Pancreatic

Antihistamines are reported from case data analysis to slow down progression. A recent study of the national health database Tiawan shows remarkably increased response to oncology treatments, with similar results seen in other national scale analysis. Histamine levels are frequently reported to increase cancer progression rates, and low histamine diet might also be worth considering. Similarly from patient data, use of low dose aspirin during treatment, including resection, has shown very similar improved outcomes, and equally large suppression of metastatic spread. Also frequently reported in patient case data are the beneficial effects of higher vitamin D3 levels, deficiency is significantly associated with weaker prognosis, in other cancers relatively higher doses are reducing risk levels in some patients.

Well proven astragalus extract supplements are added to chemotherapy treatments in a recent trial reporting both overall risk reductions and lowering of more serious side effects. This is explained by immune system recovery and balance. Rapidly emerging in trials for similar reasons are beta glucan extracts from mushroom or yeast sources. Recent phase II trials combine innovative electrical ablation therapies with sustained use of an over the counter yeast glucan. This pilot study reports excellent patient risk reductions, extended survival and much improved immune system activity. Several trials are ongoing including with widely available supplements.

Moderate to high dose melatonin has shown some fascinating effects in treatment relapsed patients and continues to be researched. Melatonin is frequently reported to reduce side effects of oncology or other drugs and has no known side effects of its own even at 1g daily. Also in high doses, vitamin C in drop form has many years of research in integrative cancer therapy. Recently, phase II trials have shown a doubling of relative overall survival times in stage IV pancreatic cancer patients. Other trials with addition of anti-diabetic drug metformin have shown reduced progression rates during advanced stages. Berberine might be a natural anti-diabetic alternative, which also has positive metabolic health effects including reducing the activity of fatty acids, fat molecules often seen fueling tumor growth. Another supplement able to both lower progression including at advanced stages, as well as improve side effects, is citrus pectin. And, especially combined with alignates from seaweeds it has evidence of reducing excess heavy metal levels such as copper.

Well studied in anti-aging science is prebiotic class supplement, lactoferrin. Studies during chemotherapy that report significant reductions in the side effects of chemotherapy with lactoferrin. To fuel rapid growth cancers often increase iron metabolism seen in both circulating and locally stored ferritin at tumor sites. At the same time iron deficiency is common in pancreatic cancer, and linked to poor prognosis. Lactoferrin binds iron in the gut and increases iron balance, both reducing any deficiencies and re-regulating iron metabolism.

Like other solid tumors, the physical build up of internal pressure increases both its growth and metastatic activity. Crucially, this can be a physical barrier to oncology drugs. Oat and egg based functional foods are in several trials for other cancers including brain tumors, that may diffuse this pressure. Thus allowing oncology drugs to penetrate more fully, while reducing important side effects related to inflammation including at tumor sites and in the gut. Also apparently helping chemotherapy response, ketogenic diets even without any calorie restriction are recently reported to reduce disease progression (see Lifestyle)

Systemic inflammation is linked with increased risks for progression, especially in later stages. Both acute type inflammatory responses measured by C-reactive protein, and immune system related neutrophil-to-lymphocyte ratios. Maintaining relatively lower levels of both make a substantial difference. Commonly used astragalus root discussed above has evidence of improving immune system balance and NLR while curcumin and other other functional foods including garlic can help bring down “classic” inflammation and CRP. The immune system inflammatory respone to cancer often leads not only to vitamin D3 deficiency, but also lowers levels of selenium and zinc. Both are related to higher risk of progression. Developing trials in kidney cancer of high dose selenium are reporting improved outcomes for some patients, by increased oncology drug effects, which are of interest too

The so called Th1/Th2 immune system balance is strongly linked to the progression and to treatment resistance. It is often dysregulated in pancreatic cancer tumors. Molecular iodine solutions are emerging in this area in breast cancer management and seen boosting Th1 anti tumor activity and helping suppress over active Th2 used in resistance. The has improved results in surgery plus chemotherapy (see Supplement Library).

