Guardant Health and Collaborators Present Further Clinical Utility Data for Guardant360 at the AACR-NCI-EORTC International Conference On Molecular Targets and Cancer Therapeutics
At the Pacific/Orange Coast Medical Center of Hope, we are trained to provide complementary and Integrative treatments to patients diagnosed with cancer. This will include extensive genetic and metabolic testing and treatment as well as evaluating and treating Immune system for patients with diagnosed cancer of all types.
Cancer has been and is a prevalent disease with generally poor outcome. In 2007 overall, 758,587 men were told they had cancer and 292,853 men died from cancer in the U.S. in 2007. The ten most commonly diagnosed cancers among men in the United States included cancers of the prostate, lung, colon rectum, and bladder; melanomas of the skin; non-Hodgkins lymphoma; kidney cancer, mouth and throat cancer, leukemia, and pancreatic cancer. In women there has been a prevalence of 6,451,737 advanced cases reported by SEER at CDC and the most common cancers were reported as breast, lung and colon cancer. In general there were 11,957,599 advanced cancer cases in the US reported in 2010 by CDC and the incidence has been almost unchanged over the previous 8 years (482,000 cases in 2000 versus 456,000 cases in 2008). There has been an annual percentage change of only (-0.6) between years 1999 to 2008 in cancer incidence.
In the US, 42 prominent academic medical institutions including Cedars-Sinai, Harvard, Yale, Duke, and the Mayo clinic, are embracing integrative medicine modalities. Doctors are usually trained in the "silos" of specialized knowledge, but, increasingly they are learning to treat the whole person, look at every aspect of the patient's life, prevent disease, and become creative well rounded healers, And that's a pretty radical idea.
Every year, about 40 million Americans try alternative medicine. In cancer, generally patients seek complimentary treatments when it is in advanced stages. What usually prevents them to consider non conventional care at the beginning is the fact that they do not realize the importance of combining such therapies with their prescribed conventional treatment and simply think that what insurance companies pay for should suffice.
The truth of the matter is that most cancers respond initially well to the conventional treatments if it is surgery, chemotherapy, radiation or altogether, however they relapse or recur in the matter of months or years. Unfortunately, the conventional treatments work when the cancer is "naive" to therapy. After a while cancer cells develop resistance, what we technically call the effect of "multi drug resistant gene" or MDR.
Surgery also can increase the development of vessels around the residual tumor cells by increasing VEGF (a signaling molecule for producing vessels) to nourish the cancer cells. So the end result is that patients are under the impression that "killing" the cancer will get rid of it, when as much you kill the cells, you still carry the stem cells, that are in charge of producing new cells. It is like you have a bee colony and you are killing the bees to get rid of them, and you are not killing the queen cells, which are cancer stem cells. As a matter of fact you are stimulating the mother cells (queen) to produce more cells to replace the dead daughter cells. That is why most of the cancers will come back shortly after the first therapy and of course this time more aggressive as you have caused resistance by the mechanism just explained (MDR). We also use hyperbaric oxygen in some cases of cancer, as oxygen targets specific cancer genes ( such as LDH alpha, HIF,etc...).
Now what should we do to stop this from happening? Simply you need to use a therapy that prevents this deadly cascade, and that is what we offer.
The treatments we offer, target the QUEEN, the cancer stem cells, the mother cells. Secondly, they prevent the MDR gene stimulation by chemotherapy, so that it works better, what we know as the chemo-sensitizing effect. Third, they enhance the immune system so the undesirable immune suppressing effect of chemotherapy is ameliorated. Fourth, they block the signaling molecules (such as VEGF), so after the surgery, cancer would be much less nourished. Fifth, they block the cancer oncogenes through epigenetic modification (controlling the child through the parent). Sixth they increase the function of onco suppressor genes, which are involved in cancer cell cycle. Seventh, they block the inflammatory genetic cascade starting form NF Kappa B and ending in more than 150 genes. Eight, they block the growth factors involved in cancer growth, such as Insulin like growth factor-1. Ninth they can block the energy production in cancer, so they can cause the cancer cell to starve.
