Miscellaneous Topics » Integrative Oncology Essentials

CoQ 10 may reduce the risk of developing melanoma and reduce recurrence

Posted by Brian Lawenda M.D. at 10:36 am

Apr 232012

Reports indicate anticancer activity with higher blood levels of CoQ 10 (reduced risk of melanoma development, recurrence and progression.) Why do we rarely hear about this? Very few human studies have been conducted to confirm these findings. (imagine that…no profit potential…no money to conduct this study)

What is CoQ 10?

CoQ 10 (also known as: coenzyme Q10, Q10, Vitamin Q10, Ubiquinone, Ubiquinol, Ubidecarenone) is an important protein made by the body, that is involved in cellular metabolism (converting the energy from fats and sugars into usable cellular energy) and as a protective antioxidant.

CoQ 10 stimulates the immune system

Numerous studies have reported on the immune stimulating effects of CoQ 10, although the mechanisms involved in this physiologic activity are not known.

http://www.ncbi.nlm.nih.gov/pubmed/1673841?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/10416052?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/101414?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/5478631?dopt=Abstract

CoQ 10 can suppress cancer cell growth

The mechanisms involved in this anticancer activity are not known.

http://www.ncbi.nlm.nih.gov/pubmed/4218125?dopt=Abstract

http://www.ncbi.nlm.nih.gov/pubmed/653103?dopt=Abstract

CoQ 10 protects the heart from chemotherapy injury

Studies have demonstrated that CoQ 10 can protect heart tissue from the potentially damaging effects of a commonly used class of chemotherapy drugs, called anthracyclines (i.e. doxorubicin).

CoQ 10 blood levels correlate with the risk of developing melanoma

Researchers prospectively followed 117 early stage (none with metastatic disease) melanoma patients and 125 healthy volunteers (control group), and they discovered some remarkable differences. First, the CoQ 10 levels were significantly lower in patients than in control group. Second, those with CoQ 10 levels less than 0.6 mg/L (low) had a 790% increased risk of developing metastatic disease compared with those patients who had higher levels of CoQ 10; the time to develop metastases was also almost double in patients with CoQ 10 levels 0.6 mg/L or higher! Among the 82 melanoma patients with a low CoQ 10 level (less than 0.6 mg/L), 17 of them died during the study period…whereas, none of the patients with higher CoQ 10 levels died.

http://www.ncbi.nlm.nih.gov/pubmed/16443053

CoQ 10 has been reported to enhance the efficacy of interferon therapy for melanoma

One of the standard therapies for use in patients with advanced stages of melanoma (stages 3-4) is an immune stimulating agent, interferon (IFN). IFN stimulates the immune system to recognize and attack melanoma cells. Patients with early stage disease (stages 1-2) are not typically recommended to receive IFN after surgery, as this drug is difficult for many patients to tolerate due to various side effects and the potential benefit in reducing the risk of recurrence has not well-established in these early stages.

One enterprising group of oncologists postulated that by giving CoQ 10 to those with early stage melanoma, they might be able to further stimulate the immune system. What they found was incredible:

In their study, they gave 32 patients with early stage (stage 1-2) melanoma IFN (2 injections per day of 600,000 IU) plus 400mg per day of CoQ10 for 3 years after surgery, while 49 received only interferon. The patients were monitored for five years after their treatment ended. They reported that the patients who received the IFN + CoQ10 had a reduction in their risk of developing metastases by 10-times compared with those who received only IFN. Furthermore, the IFN + CoQ 10 patients had far fewer IFN-related side effects compared with the IFN only patients; 22% versus 82%, respectively.

Other cancers that might benefit from CoQ 10 supplementation:

Very small studies and case reports have suggested that CoQ 10 may help some cancer patients live longer, including patients with cancers of the breast, pancreas, lung, colon, rectum, and prostate. Although these reports are promising, they are unfortunately not high-quality studies, therefore not much weight can be placed on these results.

Note of caution…don’t take CoQ 10 during radiation therapy:

A mouse study demonstrated reduced anticancer activity of radiation therapy when supplemented with CoQ 10. Radiation therapy works by creating free radicals in cancer cells, which then interact with the DNA and cause cell death. It is believed that by supplementing with a potent antioxidant, such as CoQ 10, the free radicals created by radiation therapy will be diminished along with its’ anticancer efficacy. Read my review article on this in the Journal of the National Cancer Institute.

CoQ 10 side effects:

None-to-mild side effects, including mild insomnia, elevated liver enzymes, rashes, nausea, upper abdominal pain/heartburn, dizziness, sensitivity to light, irritability, headache, and fatigue.

Commonly prescribed medications can lower CoQ 10 levels:

Lipid lowering medications (such as lovastatin, pravastatin, simvastatin, gemfibrozil) and the oral diabetes medications (such as glyburide and tolazamide) are well-known to reduce CoQ 10 levels. Patients taking these medications should discuss with their primary care physician supplementation with CoQ 10.

Cautionary effects of CoQ 10:

CoQ 10 may reduce the efficacy of warfarin.

CoQ 10 may reduce insulin requirements in diabetics.

As CoQ 10 has not been exhaustively researched with every chemotherapy agent or combination of agents (it’s never going to happen), recognize that there is a possibility of interactions that can either increase or decrease the anticancer effectiveness of the chemotherapy agent. Always discuss any use of supplements with your oncology team prior to using them.

Dosing:

There are no established dosing guidelines. In human studies, supplementation doses and administration schedules have varied, but usually have been in the range of 90 to 390 mg/day (most common recommendation: 100-200 mg/day)

Most absorbable form of CoQ 10:

Ubiquinol absorbs up to 8 times greater than ubiquinone, and higher levels of ubiquinol remain in the blood far longer than ubiquinone.

CoQ 10 is fat soluble. It is more effectively absorbed when taken with a meal (particularly with lipids).

