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Naturopathic Medicine Should be a First Resort, Not a Last Resort July 14, 2016

Posted by Dreamhealer in best vancouver naturopath, Cancer, cancer therapy, Cancer Treatment, Healing, integrative cancer care, Naturopathic Doctor, Naturopathic Medicine.
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Written By: Dr. Adam McLeod, ND, BSc (Hons)

With any treatment plan the goal is to always use the least invasive therapy first before considering more aggressive invasive therapy. This makes it more likely that the health concern can be effectively treated without harming the patient. If someone has a mild infection that can be easily treated with a well tolerated low dose oral antibiotic then it makes sense to use this prior to trying high dose intravenous antibiotics that are more likely to cause complications. This rationale is common sense.

When faced with a diagnosis of cancer, patients are often overwhelmed with information and this can scare them into immediately resorting to the most aggressive treatment plan possible and in the process natural therapies are dismissed out of fear. In many cases, only after all conventional options have been exhausted do they seek integrative care. This is not the ideal time to integrate natural therapies into the plan as the bodies immune system is often severely weakened at this point in time. Naturopathic medicine should be integrated into the plan from the first day of diagnosis.

I am not in any way suggesting that patients should be avoiding conventional care. The evidence is clear, patients do better when they have an integrative health care team. This means that conventional and natural therapies are used together in a synergistic manner. After consulting with their oncologist, some patients are left with the impression that there is no evidence to support any therapy beyond what is being recommended. This could not be further from the truth. These therapies have hundreds of peer reviewed studies and depending on where you are in the world they can be the standard of care. In many major cancer centres in the USA, naturopathic doctors are now working in hospitals along side medical oncologists and patients are doing better as a result.

Naturopathic medicine can be very effective at supporting the immune system and reducing side effects during conventional cancer therapies. You can do all the chemotherapy in the world but if you do not have a functioning immune system to clean up the metabolic mess then it will not be a successful plan. This is where naturopathic medicine excels and it should be used from day one. It is not unusual for me to have patients at my office using the strongest and most toxic chemotherapy that medicine has to offer, and they breeze through it with minimal side effects.

It is critical to recognize that you must have professional guidance when developing an integrative treatment plan. Do not take advice from friends or the internet and start taking a supplement because you heard it was good for cancer. Not all cancers are the same and there are legitimate interactions that you must be aware of. Only a naturopathic doctor who works with oncology will be able to help you develop a targeted and effective treatment plan that is indicated for your unique health circumstances. Working with a naturopathic doctor also makes it possible to have true integrative care where multiple health care practitioners are working collaboratively on your case.

You do not have to take these supplements in secret. If you desire an integrative treatment plan then your naturopathic doctor should be making an effort to reach out to your oncologist to inform them about what you are taking. When oncologists are provided with information about what you are taking and why, they are often happy to work collaboratively. Both naturopathic medicine and conventional medicine have a lot that they can offer patients. The ideal treatment plan does not have to be one extreme where the other healthcare practitioners are completely disregarded. The most effective plan is a collaborative integrative plan that is developed based on the best available scientific evidence. Integrating naturopathic medicine with conventional medicine should be every patients first resort, not their last.

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology. http://www.yaletownnaturopathic.com

Breakthrough in Early Cancer Detection July 11, 2016

Posted by Dreamhealer in best vancouver naturopath, Cancer, cancer prevention, cancer therapy, Cancer Treatment, Healing, immune system, immunity, integrative cancer care.
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There is no question that the future of oncology will be focused around early detection of cancer cells. If we can detect these cells at an extremely early stage then it will be possible to cure the cancer before it manifests as a clinical disease. At this point in time there is no single test that is guaranteed to detect cancer at these early stages but there are several tests that are showing great promise.

One such test is known as the Oncoblot test which has been demonstrated as a reliable detector of early stage cancer in several studies1,2. This test analyzes the blood for the presence of ENOX2 which is a protein often released into the blood stream via cancerous cells. These proteins are detectable before any scan would be able to identify an abnormal mass. A mass of several millions of cancer cells would be far too small for any scan to detect but these cells would be releasing significant levels of this protein which this test could potentially identify.

Not only does this test identify the presence of cancer in these early stages, it can often identify the tissue of origin based off of variations in the protein. In other words, the test also identifies the most likely area where these abnormal cells are growing. It is clear that in the near future oncology will rely heavily on these types of tests to proactively treat cancer.

It is important to point out that no test is 100% and tests such as the Oncoblot are not intended to be used in patients as a replacement for conventional screening. It should be used together with conventional screening. This test is often used several months post surgery to assess for the presence of residual cancer cells. For example, following the removal of a cancer and when given the all clear diagnosis, patients are often left with the constant fear of recurrence. Conventional screening will only be able to detect a mass when it has grown to a clinically significant size. This test can help to detect the presence of cancerous cells far earlier and can help to justify a more aggressive treatment plan. Another test which can be helpful in these circumstances is the circulating tumour cells test, which directly detects cancerous cells in the blood stream following a surgery3.

In patients with a family history of cancer, these tests provide an additional way to test for the early development of cancer. This can potentially identify the cancer far sooner than any CT scan or MRI. The controversy about this test is not about the reliability, it is about what to do with this information. The vast majority of clinical trials look at how chemotherapy and radiation impact masses that are detectable on scans. These protocols are generally not designed to work with cancer that is only detectable in the blood via these markers. As a consequence it is difficult to assess the effectiveness of a conventional therapy if we cannot “see” what we are fighting. This is the reason why these tests are not covered by MSP.

There is a growing interest in the mainstream oncology community to use these tests and proactively treat cancer before it has the opportunity to progress. Once the cancer is identified we can also support the immune system using natural tools so that your body is more likely to identify and engage these cells. A truly integrative plan can help to get all the necessary information and develop the most effective treatment plan possible.