In concert with the above mechanisms, it would be extremely important to include such treatments in ALL cancer patients, regardless of their stage or type of cancer. The reason is clear, and it is simply because the treatments work in so many different ways and levels including targeting the stem cells, which unfortunately, chemotherapy does not even touch!
What we recommend is to combine such treatments with conventional treatments, if we have a good idea of what agent to use and have done all we need to do to understand the specific cancer sensitivity to different agents, otherwise conventional treatment by a good chance will fail.
Some of our patients are under chemotherapy or post surgery, and some hesitate to start any conventional treatments due to toxic side effects and the potentially recurring nature of the disease. We have seen many terminal stage four cancer patients who respond to the treatments we offer in one way or the other, improving their quality of life, extending their survival, measured by surrogates of survival, and usually a good clinical response defined by standard oncology measurements. The results are so exciting that National Cancer Institute has shown interest in considering the results as the best case series in complimentary and alternative medicine in the nation. NCI considers our results " very interesting".
Many oncologists in town refer patients to us, and some are even their own family members who have advanced cancer and the conventional treatments have all failed to keep working. Now their treating oncologist is exploring other alternatives and since this time, it is their family member, they cannot simply send the patient to hospice, what they generally do without any hesitation when the "drugs" don't work anymore.
In a nut shell, we do not recommend against conventional treatments and encourage the patient to follow with their oncologist. However, we provide a new cutting edge approach to control and manage the cancer and assist the body to fight with it through different method generally without permanent toxic and dangerous side effects. These available modalities of treatment include modifying cancer genetic behavior with targeted intravenous Epigenetic treatments, enhancing the immune function, and lower the inflammation with methods such as hyperbaric oxygen available at our clinic. ( For more information about hyperbaric oxygen therapy you can check: www.medhyperbaric.com). Most of these methods of treatment are cutting edge and unfortunately not available at local oncology offices. Even most of the labs we use are not locally available and they are performed at the East coast or in Germany. Also by correcting metabolic imbalances caused by cancer cells, such as correcting excessive acidity and glucose abnormal metabolism, and removing toxic products produced by cancer, patients gain significant improvement in their response to treatment and their symptoms and their quality of life improves. The results are beyond expectations sometimes even in advanced stages of the disease.
The job of the physician in our view, is to alleviate and, if possible, eradicate disease. However, accomplishing this is often very difficult as most conventional treatments (surgery, radiation and chemotherapy) for cancer also come with significant long term adverse effects, often making it impossible to truly recover and compromising the patient's remission. Essentially, the potential benefit of the treatment thwarted by its harsh toxicity. The other failure of conventional medicine is that only a few percentage of patients that are diagnosed with cancer are educated about their options of treatment and diet. Their life style choices are almost always ignored. All this said, we admire the oncologists who have committed their life providing excellent care to the patient and respect the patients' wishes. We are pleased to have some oncologists who are working with us in a collaborative and meaningful manner and respecting patients' choices, but unfortunately the busy schedule of many of them prevents them to have a full discussion about the patients' choices of care and life style management, preventing them from making an informed decision about their choice of care.
Our experience in treating patients who have cancer, has been outstandingly rewarding and with amazing response in most patients. That is why we have patients who travel from other distant areas and states in the country and even from Europe and Asia to here. In general, we expect almost ALL cancer patients to show improvement whether in their quality of life, tumor markers, or shrinkage of the tumor and in some prolonging their life beyond expected. This is achieved with a close collaboration with their oncologist and/ or with our consulting oncologist who works closely with us in treating our patients.
The treatments are mostly natural, but we also use synthetic medicine that are proven effective or at least with promising results in available research. These modalities are absolutely cutting edge and as far as we know, there is no other clinic in California that provides all of our services at one facility. Our intention is to provide a care that is competent, compassionate, and collaborative (3Cs) and we are excited and encouraged when we see the results on our patients. There is not a single week that we don't have someone treated successfully with outstanding results.
