Using temperature to awaken immune response to fight brain cancer

14 Oct 2019 Cancer

This certainly may apply to many cancers, as unfortunately, most are immunologically “cold,” which is why the current FDA approved immunotherapies fail in the majority of cases. There are numerous techniques to turn “cold” tumors to “hot.” Among these are injection into a tumor TLR agonist, STING agonist, CD40 agonist, and Oncopore peptides, to name a few. This article discusses using ultrasound to control temperature. The surprising aspect was it was not necessarily heating things up, like hyperthermia, but keeping the temperature stable. A very interesting and unexpected conclusion.

There is also a nice animation explaining the immune response to cancer and how cancer can evade the immune system.

Source: Labroots

Photo: Pixabay

Antibiotic use before cancer treatment cuts survival time study

We have discussed this before. It is becoming standard in our patients to not only evaluate the microbiome with Microbiome Dx, but also patients with recent antibiotic use prior to immunotherapy probably will need a fecal microbiota transplant (FMT).

Taking antibiotics in the month before starting immunotherapy dramatically reduces a cancer patient’s chances of survival, according to a small but groundbreaking study.

Scientists at Imperial College London believe antibiotics strip out helpful bacteria from the gut, which weakens the immune system. This appears to make it less likely that immunotherapy drugs will boost the body’s cancer-fighting capability.

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How is Immunotherapy Changing the Outlook for Patients with Breast Cancer?

9 Aug 2019 Cancer

Breast cancer is one of the most commonly diagnosed cancer types among women globally. Globally, there were an estimated 2.1 million new cases of breast cancer and 630,000 deaths due to breast cancer in 2018. In the United States alone, there were an estimated 270,000 cases of breast cancer diagnosed in 2018 along with 41,000 deaths, and approximately 1 in 8 women and about 1 in 1,000 men will develop invasive breast cancer at some point in their lives. Thus, the need for effective, lasting breast cancer treatment is urgent.

Increased risk for breast cancer is associated with a personal or family history of the disease and inherited genetic mutations in breast cancer susceptibility genes. These include BRCA1 and BRCA2 and other less common inherited gene mutations. An inherited predisposition to develop breast cancer accounts for approximately 5%-10% of all breast cancer cases, but is rare in the general population (less than 1%). Women with BRCA1 and BRCA2 mutations have an estimated 45% to 65% higher risk of developing breast cancer by age 70, though the risk is highest around age 40. People with these mutations should discuss their risk with a genetic counsellor. Other known risk factors include obesity, use of MHT (a hormone therapy that combines progestin and estrogen), high breast tissue density, alcohol consumption, and physical inactivity.

Current methods for breast cancer treatment typically involve surgery if the disease is diagnosed early. Depending on the stage and molecular characteristics of the cancer when diagnosed, breast cancer surgery may be followed by additional chemotherapy, radiation, or targeted therapies, including hormone therapy.

Although breast cancer has long been regarded as difficult to treat with immunotherapy because it is immunologically cold, several newer preclinical and clinical studies now suggest that immunotherapy treatment has the potential to improve outcomes for breast cancer patients.

In March 2019, the FDA approved the first checkpoint inhibitor immunotherapy drug, an anti-PD-L1 antibody called atezolizumab, (Tecentriq®), in combination with chemotherapy, for the treatment of triple-negative, metastatic breast cancer in patients whose tumors express the PD-L1 protein.


Breast Cancer Cryoablation. The future of breast cancer treatment. Contact us today! 251-943-9409

A poor gut microbiome could cause breast cancer to spread

New research from the University of Virginia Cancer Center and recently published in the journal Cancer Research suggests that an unhealthy gut microbiome could result in the spread of breast cancer throughout the body.

The research was spearheaded by Melanie Rutkowski, PhD, of UVA’s Department of Microbiology, Immunology and Cancer Biology. Dr. Rutkowski used mice to show how an unhealthy gut caused breast cancer to become much more aggressive, leading it to disseminate to other parts of the body.

“When we disrupted the microbiome’s equilibrium in mice by chronically treating them antibiotics, it resulted in inflammation systemically and within the mammary tissue,” Dr. Rutkowski explains. “In this inflamed environment, tumor cells were much more able to disseminate from the tissue into the blood and to the lungs, which is a major site for hormone receptor-positive breast cancer to metastasize.”

“Disrupting the microbiome resulted in long-term inflammation within the tissue and the tumor environment, “Rutkowski said.” These findings suggest that having an unhealthy microbiome, and the changes that occur within the tissue that are related to an unhealthy microbiome, may be early predictors of invasive or metastatic breast cancer. Ultimately, based upon these findings, we would speculate that an unhealthy microbiome contributes to increased invasion and a higher incidence of metastatic disease.”

