Chemotherapy Is Losing Its Luster

chemotherapy side effects

Story at-a-glance -

  • Research dating back over a decade suggests many women with breast cancer can opt for gentler versions of chemotherapy, or skip it altogether, without harming their chances of recovery
  • According to the American Society of Clinical Oncology (ASCO), many cancer patients are being overtreated to their detriment; an estimated 70 percent of women with early stage breast cancer probably do not need chemotherapy, and fare just as well without it
  • The Oncotype DX test can help determine whether a breast cancer patient might benefit from chemo by measuring the activity of 21 genes involved in cancer recurrence
  • According to ASCO’s findings, women with estrogen-sensitive breast cancer that test negative for HER2, and whose tumors are smaller than 5 centimeters, have not spread to the lymph nodes, and have an Oncotype DX score between 11 and 25, can forgo chemo
  • An increasing number of cancer patients are now electing not to use chemo. A recent survey found the overall use of chemo declined from 34.5 to 21.3 percent between 2013 and 2015

By Dr. Mercola

Surgery, drugs and radiation — aka the “cut, poison, burn” strategy — are typically the only solutions offered by most conventional oncologists to treat cancer, and upon receiving a cancer diagnosis most people are willing to do just about anything to get better. Unfortunately, the standard of care for cancer is not necessarily the most effective.

Research dating back over a decade suggests many women with breast cancer can opt for gentler versions of chemotherapy, or skip it altogether, without harming their chances of recovery. One 2007 study found some breast cancer patients had better outcomes when given Taxotere, a milder chemotherapy drug than Adriamycin, which had been the standard for decades.1

Another suggested the Oncotype DX test2,3 may be able to help determine whether a breast cancer patient might benefit from chemo by measuring the activity of 21 genes involved in cancer recurrence. At the time, Dr. Eric Winer of the Dana-Farber Cancer Institute in Boston said,4 “We are backing off on chemotherapy and using chemotherapy more selectively." Now, a number of additional studies have come to the same conclusion: Many breast cancer patients do not need chemotherapy, and have better outcomes without it.

Many Cancer Patients Fare Better Without Chemo

According to the American Society of Clinical Oncology (ASCO), many cancer patients are being overtreated to their detriment; an estimated 70 percent of women with early stage breast cancer probably do not need chemotherapy, and fare just as well without it.5 As reported by NPR:6

“One dramatic example revealed at the [2018 ASCO] meeting relates to the most common form of breast cancer, known as hormone-positive, HER-2 negative disease. For many women who have this diagnosis, but for whom the disease has not spread to lymph nodes, a new study7,8 finds that anti-hormone treatment after surgery is enough, and women won't benefit from rounds of toxic and uncomfortable chemotherapy.

Treatment of breast cancer for this large group of women will become easier. And for the many women who already choose not to undertake chemotherapy, they can be reassured that it's the right call. Likewise, researchers from France presented evidence that people with severe colon cancer don't benefit from a common treatment, which involves heated chemotherapy administered at the time of surgery.

This treatment has been in use for 15 years, without good evidence that it actually works … The study9 of 265 patients found that it didn't work … The study is ‘an excellent example of how less is more,’ when it comes to certain cancer treatments, says Dr. Andrew Epstein, an oncologist from Memorial Sloan Kettering Cancer Center who spoke on behalf of ASCO.”

Genetic Testing Allows for Safer Treatment Protocols

In the case of breast cancer, ASCO confirms that the 21-gene test, which assesses your risk of cancer recurrence, is a valuable tool that helps spare women from unnecessary treatment. It’s been estimated that about half of all women diagnosed with breast cancer worldwide have HER2-negative cancer, meaning it is a node-negative, hormone-receptor positive type of cancer, which is typically treated with a combination of estrogen-blocking drugs and chemo.

According to ASCO’s findings, women with estrogen-sensitive breast cancer that test negative for HER2, and whose tumors are smaller than 5 centimeters, have not spread to the lymph nodes, and have an Oncotype DX score between 11 and 25 (out of a max score of 100), can forgo the chemo. 

For this study, more than 10,000 breast cancer patients were followed for an average of nine years. Just over 6,700 of them had Oncotype DX scores between 11 and 25, which is considered an intermediate risk. Half of this group received hormone therapy alone, while the other half received hormone therapy in conjunction with chemo.