These tests are regularly run at Yaletown Naturopathic Clinic in Vancouver, BC and they can provide patients with the critical information necessary to make informed decisions about their integrative cancer plan.

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology. http://www.yaletownnaturopathic.com

References:

  1. Morré, D. James, et al. “ENOX2-based early detection (ONCOblot) of asbestos-induced malignant mesothelioma 4–10 years in advance of clinical symptoms.” Clinical Proteomics 13.1 (2016): 1.
  2. Morré, D. James, and David J. Taggart. “ONCOblot consistently detects State 0 and Stage 1 cancers and correctly identifies the tissue of origin.” ONCOblot Reports 1.4 (2015): 1-2.
  3. Zhang, Liling, et al. “Meta-analysis of the prognostic value of circulating tumor cells in breast cancer.” Clinical Cancer Research18.20 (2012): 5701-5710.

Weight Loss and Cancer April 28, 2016

Posted by Dreamhealer in Cancer, cancer therapy, Cancer Treatment, Healing, immunity, integrative cancer care, Naturopathic Doctor, Naturopathic Medicine, Naturopathy, nutrition.
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Written By: Dr. Adam McLeod, ND, BSc (Hons)

Everyone has seen a cancer patient who has lost a significant amount of weight as the disease progressed. It is a scary experience to see someone that you love waste away as the cancer deprives their body of the nutrients that they so desperately need. In the chaos of going from one appointment to the next, patients often do not realize how malnourished they have become.

The significant wasting that late stage cancer patients experience is known as cachexia. To understand why this happens it is helpful to look at the molecular pathways relevant to cachexia. The exact mechanism is not well defined but inflammatory cytokines are thought to play a major role. Cancer is a condition that creates significant systemic inflammation and this dramatically increases the concentration of inflammatory cytokines through out the body. The most prominent inflammatory cytokines during cachexia are often TNF-a and IL6 5.

The good news is that there are a number of natural tools which can help to significantly reduce these inflammatory cytokines. Of course there are cases where the disease has progressed to the point where it is not possible to reverse the effects of cachexia. However, in my clinical practice I have seen many patients reverse the effects of cachexia rather quickly when the correct natural supports are used. When we take the time to look at how these natural supports work it is immediately obvious why they can be so effective.

Omega-3’s are potent natural anti-inflammatories and specifically they reduce TNF-a and IL6 levels in the body1,2,3. In order to have the desired therapeutic effect from supplementation with omega-3’s it is critical that the proper dose is used. Many supplements (especially pill forms) containing omega-3’s do not have the appropriate dose of eicosapentaenoic acid(EPA) and this will not have any impact on an extreme case such as cachexia. When the appropriate dosing is used sometimes patients can see significant improvements in cachexia from supplementing with omega-3’s 4.

Cancer loves L-glutamine and it uses it in high amounts to support its metabolic needs. Some patients upon hearing this falsely assume that removing glutamine from the diet would then starve cancer cells. This is the wrong approach to take. Cancer cells will get glutamine whether you have it in your diet or not. If it is not in your diet then the cancer cells will cause the muscles to break down so that the glutamine can be extracted from the muscles. This will rapidly worsen the cachexia. The simplistic view that if cancer uses a substance then it should be avoided is not always correct in these complex clinical cases. When patients are supported with adequate amounts of glutamine this can help to slow down muscle breakdown and give healthy cells the glutamine that they also need to function6. The glutamine is also necessary for your immune system to function properly and this need far outweighs any concerns of “feeding” cancer cells glutamine in cases of cachexia.

In my experience the combination of L-glutamine and omega-3’s can help to heal the gut and this allows cancer patients to absorb nutrients more effectively from their food. A major challenge for advanced cancer patients is that even if they eat enough food, they struggle to adequately absorb nutrients from their food. By supporting gut health with adequate amounts of these simple remedies, this can help to enhance the absorption of nutrients at a time when patients are extremely malnourished.

There are many other natural therapies which can also be applied in cachexia to help improve the patients quality of life. For example, cannabinoids can be used to help stimulate appetite while reducing the sensation of nausea that many of these patients have. In other cases, the use of a Myers IV is indicated to bypass any concerns with absorption and get nutrients directly into the blood. Patients generally feel better when the inflammation is reduced following the application of these various naturopathic supports. It is critical that patients have professional guidance from a qualified naturopathic physician when utilizing these supports. Cachexia is a unique metabolic circumstance that requires the appropriate doses if you expect to see any benefit.

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology. http://www.yaletownnaturopathic.com

References:

1) Kang, Jing X., and Karsten H. Weylandt. “Modulation of inflammatory cytokines by omega-3 fatty acids.” Lipids in Health and Disease. Springer Netherlands, 2008. 133-143.

2) De Caterina, Raffaele, et al. “The omega-3 fatty acid docosahexaenoate reduces cytokine-induced expression of proatherogenic and proinflammatory proteins in human endothelial cells.” Arteriosclerosis, Thrombosis, and Vascular Biology 14.11 (1994): 1829-1836.

3) Nelson, Tracy L., and Matthew S. Hickey. “Acute changes in dietary omega-3 fatty acid intake lowers soluble interleukin-6 receptor in healthy adult normal weight and overweight males.” Cytokine 26.5 (2004): 195-201.

4) Radbruch, L., F. Elsner, and P. Trottenberg. “Clinical practice guidelines on cancer cachexia in advanced cancer patients. European Palliative Care Research Collaborative.” (2011).

5) Yeh, Shing-Shing, Kimathi Blackwood, and Michael W. Schuster. “The cytokine basis of cachexia and its treatment: are they ready for prime time?.”Journal of the American Medical Directors Association 9.4 (2008): 219-236.

6) May, Patricia Eubanks, et al. “Reversal of cancer-related wasting using oral supplementation with a combination of β-hydroxy-β-methylbutyrate, arginine, and glutamine.” The American journal of surgery 183.4 (2002): 471-479.