However, Rutkowski is quick to reassure that the use of antibiotics in human women should not be enough to disrupt a women’s microbiome to the extent that she was with the mice in her research. Instead, she says, her methods utilized antibiotics as a means to disrupt the microbiomes of the mice and simulate what an unhealthy biome looks like, so as to determine its influence on the spread of breast cancer. Women with breast cancer should not, she says, refrain using antibiotics if needed to treat an infection just because of her study’s results.

The take-home message from Dr. Rutkowskiâ’s research is how crucial a healthy microbiome is, not just to prevent the spread of breast cancer, but for overall good health.

Source: Labroots

Novel protocol improves pancreatic cancer outcomes

6 Jun 2019 Cancer

Combination of radiation, chemo, and blood-pressure drug losartan extends patient survival.

Locally advanced pancreatic cancer (LAPC) a tumor that, while still confined to the pancreas, involves major abdominal blood vessels is one of the worst forms of an already deadly tumor, as it cannot be removed surgically. Now a Massachusetts General Hospital (MGH) Cancer Center clinical trial of a treatment protocol combining intensive chemotherapy and radiation with the blood-pressure drug losartan has produced unprecedented results, allowing complete removal of the tumor in 61 percent of participants and significantly improving survival rates.

Around 40 percent of pancreatic cancer patients have either locally advanced or borderline resectable disease, with historically poor rates of successful surgery, said Janet Murphy, an instructor in medicine in the hematology/oncology division of Mass. General’s Department of Medicine, co-lead and corresponding author of the report in JAMA Oncology. To be able to successfully remove the primary tumor in 61 percent of patients sets a new benchmark and offers much hope. To our knowledge, this is the first LAPC clinical trial that defined surgical success as its primary outcome.

The most novel element of the trial use of the antihypertension drug losartan builds on the findings of co-author Rakesh K. Jain, director of the Steele Laboratories for Tumor Biology at MGH and Andrew Werk Cook Professor of Radiation Oncology at Harvard Medical School, and his colleagues. Those studies found that losartan, which targets the angiotensin signaling pathway, improved the delivery of chemotherapy drugs in animal models of breast, pancreatic, and ovarian cancer. It does so by relieving pressures in the tumor microenvironment that physically block drug delivery and reduce the supply of oxygen, which is required for the tumor-killing effects of radiation therapy. Those studies also found that cancer patients who happened to be taking losartan or similar drugs for hypertension tended to live longer than others receiving the same sorts of cancer therapies.

From August 2013 through July 2017 the study enrolled 49 MGH Cancer Center patients with previously untreated LAPC. All participants received chemotherapy with a combination of fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFIRINOX) over a four-month period, during which they also took daily doses of losartan. After CT scan evaluation to determine whether blood vessels were still involved in the tumors, patients who no longer had vascular involvement received a short course of proton-beam radiation therapy, while those whose tumors still included major blood vessels had a longer course of conventional radiation therapy. Both groups received capecitabine chemotherapy during this period.

After completing the chemoradiotherapy stage, 34 of the 49 participants were able to have their tumors removed, with 30 of those procedures successfully eliminating all evidence of cancer around the tumor. A pathologic complete response which signifies no tumor found anywhere was achieved for three patients. Analysis of circulating biomarkers throughout the course of the study found significant drops in the expression of TGF-β, a key element in the angiotensin-signaling pathway, indicating that losartan was having its desired effect. Both the time until recurrence and the overall survival time were significantly longer than what previously had been seen in LAPC patients.

A key part of the success of our approach was our surgeons willingness to attempt an operation even in patients who had the appearance of cancer at or near their blood vessels, said Murphy. We learned in a previous study, confirmed here, that CT scan results and resectability are no longer clearly correlated after chemotherapy and radiation. While we did not see total blood vessel clearance in 61 percent of patients, 61 percent achieved a complete removal of their cancer.

lead author Jennifer Wo, an assistant professor of radiation oncology, adds, Locally advanced pancreatic cancer has been generally considered an incurable disease, so these results mark a dramatic improvement with respect both to rates of conversion to surgical resectability and to long-term disease outcomes. Based on these results we have launched a new, multi-institutional clinical trial that will also include the immunotherapy drug nivolumab, since losartan treatment has also been shown to activate several immune-system pathways.

The co-senior authors of this report are Theodore Hong, MGH Radiation Oncology, and Carlos Fernández-del Castillo, MGH Department of Surgery.