Additional Resources:

National Cancer Institute PDQ: CoQ 10

About Herbs, Botanicals and Other Products (Memorial Sloan-Kettering Cancer Center): CoQ 10

Wikipedia; CoQ 10

Medline Plus (National Library of Medicine): CoQ 10

CoQ 10 and Cancer Treatment (Life Extension)**although I like many of their products, this is still a supplement company**

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Anticancer Nutrition: Protein 101

Posted by Brian Lawenda M.D. at 1:42 pm

Apr 162012

The main point on protein is that you want to consume as much of your daily protein requirements from a variety of low fat sources, such as legumes (beans, peas, lentils, soy, nuts and nut butters), deep, cold-water fish (salmon, sardines, mackerel, cod), poultry (skin removed) and whey (a milk protein.) You don’t have to completely eliminate dairy and meat (particularly, red meat: beef, pork, lamb) from your diet to live an anticancer lifestyle, but you will need to limit the quantity you consume. Increasingly, the results of numerous studies are consistently suggesting that the most healthful overall diet (anti-cancer, anti-diabetes, anti-cardiovascular disease, anti-inflammatory, [...read more...]

Anticancer Lifestyle: Stress Reduction 101

Posted by Brian Lawenda M.D. at 12:07 am

Apr 152012

One of the key pillars of integrative oncology is stress reduction. The majority of us intuitively recognize the link between stress and the immune system. How many times in your life have you come down with a cold or other viral infection shortly after periods of high-stress? Now, imagine what your body goes through when exposed to stress over years. Substantial evidence suggests that exposure to long periods of stress increases rates of cancer development and growth. How is this possible, you ask? Stress and cancer development: Scientists (psychoneuroimmunologists), believe that this is the end result of our chronically stressed-out [...read more...]

Anticancer Nutrition: Fats 101

Posted by Brian Lawenda M.D. at 4:27 pm

Apr 092012

Dietary fats are essential components of our daily nutritional intake, but the amount and type of fats have a large impact on the development of cancer, cardiovascular disease, systemic inflammation, oxidation, immunity and numerous other important aspects of health and disease. This article provides a basic understanding of the various dietary fats and their relevance in anticancer nutrition. General Recommendations: Limit total fat intake and avoid trans fats Increase your intake of foods high in omega-3s (i.e. cold-water, deep sea fish and nuts, flax seed) Limit foods that are higher in omega-6 fatty acids (grain-fed animal meat) Avoid foods that [...read more...]

Anticancer Nutrition: Sugar & Insulin 101

Posted by Brian Lawenda M.D. at 12:45 am

Apr 042012

Anticancer Nutrition: Sugar & Insulin 101

The Basics: How does insulin work? In a healthy person, insulin helps turn food into energy — in an efficient manner. The stomach breaks down carbohydrates from food into sugars, including glucose. Glucose then enters the bloodstream, which stimulates the pancreas to release insulin in just the right amount. Insulin, a hormone, allows glucose to enter cells throughout the body, where it is used as fuel. Excess glucose is stored in the liver. What is IGF-1 (Insulin-Like Growth Factor-1)? IGF-1 is an important protein (hormone) that stimulates cells (including many cancer cells) to grow and is involved in multiple aspects of [...read more...]

Anticancer Nutrition: 7 Important Anti-Cancer Diet Tips

Posted by Brian Lawenda M.D. at 5:28 pm

Apr 032012

Anticancer Nutrition: 7 Important Anti-Cancer Diet Tips

Point #1: Limit The Amount Of Fat In Your Diet Studies suggest that diets higher in the bad fats: Increase the risk of developing cancer (especially more aggressive cancers) and cancer progression. Suppress the immune system and increase inflammation in the body. Increase the risk of dying from numerous cancers (i.e. breast, prostate, colorectal, lung) Bad fats include the trans fats (partially and fully hydrogented fats) and saturated fats: Try to limit your intake of saturated fats to 5-10% of your total daily calories. Transfats are bad. There is no reason to ever consume them. The risk of breast cancer almost [...read more...]

What Is Integrative Oncology? (Free Patient Guide)

Posted by Brian Lawenda M.D. at 3:17 pm

Apr 032012

What Is Integrative Oncology? (**Free Patient Guide**)

Integrative Oncology uses the best evidence-based treatments (i.e. surgery, chemotherapy, radiation therapy, acupuncture, massage, stress reduction, herbal/botanicals, etc.) with the following goals: Treating the cancer Preventing recurrence Reducing side effects and symptoms Integrative Oncology encourages living a healthy lifestyle to help the body in its’ innate abilities to fight and prevent cancer. This can be accomplished by learning strategies to reduce stress, increasing physical activity and eating healthfully (“anti-cancer diet & nutrition.”) Practicing these lifestyle changes leads to beneficial “anti-cancer” effects: Strengthening the immune system Decreasing inflammation throughout the body Reducing (free radical) oxidative damage to cells Decreasing hormonal stimulation of cancer cells Treatments are selected using a customized approach for each person [...read more...]

12-minute yoga slows cellular aging, improves cognitive function and reduces depression

Posted by Brian Lawenda M.D. at 11:04 pm

Mar 132012

12-minute yoga slows cellular aging, improves cognitive function and reduces depression

This remarkable study explored the effects of a convenient 12-minute, daily yoga practice on a group of psycho-emotionally taxed caregivers. What they discovered is truly amazing. In their study, the researchers compared two groups of study participants. The first group, the yoga group, were instructed to practice a chanting meditation, “Kirtan Kriya“, every day at the same time for eight weeks. The second group, the control group, was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes every day at the same time for eight weeks. Results: [...read more...]

Would you change your lifestyle if you knew you had silent (occult) cancer cells hiding in your body?