Statin users are frequently reported to have slower disease progression in many studies of patient data, and that includes examples in pancreatic cancer especially in early stages. Effects for some patients are quite large, and clearly a subgroup of patients is able to derive significant benefits from statin use, red yeast rice supplements are the natural alternative where a prescription is lacking

In a few cases immunotherapy may be used, in which case there are some new studies in other cancers showing the importance of naturally high sodium levels. Similar data exists for inosine Also emerging from anti aging science, keto type protein called alpha ketogluratare. (see Supplements Library). There are also reports of better responses for morning therapy.

In repurposed drug trials, the combination of etodolac and propranolol is showing promise and recent preliminary findings with SGLT2i, dapagliflozin, as well as hydroxychloroquine (see Repurposed Drugs)

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Antihistamines have large scale analysis of case data supporting their use in most cancers

  • Desloratadine or other “cationic” antihistmine use cuts progression risks more than half
  • Almost the same impacts reported for progression free periods
  • Response to treatment was 39% compared to 4% in the non user group

In Cox proportional hazard models, the use of cationic amphiphilic antihistamines [ includes loratadine, desloratadine and ebastine] was associated with an approximately 60% lower risk of all-cause mortality and disease progression. Cationic amphiphilic antihistamine users also had greater ORR than non-users (complete or partial response, 39% vs. 7%). Conclusions: The use of cationic amphiphilic antihistamines was associated with improved survival among patients with pancreatic cancer.

Aspirin has a majority of analysis in its favor including all-cause risks

  • Study on patient outcomes post-surgery and treatment
  • Low dose aspirin use is reported to reduce risks by 64%
  • Largely due to the same sized reduction in metastatic spread

Our propensity score matched study demonstrates that patients undergoing curative resection of pancreatic adenocarcinoma with continuous perioperative aspirin intake show significantly better survival endpoints than patients without aspirin intake. This was mainly due to a prolonged metastasis-free interval following surgery..Taken together with pre-existing evidence, there is sufficient indication of efficacy to justify testing this hypothesis in a prospective randomized study.

Astragalus actions include protecting and balancing immune responses often with clear effects reported

  • Addition of astragalus almost doubles response to chemotherapy
  • Relative overall risk reductions are reported to be around a third
  • Significantly improved immune system health and reduced treatment side effects

In this study, patients receiving the combined therapy of APS [astragalus] and GS [chemo] with pancreatic cancer achieved a significantly higher ORR and DCR (51.22% and 56.10%, respectively) compared with those receiving the monotherapy of GS alone (30.36%, 35.71%) after four cycles of chemotherapy . Besides, the median OS time of patients receiving the combined therapy of APS and GS was longer than those receiving the monotherapy of GS alone (P < 0.05; Figure 1). APS also effectively improved fatigue, thick greasy tongue coating, and weak pulse in patients receiving the combined therapy...

Beta glucans protect and balance immune system activity improving outcomes

  • Increased relative overall and progression free times by around 44%
  • Significantly improved immune system activity reported in patients due to glucans
  • Yeast or mushroom glucan over the counter supplements may have similar activity

Median disease-free interval of 18 months (range 6-48), with a median overall survival of 32.5 months(range 4-53). At 12-months post IRE, immunophenotyping was demonstrated a significant effect with improvement in the IRE-Beta-Glucan treated group. This also resulted in a significant decrease on naïve CD4 and CD8 T cells with increased CD4 and CD8 terminal effector cells in the IRE-Beta glucan treated group, which correlated with a significant improvement in disease free interval (DFI) and overall survival (OS)

Vitamin D3 and its immune system health actions are key, higher doses being trialed in oncology

  • Higher vitamin D3 levels show significant impact on outcomes in patient case data
  • Analysis of high vs low relative levels shows over 60% overall risk reducions
  • Effects are seen in stages I to III, less clear in advanced disease

In conclusion, our results indicate that high plasma 25(OH)D levels was significantly associated with favorable survival for pancreatic cancer patients…Vitamin D deficiency was associated with increased inflammatory biomarkers in all PDAC stages. The resected stage I and II patients with sufficient vitamin D levels had a higher OS than those with a vitamin D deficiency. However, there was no correlation between vitamin D levels and survival in advanced PDAC. Future studies need to investigate vitamin D supplementation effects on survival in PDAC.