At the end of the study, 83.3 percent of those who received hormone therapy alone had not developed a recurrence. Among the dual-treatment group, that percentage was 84.3 percent — a not statistically significant difference.

The survival rate was also near identical — 93.9 percent among those receiving hormone therapy alone versus 93.8 percent for those receiving both hormone therapy and chemo. According to Dr. Jeffrey Abrams, associate director of the National Cancer Institute’s Cancer Therapy Evaluation Program:10

“These findings, showing no benefit from receiving chemotherapy plus hormone therapy for most patients in this intermediate-risk group, will go a long way to support oncologists and patients in decisions about the best course of treatment.”

Chemotherapy Takes a Toll on Long-Term Health

Previously, patients with this intermediate score have typically been treated with chemotherapy as a preventive measure, which often has devastating side effects, including hair loss, fatigue, cognitive decline, osteoporosis and heart problems, just to name a few. Numerous studies in both mice and human subjects have also shown that common chemotherapy drugs can foster tumor microenvironments for metastasis to occur later.

As just one example, a 2009 study11 found that long-term use of the breast cancer drug Tamoxifen — commonly prescribed for the prevention of estrogen-sensitive breast cancer — may actually increase your risk of developing a more aggressive, difficult-to-treat tumor fourfold. In other words, the very drug that’s supposed to help you can later harm you.

The side effects of chemo can also last a decade or more after treatment has ended. One 2006 study12 found that cancer patients who received chemotherapy had lower metabolism in a key region of the brain's frontal cortex, which translates into poorer memory. Scientists also noticed jumps in blood flow to the cerebellum and frontal cortex, a sign the brains of women who had chemo worked harder to perform normally than did healthy patients.

What's more, chemotherapy patients who underwent both hormone therapy and chemo also experienced an 8 percent drop in the resting metabolism in the basal ganglia. All of these effects — which explain the “chemo brain” or mental fog so often reported by those receiving chemo — were found to linger for at least 10 years post-treatment.

New Trend: More Cancer Patients Forgo Chemo Despite Lack of Change in Practice Guidelines

The good news is increasing numbers of cancer patients are now electing not to use chemo. A recent survey13 published in the Journal of the National Cancer Institute found the overall use of chemo declined from 34.5 to 21.3 percent between 2013 and 2015. More specifically, for node-negative cancers, usage declined from 26.6 to 14.1 percent, and for node-positive cancers, it declined from 81.1 to 64.2 percent. Use of Oncotype DX testing is thought to be responsible for about one-third of this decline in chemotherapy use.

According to the authors, “Patients’ report of oncologists’ recommendations for chemotherapy declined from 44.9 percent to 31.6 percent … Oncologists were much more likely to order RS [the 21-gene recurrence score] if patient preferences were discordant with their recommendations, and they adjusted recommendations based on patient preferences and RS results.”

To me, this is good news as it appears that more people are starting to take control of their own cancer treatment and care, which is encouraging. As noted by the authors of this survey, all of this happened in the absence of any substantial changes in practice guidelines. Overall, years of research supports the sanity of this trend.

Chemotherapy — Not Nearly as Effective as Most People Think

Despite its reputation as the gold-standard in cancer treatment, a meta-review14 published in 2004 showed chemotherapy has an average five-year survival success rate of just over 2 percent for all cancers — hardly the kind of success rate you’d expect from “gold standard,” evidence-based medicine. According to the authors:

“The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3 percent in Australia and 2.1 percent in the USA. As the 5-year relative survival rate for cancer in Australia is now over 60 percent, it is clear that cytotoxic chemotherapy only makes a minor contribution to cancer survival.

To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.”

Chemo Hastens Death When Given to Severely Ill Patients

Fast-forward 14 years, and the research still shows the same thing — chemotherapy is often contraindicated and hardly a reliable cure. Instead, it often does more harm than good when administered across the board. Another study,15 the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), published in 2008, found more than 4 in 10 patients who received chemotherapy toward the end of life experienced potentially fatal effects.