Posted by Brian Lawenda M.D. at 1:55 pm

Jan 302012

Would you change your lifestyle if you knew you had silent (occult) cancer cells hiding in your body?

I ask this question based on the fact that we know that cancer cells often spread early in the course of disease and they can remain silent (occult or hidden) for years. The Background: Among women with the earliest stage of invasive breast cancer (stage 1), 25% of them already have breast cancer cells that can be found in their bone marrow. (reference) Among men with the earliest stages of prostate cancer (pT2, no lymph node involvement, Gleason scores </=6, PSA </=4 ng/mL), over 70% of them have prostate cancer cells that can be found in their bone marrow. Even [...read more...]

Cannabis and Cancer: 1 plant versus 5 common symptoms that affect cancer patients

Posted by Brian Lawenda M.D. at 7:32 pm

Jan 282012

Cannabis and Cancer: 1 plant versus 5 common symptoms that affect cancer patients

This is a completely apolitical blog entry on the science of the medical efficacy of Cannabis (marijuana) in oncology. Cannabis is plant that is classified in the U.S. as a controlled substance with an “increased potential for abuse and no known medical use” (Schedule 1). By federal law, possessing Cannabis, is illegal in the U.S. Although U.S. federal law prohibits the use of Cannabis, 16 states and the District of Columbia permit its use for certain medical conditions with a physicians’ prescription. That said, doctors in these states may not legally do so without violating federal law and can lose their federal license to [...read more...]

Emmy-nomimated Peanuts Episode On Childhood Cancer

Posted by Brian Lawenda M.D. at 9:08 pm

Jan 242012

Emmy-nomimated Peanuts Episode On Childhood Cancer

This heartfelt story is a great way to introduce the difficult life topic of cancer to your children or students. I encourage you to watch this Emmy-nominated 1990 episode (“Why, Charlie Brown, Why?”) of the prime-time animated TV comic strip, Peanuts. It’s a touching story about a classmate of Charlie Brown and Linus, Janice, who gets diagnosed with leukemia. In typical Peanuts fashion, the story not only educates us (and our children) about the disease (symptoms, diagnosis, treatment, side effects) but, Charles M. Schulz instills wonderful messages of empathy, compassion and strength throughout the 28-minute episode. I rate this two thumbs up!! (Shamelessly, I am sharing this with [...read more...]

Depression and cancer: Screening is essential

Posted by Brian Lawenda M.D. at 1:40 pm

Dec 262011

Depression and cancer: Screening is essential

Depression affects up to 50% of patients with cancer, and unfortunately many go undiagnosed and suffer in silence. The problem is two-fold: 1) Oncologists often feel too busy or not qualified to be able to diagnose and treat this condition, and 2) The majority of patients do not volunteer their concerns about their psychoemotional distress, either feeling too ashamed to admit that they are not coping well with the emotional and psychological distress of their cancer or believing that their physicians and nurses are not concerned about these issues. Background: In some studies, depression has been associated with poorer survival [...read more...]

Employing a multi-pronged anticancer approach using natural supplements and whole foods

Posted by Brian Lawenda M.D. at 11:52 am

Dec 022011

Employing a multi-pronged anticancer approach using natural supplements and whole foods

The data supporting anticancer activity in natural supplements is extensive. Unfortunately, oncologists and patients are hampered by the paucity of high-quality clinical trials in deciding which supplements might improve clinical outcomes. Designing and conducting these studies is expensive and will take many years before we have answers (i.e. which supplements work for which cancers, what doses are effective, how do they interact with other therapies/compounds, etc.) These studies can be done and must be done, but what do we do in the meantime? Most oncologists suggest to their patients that they simply consume a diet containing a wide-variety of phytonutrient [...read more...]

Struggling with nausea? Try this simple and effective Chinese medicine technique (“moxibustion”)

Posted by Brian Lawenda M.D. at 5:38 pm

Nov 192011

Struggling with nausea? Try this simple and effective Chinese medicine technique ("moxibustion")

One of the effective techniques for dealing with chemotherapy and radiation therapy-related nausea involves an ancient Chinese technique called “moxibustion.” It involves the use of a rolled herbal cigar of dried and/or processed mugwort, also called “moxa.” When burned, the smoldering moxa serves as a medicinal heat source that is held directly over the skin at specific acupuncture points to stimulate their activity. Stomach 36 (or “ST 36″) is my favorite acupuncture point for treating nausea. I feel that this point is even more effective than Pericardium 6 (“P 6″), on the underside of the wrist. ST 36 is located by [...read more...]

Potentially-lethal blood clots, embolism and cancer: up to 20% of cancer patients affected (reduce your risk)

Posted by Brian Lawenda M.D. at 7:33 pm

Sep 212011

Potentially-lethal blood clots, embolism and cancer: up to 20% of cancer patients affected (reduce your risk)

Did you know that within the first year of being treated for cancer, up to 1 in 5 individuals will develop a potentially life-threatening blood clot within the deep leg or pelvic veins (called a deep vein thrombosis or DVT) that dislodges and travels through the circulatory system until they become lodged in an artery or vein? This event can be lethal when the clot blocks blood flow to critical tissues within the lungs, brain or heart. This condition is called a venous thromboembolism (VTE). Risk factors for DVT’s and VTE’s: DVT’s and VTE’s occur much more commonly among those with [...read more...]

Amazing anti-cancer compound derived from the French Lilac: Galega officianalis (metformin)

Posted by Brian Lawenda M.D. at 12:39 pm

Aug 292011

Amazing anti-cancer compound derived from the French Lilac: Galega officianalis (metformin)

Metformin is a medication derived from the herb Galega officinalis (French lilac, also known as Goat’s Rue or Italian Fitch) and has been used as a traditional botanical (tea infusion) for over 3,000 years to relieve polyuria (frequent urination) and halitosis (sweet odor on the breath), both are now well known symptoms of diabetes. Approved for the treatment of hyperglycemia in Britain since the late 1950′s, Canada in the 1970′s and U.S. in 1995, metformin is the most widely prescribed diabetes drugs (over 120 million prescriptions filled yearly worldwide). Although the mechanism of action of metformin in diabetes is only partially understood, metformin treatment [...read more...]