How Can Integrative Oncology Prevent Cancer? April 14, 2016

Posted by Dreamhealer in best vancouver naturopath, Cancer, cancer therapy, Cancer Treatment, Healing.
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Written By: Dr. Adam McLeod, ND, BSc (Hons)

It seems that every week there is another headline talking about the importance of preventative medicine. These articles often focus on how much money governments could save if people were adequately screened to treat disease before it manifests into a complex clinical pathology. Clearly improved screening is important in the context of preventative medicine but this approach only allows us to detect disease at an earlier stage. What is frequently neglected is the fact that much can be done to modify your risks so that the disease will not develop in the first place. This is particularly relevant in the context of cancer.

Every day I see patients who were treated by the cancer agency before being declared cancer free. Upon being declared cancer free they are quickly discharged from the cancer agency and they are given no tools or information about how to prevent the recurrence of cancer. In fact, when patients inquire about what they can do to prevent future cancers they are directly told “nothing”. This could not be further from the truth and [the scientific literature does not support] this bizarre statement. Any doctor who claims to be practicing evidence based medicine must stop telling patients that there is nothing that they can do because this is not what the scientific literature says on the subject. There are many things that can be done to prevent the recurrence of cancer and often the proper application of only a few simple natural therapies can substantially reduce the risk of recurrence.

In this article I will break down a few simple lifestyle modifications and natural therapies which when used appropriately can help to prevent the recurrence of cancer. There are of course additional strategies that can be used to reduce the risk of recurrence and this article only discusses a couple of approaches. You must have professional guidance when implementing these therapies as they must be used in the proper clinical context. Not all cancers are the same and completely different strategies are used with different forms of cancer.

Reducing your intake of simple sugars

Study after study has demonstrated a direct connection between sugar intake and cancer risk14,15,16,17,18. Cancer cells often have significantly more insulin receptors than normal cells. Therefore they respond rapidly to insulin and they will always be more effective at grabbing sugar from the blood stream and utilizing it as an energy source.

Patients often get confused about what this information means and how it can be integrated appropriately into their diet. There is a big difference in the metabolism of a food rich in simple sugars compared to a food that contains complex carbohydrates. When you eat a food rich in simple sugars such as candy, the body rapidly absorbs the sugar. This causes a rapid and significant elevation of the sugar concentration in your blood. In response to this sugar spike, the pancreas secretes insulin, which circulates through the entire body in an effort to bring the sugar levels back to normal.

Insulin interacts with the receptors on the surface of both normal and cancerous cells. Upon interacting with the cells, it triggers them to pull sugar in from the blood until the blood sugar level drops back to a normal level. Cancer cells have more insulin receptors, so they will always take advantage of this insulin spike more effectively than normal cells. It is this spike in insulin and insulin-like growth factors that stimulate the growth of cancerous cells15. In other words, it is not the sugar content that is stimulating growth; it is the response to sudden increases in sugar levels.

Complex carbohydrates are metabolized very differently in the body. They do not cause a sudden spike in blood sugar levels. The sugar in complex carbohydrates is slowly released as the food passes through the gastrointestinal tract. As a result, it is not necessary for the pancreas to secrete as much insulin because there is no spike in blood sugar that needs to be controlled. Often by making just a few simple dietary changes it is possible to dramatically reduce these sugar spikes and eliminate hidden sources of these simple sugars.

The correlation between high glycemic diets and cancer risk is well established. It is essential that patients looking to prevent recurrence of cancer adhere to a low glycemic diet. In one study researchers looked for a connection between fasting blood glucose levels and risk of cancer recurrence. There was a strong correlation between high fasting blood glucose levels and cancer recurrence20. In other words, the women who consistently had high levels of sugar in their blood had a higher risk of developing cancer. This is not surprising given what we know about the relationship between sugar and cancer.

Supporting the Immune System

After removing cancer it is critical that your immune system remains strong to patrol the body and attack any residual cells prior to them manifesting into a clinical disease. There are many naturopathic therapies which can be used to effectively support the immune system. The first year following the removal of cancer is the most important time to stimulate the immune system.

It is absolutely essential that you have professional guidance when developing a treatment plan to support the immune system. Every cancer is different and in some cancers this is completely contraindicated. You do not have to be on many different supplements to stimulate the immune system. In fact, less is more when it comes to natural immune supports.

I always recommend that patients keep their treatment plan dynamic and simple when trying to stimulate the immune system. The reason I say this is due to the biochemistry behind these natural immune supports. Essentially we are throwing a molecule at the immune system which it does not recognize and as a result the immune system gets excited. In the process of getting excited in response to these new supplements, it also gets excited against any cancer cells that remain. The problem is that if you keep using the same supplement repeatedly for a long period of time (ie. years) then your immune system simply stops reacting to it. If you throw everything at your immune system right away then your immune system will eventually stop reacting to everything.

Natural therapies such as astragalus, coriolus versicolor and mistletoe have a long history of safe and effective use for immune stimulation. They work very well to stimulate the immune system and when used appropriately it can give your body the tools that it needs to fight of any residual remains of the disease.

Exercise and Cancer

Everyone has heard that exercise is good for your well-being. Exercise has been shown to elevate your mood and increase energy levels. Patients who regularly exercise are statistically less likely to develop a number of serious health conditions. The effectiveness of exercise is not questioned in the medical community; yet when it comes to cancer care, patients often forget about the benefits of exercise. Instead, they focus their attention on more exotic treatment plans. Exercise is an important part of any integrative cancer program.

There are several reasons why exercise has such a positive impact on cancer patients3. The immune system becomes more active during exercise as the monocytes increase the concentration of specific receptors on their surface1. Exercise also significantly helps patients with their sleep and it is well known that the majority of healing takes place during sleep. When you get better quality sleep, your cells will be less stressed and this will significantly boost the strength of your immune system.