Moreover, after reviewing data from over 600 cancer patients who died within 30 days of receiving treatment, it was found that chemotherapy hastened or caused death in 27 percent of those cases. As noted in a commentary on these findings, published in the BMJ that same year:16

“The … NCEPOD has reported that chemotherapy has probably hastened or caused death in over a quarter of patients who died within 30 days of receiving treatment. They suggest therefore, that greater caution be used in prescribing chemotherapy in very sick patients …

The reality is that patients receiving chemotherapy have been deemed to be fit by their oncologist. Currently, this is assessed, in the main, by performance status. However, although simple to use, it is recognized to be subjective and therefore determination of “fitness” and the selection of patients for chemotherapy is sub-optimal.

There is increasing evidence that the presence of a systemic inflammatory response, as evidenced by elevated concentrations of C- reactive protein and hypoalbuminaemia, are useful prognostic factors in patients with advanced cancer, independent of stage or treatment …

[E]levated C-reactive protein and hypoalbuminaemia may be combined in a simple, objective scoring tool, the Glasgow Prognostic score (GPS) … [W]e believe that the use of simple objective prognostic tools, such as the GPS, will improve the selection of patients for chemotherapy and reduce the number of chemotherapy associated deaths.”

Surgery Lowers Survival in Those With Advanced Kidney Cancer

Yet another study presented at the 2018 ASCO meeting showed patients with advanced kidney cancer do not need surgery. The French study,17 which looked at the outcomes of 450 patients, found “the surgery was pointless,” as the removal of the diseased kidney did not improve outcomes compared to those receiving chemotherapy alone.

In fact, those who received the chemo drug Sunitinib alone had a median survival of 18.4 months, while those who received both chemo and surgery had a median survival of just 13.9 months. According to lead study author Arnaud Méjean, a urologist at Hôpital Européen Georges-Pompidou—Paris Descartes University,18 “When medical treatment is required, cytoreductive nephrectomy should no longer be considered the standard of care for these patients with synchronous metastatic disease.”

Indeed, as noted by NPR,19 “There may be many other cancer treatments that are unneeded and possibly even harmful. Many longtime medical practices are based on tradition and thin evidence.”

Your Lifestyle Significantly Impacts Your Cancer Risk

As the old saying goes, “An ounce of prevention is worth a pound of cure,” and this certainly holds true for cancer. Optimizing your body’s ability to burn fat as its primary fuel by eating a cyclical ketogenic diet and/or fasting is a foundational aspect of both cancer prevention and treatment.

To learn more, please review “Metabolically Supported Therapies for the Improvement of Cancer Treatment,” in which Travis Christofferson and Dr. Abdul Slocum discuss how nutritional ketosis and fasting can radically improve treatment outcomes and minimize the need for chemo, even in advanced-stage and hard to treat cancer cases.

Detoxification is another crucial component, as most of us are inundated with thousands of toxins each day, many of which have carcinogenic potential. One of the simplest and perhaps safest ways is to use a low EMF, infrared sauna coupled with a near-infrared light, as your skin is a major organ of elimination.

Optimizing your vitamin D is another essential step, both for prevention and as an adjunct to treatment. For example, in a study20 published in 2010, data collected over a decade from more than 67,000 women showed that women in sunny climates with high vitamin D levels were at a significantly reduced risk of breast cancer. Other lifestyle strategies that will help minimize your cancer risk include the following:

Control your insulin level by limiting your intake of processed foods and sugars, especially fructose, as much as possible. This is one of the most powerful ways to reduce your cancer risk. By avoiding processed foods, you’ll also minimize your exposure to pesticides, herbicides, genetically engineered ingredients and factory farmed foods. Ideally, choose organic or biodynamic locally grown whole foods whenever possible.

Switch over to a cyclical ketogenic diet and then intermittent feasting and fasting. You'll find the exact steps detailed in my book, "Fat for Fuel."

Make sure your vitamin D and omega-3 levels are both optimized. For health and disease prevention, aim for a vitamin D level between 60 and 80 ng/mL and an omega-3 index of at least 8 percent.

Exercise. One of the primary reasons exercise works is that it drives your insulin levels down. Also make sure to get more movement into your waking hours. Simply sitting less can make a profound difference in your health.

Minimize your exposure to electromagnetic fields (EMF), including both wireless technologies and household wiring. To learn more, see “The Real Dangers of Electronic Devices and EMFs,” and “The Harmful Effects of EMFs Explained.”

Have a tool to permanently erase the neurological short-circuiting that can activate cancer genes. My particular favorite tool for this purpose is the Emotional Freedom Techniques.

