Subject: Esophageal Cancer
Hi David- My brother was recently diagnosed with stage IV Esophageal cancer, he also has cancer in his liver different from the esophagus. He has started chemo treatments at MD Anderson in Texas. He and his wife are looking at a more holistic approach to his treatment.
Can you shed some light on some of the options available to him. He has no real adverse effects form the cancer at this time. He eats well has lost no weight was running a 10 minute mile in Late December. No pain to speak of, all liver enzymes test look great this has just floored us and we are hoping for more information and something that will make the chemo work better and faster.
Thanks a very concerned and loving sister!
I am sorry to learn of your brother’s advanced esophageal cancer. I will be direct. If your brother’s EC has metastasized (spread), which it has, his odds of survival (5 year) is less than 5%. Several issues for you to consider.
1) Your brother is doing so well physically that I would confirm his diagnosis through a second opinion. MDAnderson is a top notch cancer center but I would confirm the diagnosis and stage just the same.
2) If your brother was older and experiencing the usual symptoms, I would raise the issue of palliative care. Palliative care is designed to provide symptom and pain management. Your brother has no symptoms so he doesn’t need palliative care.
3) But don’t let the fact that your brother feels fine lull you all into a sense of disbelief. If the diagnosis is accurate then you, your brother and his wife must throw the therapy book (figuratively speaking) at his cancer in order to slow his cancer down. I would consider conventional therapies combined with evidence-based integrative therapies (see below), complementary, nutritional and mind-body therapies.
Integrative therapies are important. For example, if your brother undergoes a toxic chemotherapy, say, 5-FU, he can supplement with antioxidant therapies that studies have show enhance the efficacy of 5FU while reducing the toxicity. I can provide the studies for you three to read and consider.
I am the first person to dissuade cancer patients from doing anything toxic. Unfortunately, your brother’s cancer and stage is so serious that he must employ every available therapy to slow his cancer.
Let me know if you have any questions.
Hang in there,
“Background: 5-fluorouracil (5-FU) is one of the most commonly used first-line anticancer drugs to treat gastric cancer in clinical practice. However, severe adverse events such as gastrointestinal toxicity and bone marrow suppression limit its clinical application. Combination chemotherapy to combine two or more anticancer drugs with different mechanistic action is an effective anticancer strategy against gastric cancer. Therefore, we studied the anticancer effect of the combination of 5-FU with curcumin against gastric cancer MKN45 and AGS cells (normal gastric mucosal GES-1 cells as control) and associated molecular mechanisms.
Methods: Cytotoxicity of 5-FU and curcumin alone or in combination was evaluated in MKN45, AGS and GES cells by MTT assay. The protein expressions of COX-2 and NF-κB were evaluated in MKN45 cells by Western blotting analysis. In addition, antitumor activity of 5-FU and curcumin alone or in combination was evaluated in nude mice bearing MKN45 tumor xenografts in vivo.
Results: The combination of 5-FU and curcumin (2:1, mol/mol) showed 2.2-, 3.5-fold and 2.3-, 3.9-fold enhanced cytotoxic effect compared to 5-FU or curcumin alone and generated synergistic effect at the concentration of 5-FU (>4.09 and >5.71 μmol/l) and curcumin (>2.05 and > 2.86 μmol/l) in MKN45 cells for 48 h and 72 h exposures, respectively. The combination of 5-FU and curcumin also potentiated cytotoxicity in AGS cells compared to 5-FU or curcumin alone but the effect was moderate. However, the cytotoxicity of 5-FU and curcumin alone or in combination was much less in GES-1 cells. Furthermore, the protein expressions of COX-2 and NF-κB in MKN45 cells were decreased by 44.79% and 37.67%, 47.17% and 48.21%, 60.21% and 62.44%, respectively, after treatment of curcumin (25 μmol/l) and 5-FU (50 μmol/l) alone or in combination for 48 h. Curcumin also enhanced the anticancer activity of 5-FU without increasing toxicity in nude mice bearing MKN45 tumor xenografts in vivo.
Conclusions: Curcumin enhances the anticancer effect of 5-FU against gastric cancer in vitro and in vivo. The possible molecular mechanism may be, at least in part, related to down-regulation of COX-2 and NF-κB pathways.”
“Many studies have shown that natural dietary agents, in combination with chemical agents, can improve the therapeutic response of cancers to chemotherapy and reduce the associated side-effects.
In the present study, we investigated the therapeutic potential and mechanisms of anticancer effects for the combination of 5-fluorouracil (5-FU) and resveratrol (Res).
In these studies, we employed the cancer cell lines TE-1 and A431 and an animal model of skin cancer. The presented results provide the first evidence that Res can enhance the anti-tumor potency of 5-FU by inducing S-phase arrest. The combination of Res and 5-FU demonstrates synergistic efficacy, causing tumor regression in a two-stage model of mouse skin carcinogenesis induced by DMBA and TPA.
There was clear evidence of Res augmenting the growth inhibitory effect of 5-FU on the TE-1 and A431 cancer cells in vitro. In the in vivo studies, the tumor regression rate in the combination group increased significantly after four weeks of treatment (P < 0.01).
The combination of 5-FU and Res significantly increased the percentage of apoptotic cells and the level of activated caspase-3, cleaved PARP and p53 proteins as well as increased the Bax/Bcl-2 ratio.
In conclusion, the 5-FU/Res combination enabled a more effective inhibition of cell growth and the induction of apoptosis in cancer cells than 5-FU alone. The results of this study suggest that chemotherapy using natural dietary agents with chemical agents represents a superior cancer treatment option.”