Is Immunotherapy for Cancer Safe?

Your immune system does more than simply fight colds and flu. Throughout your life, your natural defenses seek out and destroy anything that is not recognized as part of the self including all kinds of germs and cancer cells before they have a chance to cause disease. Your immune system manages to destroy most rogue cells before they form a full-fledged tumor, but some of them get by your defenses. If you already have cancer, your immune system will still be working hard to keep your disease in check, but it probably can’t do the job on its own.

In recent years, more and more cancer patients have received treatments designed to give the immune system the upper hand against cancer. This approach called immunotherapy or biological therapy isn’t as widely used as radiation or chemotherapy. For most types of cancer, immunotherapy hasn’t been shown to be more effective than these standard treatments. And like the others, it can cause its own unpleasant side effects.

But immunotherapy can still be a powerful tool, either on its own or combined with chemotherapy or radiation. For certain patients including some in the advanced stages of skin cancer or kidney cancer immunotherapy can offer more than the conventional options, even the possibility of a complete cure. For others, it’s an additional, less toxic method of controlling their disease or reducing side effects from other treatments. In the years to come, as scientists learn more about the immune system, immunotherapy promises to become even more common and more effective.

What does it involve?

Immunotherapy often involves adding more immune cells, immune signaling molecules, or other biochemicals to the body. Unlike chemotherapy, which affects all fast-growing cells, immune treatments target specific processes or types of cells and should have a low impact on healthy tissues. The side effects depend on the particular biological agent used. Some have very mild side effects, while others cause serious problems.

The delivery will also depend on the agent used as well as your treatment plan. Some immunotherapy treatments are in the form of pills or shots you can take at home, while others are delivered intravenously (IV) in the hospital or clinic. Immunotherapy may be administered a couple of times a day or as seldom as every month or two.

What are the different types of immunotherapy?

There are two major types of immunotherapy: Treatments that add new disease-fighting cells to your body (T cells) and treatments that add other elements to your own immune system (such as antibodies, cytokines, and others). Many immunotherapy agents are experimental or investigational and are only available by enrolling in clinical trials.

How will my doctor decide if immunotherapy is right for me?

Not all patients or all cancers are good candidates for immunotherapy. At this time, the approach isn’t used very often for patients with cancer of the prostate or ovaries. And if your cancer was caught at an early stage or is responding well to other treatments, immunotherapy may simply not be necessary.

In certain cases, however, immunotherapy does seem to be more effective when used for some smaller, earlier-stage cancers. If your doctor does recommend immunotherapy, you will be getting a cutting-edge treatment that could make a big difference.

Call Us now to know if you are a candidate.


American Cancer Society. What is immunotherapy? October 2010.
American Cancer Society. Types of immunotherapy. October 2010.
National Cancer Institute. Biological therapies for cancer. Questions and answers. 2006.

“Lock-‘n’-block” drug may prevent cancer from metastasizing

A new approach to breast cancer may prevent cancer from reappearing years later.

They got all of it are the reassuring words people hope to hear following cancer surgery, but a growing understanding of the science of how cancer spreads, and metastasizes, is suggesting that not only is this almost never true but and here is the surprising part it might be better to try to contain the cancer than to eliminate it.

The new approach, which at this point has been tested only in animal models, is called “Lock-‘n’-block” and a national team of scientists led by researchers at Purdue University has found that a drug already on the market for another use is showing strong promise as a therapy to keep breast cancer from metastasizing.

Michael Wendt, assistant professor of medicinal chemistry and molecular pharmacology, says that cancer researchers are beginning to realize they have been chasing an impossible goal.

Most cancer therapy is targeted with the idea that we want to kill all of the cancer cells. Rid the body of cancer. But recently, there are lots of studies that suggest that we’re never going to be able to do that. Cancer cells evolve so fast that they will always find a way to overcome any type of therapy Wendt said. An emerging concept in cancer treatment is that maybe we shouldn’t try to kill all of the cancer cells, but try to keep them in a low state that doesn’t generate any kind of symptoms. A sort of dormancy, if you will.

Wendt has led a multi-institutional study that has identified a drug fostamatinib, which is sold under the trade name Tavalisse that was shown to be effective in mice in blocking and containing metastatic cancer cells. The research was recently published in the journal Cancer Research.

Aparna Shinde, a researcher at AbbVie Inc., and formerly a graduate student in the Purdue’s Department of Medicinal Chemistry and Molecular Pharmacology, said the research focused on breast cancer because it is especially known to lead to metatisizing cancers years later.