Relaxation gizmos: Rapidly reduce stress & improve emotional balance with these palm-sized biofeedback devices

Posted by Brian Lawenda M.D. at 6:08 pm

Aug 262011

Relaxation gizmos: Rapidly reduce stress & improve emotional balance with these palm-sized biofeedback devices

Chronic stress (via prolonged stimulation of the sympathetic nervous system and inhibition of the parasympathetic nervous system) is toxic to the body and mind, and is causally linked to a wide-range of deleterious conditions (examples): Anxiety Disorders Asthma Chronic Obstructive Pulmonary Disease (COPD) Cardiac-related morbidity and mortality Cognitive impairment Coronary heart disease Depression Chronic pain Diabetes Digestive problems (i.e. IBS, etc.) Immune suppression (leading to increased susceptibility to viral infections, etc.) Inflammation Insomnia Headache (migraine and tension) Hostility Hypertension Memory impairment Sedentary Lifestyle Skin problems (i.e. eczema, etc.) Stress Substance Abuse Effects of Chronic Stress: Periods of long-term exposure to [...read more...]

The rising tide of the contralateral prophylactic mastectomy: know the facts

Posted by Brian Lawenda M.D. at 3:11 pm

Aug 172011

The rising tide of the contralateral prophylactic mastectomy: know the facts

The last decade has seen a steady rise (300% increase) in the number of individuals who are opting to undergo a contralateral prophylactic mastectomy (CPM) as a means of reducing their risk of developing a new breast cancer in their opposite breast. (Listen to an audio discussion on this trend) This procedure is most compelling to those patients with an increased risk of developing a contralateral breast cancer (i.e. BRCA 1/2 gene mutations, strong family history of breast cancer, prior exposure of radiation to the breast, etc.), although CPM will significantly reduce the risk of developing a contralateral breast cancer in all [...read more...]

Reduce skin fibrosis & possibly breast implant contracture after radiation therapy: vitamin E & pentoxifylline

Posted by Brian Lawenda M.D. at 5:40 pm

Aug 012011

Reduce skin fibrosis & possibly breast implant contracture after radiation therapy: vitamin E & pentoxifylline

Most patients typically develop only minimal skin fibrosis after their radiation therapy, however for those who have a more significant degree of fibrosis I often recommend a combination of vitamin E (400 I.U, twice a day) and pentoxifylline (400 mg, three times each day). Fibrosis can develop months-to-years after radiation therapy to any region of the body, but is most common in the extremities, breasts (read more about implant contracture, below) and head and neck where higher radiation doses are often required on or just below the skin surface. How does this treatment work? It is not entirely clear how [...read more...]

Testosterone replacement therapy in men with prostate cancer: An oncologist’s perspective

Posted by Brian Lawenda M.D. at 5:41 pm

Jul 252011

Testosterone replacement therapy in men with prostate cancer: An oncologist's perspective

“Does testosterone replacement therapy (TRT) increase the risk of my prostate cancer coming back?” It seems that this question is coming up more often these days among patients who have completed treatment for prostate cancer. The Background: Very effective direct to consumer marketing campaigns touting the benefits of TRT and “bio-identical hormone therapy” (i.e. Dr Life’s Cenegenics, BodyLogicMD, etc.) have peeked the interest of many men who are starting to feel the mental and physical effects of ‘aging’. Popular TV news, talk shows and radio programs have spread the word about so the called “male menopause” or “andropause”. As part [...read more...]

The power of the placebo effect: who cares if it’s the placebo effect if it works (…and other thoughts)!?

Posted by Brian Lawenda M.D. at 10:36 pm

Jul 132011

The power of the placebo effect: who cares if it's the placebo effect if it works (...and other thoughts)!?

The simple act of offering a therapy to a patient has tremendous psychological effects that can strongly blunt the perception of physiologic processes. This effect, also known as the “placebo effect” is hardly a new concept, but for the first time it is legitimized as an important aspect of care in the most prestigious American medical journal (The New England Journal of Medicine). In a fascinating and (as always) thought-provoking Ted Kaptchuck (Harvard Medical School) study, 39 asthma patients were randomized to one of four groups and instructed to discontinue their asthma medications: albuterol inhaler (a common asthma medication) given [...read more...]

Integrative Oncology: Given the choice, would you really want any other approach to the treatment of cancer?

Posted by Brian Lawenda M.D. at 10:51 pm

Jul 102011

Integrative Oncology: Given the choice, would you really want any other approach to the treatment of cancer?

In the “Integrative Oncology-Essentials Blog” (IOE Blog), I have covered a wide-range of topics pertaining to cancer treatment (i.e. from proton beam therapy to botanical medicines), managing side effects and symptoms (i.e. from exercise to acupuncture), identifying and preventing treatment-related complications (i.e. from lymphedema detection to acupuncture treatment for dry mouth), cancer prevention (i.e. from consuming an anti-cancer diet to taking baby aspirin), anti-cancer interventions and lifestyle modifications (i.e. from stress reduction to smoking cessation), and others. From time to time, we need to take a step back and simply review the overall concept of integrative oncology. What Is Integrative Oncology? [...read more...]

