When I see patients with cancer, my main goal is to see how I can support them in their choice of therapies – whether conventional or alternative. In either event, I try to strengthen their immune system function in order to maximise their ability to fight off the cancer.
How do I know if what I’m doing is working?
Well, with many of my patients, I rely at least in part on a type of measurement called ‘biomarkers’.
In general, biomarkers can give some information about how your body is functioning in the present… and how it will function in the future. It’s important to ‘look under the hood’, so to speak – because you could actually feel fine, but your biomarkers may tell another story. Even if you don’t know them by name, you’ve surely run into biomarkers many times before.
Blood pressure and pulse are biomarkers… as are your weight, height, and ability to read an eyechart… and those measured via blood tests, like fasting blood sugar, cholesterol, serum uric acid, and so on. There are two biomarkers you may not have heard of, though, that I’ve been using in my practice with cancer patients: vascular endothelial growth factor and galectin-3.
These biomarkers are actually involved in the genesis and growth of the cancer. Constructing a therapeutic approach that addresses them, can have a positive effect on the immune system and its battle with cancer growth. The science behind the process can get a little complicated, but stick with me – because if you or someone you love is struggling with any number of different types of cancers, you’ll want to know how targeting these biomarkers can improve your odds.
A matter of supply and demand
The first biomarker I mentioned, vascular endothelial growth factor (or VEGF, pronounced VEG-F), is a signal protein that stimulates the formation of new blood vessels (vasculogenesis) as well as their growth (angiogenesis).
There are several situations that might make it necessary for your cells to produce VEGF, including:
- To develop new blood vessels associated with the growth of the embryo in utero.
- When an injury presents the need for new blood vessels to grow.
- During exercise, which stimulates the growth of new blood vessels.
- When arteries are blocked, usually via atherosclerosis, angiogenesis occurs as part of the compensatinghealing process.
Obviously, the production (or, in medical terms, ‘expression’) of VEGF is necessary for many healing functions.
But if left unchecked, the formulation and growth of blood vessels can be a sign of disease as well.
You see, in order to support their growth, cancers – particularly solid tumours – need a lot of blood supply. In order to create that blood supply, cancer cells express high amounts of VEGF, creating angiogenesis.
So, if we can see how much VEGF is being produced (expressed), we can get a sense of how far along the cancer has gotten. In fact, multiple studies have recently validated the use of VEGF to track the progress of cancer therapy and to predict the growth and spread of tumour cells.
Among the cancers for which VEGF measurements can be useful are gastric (stomach), breast, prostate, angiosarcoma (blood vessels), and ovarian, among others.
In pharmaceutical medicine, of course, that means the race is on to develop a monoclonal antibody that will block VEGF and, presumably, block the growth of cancer by strangling its blood supply.
So far, this result has been elusive – but several chemotherapy drugs do currently target VEGF, thereby blocking angiogenesis and the means by which cancer cells grow and metastasise.
As you know, chemotherapy generally takes a ‘scorched earth’ approach – destroying everything in its wake. That means that it poisons the cancer cells AND the healthy cells, because it can’t tell the difference between the two.
But there’s something found in nature that can – and believe it or not, it comes from the bark of a tree.
This bark takes a bite out of cancer Magnolia bark – or, more specifically, a compound extracted from the bark of a magnolia tree, called honokiol (HNK) – is well known by practitioners of Chinese medicine for its variety of applications over the last several millennia, including for anxiety, digestive disturbances, and skin conditions.
Its role in cancer prevention and treatment, however, has only been investigated seriously over the past decade or two – but in that short time, it’s been extensively studied for its possible role in controlling the growth and metastasis of cancer cells.
In cases of osteosarcoma (bone cancer), this natural compound appears to directly block VEGF – and it seems to do so without poisoning your healthy cells and sickening YOU.
In fact, as shown in a 2012 study of its lethal effects on metastatic bone cancer cells, it directly attacks tumour cells!1
But that’s not all it can do.
In fact, multiple mechanisms have been suggested and studied, given the range of effects of this remarkable substance.