Melatonin trials report slowing of progression, even in late stages, and improved side effects

  • Across several cancer types 2 of 3 late stage patients experienced notable response
  • Of these, one patient gained over 10 months of stable disease, even in palliative phase
  • High dose melatonin has no signifcant side effects, but does improve quality of life

A preliminary study with a very high dose of MLT [melatonin], consisting of 1000 mg/once day in the evening, was carried out in untreatable cancer patients, who failed to respond to the conventional anticancer therapies, and for whom the only available treatment was the palliative therapy. The treatment was well tolerated, and a disease control was achieved in 54% patients. These preliminary results would justify further clinical studies to generate a new interpretation of cancer control, consisting of the pharmacological reproduction of the same mechanisms responsible for the natural resis...

Citrus Pectin removes heavy metals such as copper and has its own anti-cancer mechanisms

  • Palliative stage patients including some digestive system cancers
  • Of those able to complete 2 cycles, a third saw over 4 months stable disease
  • 20% of this subgroup were shown as stable for more than 6 months

MCP [modified citrus pectin] seems to have positive impacts especially regarding clinical benefit and life quality for patients with far advanced solid tumors…In this context, it is remarkable, that in our study the treatment with MCP over a period of 8 weeks was associated with an overall clinical benefit response of 20,7% (6 patients out of 29) as well as an improvement of quality of life. However, the high drop out rate of 20 patients already 8 weeks after the start of treatment has to be considered, reflecting the poor clinical condition of most patients entering our trial and com...

Lactoferrin increases iron balance and reduces anemia rates, countering cancers use of iron

  • High circulating iron as ferritin has a 60% increased risk
  • An even higher, 70% increased risk for progression is found
  • Other studies high rates of deficiency in red blood cell levels

Elevated pretreatment SF was associated with worse OS and RFS/PFS/TTR in patients with HBP cancers. Subgroup analysis further revealed that high SF was significantly associated with shorter OS in patients with HBP cancers regardless of cancer type, race, SF cut-off value, TNM stage and NOS score. Consequently, pretreatment SF may be considered as an available prognostic biomarker for patients with HBP cancers. These results were proved to be credible and stable based on sensitivity analysis.

Akkermansia gut bacteria levels are becoming a key marker of improved response in oncology, especially immunotherapy

  • Two gut bacteria highlighted as particularly important in long term survivors
  • A doubling of progression free survival with Faecalibacterium prausnitzii and Akkermansia muciniphila 
  • Increasing levels though functional foods such as walnuts are indicated as an intervention

Significant enrichment of species relative abundance was observed in LTSs [long term survivors] for the Ruminococacceae family specifically Faecalibacterium prausnitzii species as well as Akkermansia muciniphila species.In this highly select cohort of patients cured from pancreatic adenocarcinoma, the finding of enriched Faecalibacterium prausnitzii and Akkermansia muciniphila within stool is intriguing. Previous studies in pancreas cancer have demonstrated that patients with long-term survival have a more robust immune response within their tumor specimens through unknown m...