Biologists and physicians are charged with the task of understanding the origin of the disease and preventing its appearance and development. Both physicians and scientists approach this task differently, but their goals are complementary. This dilemma calls for innovation for thinking outside the box. We apply rigorous scientific standards to a combination of conventional and non conventional approaches. Sometimes we are asked to show evidence of what we offer. Research is fundamental in my opinion in the field of integrative oncology and cancer care. However, the term "evidence based medicine" has been abused and misinterpreted since pharmaceutical companies started to fund most of the research studies in the field of cancer. These companies are trying to support the positive effects of their manufactured products (chemotherapy) when 70 percent of chemotherapies were originally extracted from plants. I was looking at statistics in cancer treatment in the last decade. For almost all cancer types at advanced stages, we have not been able to change the overall survival rate. I know the first chemotherapy was used as mustard gas in World War two to kill soldiers (Meclorethamine, which is interestingly still used in treating leukemia). At that time the soldiers who did not die, coincidentally had leukemia, which " responded" to the mustard gas!. Their cell count improved, and therefore physicians used this as the treatment for leukemia.
Since then there have been claims made every day about treating cancer and as I mentioned only 3-7 percent of such claims are valid and curative but still we do not change our approach. We are still looking for new "drugs" and if a natural product proves to be effective for a patient, since no natural product can be patented, no one is interested in studying it. Since there is no research or "evidence based medicine" all of the sudden it becomes a non conventional treatment, that obviously insurance companies will not pay for ......and guess who pays for the price: The patient. The patient is the one who if he/she can afford the treatment has to pay for the cost, and if can not afford it, they still have to pay for the cost, which this time may be their life.
Is this ethical? We believe it is not. We believe that the same way that insurances pay for conventional treatments, they should cover non conventional treatments and in the same way that the research is funded and conducted for " drugs", it should be funded for natural treatments that are suggested to be effective. We believe that the patient has the right to make an informed decision about their preferred care and should be given the right to choose their treating physician and method. As it was published in JAMA 1995, and I personally believe "evidence based medicine does not replace clinical judgment". We as physicians need to look at the results, and practice outcome-based medicine. I believe in individualized and customized care and what matters to me is the patient's response to the treatment and their quality of life.
In one of the most prestigious hospitals in the US, (MD Anderson) the budget for one year selling drugs exceeded 5 billion dollars. Interestingly I spoke with Dr. Aggarawal, who is a famous scientist in that center doing research on using Curcumin in cancer and apparently he has published 600 papers on Curcumin and natural products and he admitted that there is resistance in doing any clinical trials on natural therapies at MD Anderson. Still MD Anderson has published studies proving effectiveness of such treatments. For example, homeopathic agents Phytocaba and Carcinosin are as effective as taxol (chemo) in killing ( apoptosis) of breast Cancer cell lines. This study was just published in 2010, and amazed everyone in this field.
So going back to available literature in the field of natural therapies, I collectively started making a library of available scientific data to prove the efficacy of such treatments about five years ago. Now my office does not have enough space for literature and papers published in this field. Available studies are absolutely overwhelming, 50,000 articles on Vitamin C, and a thousand others on almost all therapies which many of them have been published by JAMA, the New England Journal of Medicine, the British Journal of Medicine and others. The history of using natural therapies goes back centuries. There are even randomized clinical trials that are only funded through small private clinics. Interestingly some of these studies have been sponsored by the National Cancer Institute and published in oncology bible, Clinical Journal of Oncology, and still some of the oncologists are not even aware of them.
I am working now on a study that we are doing here on our own patients receiving therapies for advanced cancer and their results are being reviewed for publication. When I showed these results to one of the oncologists here in town, he reviewed it in detail and was at least fair enough to say this is a very good beginning. When I asked him why is he interested in our treatments, this is what he said to me: " Dr .Nezami, When you bury enough people, you look for an alternative". Obviously he was an oncologist who had the conscious to feel bad about a patient dying under his care.