Basal & squamous skin cancers cured without surgery: 100+ years of experience using this non-surgical treatment

Posted by Brian Lawenda M.D. at 6:46 pm

Jul 062011

Basal & squamous skin cancers cured without surgery: 100+ years of experience using this non-surgical treatment

Did you know that radiation therapy is the most highly-effective, non-surgical treatment option for basal and squamous cell skin cancer? Radiation therapy has been used for the treatment of skin cancers since the early 1900′s and continues to be one of the best therapies available. Significant advances have revolutionized radiation therapy technologies, increasing treatment precision and reducing side effects. Although surgery is a very effective treatment, there are occasional risks: impaired wound healing (particularly in those with diabetes, the elderly, peripheral vascular disease, smokers) post-operative bleeding post-operative wound infections surgical scars functional and/or cosmetic deformities (in some circumstances skin grafts/flaps [...read more...]

“Do-it-yourself” acupuncture…really?: Lasers make simple treatments possible

Posted by Brian Lawenda M.D. at 1:34 pm

Jun 282011

"Do-it-yourself" acupuncture...really?: Lasers make simple treatments possible

Acupuncture is effective treatment for various psychoemotional and physical symptoms experienced by oncology patients (ie, pain, dry mouth, chemotherapy-induced nausea and vomiting, fatigue, anxiety). The mechanisms of action involved in acupuncture have been rigorously studied since the 1970s, and numer- ous neurohormonal processes have been demonstrated. Read more about acupuncture (National Center for Complementary and Alternative Medicine) There are multiple methods that can be used to stimulate acupuncture points (i.e. needles, acupressure, massage, heat, cupping, electrical stimulation, lasers, etc.) Because I am a ‘tech-geek’, I chose to focus of this blog entry on the use of lasers in acupuncture. Conditions treated with [...read more...]

Smoking increases the risk of prostate cancer recurrence and death

Posted by Brian Lawenda M.D. at 8:31 am

Jun 242011

Smoking increases the risk of prostate cancer recurrence and death

One of the most important studies I have read on prostate cancer was published earlier this week in the Journal of the American Medical Association. Researchers at the Harvard School of Public Health investigated the possible effects of smoking and prostate cancer. They followed a group of over 5,300 men for an average of 8 years after being diagnosed with prostate cancer. They found something VERY surprising. Men who continued to smoke after their diagnosis of prostate cancer (compared to either men who never smoked or who quit 10+ years before their diagnosis) had much worse outcomes. They had: a [...read more...]

“Proton Beam Therapy”: The Rolls Royce of radiation oncology

Posted by Brian Lawenda M.D. at 11:16 pm

Jun 142011

"Proton Beam Therapy": The Rolls Royce of radiation oncology

Have you heard of “proton beam therapy” (PBT)? Simply put, PBT is the most advanced radiation therapy technique available. This star wars-like technology has been used in the treatment of malignant and benign tumors since the 1950′s. As of 2011, over 73,000 patients have been treated at proton beam treatment centers around the world. The number of these centers is growing quickly. Since 1990, when the first hospital-based proton facility opened (Loma Linda University, California), there are now 37 proton beam therapy centers located in Canada, China, England, France, Germany, Italy, Japan, Korea, Poland, Russia, South Africa, Sweden, Switzerland, and USA…and [...read more...]

Bioidentical hormone therapy in cancer patients: an integrative oncologist’s perspective

Posted by Brian Lawenda M.D. at 1:27 pm

Jun 012011

Bioidentical hormone therapy in cancer patients: an integrative oncologist's perspective

Hormones are proteins that have very important stimulatory effects on tissues, organs and glands within the body. In normal physiologic states, the production and release of the endogenous (made by the body) hormones is tightly controlled. However, when the normal hormonal physiology is disturbed these hormone levels may become too high or too low, potentially leading to a variety of deficiency or excess hormone states and conditions (i.e. hypogonadism, hypo/hyperthyroidism, adrenal insufficiency, menopause, diabetes, etc.) Hormones produced by the following tissues (i.e. thyroid, pituitary gland, adrenal glands, pancreas, ovaries, testes, etc.) control all of our most important bodily functions: digestion [...read more...]

Inhaling vaporized botanicals as medicine

Posted by Brian Lawenda M.D. at 12:06 am

May 292011

Inhaling vaporized botanicals as medicine

The use of plants as medicine has been and continues to be employed by cultures throughout the world in the treatment of numerous physical and psychological conditions and symptoms. It is estimated that 80% of the world’s population use plants as medicine. The most common routes of administration of these botanical compounds are oral, topical or inhalational (smoke), and they come in a variety of forms: concoctions, decoctions, salves, lotions, ointments, pills, tablets, powders, extracts and pure plant sources. When smoking herbal/botanical compounds (think: cigarettes, cigars, pipes, etc.), an individual inhales a long list of toxins and carcinogens that are [...read more...]

Mushrooms: Promising natural anti-cancer and immune modulatory effects

Posted by Brian Lawenda M.D. at 3:24 pm

Apr 182011

Mushrooms: Promising natural anti-cancer and immune modulatory effects

The medicinal use of mushrooms have been employed for over 3,000 years in the treatment of many conditions. Hundreds of peer-reviewed studies have been published indicating the wide-range of positive health effects of fungi (click on this link to see a breakdown of effects for various mushroom species), with much of the research focusing on varieties more commonly found in Asia. Human studies have found: immune stimulating/enhancing effects stimulation of cytotoxic T cells and enhanced natural killer (NK) cell activity anti-viral effects (active against: herpes, human papilloma virus, Epstein Barr virus) anti-bacterial effects anti-cancer effects (i.e. pro-apoptosis, anti-angiogenic, inhibition of [...read more...]

Fight weight loss (and potentially improve survival) during cancer therapy using a fish oil supplement

Posted by Brian Lawenda M.D. at 5:44 pm

Apr 162011

Fight weight loss (and potentially improve survival) during cancer therapy using a fish oil supplement

The conclusions of two studies published in 2011, in the journal Cancer, suggest that the use of a fish oil supplement taken during treatment for cancer can help patients maintain their weight (**and improves the efficacy of chemotherapy**) The first study examined the use of a fish oil supplement (2.5 grams of EPA + DHA/day) in patients undergoing first-line chemotherapy for non-small cell lung cancer. The control group of patients only received chemotherapy. The authors found at one year: A significant improvement in the response rate to the chemotherapy in those patients that received the fish oil supplement versus the [...read more...]