Get seven to nine hours of high-quality sleep each night.

Reduce your exposure to environmental toxins like pesticides, household chemical cleaners, synthetic air fresheners and air pollution.

Boil, poach or steam your foods, rather than frying or charbroiling them to avoid the creation of acrylamide, a known carcinogen. Avoid all processed meats for the same reason.

Breastfeed exclusively for up to six months. Research shows this too will reduce your breast cancer risk.

Blood Tests That Help Reveal Your Cancer Risk

While a healthy diet and lifestyle are recommended for everyone, a number of standard blood tests can help you determine your cancer risk, thereby putting you on notice that more radical lifestyle intervention may be prudent. Dr. Leigh Erin Connealy, whom I’ve interviewed on this topic, details these tests in her book, "The Cancer Revolution: A Groundbreaking Program to Reverse and Prevent Cancer." 

One such test is the high-sensitivity C-reactive protein (CRP) test, also mentioned above, which is a nonspecific marker for inflammation. “It doesn’t tell me where the cancer is, but it tells me something is brewing,” Connealy says. Ideally, you’ll want your C-reactive protein to be below 1. Other valuable blood tests include:

The hemoglobin A1C test, which reflects your blood sugar over the past 90 days. The reason for this test is because high blood sugar is a cancer-friendly environment

A cancer profile test (fasting blood and urine) from American Metabolic Laboratories, which checks for:

Quantitative human chorionic gonadotropin (hCG)

Phosphohexose isomerase (PHI), the enzyme of hypoxia or low oxygen, which allows cancer to thrive

Dehydroepiandrosterone sulfate (DHEA), a stress hormone

Thyroid hormones, as low thyroid levels may predispose you to cancer

Gamma-glutamyl transferase (GGT), a liver marker and a sensitive screening tool for inflammation

Arachidonyl-2-chloroethylamide (ACEA), a nonspecific marker for many cancers

ONCOblot, which can identify up to 33 tissue types of cancer and has a 95 percent accuracy rate. It measures the ENOX2 protein

Circulating tumor cell test by the Research Genetic Cancer Center (RGCC). The vast majority of people die not from the tumor itself but from circulating cancer stem cells, which allow the cancer to metastasize and spread throughout the body. This test is used after cancer treatment, to determine whether or not you might need to continue an anticancer program. Connealy explains:

“Even if you have surgery, chemo or radiation, it will not eradicate or eliminate circulating tumor cells … The biggest cause of reoccurrence is the circulating tumor cells and stem cells … Anybody who’s had cancer must have their circulating tumor cells [or] stem cells checked quantitatively.

RGCC is not the only lab that does it, but … they’re in 13 countries [and] have the highest laboratory international certification you can have. It is, to me, probably the most accurate …” 

Treatment Alternatives: Cryotherapy, IPT Chemo and Hyperthermic Therapy

It’s important to realize that chemotherapy drugs are, by their very nature, extremely toxic and typically do not work with your body to modulate and normalize its response to allow the cancer to resolve normally and they do absolutely nothing to address the cause of the cancer. Natural approaches, on the other hand, do not have the types of fatal side effects common with cancer drugs because they work by optimizing your body's own natural healing capacities.

Fortunately, there are natural approaches that rival and/or exceed the limited effectiveness of conventional therapies, without the risks. In her book, Connealy discusses the use of a number of alternative treatment methods, such as cryotherapy, which is where you freeze the cancer cells. Cryotherapy typically works well for breast cancer. Connealy has treated 9-centimeter breast tumors with cryotherapy in combination with a cocktail of low-dose chemo and hypodermic mistletoe, successfully eliminating the tumor in a single month.

In patients with cancer in multiple locations, she will often use insulin potentiation therapy with low-dose chemotherapy. Connealy has done a great job of compiling a variety of valuable resources into her book, “The Cancer Revolution,” and if you or someone you love is faced with cancer, it’s definitely worth reading.

As for finding an open-minded oncologist or doctor willing to implement these kinds of integrative methods, an organization called The Best Answer for Cancer is a helpful resource that lists qualified physicians. You can find more information at www.bestanswerforcancer.org/. It's a hybrid nonprofit that services both integrative physicians and patients with cancer and other chronic disease.

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