Head & Neck

Under ten percent of head and neck cancer patients have sufficient levels of vitamin D3 at diagnosis. Treatment responses and results are strongly linked to patients vitamin D3 levels. And based on compelling lab studies, most patients could benefit from supplements. Notably, HPV (common herpes viruses) positive tumors are more responsive to therapy, independent of vitamin D3, and have lower recurrence in the presence of the virus (the opposite to some other cancers). Many nutrients including D3 are constantly depleted by cancer activity including related inflammation as well as by many drugs, so supplements need to be able to constantly compensate this.

Use of statins during and after oncology therapies is gaining evidence in cancers including head and neck, both for benefits in treatment response and outcomes, as well as reduced risk of other events. Multiple studies based on patient data show significant benefit, and these are starting to be confirmed in clinical trials. Atorvastatin is the most well researched prescription drug. Red yeast rice is widely available and is the source of lovastatin, can can be an alternative. In other cancers, impacts of statins are clearest in patients that also see a major drop in LDL on their introduction.

About 35% of head and neck cancer patients are reported with a common dysregulated gene expression, so called PIKC3A . In this group, use of NSAIDs, most commonly low dose aspirin, results in substantial risk reductions. Both for progression and even for all cause risk. Most commonly this is low dose aspirin use. Similar findings have been confirmed recently for colorectal cancer patients with the same gene expression.

Higher levels of both selenium and zinc are seen in comparisons of patient data to drastically improve treatment outcomes. Correcting and sustaining levels of selenium in particular, with higher dose regimes, is now emerging as a new supporting treatment in areas such as kidney cancer management-

Equally remarkable impacts are linked with microbiome where certain families of gut bacteria strongly decrease risks for progression. These bacteria can in some instance be supplement but mainly are encouraged with functional foods and diet.

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 has evidence of improving immune system balance and NLR while curcumin and other other functional foods including garlic can help bring down CRP.

The so called Th1/Th2 immune system balance is strongly linked to the progression of head and neck cancers, including treatment resistance. Molecular Iodine solutions are emerging in this area in breast cancer management, and may support increased treatments responses in HNSCC in a similar way during chemo or immunotherapy ( see Supplement Library). For immunotherapy the presence of high sodium levels is now idenfied as a key marker for success in other cancers. And in other cancers, AM treatment programs are substanitally more effective that PM/evening sessions.

Certain nutrients from healthy diets have been reported to reduce progression risk by around a third. https://pmc.ncbi.nlm.nih.gov/articles/PMC4844799/, so called xanophylls, including lutein and zeaxanthin known for eye health as well as β-cryptoxanthin. Whilst at least the former are used extensively as supplements the study if focused on the benefits of healthy diet. And here, almost a report that higher omega3 and omega6 oils before therapy have significant benefit https://www.researchgate.net/publication/358657387

Subscribe to the site for Pathfinder ANALYSIS and helpful GUIDE. Build you personal plan with confidence.

Click the IMAGE to view the library entry

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

  • Clinical study reports 40% increased overall survival with higher levels for HPV negative tumors
  • In a small group of test subjects, 80% had meaningful increases of serum levels with D3 supplements
  • 15% of patients were HPV positive and had significantly longer survival for any vitamin D3 level

 

HNSCC patients with severe vitamin D deficiency showed significantly altered intra- and peritumoral immune cell infiltrate levels. After vitamin D substitution, the patients’ NK cells showed a significant rise in cytotoxic activity..Taken together, we could show that Vitamin D deficiency is highly prevalent in HNSCC patients and is a predictor of poor survival. Vitamin D substitution used as an adjuvant in immune therapies such as cetuximab and nivolumab treatment could support antitumorigenic immune responses, thus contributing to the improvement of the patients’ prognosis in the conte...