Not only is exercise important during cancer therapies, it is also effective at preventing cancer recurrence7. Although some researchers dispute the significance of recurrence prevention, no one disputes that regular exercise decreases overall mortality in cancer survivors5,6. Women with estrogen positive breast cancer after a successful surgery will be put on tamoxifen for a minimum of five years to reduce the risk of recurrence by only a few percentage points in some cases8. In one large study of women with a history of breast cancer, it showed that women who walked three to five hours per week were 43% less likely to develop recurrent breast cancer and 50% less likely to die from breast cancer. This exercise group was compared to women who engaged in less than one hour of physical activity per week9. This study clearly demonstrates the importance of exercise in the context of cancer prevention. I find it amazing that some patients will readily comply with taking a drug for five to ten years, yet are resistant to regular exercise.

The exercise program does not need to be an extreme and rigorous routine, nor does it have to be a specific activity to prevent recurrence. All that matters is that your cardiovascular system gets a good workout from regular aerobic activity. Even a moderate cardio workout for less than 30 minutes, five days per week, can be very helpful. Make the time for this activity because it can make a significant difference in your response to treatment.

At every phase in cancer treatment, regular exercise is a powerful adjunctive therapy. Regular exercise helps to prevent the development of cancer and it also helps patients to get through the aggressive cancer therapies necessary to kill cancer. More cancer patients need to be aware of the simple fact that regular exercise makes a significant difference when fighting cancer. This is a simple yet effective adjunctive therapy that should be actively encouraged in every patient capable of regular exercise.

Meditation

You can help your body fight cancer by reducing stress and focusing your intentions on healing. One of the most comprehensive intervention studies in cancer research evaluated the effects of stress management techniques, such as relaxation on cancer recurrence following removal of malignant melanoma11. Not only did the relaxed group experience reduced psychological distress, they also had more active immune systems than the control group not practicing relaxation. A six-year follow up of these patients showed a trend toward greater recurrence and higher mortality rates in the control group, compared to the relaxed group. The bottom line is that patients who focus on reducing stress and focus their minds on healing not only have a better prognosis, they also have lower rates of developing cancer in the first place10. Given what we know about the connection between immune function and stress, this conclusion is not surprising.

If there was a drug which had a similar effect on reducing cancer recurrence, you can bet that every patient who had a melanoma surgically removed would be on that medication. The great thing about this is that you don’t even need a pill, you can make a measurable difference by reducing stress and focusing your intentions. When fighting cancer it is essential that the patient use every tool at their disposal to increase the chances of a successful recovery. The immune system must be strong to fight off any serious disease. Our minds can dramatically influence how our cells respond to stress and this is intimately connected to the function of the immune system13. We all need to take control of our health and use this mind-body connection to our advantage. By reducing stress and focusing our minds on healing we will live longer and happier lives12. This is a powerful tool that we can all use to our advantage.

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology. http://www.yaletownnaturopathic.com

References:

1) Peters, C., et al. “Exercise, cancer and the immune response of monocytes.” Anticancer research 15.1 (1994): 175-179.

2) Mock, Victoria, et al. “Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer.” Oncology nursing forum. Vol. 24. No. 6. 1997.

3) Burnham, Timothy R., and Anthony Wilcox. “Effects of exercise on physiological and psychological variables in cancer survivors.” Medicine & Science in Sports & Exercise (2002).

4) Courneya, KERRY S. “Exercise in cancer survivors: an overview of research.” Medicine and Science in Sports and Exercise 35.11 (2003): 1846-1852.

5) Irwin, Melinda L., et al. “Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study.” Cancer Epidemiology Biomarkers & Prevention 18.1 (2009): 306-313.

6) Irwin, Melinda L., et al. “Influence of pre-and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study.” Journal of clinical oncology 26.24 (2008): 3958-3964.

7) Loprinzi, Paul D., et al. “Physical activity and the risk of breast cancer recurrence: a literature review.” Oncology nursing forum. Vol. 39. No. 3. Oncology Nursing Society, 2012.

8) Early Breast Cancer Trialists’ Collaborative Group. “Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials.” The lancet 378.9793 (2011): 771-784.

9) Holmes, Michelle D., et al. “Physical activity and survival after breast cancer diagnosis.” Jama 293.20 (2005): 2479-2486.

10) Bovbjerg, Dana H. “Psychoneuroimmunology. Implications for oncology?.” Cancer 67.S3 (1991): 828-832.

11) Fawzy, Fawzy I., et al. “Malignant melanoma: effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later.” Archives of General Psychiatry 50.9 (1993): 681-689.

12) Fawzy, Fawzy I., et al. “A structured psychiatric intervention for cancer patients: I. Changes over time in methods of coping and affective disturbance.” Archives of General Psychiatry 47.8 (1990): 720-725.

13) Veenhoven, Ruut. “Healthy happiness: Effects of happiness on physical health and the consequences for preventive health care.” Journal of happiness studies 9.3 (2008): 449-469.

14) Augustin, L. S. A., et al. “Dietary glycemic index and glycemic load, and breast cancer risk: a case-control study.”Annals of Oncology 12.11 (2001): 1533-1538.

15) Franceschi, S., et al. “Dietary glycemic load and colorectal cancer risk.” Annals of Oncology 12.2 (2001): 173-178.

16) Michaud, Dominique S., et al. “Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study.” Journal of the National Cancer Institute 94.17 (2002): 1293-1300.

17) Gnagnarella, Patrizia, et al. “Glycemic index, glycemic load, and cancer risk: a meta-analysis.” The American journal of clinical nutrition 87.6 (2008): 1793-1801.

18) Qi, Lu, and Frank B. Hu. “Dietary glycemic load, whole grains, and systemic inflammation in diabetes: the epidemiological evidence.” Current opinion in lipidology 18.1 (2007): 3-8.

