Inegrative Breast Cancer Treatment at Oasis of Hope

A Multi-Focal Strategy for Cancer Control

Oasis of Hope Integrative Regulatory Therapies

Cancer is heavy-handed. There is nothing subtle at all about the presence of a malignant tumor in the kidney or lung. Cancer makes no attempt to veil its threat. It is a disease that can gather momentum quickly and attack with frightening ferocity. Only a concerted and combined effort can repel such an attack.

Dr. Contreras, Sr. believed that to defeat cancer, it was necessary to attack it from every possible angle. He understood the importance of both direct and indirect approaches. The foundation of the Metabolic Therapy that he devised is its multi-faceted approach. Yes, we do attack the tumor, but we also stimulate the immune system, shield normal healthy tissues from the attack, and address causal factors. The total care approach requires the patient’s full participation. Cancer treatment is not a spectator sport. The patient must be prepared for the fight. We go through a process of structuring a patient for success by providing the necessary resources to face the threat at the physical, emotional, and spiritual levels. There is no question that the alliance between body, mind, and spirit can even the playing field against cancer. In the chapters that follow, the Oasis of Hope body/mind/spirit medicine therapeutic protocols will be explained. The present chapter constitutes an overview that will explain how Oasis of Hope attacks cancer, sensitizes it to this attack, cuts off its supply lines, and block its avenues of spread.

It is probably unrealistic to expect that the "wonder drug" for "curing" cancer is just about to emerge from some pharmaceutical lab. Cancer is so wily that the chance that it will remain permanently responsive to any single agent is quite low. That’s why an integrative cancer therapy approach, that intervenes simultaneously in as many ways as is feasible to promote the death and impede the spread of cancer cells, is likely to remain the most effective and logical way to control cancers that are no longer localized.

In addition, it is important to remember that the ultimate goal when treating advanced cancer is to insure that patients can enjoy a reasonably high quality of life during the months and years that they are managing cancer. All too often, traditional oncologists are so focused on the tumor that they show insufficient regard for the overall psychological and physical health of their patients. Truly compassionate cancer therapy should address the psychological and spiritual well being of cancer patients as a way of helping them to maintain a hopeful, and reasonably cheerful, attitude even if the chance of definitive "cure" must realistically be viewed as small. After all, mortality is a reality that most well adjusted people learn to cope with while enjoying life and being grateful for the time on Earth that they are allotted. There is no reason why the attitude of cancer patients, even those with advanced disease, should be any different - provided that appropriate measures are taken to minimize the pain and disability that often accompany cancer and cancer therapy. So the purpose of integrative cancer therapy should be, not just to maximize survival, but also to maximize the number of months and, hopefully, years of high-quality life that the patient can enjoy.

Now that an overview of the nature of cancer and of the fundamental goals that underlie the Oasis of Hope approach to cancer therapy has been presented, a closer look at the strategies that Oasis of Hope employs in its Integrative Regulatory Therapies (IRT) for cancer will follow.

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The Oasis of Hope IRT Protocols

Patients at Oasis of Hope are enrolled into one of two main protocols, known as "IRT-Q" and "IRT-C." Although these protocols share many common features, they are differentiated by the fact that patients on the IRT-Q protocol receive cytotoxic chemotherapy, whereas those on the IRT-C protocol do not, but rather receive extra infusions of high-dose intravenous vitamin C as an alternative approach to attacking the cancer. Patients on each protocol receive a range of additional interventions including oxidative preconditioning therapy, redox regulatory therapy, cell signal transduction modulatory therapy, metronomic chemotherapy, cancer-retarding anti-inflammatory therapies, optimal diet and exercise, and emotional and spiritual support. This may sound very complicated, but in the pages below, the "why" and "how" of each of these approaches will be explained.

Destroying Cancer Cells with Chemotherapy – The IRT-Q Protocol

For some types of advanced cancer, specific cytotoxic chemotherapy drugs are known to have at least some efficacy in a high proportion of cases – especially if the patient has not received that drug previously. For patients who fall into this category, and whose physical condition makes chemotherapy feasible, Oasis of Hope physicians will usually recommend an IRT-Q protocol. (The "Q" reflects the fact that the Spanish word for "chemotherapy" is "quimioterapia"). Patients enrolled in an IRT-Q protocol will visit the clinic at least three times for a course of appropriate chemotherapy. The chemotherapy regimens employed at Oasis of Hope are well documented in the credible medical literature, and are used in the full doses shown to have potential efficacy.

What sets Oasis of Hope apart from many other clinics employing chemotherapy is its use of many adjuvant measures intended to make the chemotherapy more effective at annihilating cancer cells, while simultaneously minimizing the damage done to healthy tissues. These measures are cited very briefly here. Later in the book, a more detailed explanation of these measures, with citations of the relevant biomedical literature, will be provided.

