Chemotherapy: What to know (and the alternatives)

Integrative cancer treatments — using chemotherapy as part of a larger treatment regimen — is a combination of medical treatments and complementary therapies to cope with the symptoms and side effects. Dr. Jonathan Stegall, who heads The Center for Advanced Medicine in Atlanta, is among the health care professionals at the forefront of the movement.

5 Facts about chemotherapy

1. Some cancers respond to chemotherapy, while others do not.

2.  Chemotherapy can be part of a much larger treatment regimen consisting of the best aspects of both modern medicine and natural medicine.

3.  Patients who expected to have more side effects from chemotherapy indeed had more side effects.

4. Survival rates for chemotherapy based on an Australian study are often misquoted.

5. Chemotherapy used in the proper context can be a very valuable tool.

I took care of many cancer patients in the hospital during my medical training and was always struck by how worn down they became from full dose chemotherapy. The hair loss, vomiting, diarrhea, and dehydration were very common.

On lab testing, their immune systems frequently showed little to no white blood cell function, resulting in frequent infections. Their electrolytes were often out of balance. Their kidneys and liver — the two main organs responsible for detoxification — routinely showed decreased functioning.

In addition, they often suffered from depression and anxiety. Some even became suicidal. Some patients had wonderful and supportive families, while others never had any visitors. No matter what their unique situation was, I saw many people spend their last days in the hospital with a very poor quality of life.

Dr. Jonathan Stegall — founder of the Center for Advanced Medicine, one of Cancer Tutor's verified clinics — practices integrative oncology, which involves combining the best of modern medicine with natural therapies.

• Center for Advanced Medicine
• Dr. Stegall on Cancer Tutor

Frustrated and discouraged, I thought to myself, “There has to be a better way!” After much education, training, and clinical experience treating cancer patients, I feel strongly that there is a much better way to administer chemotherapy.

What would you say if I told you that we could take advantage of chemotherapy's documented cancer-killing effects, but do it in a way that reduces the collateral damage? What if we could turn an atom bomb into a heat-seeking missile?

If you are reading this and thinking, “I want nothing to do with chemotherapy, because it is poison,” I would ask that you start thinking about chemotherapy as a tool. Just as a hammer can be used for good (hammering nails to build a house) or bad (to hit someone over the head), chemotherapy can also be used for good or bad. A more dramatic example is a handgun. In the hands of a policeman, a gun can be used for good to protect us, whereas, in the hands of a criminal, that same gun can be used to commit murder. Chemotherapy used in the proper context can be a very valuable tool. In fact, I would argue that in many cases it is a necessary tool in order to get patients well.

We know that chemotherapy typically kills cancer cells by affecting the production of DNA within cancer cells, leading to the death of those cells. Chemotherapy also can do the same thing to healthy cells. So how do we administer chemotherapy in a way to preferentially target cancer cells? Research has shown us that cancer cells have more insulin receptors on their surface compared to normal cells, and we can take advantage of this phenomenon with an approach known as insulin potentiation therapy (IPT).

IPT is an off-label treatment which was first used by Dr. Donato Perez Garcia in Mexico in the 1940s and has been used since by a small group of forward-thinking physicians. IPT is an in-office treatment whereby insulin is given to lower the patient's blood sugar to the point where we feel that cancer cells are very eager for some sort of “food.” This point was termed the therapeutic moment by Dr. Garcia, and it is at this point when we strategically give several different chemotherapy agents.

The doses used are typically 10-15 percent of the high doses used in conventional oncology; we feel that less is needed due to it being better targeted to the cancer cells. Due to these lower doses, we can give more frequent treatments (typically twice per week) while greatly reducing the incidence of side effects such as hair loss, nausea, vomiting, and diarrhea.

Due to the excellent results I have seen with IPT, I became eager to see research comparing it to full-dose chemotherapy. Unfortunately, we do not yet have any large-scale scientific studies comparing the two methods.

However, my clinic is one of a handful of treatment centers in the United States doing a clinical study evaluating the five-year outcomes from an integrative treatment program using IPT and low dose chemotherapy along with other interventions such as high dose IV Vitamin C, IV Poly-MVA, chemosensitivity testing, and nutritional supplementation. Based on my clinical experience, I expect these results will be significant.

If you or a loved one is dealing with cancer, I would encourage you to strongly consider chemotherapy, keeping in mind that it is a powerful tool which can be used in both good and bad ways. And as always, I encourage patients to make chemotherapy part of a much larger treatment regimen consisting of the best aspects of both modern medicine and natural medicine. This integrative approach, I feel, gives us a nice balance between the two while honoring each patient's unique health concerns and treatment goals.

Chemotherapy: What to know

Every treatment has potential risks and benefits, whether a drug, supplement or procedure. Of the multitude of cancer treatments today, chemotherapy is the one that evokes the most fear in patients.