After you have breast cancer you always get this dissemination of cancer cells, she said. Breast cancer is no longer considered a curable disease it is now considered a chronic disease, because 10 or 20 years later, you can get secondary tumors because of the metastasizing cells.

But now we have shown that we can block these cells in a dormant state so that even if a patient has these metastizing cells we can hold them in this state for a very long time.

Wendt explains that when cancer cells move from a primary tumor and go to another part of the body, they can go through some form of years-long dormancy or latency. These cancer cells are very resistant to current drug therapies, because current drugs are designed to target cells that grow faster than normal cells, as tumor cells do. That is not true of these disseminated cancer cells, which can lie dormant for many, many years.

So that’s the goal we are exploring now. Instead of trying to eliminate those disseminated cells, how do we keep them in that dormant state? Wendt said.

The researchers used the drug fostamatinib because it inhibits a particular protein, spleen tyrosine kinase (SYK), that is found in these disseminated cancer cells.

This is great for us because this is a drug with low toxicity. It’s designed for people with chronic disease so that they can take for a long time, Wendt said. So, we think fostamatinib is a perfect candidate for this kind of years-long “Lock-‘n’-block” type of approach. We think this is a good candidate to move forward for a trial to see if we can stabilize dormancy. If SYK is expressed in other cancers this could apply to those as well.

In their current study, the researchers removed breast cancer tumors from the mice surgically. The tumor cells were labeled with luciferase, the bioluminescent firefly protein, which allows the researchers to track and quantify the level of metatisizing cells.

The researchers found that the cancer cells treated with fostamatinib remained in a dormant state and did not cause metastases in other areas of the body.

Our work is unique because there hasn’t been much research that tests treatments in a post-surgical metastatic setting. Most research is focused on treating the primary tumor. We are looking to target the later processes of disease to see if we can hold tumor cells in their dormant state, Wendt said. But you can imagine that clinical trials for this kind of thing is going to be very difficult because technically the patients are in remission and disease-free. We suspect that these patients have these dormant cancer cells disseminating through their bodies, but we don’t have a way to detect those right now.


A gut punch fights cancer and infection

27 Mar 2019 Cancer

Microorganisms in the human gut can affect immune-system cells. Gut bacterial strains have been discovered that boost immune cells that have cell-killing capacity and that can target cancer and protect against infection.


How to Improve Your Health After Cancer Treatment and Beyond

No doubt, cancer feels like an insurmountable obstacle. But it can be overcome and perhaps you’re one who is or has done so.

More than 15.5 million Americans with cancer in their history are alive today, according to 2016 data. And that number is projected to surpass 20 million by 2026. 1

What’s next?

As a cancer survivor, you face the opportunity to improve and sustain your health post treatment. Though you’re well some side-effects could remain.

But you can take a proactive approach.

cancer survivors should feel empowered to be their own advocates by proactively discussing their health questions and concerns with their physicians. They can also take control of their health by maintaining a healthy weight and diet, avoiding tobacco products, increasing physical activity, and reducing sun exposure. 2

Strategy for a healthy lifestyle

Following cancer treatment you’re eager to restore your health. This requires a strategy so you can enjoy your new life and renewed perspective.

There’s no need to to complicate the process. In fact, your entire strategy is lifestyle focused.

You’re a survivor. Now’s the time to take care of yourself and enjoy life.

Keep moving

If you heard the word, exercise, you might be tempted to skip this point. That said, an exercise routine (that focuses on movement) can improve your recovery and renewal.

You’ll experience:

  • Increased strength and stamina
  • Less depression, anxiety, and fatigue
  • Better mood
  • Improved confidence and self-esteem
  • Reduced pain
  • Quality sleep


Start small. Add more movement to your lifestyle.

  • Take the stairs
  • Park further from your destination to add walking distance
  • Walk daily
  • Increase your pace during household tasks (cleaning, yard work, etc.)
  • Stand up frequently after sitting periods

The American Cancer Society recommends adult cancer survivors exercise for at least 150 minutes a week, including strength training at least two days a week. 3

Realty is you won’t always feel like exercising. Give yourself a break on occasion especially if you still experience post treatment fatigue.

After a break, return to your exercise routine. And remember that adequate rest and recovery matter to a healthy lifestyle.

Speaking of rest

Push pause

Routine restfulness will add margin to your recovery and renewal. Start with your sleep routine.

Sleep issues are common during and after cancer treatment. Your body has experienced changes, treatment side-effects, and stress.

Quality sleep is vital to recovery and lifestyle renewal.