Coping with Tumor Hypoxia

One way to make chemotherapy more effective is to insure that cancer cells are adequately oxygenated. Because tumors tend to have haphazard blood supplies, some parts of tumors tend to receive relatively little blood flow, and are thus poorly oxygenated (hypoxic). For reasons that are not yet entirely clear, hypoxic cancer cells are often harder to kill with chemotherapy. So we use several strategies for improving the oxygenation of tumors. Prior to the administration of chemotherapy, patients are infused intravenously with a perfluorocarbon polymer called "Perftec." This is an oxygen carrier that complements the ability of red blood cells to deliver oxygen to the tumor. Because the particles of Perftec are so much smaller than red blood cells, they can flow through constricted capillaries that would exclude red blood cells. The oxygen-carrying capacity of Perftec is boosted by having the patients breathe oxygen-enriched air when chemotherapy drugs are subsequently administered. Another way in which we improve tumor oxygenation is by administering ozone autohemotherapy prior to chemotherapy. This strategy has been shown to make red blood cells more flexible and blood less viscous, thereby boosting blood flow through hypoxic tumor regions. Ozone autohemotherapy also increases the capacity of red blood cells to deliver oxygen to the tumor.

Oasis of Hope has also developed a novel strategy for increasing the chemosensitivity of cancer cells that nevertheless remain hypoxic. Recent research demonstrates that hypoxia protects tumor cells, at least in part, by diminishing the capacity of these cells to produce an intracellular signaling factor known as cyclic GMP (cGMP). Prior to chemotherapy, Oasis of Hope administers high oral doses of the B-vitamin biotin. In high concentrations, biotin has been shown to directly stimulate cGMP production, both in tumors and healthy tissues. Fortunately, increased cGMP doesn’t seem to influence the chemosensitivity of cells that are well oxygenated, so biotin shouldn’t boost the chemosensitivity of healthy tissues.

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Chemosensitizing Agents

Recent rodent research shows that high but tolerable intakes of the antioxidant nutrient selenium can boost the chemosensitivity of many types of cancer while making healthy tissues more chemoresistant. So Oasis of Hope employs high-dose selenium supplementation prior to and during chemotherapy. Another agent, which boosts the chemosensitivity of many cancers is the activated metabolite of vitamin D (calcitriol). Since some cancers are capable of making their own calcitriol when supplied with vitamin D, we use high but safe doses of that vitamin in conjunction with chemotherapy.

In many cancers, their relative chemoresistance reflects increased intracellular activity of a factor known as NF-kappaB. Since the natural drug salicylate and the herbal compound silibinin have shown the capacity to inhibit NF-kappaB activity in clinically feasible doses, these agents are also employed as chemosensitizing agents in the IRT-Q protocols.

Other agents which have potential for chemosensitizing certain tumors, and that are often administered in conjunction with chemotherapy at Oasis of Hope include boswellic acids (derived from an Ayurvedic herbal preparation with anti-inflammatory activity), and the drugs pioglitazone, diclofenac, and valproic acid. Suffice it to say that we spare little effort to insure that the chemotherapy we employ will kill as many cancer cells as is physically possible!

Protecting Healthy Tissues

One reason why the IRT-Q protocols are gaining increased popularity with our patients is that we incorporate several measures to protect healthy tissues, which makes chemotherapy a less traumatic experience. The ozone autohemotherapy mentioned above has a dual purpose – in addition to improving tumor oxygenation, it also provides oxidative pre-conditioning. The chemically altered compounds in ozonated blood are "perceived" by healthy tissues as a sign of oxidative stress. In response, these tissues boost their production of antioxidant enzymes and other protective factors. Then, when chemotherapy is subsequently administered, these tissues are better able to cope with the pro-oxidant activity of these cytotoxic drugs, so that they are less damaged. This translates into less bone marrow damage, less nausea, and fewer side effects of other kinds.

As noted, the high-dose selenium employed with IRT-Q has the potential to protect normal tissues. Another component of IRT-Q that is protective in this regard is the hormone melatonin, which mitigates chemotherapy-induced damage of the bone marrow. And supplementation with the amino acid glutamine, a key source of calories for cells in the intestinal tract, in employed to reduce damage to these cells.

Quite commonly, patients comment on how much better they tolerated their chemotherapy at Oasis of Hope compared with prior negative experiences with chemotherapy at other clinics. This, despite the fact that Oasis of Hope physicians don’t hold back when it comes to dosing. The increase in efficacy, coupled with the decrease in negative side effects, reflects thoughtful planning.

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An Alternative Strategy for Eliminating Cancer - IRT-C

Some types of cancer are not very responsive to available chemotherapeutic drugs. Some patients may have clinical conditions, such as bone marrow depression or bile duct blockage that make chemotherapy inadvisable. On occasion, some patients simply refuse to accept chemotherapy, owing to negative past experiences with it in their own lives or that of a loved one. For patients who fall into these categories, Oasis of Hope offers an alternative protocol known as IRT-C. The intent of this strategy is to induce oxidative stress in the tumors by employing intravenous infusion of sodium ascorbate (a form of vitamin C) and Vitamin K3 (menadione) to generate hydrogen peroxide in the tumor. For the many cancers that are relatively deficient in the antioxidant enzyme catalase, this approach has the potential to kill cancer cells selectively while healthy cells remain unharmed. We have found that some patients show a very gratifying response to this strategy. In patients whose tumors are potentially responsive to chemotherapy but whose physical condition is not yet ready to tolerate it, IRT-C often provides enough tumor control to give their normal tissues a chance to heal, so that they again become appropriate candidates for chemotherapy.

It stands to reason that hypoxic tumor cells are likely to be less responsive to intravenous ascorbate, owing to the fact that ascorbate must react with molecular oxygen to generate the hydrogen peroxide that can be toxic to the tumor. So Perftec and ozonated autohemotherapy are included in the IRT-C protocol, as well as the chemosensitizing agents employed with IRT-Q.

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