Acupuncture alleviates hot flashes in men treated with hormone therapy: 80% improvement in hot flash symptoms and no side effects

Posted by Brian Lawenda M.D. at 6:54 pm

Apr 062011

Acupuncture alleviates hot flashes in men treated with hormone therapy: 80% improvement in hot flash symptoms and no side effects

Another study has been published on the efficacy of acupuncture in the treatment of hot flashes. Having used this treatment for many of my patients (men and women) with hormone therapy-induced hot flashes, I am not surprised at the published results. The patients included a small cohort of men with prostate cancer who were being treated with androgen deprivation therapy (ADT). The investigators used a simple protocol of electroacupuncture (sorry for the acupuncture lingo to follow: 10 bilateral points at GB34, SP6, KI3, ST36, BL15, BL23, Taiyang, HT7, PC6, LI11; De Qi was elicited at all points and 2Hz was [...read more...]

Radiographic imaging for staging prostate cancer is inappropriate for low and intermediate risk patients

Posted by Brian Lawenda M.D. at 11:08 am

Apr 032011

Radiographic imaging for staging prostate cancer is inappropriate for low and intermediate risk patients

Did you know that radiographic imaging studies (CT scans, bone scans and MRI) will detect disease outside of the prostate gland less than 1% of the time in men who are diagnosed with either “low” or “intermediate” risk prostate cancer? (i.e. Gleason scores </=7, clinical T1-T2 tumors, PSA </=20 ng/ml) Based on a recently reported study of over 30,000 men with prostate cancer, radiographic staging studies are being inappropriately used in 36% of men with low-risk disease and 49% of the time in those with intermediate-risk disease. These findings raise obvious potential health concerns for many patients (i.e. exposure to ionizing [...read more...]

Learn more about prostate cancer and nutrition: the same concepts apply to most cancers and are an integral component of integrative oncology

Posted by Brian Lawenda M.D. at 4:11 pm

Mar 122011

Learn more about prostate cancer and nutrition: the same concepts apply to most cancers and are an integral component of integrative oncology

I was asked to give a short talk on this topic recently. Although it was specifically targeted to an audience interested in learning more about the role of nutrition and prostate cancer, the concepts broadly apply for most cancers. One of the most important slides is the one that highlights the fact that the “anti-cancer” diet is similar to the “heart-healthy” diet, “anti-aging” diet, “anti-diabetes” diet, “anti-Alzheimer’s” diet, “anti-inflammatory” diet, etc… (the point being: if you are following any one of these diets, you are reducing your risk of of various diseases.) Read the presentation here: Dr. Mark Moyad (University [...read more...]

It’s crucial to keep in mind the impact of cancer on our patient’s children: Guides to help with communication, education and support

Posted by Brian Lawenda M.D. at 6:34 pm

Feb 222011

It's crucial to keep in mind the impact of cancer on our patient's children: Guides to help with communication, education and support

As oncologists, we unfortunately find ourselves caring for patients who have young children. The majority of our time is spent focusing on the medical, psychological and emotional concerns and issues of the patient, and we often overlook the fact that there are also young children that are affected by the dramatic changes happening in their mom or dad’s life. Did you know that nearly 3 million children, in the U.S., are living with a parent who has been diagnosed with cancer? It may not be surprising to learn that multiple studies have shown that the children of cancer patients can [...read more...]

New 2010 USDA Dietary Guidelines for Americans: Reduce your risk of cancer development, recurrence and progression.

Posted by Brian Lawenda M.D. at 4:18 pm

Feb 052011

*New* 2010 USDA Dietary Guidelines for Americans: Reduce your risk of cancer development, recurrence and progression.

The USDA published its’ updated dietary guidelines in late January 2011. The latest USDA dietary recommendations incorporates most of the same recommendations that are touted under different names: “Heart healthy diet” “Anti-cancer diet” “Anti-aging diet” “Anti-Alzheimer’s disease diet” “Anti-inflammatory diet” “Anti-diabetes diet” “Mediterranean diet” “Japanese diet” …and the list goes on… In summary, these are the recommendations: Consume less total fat (especially saturated fat) Maintain a healthy caloric balance (through a combined approach of calorie intake and physical activity) Increase your intake of fruits and vegetables, beans and grains Decrease your intake of processed foods, simple carbohydrates (i.e. refined sugars, [...read more...]

Integrative Oncology Basics: download the NEW 2011 free guide on integrative oncology cancer care and prevention

Posted by Brian Lawenda M.D. at 3:50 pm

Jan 102011

Integrative Oncology Basics: download the *NEW 2011* free guide on integrative oncology cancer care and prevention

Welcome to INTEGRATIVE ONCOLOGY-ESSENTIALS (IOE). My name is Dr. Brian Lawenda, and I am one of only a handful of physicians in the United States who is a radiation oncologist, integrative oncologist and medical acupuncturist. I developed the IOE WEBSITE, BLOG and the Integrative Oncology Essentials: A Patients’ Guide To Cancer Care And Prevention as a means of sharing up to date “Integrative Oncology” news, information and resources with my patients. I hope that this content is helpful to anyone living with or beyond a diagnosis of cancer.” Download the new 2011 guide here. Become a FAN to follow us [...read more...]

Typical U.S. diet (high fat and cholesterol) increases breast cancer development and progression by 50% (in mice)!!

Posted by Brian Lawenda M.D. at 12:38 pm

Jan 072011

Typical U.S. diet (high fat and cholesterol) increases breast cancer development and progression by 50% (in mice)!!