HNK is a small molecule, making it easy for your body to absorb and easily assimilated into cells. And, as it can cross the blood-brain barrier, it can be useful with intracranial (brain) cancers, which are notoriously difficult to treat.
A 2012 study demonstrated that HNK interfered with the signals maintaining the viability of leukemia cells, hastening their cell death.2In gastric cancer, HNK appears to prevent the spread of cancer cells by inhibiting angiogenesis.
Breast, prostate, lung, liver, colon, and other cancers are all also susceptible to HNK’s effects, demonstrating the same increased cell death and lack of growth.
A 2013 study showed the same effect on non-small cell lung cancer cells,3 and another in 2007 showed this cell death in prostate cancer cells, regardless of the hormone sensitivity of the cancer.4
Make your conventional therapies work better
Not only does HNK appear to interfere with the cancer life cycle (thereby triggering apoptosis of the cancer cell by a number of different mechanisms), but it works well in conjunction with other anticancer agents… and it even seems to reverse multi-drug resistance!
And these effects are present whether the tumour is solid (as with breast or prostate cancers) or blood-based (as with leukaemia).
That’s why we like to say that honokiol ‘plays well with others’. That is, HNK actually makes chemotherapy drugs work better. This has been shown in multiple studies – including treatment of breast, colon, and ovarian cancers, as well as leukaemia.
In the case of radiation, HNK has been shown to make colon cancer cells more sensitive to the effects of radiation (yet another ‘scorched earth’ approach to treating cancer), including those cancerous cells otherwise known to be resistant to radiation damage.
In addition to its toxic effects on cancer cells, HNK has been shown to have powerful antioxidant effects on normal cells – in one study, up to 1,000 times the antioxidant effects of vitamin E.5 This suggests a use for HNK in radiation therapy – both to enhance the effect of the therapy and to protect the surrounding cells from damage.
But, as I mentioned earlier, VEGF isn’t the only cancer-related biomarker that can be targeted… and magnolia bark isn’t the only natural compound that can help treat cancer by targeting a biomarker.
The ties that bind
The second biomarker I’d like to share with you is galectin-3, a type of protein called a ‘lectin’ that has the ability to bind to a certain kind of carbohydrate called starch beta-galactose.
The expression of this type of protein by cells contributes to inflammation, cell growth, the formation of scar tissue (aka fibrosis), and the ability to ‘stick’ to cells around it – all processes that are involved in the progression of cancer.
In short, galectin-3 is expressed by cancer cells to facilitate their growth and spreading (metastasis) – because in order for a cancer cell to metastasise, it first must clump together, become stickier, and then begin to spread.
Once galectin-3 is present in elevated amounts, it also contributes to angiogenesis, tumour cell survival, and the ability of some cancer cells to transform themselves into cells with different properties, making them harder to kill.
There’s even a suggestion that galectin-3 and other lectins help the tumour cells to avoid detection by the immune system! And, as biomarkers like these don’t always work completely on their own, galectin-3 actually has the ability to modify VEGF expression.
A wide range of cancers appear to use this method to do their damage – including prostate, ovarian, melanoma, thyroid, liver, colorectal, and others.
It seems to work something like this: A tumour is ready to grow, so it expresses galectin-3, which then turns on a number of other processes, including the expression of VEGF. VEGF promotes angiogenesis, opening up more ‘supply routes’ for the growing malignance.
Immune cells respond, but scar tissue blocks their access to the tumour. And the immune cells that do manage to get through can’t easily detect growing cancer cells they come into contact with because of their unique ability to ‘hide’.
But there is something that can put this game of cat and mouse to an end – and it’s not a drug.
In fact, like HNK, it comes from a tree!
The citrus secret to becoming cancer-free
I’m talking about modified citrus pectin, or MCP.
Cancers shown to be negatively affected by MCP treatment include colon, breast, prostate, melanoma (skin), multiple myeloma, and angiosarcoma, among others.
You may have heard of ‘pectin’ before – it comes from the starchy portion of the peel and pulp of citrus fruits.
