today where one of 13 will get the disease within their lifetime.

The 1st woman had submitted herself to all medical interventions at the Chinese General Hospital and total expenses reached a total of around P2 million pesos. The 2nd  woman was so poor that she could not even afford a P3,000 biopsy at the East Avenue Medical Center. Rosa however, did not submit to chemotherapy and radiation by choice.

The 1st woman wrote in her journal that her medical breast exam a year before her diagnosis was just fine. The 2nd woman first noticed a breast lump 10 years before medical diagnosis. This brings forth what I have long been saying that there really is no such thing as early detection because it takes 5 to 10 years before the first symptoms of breast cancer are manifested. Moreover, 80% of lumps are normal in the course of a woman’s reproductive life and not all of the remaining 20% are necessarily a malignancy. Furthermore, not all malignancies are of the aggressive type and this is will only be known after the fact.

During Rosa’s time, we had zero knowledge and understanding of the disease and neither was thermal imaging available then.  I am very sure that if the 1st woman had undergone thermal imaging a year before her diagnosis, a severe breast abnormality would already have been seen as against her being told that all was fine. She could have had the benefit of avoiding the harrowing experience of chemotherapy. In her journal, she wrote that, “Chemotherapy was the most painful treatment I experienced in my whole life”.

The 1st woman mentioned of how kind, gentle and approachable her doctors were, especially that her surgeon was considered the “king” among breast cancer surgeons.  All I have to say is that they have to be such because of how unkind and terrible their treatments would be. The ill effects and irreversible damages done by invasive and toxic procedures are known only afterwards. But because of the hope of extending life, patients will “bite the bullet.”  Unfortunately the often said “5-year survival rate” is in the USA and not in the Philippines where I have observed to be much, much lower.  As far as the doctors were concerned, she had already surpassed the 5-year period.

The 2nd woman went to the provincial hospital in Sta Cruz, Laguna more than 10 years after she her lump first surfaced. She was then referred to the East Avenue Medical Center but could not afford treatment, no matter how negligible the costs. Her breast has now worsened because she did not do anything at all – but, she is "staying alive" without medical intervention. Breast cancer is not a disease that our Lord God Almighty created and neither can its resolution be given to His hands. Neither is the supposed cure a question of money.  

These two women had no prior information, knowledge and understanding of breast cancer. The 1st one died 10 years after diagnosis and medical treatment while the 2nd one is still alive after 10 years of non-diagnosis and non-treatment. Unlike many others, Rosa and I had learned tremendously from attending five World Conferences of Breast Cancer which is how the Philippine Breast Cancer Network was founded in 1997.

Had I then the knowledge and experience that I possess now, Rosa would most possibly be with me today continuing the advocacy for the eradication of breast cancer.  But then, if not for her battle with breast cancer, I would not be able to do what I do now.

The Philippine Breast Cancer Network continues its most difficult task in honor of Rosa, the 1st woman, the 2nd woman and countless victims of this most dreaded woman’s disease. The PBCN strongly believes that breast cancer does not have to happen.  

Happy "would-be" 40th anniversary, dearest Rosa!

Mining, mercury and breast cancer

Former President Joseph Estrada totally banned mining during his term but his predecessors have since lifted the ban.. In fact, during President Nonoy Aquino's state visit to China two years ago, four Chinese mining companies agreed to invest US$14 billion in mining operations between 2011 and 2014.

Photo from beforeitsnews.com

China's rapid industrialization needs has led to thousands of small scale mining operations in more than 30 provinces. Being the 12th largest source of gold in the world, the Philippines has become the 3rd largest gold exporter to Hongkong, after Switzerland and China itself with total shipments averaging 80 tons annually since 2010 from a measly 11 kg in 2001. Mt. Diwalwal in Compostela Valley is considered to have the largest gold deposit in the world and alone has about 30,000 miners (60% of all the country's artisinal miners). Today, the Naboc and Agusan rivers are grossly contaminated with mercury and cyanide and these long-lasting elements have accumulated in the ground water and food chain.

The typhoon that hit Compostela in December 2012 released untold amounts of mercury in the lowlands.

Photo from geotayo.com

In Bulacan, enormous amounts of industrial waste and mercury is dumped into the Marilao-Meycauyan-Obando river system from small-scale lead recylers in Marilao and from leather tanneries and numerous gold jewelers in Meycauyan.

These effluents go directly into Manila Bay and find their way to Cavite, a clear symptom of which are the contaminated shellfish. Both Bulacan and Cavite are now experiencing an alarming rate of breast cancer cases.

Photo from aboutphilippines.ph

Years ago, I visited Guihulngan in Negros Oriental (100 kms north of Dumaguete City) where I learned that it had the highest incidence rate of breast cancer in the province. How could a small and sleepy town have an epidemic? What was common among the population was their ground water which I already suspected. When the weather was too rough to travel by sea from Dumaguete to Cebu City, one could travel by land to Guihulngan and take a small boat to Toledo and then take a land ride Cebu. What was in Toledo? Atlas Consolidated Mining and Development Corporation whose operations were stopped when fisher folk complained that its tailings had so contaminated the fishing grounds. Guess where all the mercury and cyanide had also gone? To the ground water of Guihulngan.

In the recent earthquake that hit Guihulngan in February 2012, a rapid increase of breast cancer cases can be expected when all the mercury and cyanide were abruptly released from the groundwater.

Photo from denverpost.com

And with the recent typhoon that hit Compostela Valley in December 2012, also expect an outbreak of breast cancer when all the mercury and cyanide from the mining areas widely spread.

Photo from HANDOUT/Reuters

Mercury exerts an estrogenic effect on breast cancer cells by binding to estrogen receptors mostly found in the breast area, causing increased abnormal cell growth. This heavy metal disrupts normal cellular repair and disrupts the natural detoxification mechanisms of the kidney and liver (the blood factory).

Do medical oncologists ever determine the presence of heavy metals such as mercury in their breast cancer patients? They never do! So how can they ever really treat breast cancer caused by mercury and cyanide. Breast cancer caused by environmental contamination and treated with toxic chemo drugs will only aggravate and result into further health complications.

One out of 13 women in the Philippines will get breast cancer during her lifetime and only a firm environmental solution can reverse this public health crisis.