The other important thing is that most of the new chemotherapy agents that are promoted in the market now are only been studied for a short period of time and as they are practiced more and more, the side effects are being released. This is unfortunately even true for more targeted agents. For example, Avastin which was first promoted and approved for breast cancer when it came to the market, was pulled out shortly by the FDA since the lethal side effects were more than the results and I have seen patients who have died taking this drug as a side effect of it. Now, I also want to clarify some misconceptions in regards to Chemo-sensitivity testing. When you refer to your oncologist, they treat the cancer based on the available data on the FDA approved chemotherapies for each Cancer type. In other words the conventional medicine that usually treats cancer is not based on the individuality of the person, nor even based on the genetics of the cancer itself. We believe that a patient deserves individual treatment which can be based on the genetics of cancer and it's response to the different chemotherapies at least invitro. When there is response to some chemo agents invitro, there is a likelihood that this would be the case in your body as well. There are a lot of arguments to make from each side on this matter, but I personally do not want my patient to be treated blindly, especially if they have failed the first line of chemotherapies and their cancer has recurred.
In our clinic we approach patients differently. We believe that patients deserve to be treated with the most effective therapies, not based on the most available drug profile, and not based on the most expensive drug profiles. The customized therapies need to be investigated and offered to patients based on the genetic profile of the tumor, and this general rule should be included in every patients plan of care. We also believe that conventional therapies should not be used unless carefully evaluated for the toxicity profiles and discussed with the patient. We NEVER recommend a therapy unless we have educated the patient about their options. Ultimately we believe that the patient has the right to decide what therapy is right for her. It is also important to consider second and third opinion when needed and despite some oncologists who hesitate to refer patient for second opinion, we always encourage this.
Unfortunately I see many patients who come to see us and they have been given options for experimental therapies at research institutes for drugs that have least been studied and can be very toxic as their last option, and still the patient has no idea how terrible these trials can be and sometimes they still are mislead by the big names of the universities running such trials and prefer that to our therapy which almost has no toxic side effects.
It is very often when I see a patient with advanced cancer who comes jumping up and down with happiness as his " case" has been approved for a new drug with 10 percent efficacy and 70 percent toxicity, and I always think how can someone be so irrational! When I ask them to try our therapy, they tell me that they want to try the experimental therapy first, as there is 10 percent chance! and this is when they see everyone in my clinic telling them, they have already tried these experimental therapies and they have ended up here, and they are getting good results. It feels as not everyone really is destined to be here and receive the therapies that can save their life.
Talking about cancer stem cells and the epigenetic therapies, I attend almost every seminar in the country and out side the country in the field, and have been lucky to get connected with the scientists in this field and share my method with them. many have shown interest to learn more and even collaborate. Some from very credible research institutions have invited me to speak or present. When I attend these conferences, I am one of the only MDs at the conference, as all others are PhDs working in the translational research which is extensively complicated but very scientific. In Spain, where I was invited for a presentation in November 2013, I found myself among two other US invited presenters, and many from Europe. Perhaps my poster was the only one with clinical data, but here it comes the most important element of collaboration between laboratory and clinic. I believe such collaboration is extremely important to open doors to novel therapies.
Speaking in relevance to clinical therapies, we would be happy to work with any oncologist to come up with a plan of care for the patient. We use our consulting oncologist if need be, but we never force the patient to do chemotherapy and we always respect their decisions, as many of our patients refuse this option.
Currently 80 percent of my time is dedicated to research activities in the field of cancer and epigenetic science where I present in major conferences around the world. All our research activities are supported by our patients who fund the studies and support other patients who can not afford the therapies through a non profit organization that we have established. The patients donate to such entity and participate in saving one another's life. We yet have not received any governmental money neither have worked with any pharma company. We proudly continue to work with NCI on our research projects and we hope one day we can bring a new perspective in cancer therapy, that is covered by insurances and save the country from the second largest expense in health care......To that day.