19) Turina, Matthias, Donald E. Fry, and Hiram C. Polk Jr. “Acute hyperglycemia and the innate immune system: clinical, cellular, and molecular aspects.” Critical care medicine 33.7 (2005): 1624-1633.

20) Belle, Fabiën N., et al. “Dietary fiber, carbohydrates, glycemic index, and glycemic load in relation to breast cancer prognosis in the HEAL cohort.” Cancer Epidemiology Biomarkers & Prevention 20.5 (2011): 890-899.

21) Kroenke, Candyce H., et al. “Dietary patterns and survival after breast cancer diagnosis.” Journal of clinical oncology23.36 (2005): 9295-9303.

22) Contiero, Paolo, et al. “Fasting blood glucose and long-term prognosis of non-metastatic breast cancer: a cohort study.”Breast cancer research and treatment 138.3 (2013): 951-959.

Turning up the Heat on Colorectal Cancer March 17, 2016

Posted by Dreamhealer in Alternative medicine, best vancouver naturopath, cancer therapy, Cancer Treatment, Healing, Health, integrative cancer care, Naturopathic Doctor, Naturopathic Medicine.
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Written By: Dr. Adam McLeod, ND, BSc (Hons)

Loco-regional hyperthermia is an advanced adjunctive cancer therapy which involves heating the tumour immediately after chemotherapy or radiation. Hyperthermia is characterized as the fourth pillar in treating cancer, including surgery, chemotherapy and radiation. This therapy is commonly used in hospitals and clinics across Europe and Asia but it is oddly not used regularly in North America. There are only a few advanced devices which actually have the capacity to significantly heat a tumour located deep within the body1,2. Recently there has been exciting research on a device called Celsius TCS and its use in colorectal cancer.

A recent clinical study in Greece investigated hyperthermia in patients with metastatic colorectal cancer when used in combination with chemotherapy1. In this clinical trial 32 patients diagnosed with colorectal cancer were divided into a control group who just received chemotherapy and the treatment group who received hyperthermia immediately following their chemotherapy infusion. When compared to the control group, the hyperthermia group showed a shrinkage of metastatic spots derived from colon cancer. This is in contrast to the control group which on average showed an increase of size during this time interval. The conclusion of the study was “the beneficial effects of hyperthermia are undeniable. The consolidation of the application of hyperthermia cancer treatment, is now a matter of time.”

I have personally observed the positive benefits of loco-regional hyperthermia many times in my practice with colorectal cancer. In some of these cases the cancer was progressing everywhere except for the specific masses that were being targeted by the hyperthermia. Upon shifting the treatment focus to a different metastasis, these new masses then started to also respond to the therapy as well. The heat that is applied to the tumour adds additional stress to the tumour cells when they are being treated with chemotherapy or radiation.

There are several naturopathic therapies which can be used to potentially help enhance the effectiveness of hyperthermia. Quercetin is a bioflavonoid that is safe to use in conjunction with some chemotherapies. This commonly used remedy is not safe with all chemotherapies and you must have professional guidance before using it. Quercetin has been shown to be a potent inhibitor of heat shock proteins. In other words, it inhibits the proteins that cancer cells use to resist the effects of the heat and thus makes colon cancer cells more vulnerable to hyperthermia3. There is also research to suggest that the diabetes medication metformin may be helpful to enhance the effects of hyperthermia by killing cancer stem cells4. These are just a few of many natural therapies which as starting to show promise as useful adjuncts to hyperthermia.

It is important to point out that hyperthermia is very different from an infrared sauna or the application of a heat pack. A loco-regional hyperthermia device is an advanced medical device that significantly heats the tissues surrounding a tumour2. You will not heat any tumour effectively without these advanced devices, especially if it is a deeper tumour. These are state of the art devices where the patient must be medically monitored during the procedure.

When looking at the evidence there is a clear and consistent trend. Localized hyperthermia has significant potential as an adjunctive cancer therapy. The application of heat using these advanced medical devices increases the effectiveness or chemotherapy and radiation. Hyperthermia reduces the risk of the cancer developing resistance to chemotherapy or radiation5,6,7. At the end of the day the goal is to use every tool at our disposal to increase the effectiveness of conventional therapies and destroy the cancerous cells. Hyperthermia is a potent adjunctive therapy that can help to accomplish that goal.

References:

1) Mandraveli, E., et al. “The action of hyperthermia in metastatic colorectal cancer in combination with chemotherapy.” Progress in Health Sciences 5.1 (2015): 69.

2) Noh, Jae Myoung, et al. “In vivo verification of regional hyperthermia in the liver.” Radiation oncology journal 32.4 (2014): 256-261.

3) Koishi, Mototsugu, et al. “Quercetin, an inhibitor of heat shock protein synthesis, inhibits the acquisition of thermotolerance in a human colon carcinoma cell line.” Japanese journal of cancer research83.11 (1992): 1216-1222.

4) Lee, Hyemi, et al. “Response of breast cancer cells and cancer stem cells to metformin and hyperthermia alone or combined.” PLoS One9.2 (2014): e87979.

5) Group, International Collaborative Hyperthermia, et al. “Radiotherapy with or without hyperthermia in the treatment of superficial localized breast cancer: Results from five randomized controlled trials.” International Journal of Radiation Oncology* Biology* Physics35.4 (1996): 731-744.

6) Uckun, Fatih M., et al. “Radiation and heat sensitivity of human T-lineage acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) clones displaying multiple drug resistance (MDR).”International Journal of Radiation Oncology* Biology* Physics23.1 (1992): 115-125.

7) Souslova, Tatiana, and Diana A. Averill-Bates. “Multidrug-resistant hela cells overexpressing MRP1 exhibit sensitivity to cell killing by hyperthermia: interactions with etoposide.”International Journal of Radiation Oncology* Biology* Physics 60.5 (2004): 1538-1551.