Red Yeast Rice or where possible a prescription statin have multiple beneficial actions including all-cause risks

  • A 30% improved relative overall survival rate with post diagnostic statin
  • National scale patient data analysis has reported a 20% effect
  • Given during radiotherapy, lovastatin has shown more than 30% benefit

Compared to non-users, increased post-diagnosis cumulative use of statins (per one-year of use) conferred a significant improved survival with adjusted hazard ratio (HR) of 0.70. When analysis was stratified by status of statin use prior to HNSCC diagnosis, the HRs were 0.31 and 0.81 for post-diagnosis users who also used it before HNSCC diagnosis and those who only used it after the diagnosis, respectively.

Aspirin has a majority of analysis in its favor including all-cause mortality and clinical studies are increasing

  • Tumor mutations of PIKC3A gene expression strongly linked to NSAID benefits
  • About 55% are users of low dose aspirin, and NSAIDs show almost 3X improved overall survival
  • Around a third of head and neck cancer patients have upregulated PIKC3A activity

We conclude that regular NSAID use likely confers a statistically and clinically significant advantage in DSS as well as OS in patients with PIK3CA-altered HNSCC, irrespective of HPV status, through direct interaction between the PI3K and COX pathways. The magnitude of this apparent advantage, especially given the marked morbidity and mortality of this disease, warrants further study in a prospective randomized clinical trial.

 

ZINC along with selenium-zinc ratio is implicated in prognosis of several cancer types

  • In Laryngeal patients higher vs lower serum zinc at diagnosis strongly linked to progression
  • Results show 2.3X higher relative overall survival rate for high vs low level
  • At least one earlier trial has reported benefits of active supplementation

A total of 86% of all laryngeal cancer patients have at least one of those genotypes, suggesting survival is dependent on serum zinc level with a HR of 2.55; 40% have both, with a HR of 3.13. Zinc supplementation in those patients might have positive effect on survival. A total of 13% of patients have neither the SOD2 TC/TT nor CAT CC variant and in that particular subgroup zinc influence on survival seems to be the opposite, suggesting that those patients should be excluded from zinc supplementation.

Selenium is developing in kidney and ovarian cancer, high doses pulsed with oncology drugs

  • Study of effects on serum selenium level at diagnosis
  • Tripled survival rates for higher vs lower levels
  • Pilot trials in kidney cancer at high doses are ongoing

 

The effect appeared to be continuous; that is, the risk of death declined continuously with increasing circulating levels of selenium and there was no apparent threshold value. Individuals in the lowest quartile of selenium had a three-fold increased risk of death during five years of follow-up. We observed a stronger prognostic role of low selenium status on mortality among those with advanced stage disease (stage III/IV). Together with our earlier observations, these findings collectively suggest that low selenium levels are both a risk factor for laryngeal cancer and a prognostic factor<...

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

  • Measure increases in fluid pressure in tumors up to 33mg Hg in H&N cancer
  • Comparable to levels in other cancers where effects on survival are strongly negative
  • Gut produced anti-inflammatory compounds (ASF) reduce this and result in improved therapy outcomes

Furthermore, the IFP increased with tumor size. The highest IFP was 33 mm Hg in a 24-ml tumor. In one tumor, the IFP was found to be negative (-2.6 mm Hg), which is comparable to that in human skin or subcutaneous tissue. The histopathology of this tumor was benign. If this pressure difference between malignant and benign lesions can be confirmed in a large number of tumors, then the IFP could be used to aid tumor detection during needle biopsy. The value of IFP as a predictor of response to radiotherapy, photodynamic therapy, hyperthermia, and chemotherapy should be assessed prospectively....

Walnuts and urolithin-a can help the crucial need for healthy diverse microbiota

  • Anti-inflammatory gut microbiota strongly affect oncology outcomes
  • Ruminococcaceae and other bacteria improve relative survival around 3X
  • For immune response, akkermansia has remarkable evidence in immunotherapy

 

In conclusion, we demonstrated that severe mucositis is associated with worse OS outcomes in patients with locally advanced HNSCC treated with CRT. Shotgun metagenomic sequencing of fecal samples identified microbial compositions associated with an increased incidence of severe mucositis, including higher relative abundances of R. gnavus and E. clostridioformis. Gut microbiome profiling could thus serve as an additional diagnostic tool to assess the risk of severe CRT-emergent mucositis.

