I have just been reading the current issue of “Time” magazine (4th April 2016) which has a long feature on the subject of immunotherapy. Essentially this approach to the treatment of cancer is based on developing drugs, which have the objective of improving the immune system and therefore have the capability of attacking the cancer cells. It is claimed that one of these drugs, pembrolizumab, was used successfully to treat former President Jimmy Carter’s cancer of the brain. Currently there are 3,400 trials being conducted in the USA to evaluate this type of drug. Much of the article is about patients suffering from cancer who are desperately trying to sign up for these trials in the hope that the treatment will provide a cure.
It is clear that this approach is being pushed by pharmaceutical companies. It has been estimated that these immune-based treatments would generate sales of between $35 and $70 billion per year, which would exceed that of statins. The costs of treating a single patient for one year with one of these drugs is about $200,000, which obviously is not feasible for treating the 14 million cancer patients in the USA.
So while this approach may be more effective than most of the drugs already in use, it is evident that the impact will be limited. This is yet another example of a strategy in which the prime objective is to make huge profits for drug companies but there will be no significant gain in terms of tackling the disease of cancer.
The article makes it very clear that those who have cancer and their friends are looking for the “magic bullet” solution, which almost certainly does not exist.
Although there may be some success with this approach, I am highly sceptical that it will make will make a major contribution to the solving the cancer epidemic. The fundamental problem is that like all the other conventional treatments for cancer there is an almost total failure to identify the primary cause and address it. I recently wrote a blog in which I compared Type 2 Diabetes (T2D) to a flood of water in a house caused by a burst pipe (1). The only difference is that the body is flooded with glucose not water. It is obvious that the first action must be fix the burst pipe so that the flow of water is stopped. Logically the same approach should be applied to T2D which means that the supply of glucose to the blood must be reduced substantially, by lowering the consumption of sugar and carbohydrates. This is rarely done and unbelievably, patients are advised to reduce the intake of fat and INCREASE consumption of carbohydrates. If the same approach was applied to the flooded house, the occupants would be told:
“Sorry, the inflow of water cannot be stopped. Here are some buckets and mops. You will just have to cope as best you can as long as you live in this house.”
Clearly this is ridiculous but the fact remains that is exactly how conventional medicine is dealing with T2D! Confirmation is provided by research (2) and by the experience of many individuals who have effectively treated the T2D by altering their diet to reduce the amount of sugar and carbohydrates (3).
It is my contention that this analysis applies equally well to cancer. It is evident that most cancers are caused by environmental factors such as exposure to carcinogens and/or poor nutritional quality of the diet. So it follows that even if a tumour is removed or destroyed, the cause is still in place and is highly likely to produce other tumours. It is significant that one of the few major successes has been with lung cancer, where smoking cigarettes was found to be the major factor responsible for its development.
Less well known are the case histories of many individuals who have successfully overcome their own cancer by making radical changes to their habitual diet. This also makes sense from a scientific perspective with the recognition that cancer is a metabolic disease as advocated by Thomas Seyfried (4) and some other researchers.
The rationale is that there are fundamental differences between cancer cells and normal healthy cells in the way they function. In particular, cancer cells depend on a source of glucose for their energy requirements which is referred to as the “Warburg effect” after the distinguished German scientist who made the discovery. By contrast, normal cells can utilise ketones which are derived from fat as well as glucose. The significance of these differences is that if the cancer cells are starved of glucose then it will be impossible for them to survive and thrive. It follows that this is what would happen if the diet is altered so that the amount of sugar and carbohydrates is kept to a minimum or ideally not present at all. This is precisely what Archie Robertson did and he tells his story in a recent blog (5). Archie developed oesophageal cancer and was told by his specialist that surgery would be essential. However he and his wife devised a diet which was very low in sugar/carbohydrates but had a relatively high content of fat so that the body was geared up to producing ketones (ketogenic diet). Within a few months it was evident that surgery was not necessary and CT scans showed that the tumours had gone.
It must be emphasised that this is by no means an isolated case. Other examples are Raymond Francis (6) and David Servan-Schreiber(7).
Clearly these results are very encouraging but there needs to be more studies done to gain further insight and provide a powerful evidence base to justify treatments based on this approach. It is also necessary to determine the optimum diet and understand how a strategy based on diet should be related, if at all, to the conventional treatments. The hard reality is that there is nothing like the same incentive for companies to conduct investigations along these lines because the financial rewards of dietary treatments are insignificant when compared with the profitability of drugs!