A fascinating study (published in The American Journal of Pathology, in January 2011) reported that when placed on a diet of 21% fat and 0.2% cholesterol (similar to the typical diet in the U.S.), there was a 50% increase in the size and number of breast cancer tumors in mice (with a genetic proclivity for developing breast cancer) compared to those mice who were placed on a low-fat diet (4.5% fat) with negligible cholesterol. This study, albeit a mouse experiment, is still very intriguing and is consistent with findings from other groups (suggesting that diets higher in saturated fats lead [...read more...]

Who is at risk and who should be tested for the most common genetic colorectal and uterine cancer syndrome (HNPCC/Lynch Syndrome)?

Posted by Brian Lawenda M.D. at 6:23 pm

Jan 052011

Who is at risk and who should be tested for the most common genetic colorectal and uterine cancer syndrome (HNPCC/Lynch Syndrome)?

The vast majority of individuals with a diagnosis of colorectal (and/or endometrial/uterine) cancer do not have a inherited gene mutation. Most cancers develop sporadically without any familial association. However, if you or members of your immediate family have been diagnosed with colorectal and/or endometrial (uterine) cancer, you may be at risk of carrying a genetic mutation (called, “Lynch Syndrome” or “Hereditary Nonpolyposis Colorectal Cancer” or “HNPCC“.) HNPCC/Lynch syndrome is reported to be present in up to 4% of all individuals diagnosed with colorectal cancer and in up to 5% of all women who have been diagnosed with endometrial (uterine) cancer. [...read more...]

Who should consider genetic testing (BRCA1/2) for hereditary breast and/or ovarian cancers?

Posted by Brian Lawenda M.D. at 6:06 am

Dec 222010

Who should consider genetic testing (BRCA1/2) for hereditary breast and/or ovarian cancers?

The vast majority of cancers occur by chance, but a small percentage are related to inherited genetic abnormalities or mutations. In cases of hereditary breast and/or ovarian cancers, most occur as a result of mutations in either the BRCA1 or BRCA2 genes (this is called “hereditary breast and ovarian cancer syndrome” or “HBOC syndrome”.) These gene mutations can be inherited from your mother or father. What are the risks associated with the presence of a BRCA gene mutation? In women (lifetime risk): up to an 87% risk of developing breast cancer up to a 44% risk of developing ovarian cancer [...read more...]

Lung cancer eradicated in 98% of patients with a rapid, 3 to 5-day course of radiation therapy: A new paradigm in the management of early stage lung cancer.

Posted by Brian Lawenda M.D. at 5:44 pm

Dec 102010

Lung cancer eradicated in 98% of patients with a rapid, 3 to 5-day course of radiation therapy: A new paradigm in the management of early stage lung cancer.

A recently reported study (in the Journal of the American Medical Association, 2010) demonstrated the remarkable effectiveness of the latest radiation therapy technique (called “stereotactic body radiation therapy” or “SBRT”) in the treatment of early stage lung cancers (stage 1, T1-2N0M0, non-small cell carcinoma.) The study authors (Radiation Therapy Oncology Group), reported a 97.6% local tumor control rate, 3 years after a 3-day course of SBRT (3 doses of 20 Gy). These excellent results are comparable to those achievable by surgery, but SBRT has the advantage of being a non-invasive treatment. A course of SBRT frequently involves 3-5 daily doses of external beam radiation. [...read more...]

One “baby aspirin” per day cuts cancer death risk by up to 60%

Posted by Brian Lawenda M.D. at 8:57 am

Dec 072010

One "baby aspirin" per day cuts cancer death risk by up to 60%

A study (published in the journal, Lancet, December 2010) reports that compared with placebo, taking 75 mg of aspirin per day (one baby aspirin=81 mg) for 4 years or more reduced the risk of dying from a variety of common cancers. These results were identified through a meta-analysis of 8 placebo-controlled randomized trials (comparing placebo vs. aspirin), in 25,570 patients. These studies were designed to explore the long-term effects of aspirin. They found the following risk reduction in cancer deaths: prostate cancer (10% risk reduction) lung cancer (30% risk reduction) colon, rectal, pancreatic, and stomach cancers (40% risk reduction) esophageal [...read more...]

Getting adequate sleep may improve your ability to fight cancer

Posted by Brian Lawenda M.D. at 5:02 pm

Nov 262010

Getting adequate sleep may improve your ability to fight cancer

Did you know that getting less than 6-7 hours of sleep each night has been associated with physiologic changes that lead to increased risk of stroke, diabetes, high blood pressure, obesity and stress…and possibly cancer development and progression. In fact, a new study finds that short sleep durations are associated with a significantly increased risk of pre-cancerous colon polyps (published in Cancer, in October 2010.) Multiple factors are at thought to play a role when one is chronically sleep deprived: Increased production of inflammatory molecules (“cytokines” and “prostaglandins”) that: Stimulate angiogenesis (blood vessel formation) which can supply oxygen and nutrients to allow tumors [...read more...]

Green tea has no effect on breast cancer prevention: questions remain unanswered about other potential anti-cancer effects of green tea.

Posted by Brian Lawenda M.D. at 2:52 pm

Oct 282010

Green tea has no effect on breast cancer prevention: questions remain unanswered about other potential anti-cancer effects of green tea.

An excellent study (published in October 2010, in Breast Cancer Research) reported that consumption of green tea provides no benefit in reducing the risk of developing breast cancer. The authors examined the prospectively collected data on 53,793 women, in Japan, who provided information on their level of consumption of green tea over a 5-year study period. They looked at various factors to determine if there were any subcategories of women who might have experienced a reduced risk of of developing breast cancer, but they could not find any correlations (i.e. demographics, amount of green tea consumed, type of tea consumption, [...read more...]

