this systematic review..supports the use of gemcitabine-cisplatin combination therapy as standard treatment for advanced or metastatic Biliary Tract Cancer.
Biliary Tract cancer is a difficult cancer with a dismal average five-year survival. The combination of chemotherapy drugs gemcitabine and cisplatin may slow the advancement of biliary tract cancer, as compared to using gemcitabine alone. Keep in mind two things. First, Biliary Tract is a little understood, aggressive cancer and second, chemotherapy is toxic. My experience is that you will need all the help you can get be it conventional (FDA approved) or evidence-based, non-conventional therapies.
Evidence-based integrative therapies such as curcumin have been shown to enhance the efficacy of these chemo regimens while reducing their toxicity. Don’t be surprised if your oncologist isn’t comfortable with anything that is not approved by the FDA.
My point is that Biliary Tract cancer patients must look beyond conventional oncology.
I am a cancer survivor and cancer coach.
I have lived in complete remission from my “incurable” cancer since early 1999 by living an evidence-based, non-toxic, anti-cancer lifestyle through nutrition, supplementation, and lifestyle therapies.
To learn more about integrative therapies for your cancer please scroll down the page, post a question or comment and I will reply to you ASAP.
“Cholangiocarcinoma is a medical term denoting a form of cancer that is composed of mutated epithelial cells (or cells showing characteristics of epithelial differentiation) that originate in the bile ducts which drain bile from the liver into the small intestine. Other biliary tract cancers include pancreatic cancer, gallbladder cancer, and cancer of the ampulla of Vater.
Cholangiocarcinoma is a relatively rare neoplasm that is classified as an adenocarcinoma (cancer that forms glands and/or secretes significant amounts of mucins). It has an annual incidence rate of 1–2 cases per 100,000 in the Western world, but rates of cholangiocarcinoma have been rising worldwide over the past several decades.
Background- Biliary tract cancers are fairly rare in developed countries. Each year in the United States there are about 6,500 new cases of gallbladder cancer and about 6,000 bile duct cancers, known as cholangiocarcinomas. Surgery is the only curative approach, but most patients are diagnosed with locally advanced or metastatic disease, and relapse is common. Five-year survival is only 15 percent.
Because these cancers are rare and many patients have advanced disease and receive only palliative care, few phase III clinical trials have been conducted in this setting. However, small, early-phase clinical trials have indicated that chemotherapy can have some effect. Drugs in common use include gemcitabine, cisplatin, and fluoropyrimidines. The gemcitabine/cisplatin combination is used in a number of other cancers and has shown some promise for patients with advanced biliary tract cancer in smaller trials.
Conclusion- In conclusion, this systematic review presents collective evidence from a range of study designs that supports the use of gemcitabine-cisplatin combination therapy as standard treatment for advanced or metastatic BTC.
However, detailed information regarding the effectiveness of gemcitabine-cisplatin in different types of BTC, or toxicities associated with different regimens, is lacking, in part because of the difficulty of conducting studies of sufficient sample size. Of particular importance, despite heterogeneity in the study designs, no substantial difference in toxicity was observed among the different dosing schedules of gemcitabine and cisplatin. In lieu of a large, multinational, collaborative RCT powered to enable subgroup analyses, a meta-analysis of patient-level data could help to address these questions. Alternatively, individual research teams conducting smaller studies should report subgroup-level data, which could facilitate future pooled analyses.
The Most BioAvailable Curcumin Formulas
“Based on a review of these studies, it is evident that better bioavailability of formulated curcumin (CU) products is mostly attributed to improved solubility, stability, and possibly low first-pass metabolism”
A search of the Pubmed database for the word curcumin yields 601 studies spaning health topics from multiple myeloma and colorectal cancer, to chemotherapies that synergizes with CU, to Alzheimer’s Disease, arthritis and more. Based on years of reading studies and personal accounts, I think it is safe to say that CU supplementation is safe and relatively inexpensive.
I have read about myeloma patients taking daily doses of CU from 400 milligrams to 8 grams (1000 milligrams = 1 gram). By almost any measure, CU is a safe, inexpensive wonder drug.
The only challenge is that CU is famously difficult to absorb in the body. In other words, a person has to mix curcumin with some sort of fat (coconut oil, chocolate, etc.) or take a brand of curcumin capsule that is already formulated to be more “bioavailable” in order to derive the full benefit of CU.
The study linked and exerpted below reviews different formulations of CU. The study itself lists the three most bioavailable formulation/brand of CU and I’ve added an excerpt from a further review from Consumerlab.com that lists four additional bioavailable brands of CU.
I consult the independent evaluation service Consumerlab.com frequently. For one low annual payment, I can read about and evaluate all of the nutritional supplement that I take.
- Myeloma Survivor
- Cancer Coach
- Director PeopleBeatingCancer
“CU is a bright yellow chemical produced by some plants. It is the principal curcuminoid of turmeric (Curcuma longa), a member of the ginger family, Zingiberaceae. It is sold as an herbal supplement, cosmetics ingredient, food flavoring, and food coloring.“
“Curcumin is a widely studied natural compound which has shown tremendous in vitro therapeutic potential. Despite that, the clinical efficacy of the native CU is weak due to its low bioavailability and high metabolism in the gastrointestinal tract. During the last decade, researchers have come up with different formulations with a focus on improving the bioavailability of curcumin. As a result, a significant number of bioavailable curcumin-based formulations were introduced with the varying range of enhanced bioavailability.
The purpose of this review is to collate the published clinical studies of CU products with improved bioavailability over conventional (unformulated) CU. Based on the literature search, 11 curcumin formulations with available human bioavailability and pharmacokinetics data were included in this review. Further, the data on clinical study design, analytical method, pharmacokinetic parameters and other relevant details of each formulation were extracted.
Based on a review of these studies, it is evident that better bioavailability of formulated curcumin products is mostly attributed to improved solubility, stability, and possibly low first-pass metabolism. The review hopes to provide a quick reference guide for anyone looking information on these bioavailable curcumin formulations.
Based on the published reports,
exhibited over 100-fold higher bioavailability relative to reference unformulated CU. Suggested mechanisms accounting for improved bioavailability of the formulations and details on the bioanalysis methods are also discussed.”
According to Consumerlab.com:
“Novasol has the highest bioavailability (185 x compared to unforumulated CU), followed by Curcuwin (136 x), Longvida (100 x), Meriva (48 x), BCM-95 (27 x), Curcumin C3 Complex + Bioperene (20 x), and then Theracumin (16 x).”