Naturopathic Medicine and Cancer February 29, 2016

Posted by Dreamhealer in best vancouver naturopath, Cancer, cancer therapy, Chemotherapy, Healing.
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Naturopathic Medicine and Cancer

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Written by: Dr. Adam McLeod ND, BSc (Hon)

Naturopathic medicine has a wide range of tools that can be used in conjunction with conventional medicine to effectively treat cancer. Many people have this underlying assumption that naturopathic treatments are not “evidence based” because otherwise their oncologist would have recommended them. The truth is that many of these therapies are extremely well documented by scientific studies and the mainstream scientific community does not dispute their effectiveness. The bottom line is that cancer patients do better when they have an integrative health care team and Naturopathic doctors are an integral part of this team.

When dealing with a complex condition such as cancer it is very important to thoroughly review the entire health history of the patient, not just the diagnosis of cancer. It is essential that as physicians we actually take the time to listen to what the patient is saying. This allows us to develop a custom treatment plan for that individual which addresses the unique circumstances of that patient. Naturopathic doctors are experts at taking the time to listen to the patient and developing a treatment plan for that unique patient.

Chemotherapy and radiation are effective therapies and often it is a race between the death of the cancer cells and the death of healthy cells. Making sure the healthy cells are supplied with adequate nutrients allows patients to endure these harsh therapies with fewer side effects. Very often patients who are adequately supported with the appropriate nutrition and supplements will be able to tolerate additional rounds of chemotherapy and radiation. Ultimately if healthy cells are more likely to survive, this helps stack the odds against cancer cells.

Patients are often reluctant to take any supplements during chemotherapy and radiation because of potential interactions. This is a legitimate concern because there are many negative interactions if the wrong supplement is used. Any Naturopathic Doctor who regularly works with cancer is well aware of these interactions. When the appropriate supplements are used there are profound benefits to cancer patients. These supplements are well supported by scientific evidence and they have been consistently demonstrated to be safe when used in the right context. This is why the blanket statement of “avoid all supplements” is simply incorrect. It is absolutely essential that you have professional guidance from an experienced Naturopathic Doctor when you are picking supplements.

The mainstream medical community is slowly becoming more open to collaborating with Naturopathic Doctors because the evidence for the benefits of an integrative approach to cancer care can no longer be ignored. For years Naturopathic Doctors have been using high dose IV Vitamin C as a cancer therapy and traditional medical doctors considered it to be a nonsense therapy. Recently they have changed their attitude and oncologists are jumping on to the Vitamin C bandwagon. There is no doubt that when used appropriately this can be an effective integrative cancer therapy.

Patients who undergo this therapy tend to experience less significant side effects from the chemotherapy. IV Vitamin C can vastly improve quality of life by increasing appetite, raising platelet counts, easing fatigue and reducing pain. When patients are supported by the appropriate nutrients and supplements, the side effects from chemotherapy are less intense. Studies consistently show that at these high doses, Vitamin C is toxic to cancer cells while protecting healthy cells from the adverse effects of chemotherapy. The evidence indicates that IV Vitamin C is effective when used in conjunction with chemotherapy rather than as a stand-alone therapy. This is just one example of many different effective natural cancer therapies available. There is much more to integrative oncology than simply IV Vitamin C!

There is no question that there is often a strong emotional component to cancer and this must be addressed for optimal healing to take place. Patients will often be able to directly connect the formation of their cancer with a stressful event in their life. This is not an imaginary connection; there are biological reasons why emotional stress can trigger the formation of cancer. Stress can cause cancer. It is important to point out that this is not a hypothetical concept. This is a statement that is well supported by scientific evidence. The link between cancer and stress is well established and is not debated by the scientific community. Many people are not aware how significant this connection is as medical doctors often disregard this connection despite the body of evidence. Naturopathic doctors not only address the physical components of health, they will also take the time to address the emotional and spiritual components that simply cannot be ignored in patients with cancer.

If you know someone with cancer, make sure you let them know about the potential benefits of seeing a Naturopathic Doctor who focuses on cancer. There are so many amazing tools that Naturopathic medicine has to offer and the public needs to be aware that these therapies exist and that they are effective!

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular Biology, First Nations Healer, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology.

http://www.yaletownnaturopathic.com

The Real Truth About Cancer February 22, 2016

Posted by Dreamhealer in best vancouver naturopath, Cancer, cancer therapy, Healing, Naturopathic Doctor, Naturopathic Medicine, oncology.
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Written By: Dr. Adam McLeod, ND, BSc (Hons)

Recently there have been a surge in patients seeking alternative cures for cancer after watching the popular series “The Truth About Cancer”. This series does an excellent job of raising awareness about various natural therapies but it does patients a great disservice by discouraging patients from using conventional therapies. This documentary has given patients a biased view point and as a consequence they feel very polarized in their opinion against conventional care. The problem is that the best treatment plan involves integrating these two worlds together. Both conventional therapies and natural therapies have a lot that they can offer patients but they must be used together in a synergistic way for optimal results.

Patients have the right to choose what ever treatment plan they want. As a Naturopathic physician I have always respected my patients choices, even if I disagree with that choice. It is not my job to force the patient to choose a treatment plan, it is my job to give them the information and then they choose the treatment plan that feels right to them. When developing a treatment plan the key word is “integrative” not “alternative”. This means using natural tools safely and effectively in conjunction with conventional therapies. An integrative approach is what any licensed naturopathic doctor would be recommending and unfortunately this documentary confuses the public by giving them the impression that naturopathic doctors are against conventional cancer treatments. By presenting such a polarized view it often discourages patients from seeking true integrative care that could really benefit them.