Vitamin C as a high dose drop is rapidly emerging in oncology particularly for pancreatic cancer

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  • High dose intravenous vitamin C (IvC) extends overall survival
  • In advanced stage, a doubling of patient OS is reported
  • IVC is accelerating in acceptance in oncology, trials increasing

P-AscH− infusions of 75 g three times weekly in patients with metastatic pancreatic cancer prolongs overall and progression free survival without detriment to quality of life or added toxicity…This phase 2 randomized trial of P-AscH indicates a benefit in both OS as well as quality of life for patients with advanced PDAC. This benefit is tempered by the time investiture necessary for treatment. Treatment is three times weekly with a 2 h infusion….this randomized trial demonstrated adding P-AscH- to gemcitabine and nab-paclitaxel yielded increased OS and PFS w...

Berberine is the natural anti-diabetic alternative to prescription drugs for improving glucose and even lipid health

  • Lacking its own trials, berberine relies on research with metformin
  • Large scale analysis across multiple trials shows overall positive benefits
  • Up to 32% reduced relative risks are reported for early stage patients

Similarly, since the trials were heterogeneous with regards to the tumor stage of pancreatic cancer, it is still possible that patients with resectable or locally advanced pancreatic cancer can benefit from metformin. According to the present meta-analysis and systematic review, metformin has the potential to benefit pancreatic cancer patients, especially those patients with tumor at an early stage. Therefore, further clinical trials should focus on patients with resectable cancer.

Oat and egg based functional foods are entering early stage clinical trials for several cancers

  • Increased fluid pressure is reported as a prominient feature
  • Related studies demostrate how this increases metastatic spread
  • Reducing this internal pressure may help therapy results

Recent findings have revealed multiple mechanisms of stromal complicity in disease pathogenesis and resistance. In this review, we focus on altered physicomechanics as one mechanism of what we term as ‘stromal resistance’ in PDA. Extremely high interstitial fluid pressures and a dense extracellular matrix combine to limit the delivery and distribution of therapeutic agents. We discuss the genesis and consequences of altered fluid dynamics in PDA and strategies to restore them

Selenium is in phase I studies at high doses including kidney and ovarian cancer

  • Higher selenium levels during treatment halve the risks
  • Higher zinc levels are also seen to lower risk significantly
  • Copper, on the other hand, increased risk when elevated

This study revealed that decreases in Se and Zn concentrations during cancer treatment were associated with adverse outcomes in terms of cancer progression and mortality in patients with pancreatic cancer…Serum Cobalt concentrations were significantly higher in patients with chronic pancreatitis and pancreatic cancer compared to healthy controls, while serum Se concentrations were significantly lower. During treatment, serum concentrations of Cu, Se, and Zn significantly decreased in patients with pancreatic cancer.

Curcumin has evidence for reducing levels of systemic inflammation used by cancers

  • C-Reactive Protein and Neutrophil-to-Lymphocyte Ratio linked with outcomes
  • Lower levels of both CRP and NLR together triples overall survival
  • Each of CRP and NLR also separately effect prognosis

With our retrospective analyses, we show that elevated NLR, as a surrogate marker for subclinical inflammation and CRP elevation, correlate statistically significant with poor prognosis in PC independent of applied chemotherapy regiments….Patients undergoing post-first-line therapy had less elevated inflammation makers at the time point of pancreatic cancer diagnosis. Therefore, assessment of inflammation markers at diagnosis allowed to distinguish a group with a very bad prognosis using chemotherapy…With respect to the relationship between NLR and high CRP levels, our multivari...

Red yeast rice is an equivalent to lovastatin

  • Case data shows about half the progression risk in statin users
  • Confirmed by similar findings in other analysis of patient records
  • Often linked to “responders” who see lowered cholesterol levels

 

In this study, statins in combination with erlotinib and gemcitabine chemotherapy were associated with a good response in advanced pancreatic cancer for both short- and long-term chemotherapy. It is notable that concomitant use of statins showed a positive, long-term effect after >6 cycles of gemcitabine-erlotinib treatment. Considering that the median survival time of patients with advanced pancreatic cancer was approximately 6 months, the use of statins as chemoadjuvant treatment was meaningful in that it maintained tumor stabilization for the median survival time, assuming that the du...

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