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

  • Copper levels increase with head and neck cancer progression
  • Elevation of around a fifth in early stages increases to nearly 50%
  • Zinc levels decrease with progression, both linked to higher risk

Also when compared with controls, the levels of zinc decreased, while that of copper and copper/zinc ratio increased in people affected with H&N cancer and with the stage of the tumor. The results of the study suggest that levels of serum zinc were significantly lower and that of copper higher in H&N cancer patients than that in controls and also that it was dependent on the tumor stage. When analyzed cumulatively the results hint that zinc and copper, due to their role in free radical generation and prevention have an important role in cancer progression and possible prevention by...

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

  • Stored iron measured as ferritin levels are reported with metastatic spread
  • Low levels here reported as 2.8X lower risk of metastatic progression
  • Stored iron as ferritin has long been seen to increased with disease progression

The present study reported that the expression levels of ferritin were significantly higher in the HNSCC with metastasis group compared with the HNSCC without metastasis group. This is the first time, to the best of our knowledge, that this phenomenon has been described. A study indicated that ferritin may regulate vascular remodeling and angiogenesis. It was also demonstrated that ferritin may block the antiangiogenic effects of cleaved high-molecular-weight kininogen (HKa) through specific binding to the antiangiogenic domain of HKa

Berberine evidence in metabolic health may help counter cancers use of lipids and sugars to grow

  • High risk at intermediate/advanced stages vs markers of insulin resistance
  • Those with elevated insulin resistance reported with 2.7X higher progression risk
  • Some positive indications with use of metformin may align with this

HOMA-IR is independently associated with disease-free survival in patients with HNSCC. We found an optimal HOMA-IR cutoff value for disease-free survival in patients with intermediate-advanced HNSCC…Kaplan-Meier curves showed lower disease-free survival rates in patients with high HOMA-IR than in patients with low levels. In patients with intermediate-advanced stage tumors, multivariate analysis revealed that those with an HOMA-IR >2.974 presented a 2.7 times higher risk of poor outcome

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

  • Maintaining relatively low inflammation levels shown to improve outcomes
  • During oncology treatment for advanced stage disease, reductions of 80% reported
  • Aligns with large scale meta-analysis reporting 20-40% lowered risks

On-treatment CRP below 2 mg/dl, 4x the upper limit of normal (ULN), was associated with increased overall survival (OS), while on-treatment CRP below 3 mg/dl (6x ULN) was correlated with a higher disease control rate (DCR) and increased progression-free survival (PFS). CRP flare-responders and CRP responders showed a higher DCR and longer PFS than CRP non-responders. An NLR above 6 was a negative prognosticator for progression. In multivariable analysis, on-treatment CRP prevailed as the only significant prognosticator for OS

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

  • Large international analysis of case data and NLR
  • Lower neutrophil-to-lymphocyte ratios reduce risk levels 30%
  • All cause and progression risks are reduced about 40%

 

In summary, our results suggest that the elevated NLR is significantly associated with adverse OS, DFS, PFS, and CSS in HNSCC, which can serve as a cost-effective prognostic biomarker to help stratify patients and individualize the treatments. Notably, tumor site is demonstrated to be a major cause leading to the obvious heterogeneity among the included studies. However, our results failed to identify PLR as a predictive factor on either OS or DFS in HNSCC. In the future, multicenter prospective and randomized clinical trials are warranted to confirm such findings and promote the utilizatio...

Support us and get our essential pathfinder GUIDE. Impacts Analysis, Usage and doses, EXAMPLE plan and supporting comments

Help grow the community

Join the Pubmedders subscriber base

Get our monthly email newletter – designed so you can give us your opinions, thoughts and feedback…

ALL contributions are invested into growing the site to help others.