Make no mistake about it, I am a big believer in the healing power of nature but this series greatly exaggerates the effectiveness of many natural therapies. Of course there are home runs with simple natural therapies. I have personally witnessed on many occasions where patients have dramatic responses to the simplest natural therapies. Although these responses are amazing and they require further investigation, it does not mean that everyone should abandon all conventional therapies in favour of an alternative approach. What the documentary fails to document is the many people who chose to pursue only alternative therapies and had poor responses. Cancer is unforgiving of delays and poor choices. It is true that chemotherapy, radiation and surgery have side effects but cancer has side effects too.

Many of the natural therapies that this documentary chooses to highlight are not commonly recommended by experts who work in the integrative oncology field. Things like baking soda and apricot seeds are not mainstream natural cancer therapies and have virtually no evidence of being effective. There are countless natural therapies which are more effective than this and which are well supported by scientific evidence. Not all cancers are the same and you must have professional guidance when developing a plan. Many natural therapies are completely contraindicated in certain cancers and just because it is natural does not mean that it is universally safe.

Of course there are times where the use of chemotherapy is questionable. In some circumstances the cancer is unlikely to respond to the drug and intensive therapies are being recommended to only slightly extend life expectancy. In these cases the lowered quality of life must be weighed against the increased life expectancy. There are certainly cases like this where the medical oncologists are only recommending such therapies because there are no other options. It is not unreasonable for patients to resist conventional care in some of these extreme circumstances.

The key thing to recognize is that this does not apply to all cases of cancer. Conventional cancer treatments save lives when used in a timely fashion. The study cited in the series that states the ineffectiveness of chemotherapy is not presenting this information properly. This study is questioning the use of chemotherapy in the context of 5 year survival rate. By the time many of these cancers in the study were diagnosed, the disease had already greatly progressed and it is unlikely that anyone would live for 5 years, regardless of what therapy they choose.

When you take the time to dig deeper into the study it is clear that in many of these cancers the patients are living significantly longer but many of them are not living up to the 5 year mark. In this particular study someone could live for several years with a great quality of life but if they died at 4 years and 11 months then the chemotherapy would be considered ineffective. Obviously if a patient is able to live longer with a good quality of life, this is a success even if they don’t live for 5 years. The public is often left with this false impression that all chemotherapy leaves patients with a crippled quality of life. Certainly some chemotherapies significantly decrease quality of life but not all chemotherapy is the same. Particularly when patients are well supported they have significantly less side effects and can live with a great quality of life. It is not unusual for me to have a patient come to my office who has minimal side effects even when doing an intense round of chemotherapy because they are well supported naturally during this process.

You will never have all studies agree as this is how science works. We cannot base our clinical decisions on one study, we must base it on the totality of the evidence. A quick literature search will find thousands of peer reviewed studies demonstrating the effectiveness of chemotherapy for a wide range of cancers. I have had many patients in the past refuse conventional care against my advice and fly to exotic clinics around the world to receive alternative therapies. During these unnecessary delays the cancer spread to the point that it was no longer curable. In some of these cases I was confident that the patient could have been easily cured had they not hesitated.

Natural therapies can be used to help support patients through conventional treatments. They can help to significantly reduce side effects and support the immune system. When patients have this support not only do they respond better to therapy, they are more likely to embrace both therapies as their answer to this terrible disease. Often those who are the most polarized in their opinions against an integrative approach are people with little to no experience dealing with cancer. These two worlds can coexist and it is a beautiful thing when there is true collaboration.

The bottom line is that a balanced approach is best. The extreme view that no natural therapies work is simply incorrect. Just as the extreme view that only natural therapies should be used is inaccurate. The best treatment plan is an integrative approach which bridges these two worlds. Many patients get scared away from conventional therapies because their oncologist presents the treatments with such a polarized point of view. When you are trained as a hammer, everything looks like a nail. This becomes obvious to many patients after meeting with their oncologist who has a limited set of tools to offer. There are a vast range of natural therapies that can be used to help your body fight cancer but they have to be used in the proper clinical context. A Naturopathic doctor who works with oncology can help to give you a more balanced view and develop a treatment plan that utilizes the best of both worlds.

Dr. McLeod is currently accepting new patients at Yaletown Naturopathic Clinic, please call 604-235-8068 to book an appointment or for more information about integrative oncology treatments. Yaletown Naturopathic is also one of only a few clinics in all of North America who offers Loco Regional Hyperthermia to patients who qualify for this treatment.

Get well. Stay well. 

Boost the Odds After Cancer by Reducing Stress and Focusing on Healing December 17, 2015

Posted by Dreamhealer in Cancer, cancer therapy, Cancer Treatment, Healing, integrative cancer care, stress.
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Reducing stress and making lifestyle changes can yield remarkable results.

Written By: Dr. Adam McLeod, ND, BSc (Hons)

The diagnosis of cancer is a scary experience. Patients are often immediately thrust into aggressive conventional therapies without fully understanding how the therapy works or why it is necessary. We live in a culture where we put the responsibility of our health into someone else’s hands. We are told to trust that they know what is best and patients are often discouraged from doing their own research. Patients often feel that from the first day of diagnosis they are put on a conveyor belt and shuffled from one appointment to the next with no other options available. Once the treatments are complete and the patient is declared cancer free, they are abruptly discharged from the cancer agency and it is expected that they continue on with their life as if nothing had happened.

The reality is that this experience is so stressful for patients that it often leaves them traumatized emotionally and physically. Treatment does not end the moment that someone is given the “all-clear”. That is the time to focus on keeping your immune system strong and changing factors in your lifestyle to reduce the risk of recurrence. Patients need guidance to make these physical and emotional changes to reduce the chances of the cancer coming back. The good news is that there is a lot that can be done and there is substantial research to back these therapies.

You can help your body fight cancer by reducing stress and focusing your intentions on healing. One of the most comprehensive intervention studies in cancer research evaluated the effects of stress management techniques, such as relaxation on cancer recurrence following removal of malignant melanoma2. Not only did the relaxed group experience reduced psychological distress, they also had more active immune systems than the control group not practicing relaxation. A six-year follow up of these patients showed a trend toward greater recurrence and higher mortality rates in the control group, compared to the relaxed group1. The bottom line is that patients who focus on reducing stress and focus their minds on healing not only have a better prognosis, they also have lower rates of developing cancer in the first place. Given what we know about the connection between immune function and stress, this conclusion is not surprising.