We have all known cancer patients who received chemotherapy and subsequently saw their quality of life diminish greatly. Weakness, fatigue, hair loss, nausea, vomiting, and diarrhea are just some of the side-effects we associate with chemotherapy. Many patients in my office tell me that they do not want chemotherapy because it is poison. Others tell me that it is toxic. Despite its known cancer-killing attributes, the perception is that the bad frequently outweighs the good.

A 2016 study polled cancer doctors to determine how they viewed chemotherapy side effects. Nerve pain, nausea, vomiting, and fatigue were considered the most troublesome side effects. Interestingly, the same oncologists found that hair loss was the most acceptable side effect.

Do patient attitudes about chemotherapy side effects influence their occurrence? A 2013 study of first-time chemotherapy patients looked at patient expectations for fatigue, depression, nausea, and loss of appetite prior to their first chemotherapy treatment. The occurrence and severity of side effects were measured, and the study found that there was a direct relationship between pre-treatment expectations and post-treatment reports of symptoms such as nausea, sadness, and loss of appetite.

In other words, those who expected to have more side effects from chemotherapy indeed had more side effects. This is fascinating from a mind-body medicine perspective and illustrates how our attitudes and beliefs can influence treatment outcomes.

For most cancer patients, the decision whether to receive chemotherapy or not is based on a thorough conversation with their doctor regarding their diagnosis and treatment goals. Some cancers respond to chemotherapy, while others do not. Some patients feel that the potential benefits of chemotherapy outweigh their risks, while others do not.

The good doctor gathers extensive data from testing, explains the results to the patient, and then presents treatment options. The excellent doctor listens closely to the patient to ascertain his or her treatment goals, as well as fears and concerns, and then recommends a personalized treatment plan which best meets that patient's needs.

Landmark study results

A 2004 study in the journal Clinical Oncology evaluated the contribution of chemotherapy to five-year survival rates among adult cancer patients. In other words, the goal of the study was to look at how significant chemotherapy's role was in successful treatment outcomes (defined by oncologists as five-year survival).

In order to arrive at a meaningful conclusion, data from many previous studies was pooled and analyzed. The 22 most common cancer types were included in the study.

The results were surprising. The overall contribution of chemotherapy to five-year survival in American adults was 2.1 percent. This means that approximately 98 percent of the credit for survival was attributed to all other treatments, such as surgery, radiation, nutrition, etc.

It is important to note that this study is often misquoted. You have probably heard this statistic quoted in a way which suggests that those receiving chemotherapy only have a 2.1 percent five-year survival rate.

“Frustrated and discouraged, I thought to myself, ‘There has to be a better way!' … What if we could turn an atom bomb into a heat-seeking missile?”

Dr. Jonathan Stegall

The Center for Advanced Medicine

In reality, the average five-year survival rate for cancer is 69 percent. This includes all stages of cancer and makes no distinction between who received which treatments. However, given the most commonly used treatments in oncology today, it is safe to assume that many of these surviving patients received chemotherapy.

At this point, it is important to discuss what five-year survival means. In the oncology world, five-year survival measures the percentage of patients who are still alive five years from the date of diagnosis. It does not mean that they are cancer-free, and it does not mean that they are completely healthy. Instead, it simply means that they have not died from cancer (or any other cause) in the five years since diagnosis.

Survival rates can be further broken down. For example, cancer-specific survival looks at the percentage of patients with a particular type of cancer, and can be further broken down to look at survival rates for each stage of cancer. Using the five-year survival statistic with respect to breast cancer, we see that:

• Stage 0 or Stage I, the five-year survival rate is nearly 100 percent.
• Stage II breast cancer, the five-year survival rate is 93 percent.
• Stage III breast cancer, the five-year survival rate is 72 percent.
• Stage IV breast cancer, the five-year survival rate is approximately 22 percent.

Thus, when we look at survival rates for cancer, it is important to be as specific as possible with regard to cancer type and cancer stage since some cancers have very poor survival rates while others have very good ones.

I always tell my patients that it is important to look at survival statistics on the population level in order to know what we are dealing with, but it is equally important to realize that those statistics do not necessarily apply to them. Many factors contribute to treatment outcomes, and many of those are directly in the patient's control.

Potential downsides to chemo

As we previously discussed, potential side effects of chemotherapy cannot be ignored. A typical patient receiving chemotherapy will have low energy, hair loss, decreased immune system function, low mood, and a generally lower quality of life.

We must also consider the resistant nature of cancer. We know that the long-term use of certain chemotherapy agents can cause cancer cells to become resistant to those agents over time. Cancer has a remarkable ability to escape and evade attacks, whether they be from chemotherapy or from our very own immune system. We must stay one step ahead, and carefully choosing treatments in a safe, personalized way is how we do it.

• Dr. Jonathan Stegall has studied at Clemson, Georgetown, Harvard, the Medical University of South Carolina, and Yale. To learn more about Dr. Stegall and The Center for Advanced Medicine, visit his website.