Normal pectins are long-chained, making them less absorbable in the gut… and less able to dissolve in water. But treating (modifying) those pectins in a high-pH and high-temperature environment breaks them into shorter chains that are more absorbable.
Not only that, but their smaller size and dissolving abilities enable them to bind tightly to the galectin-3 – specifically to the carbohydrate (galactose) binding sites that I mentioned earlier.
If MCP can block the galectin-3 by doing that, the cancer cell can’t clump… it can’t adhere to surfaces… it can’t grow new supply routes… and so on.
The end result? Less growth and less (or no) spreading.
This anticancer effect has, in fact, been validated in both in vitro and in vivo studies, across many different cancer types.
And since metastatic cells produce galectin-3 as part of their malignancy, it’s been shown that the blocking effect of MCP reverses the ‘stickiness’ of metastatic cells to their new environment, preventing them from attaching to the target organs.
This has been demonstrated in vitro using melanoma, breast, and prostate cells, among others.
In one study of prostate cells, 11 anti-adhesion agents were studied, and MCP showed the greatest ability to prevent those cancer cells from sticking to bone marrow epithelium.6
Animal studies have confirmed this, as well.7
And even more exciting, we are beginning to see in vivo studies as well. In one 2005 study, MCP was shown to reduce the metastatic cell deposits from breast and prostate cancer to common metastatic sites of the lung and bones by OVER 90 per cent!8
Putting an end to the game of hide and seek
But that’s not all that MCP can do to fight cancer.
Other anticancer effects of MCP include inhibition of the direct growth of cancer cells at the primary site. In addition, by interfering with the regulation of the cancer cells’ life cycles, MCP appears to accelerate the process of apoptosis (programmed cell death).
And that can create increased cell death of cancer cells at the metastatic site.
In addition, MCP blocks the angiogenic (new blood cell growth) effects of galectin-3 (and of VEGF as well) – and, as I described earlier, angiogenesis is critical for cancer cells to grow.
Even more exciting is the apparent ability to augment the effect of chemotherapy drugs on cancer cells.
Remember: galectin-3 has the effect of enhancing the ‘shielding’ effect of cancer cells so that they are less recognised and susceptible to immune cells. But galectin-3 also helps them ‘hide’ from chemotherapy agents like cisplatin, doxorubicin, bortezomib, and etoposide.
The theory is that in blocking galectin-3, MCP can help make cancer cells more ‘visible’ – and therefore more vulnerable to the effects of chemo treatments.
This has actually been demonstrated on myeloma cells – which in one study became more sensitive to treatment with bortezomib9 – and on angiosarcoma cells, which showed a 10 times greater response to treatment with only doxorubicin.10
Make your cancer battle a bit more precise
When patients with cancer come into my office, we blood test them for VEGF and galectin-3, as well as other biomarkers. With the results, we are able to get a more complete picture of whether the tumour is growing, spreading, or more dormant.
We can then form a plan that’s a more individualised way of supporting the immune system and interfering with the cancer activity.
As I mentioned earlier, billions of pharmaceutical company dollars have gone into efforts to block VEGF and galectin-3, thereby slowing down or stopping angiogenesis and tumour growth.
But it turns out that NATURE has provided us with substances that are both plentiful AND effective.
Most people take HNK orally – and many supplements contain this compound. A typical dosage is 250mg, once or twice daily.
Just keep in mind that it’s not only fat-soluble but actually hydrophobic, so there needs to be some fat present in order for your body to properly absorb it.
To boot, both HNK and MCP have extraordinary safety profiles, with very few side effects. As a fibre product, for instance, MCP can loosen the stool.
Interestingly, not all preparations of MCP have the same effects – but we don’t yet know which modifications of the pectins provide the BEST effects.
At the Rothfeld Center, we give 15g of MCP daily, usually in divided doses of 5g, three times daily. If the levels of the VEGF and galectin-3 biomarkers are significantly elevated, we might go up to 10g, three times daily.
Generally, we give it as a powder dissolved in water or juice, but for those who prefer a ‘pill’, we can also put it
into 500mg capsules.
Wishing you the best of health,
Dr. Glenn S. Rothfeld
Nutrition & Healing
Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.