A common prostate cancer therapy increases the risk of stroke, heart disease and diabetes

Posted by Brian Lawenda M.D. at 3:55 pm

Oct 242010

A common prostate cancer therapy increases the risk of stroke, heart disease and diabetes

Men who have aggressive (high-risk), advanced or metastatic prostate cancer are commonly prescribed hormonal therapy drugs called, gonadotropin-releasing hormone (GnRH) agonists that suppress the growth of prostate cancer cells by inhibiting the production of testosterone. This class of medication is very effective in slowing the growth of prostate cancer progression and in many cases, increasing survival in advanced stages of the disease. Examples of GnRH agonists include: Eligard, Lupron, Synarel, Trelstar, Vantas, Viadur, Zoladex Side effects and complications from the long term use of these medications have been well-documented (i.e. hot flashes, weight gain, fatigue, muscle mass loss, osteopenia, decreased libido, etc.) New data has concluded that [...read more...]

Heart health and cancer care: “CardiOncology” emerges as a new medical subspeciality to address the cardiac complications of cancer care

Posted by Brian Lawenda M.D. at 6:11 am

Oct 182010

Heart health and cancer care: "CardiOncology" emerges as a new medical subspeciality to address the cardiac complications of cancer care

Dangerous cardiovascular complications are becoming increasingly evident in cancer patients and survivors. Radiation therapy and numerous cancer drugs can injury the heart and coronary arteries, leading to serious medical conditions that if not identified and managed appropriately can decrease both quality of life and survival. Cancer drugs such as anthracylines (i.e. Adriamycin), tyrosine kinase inhibitors (i.e. Gleevec, Sutent) and targeted antibody therapies (i.e. Herceptin) can cause or exacerbate heart failure, and drugs that block the development of blood vessels to tumors (i.e. Avastin, Nexavar, Votrient) can lead to dramatic rises in blood pressure (as well as: hemorrhage, thrombosis, nephrotoxicity and [...read more...]

Physical limitations after cancer treatment: a silent killer

Posted by Brian Lawenda M.D. at 8:49 pm

Oct 042010

Physical limitations after cancer treatment: a silent killer

In a recently published study (available online, in September 2010, Journal of the National Cancer Institute), investigators reported their findings on a group of 2202 women with breast cancer who were followed for up to 11-years after their initial treatment. During the study, the authors prospectively assessed the patients’ physical attributes, functions and limitations (i.e. endurance, strength, muscle range of motion, muscle dexterity, body mass index, smoking, physical activity) and other variables (i.e. sociodemographic factors, comorbodities, tumor charactersistics, treament.) They discovered that 39% of all cancer survivors (and 50% in those over the age of 65) reported at least one [...read more...]

Cancer patients need to select an acupuncturist with experience working with cancer.

Posted by Brian Lawenda M.D. at 3:09 pm

Sep 192010

Cancer patients need to select an acupuncturist with experience working with cancer.

Acupuncture has been shown to be an incredibly helpful therapy for patients during and after various cancer treatments (i.e. chemotherapy, surgery, radiation therapy, hormonal therapy, etc.) Studies have demonstrated efficacy in reducing stress, anxiety, depression, fatigue, hot flashes, muscle and joint pains, nausea and many other symptoms. Increasingly there are data suggesting that there may be beneficial effects on immune and inflammatory physiology. As an oncologist (and medical acupuncturist), I often recommend acupuncture to my patients. It is very important that the acupuncturist be experienced in working with cancer patients, as there are numerous important safety issues to keep in [...read more...]

Hospice Care: As an oncologist, I recognize that there comes a time when aggressive cancer treatments are no longer effective for those with a terminal-illness.

Posted by Brian Lawenda M.D. at 3:53 pm

Aug 152010

Hospice Care: As an oncologist, I recognize that there comes a time when aggressive cancer treatments are no longer effective for those with a terminal-illness.

The goal of hospice care is to enable patients to continue an alert, pain-free life and to manage other symptoms so that their last days may be spent with dignity and quality, surrounded by their loved ones. “You matter because of who you are. You matter to the last moment of your life, and we will do all we can , not only to help you die peacefully, but also to live until you die” –Dame Cicely Saunders Hospice is a philosophy of coordinated care for patients and their loved ones. Hospice is not a place, but a concept of care [...read more...]

Social services and counseling are crucial for optimizing cancer care and outcomes

Posted by Brian Lawenda M.D. at 4:28 pm

Jul 182010

Social services and counseling are crucial for optimizing cancer care and outcomes

Patients who undergo treatment for cancer (and their caregivers) frequently suffer from numerous untoward psychological and social (psychosocial) effects that are often not adequately addressed by their health care providers. A report from the Institute of Medicine (IOM), found that many cancer patients complain that health care providers didn’t acknowledge their struggles, underestimated their distress, and either don’t know or don’t offer enough information about support services. Frequent problems that cancer patients and their caregivers encounter include: patients’ lack of information or skills needed to manage the illness, anxiety, depression, lack of transportation or other resources, and disruptions in work, [...read more...]

It’s never too late to quit!! Smoking cessation after a lung cancer diagnosis can DOUBLE the survival rate

Posted by Brian Lawenda M.D. at 2:11 pm

Jul 012010

It's never too late to quit!! Smoking cessation after a lung cancer diagnosis can DOUBLE the survival rate

Although the following paper was published already 7 months ago (January 2010, in the British Medical Journal), and is no longer new news, I strongly feel that the information needs to be reinforced. The authors conducted a review of 10 high-quality studies that evaluated the potential influence on survival in patients with lung cancer who quit smoking after their diagnosis. Most of the studies (9 out of 10) looked only at the effects of smoking in cessation in patients with early stage lung cancers. What they found was quite remarkable: survival rates doubled among those patients who quit smoking after their [...read more...]

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