  • Sleep pauses your mind and body
  • Sleep recharges your cognitive (thinking) skills
  • Sleep improves your hormonal functions
  • Sleep lowers your blood pressure

Bottom line: sleep improves your overall sense of well-being.

You can optimize your sleep quality by:

  • Reducing or eliminating your caffeine intake a few hours before bedtime
  • Establishing a regular sleep schedule (bedtime and awakening hours)
  • Controlling your screen time (devices, etc) prior to bedtime
  • Maintaining a peaceful, quiet bedroom
  • Discussing any sleep related issues with your physician

Manage stress

Stressful situations are not easy to avoid. But you can reduce and manage the stress you allow to impact your life.

You might find that surviving cancer has stressed your physical, emotional, and social resources. Applying specific coping strategies can help you deal with stress and its effect on your life including depression and anxiety.

Manage your stress with:

  • Relaxation, meditation, and mindfulness techniques
  • Counseling and support groups
  • Medication that treats anxiety or depression
  • Exercise
  • Replenishing social interactions with family and friends
  • Lifestyle moderations

The key to each of these health enhancing strategies is finding what works for you and doing it! You don’t need to do a lifestyle overhaul. Instead, take small steps to improve your daily routine in ways that renews your health and well-being.

Simple wellness strategies can produce long-lasting results. And remember you’re a survivor!

Contact us for more information about improving your health and lifestyle after cancer treatment.

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What is “Off-Label” Cancer Treatment and Does It Have Advantages?

You have a lot to process when you receive a cancer diagnosis. Part of that discussion can include a decision about off-label treatment options.

You’re probably familiar with the U.S. Food and Drug Administration (FDA). Their research determines a drug therapy’s safety and its designated use.

But a particular drug’s effectiveness doesn’t stop there

What is “off-label?”

Simply put, an off-label treatment would involve use of a specific (FDA approved) drug for a purpose other than the FDA designation. A drug’s secondary use is therefore not listed on its “label”.

For example, you’ll notice a few things when examining a drug’s label.

  • Ingredients
  • How it’s designed to work
  • Relevant research data that supports its approval
  • Side effects

The FDA takes seriously their responsibility for assuring a medication is safe and effective for its specific use. That said, their control does not extend to your doctor’s decision about what drugs to prescribe you.

FDA approval is valid and essential. But your doctor has the latitude to prescribe it for a purpose that’s in your best interest following additional tests.

Off-label use can vary greatly from one doctor to another, depending on doctors preferences, knowledge, and past patient experiences. A 2008 study found that 8 out of 10 cancer doctors surveyed had prescribed drugs off-label. 1

Off-label isn’t off-the-grid

An FDA approved drug therapy can be used off-label for a specific health condition such as

  • A cancer that’s different than one the drug is specifically designed to treat
  • A different prescribed dosage or use frequency
  • Treating a child instead of an adult

Keep in mind that off-label treatments still require approval from the FDA at the manufacturing company’s request. Additional approvals also require research that shows the treatment to be safe and effective for new or innovative uses. This research requires time and money from the manufacturer.

What about off-label treatment for cancer?

Off-label use of drugs is common for treating cancer. The stages and types of cancer can be treated with off-label use of one or more drug therapies.

A cancer drug can be effective against more than one type of cancer. For example, combination chemotherapy uses more than one drug to effectively treat different types of cancer.

Research is trusted to discover new uses for approved drugs. These studies are accessible by your doctor and will be used to evaluate a drug’s effectiveness for treating your type of cancer.

At the same time an off-label use of a drug might not be safe. Circumstances can include:

  • No proof of effectiveness for a certain type of cancer or reason to believe it would be
  • The potential risks of usage are greater than the possible benefits

Again, your doctor will prescribe an off-label use of a particular drug based on their knowledge and experience with it and the drug’s effectiveness as revealed by research.

Ask these questions before you proceed with off-label cancer treatment

We’re prepared to help you understand the reason off-label treatment could be a viable solution for treating your type of cancer. We encourage you to ask and discuss these questions with us:

Why will my specific cancer respond to the off-label use of this drug?

What difference in results will I experience between the off-label drug and the one specifically approved for treatment?

What risks and benefits can I expect from the off-label use of this drug?

Does my health insurance cover my treatment with this drug?

Will my health insurance cover combination chemotherapy and the use an off-label drug?

These questions and more are common and important to ask prior to beginning cancer treatment with off-label drug therapies. Our goal is to give you the best opportunity for eliminating cancer and restoring your health.

Contact us about cancer treatment solutions. Schedule a consultation and ask us about off-label drug therapies for treating and eliminating cancer.


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