The aggressive conventional therapies that patients go through often do a good job of killing cancerous cells. The problem is that these same therapies also leave the immune system severely weakened at a time when you need the immune system to be strong. You must have a functioning immune system to patrol your tissues and identify abnormal cells before they have an opportunity to manifest as a clinical disease. The first year after being given the “all-clear” diagnosis is the most important time to support your immune system. There are many natural therapies and lifestyle changes that can be done to help support your immune system at this critical time period.

Mistletoe therapy is just one example of a therapy that can be used to effectively stimulate the immune system. Mistletoe has been shown to stimulate increases in the number and the activity of several types of white blood cells3. Immune-system-enhancing cytokines, such as interleukin-1, interleukin-6, and tumour necrosis factor alpha are released by white blood cells after exposure to mistletoe extracts4,5. It is also possible to make simple dietary changes that can significantly reduce inflammation and further support immune function.

Patients want and need continued support after they are treated for cancer. They need to be supported mentally and physically in order to help further reduce the risk of recurrence. Naturopathic doctors excel at providing this much needed support to patients and help them get back on the path to wellness.

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology.http://www.yaletownnaturopathic.com

This article was also published in the Georgia Straight Vancouver.

References:
1) Bovbjerg, Dana H. “Psychoneuroimmunology. Implications for oncology?.” Cancer 67.S3 (1991): 828-832.

2) Fawzy, Fawzy I., et al. “Malignant melanoma: effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later.” Archives of General Psychiatry 50.9 (1993): 681-689.

3) Büssing, A., A. Regnery, and K. Schweizer. “Effects of Viscum album L. on cyclophosphamide-treated peripheral blood mononuclear cells in vitro: sister chromatid exchanges and activation/proliferation marker expression.” Cancer letters 94.2 (1995): 199-205.

4) Hajto, Tibor. “Immunomodulatory effects of Iscador: a Viscum album preparation.” Oncology 43.Suppl. 1 (1986): 51-65.

5) Hajto T, Hostanska K, Frei K, et al.: Increased secretion of tumor necrosis factors alpha, interleukin 1, and interleukin 6 by human mononuclear cells exposed to beta-galactoside-specific lectin from clinically applied mistletoe extract. Cancer Res 50 (11): 3322-6, 1990.

A Naturopathic Approach for Attention Deficit (Hyperactivity) Disorder (ADD/ADHD) December 10, 2015

Posted by Dreamhealer in ADHD, Cancer, cancer therapy, integrative cancer care, Naturopathic Doctor, Naturopathic Medicine.
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Attention Deficit (Hyperactivity) Disorder (ADD/ADHD) is a term that covers a wide variety of symptoms. The most common ones include decreased concentration, poor organizational skills, decreased attention, impulsivity, learning difficulties and restlessness, to name a few.

Many children diagnosed with ADD/ADHD are treated with various medications. Side effects of these types of drugs may include abdominal cramps, insomnia, depression, headache, dizziness, high blood pressure and appetite suppression. Additionally, medication such as Ritalin which is a common stimulant used to treat ADD/ADHD can make patients prone to dependence on the medication.

Naturopathic medicine approaches the treatment of behavioural challenges in children for a holistic point of view. The naturopathic approach to ADD/ADHD may involve establishing optimal nutrition, supplementing where necessary and identifying any food sensitivities/allergies or irritants that could be instigating the symptoms.

While the goal of treatment is not to change who they are as people, there are treatment options to help ease symptoms such as learning difficulties, impulsivity, digestion issues, inattention, difficulty focusing, anxiety, as well as eating habits, coordination, mood and sleep, and finally to help them function optimally.

Contact us today to book an appointment and begin your healing journey with the Yaletown Naturopathic Clinic 604-235-8068.

Diabetes Drugs for Cancer? September 24, 2015

Posted by Dreamhealer in Cancer, cancer therapy, Diabetes, Naturopathic Doctor, naturpathic medicine.
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Diabetes drugs
Written by: Dr. Adam McLeod, ND, BSc (Hons)

Can drugs traditionally used for diabetes also be helpful with cancer? There is a growing body of evidence which indicates that both Metformin and a class of drugs known as thiazolidinediones can be a useful adjunctive cancer therapy. The biochemical mechanism behind this anticancer effect is poorly defined but there are some intriguing theories about the mechanism of action.

Metformin is the first line drug for patients with Type 2 diabetes and it is certainly effective at getting the blood sugar under control. Diabetic patients who regularly take metformin have a lower risk of developing cancer1. Metformin activates an enzyme known as AMPK. A recent breakthrough has found a key regulator of AMPK to be a protein known as LKB1. LKB1 is a well recognized tumour suppressor. Activation of AMPK by metformin and exercise requires LKB1, and this would also explain why exercise is beneficial in the primary and secondary prevention of certain cancers2.

Recent studies strongly indicate that the anticancer effects of metformin are indeed linked to AMPK3. Metformin appears to selectively target cancer stem cells, and acts together with chemotherapy to block tumour growth and prolong remission4. When used with doxorubicin it acts synergistically to reduce tumour mass and relapse rates more effectively than either drug alone.

There is a completely different class of medications that is also used for diabetes which appears to have anticancer effects. The drug class is known as thiazolidinediones. One of the most well known drugs in this class is called Avandia. Even though both of these drugs are effective at treating diabetes they work by a completely different mechanisms. The thiazolidinediones activate a receptor called PPAR and by activating this receptor it triggers a cascade of reactions that are beneficial to patients fighting cancer6,7,8. The drug increases the activity of a key tumour suppressor called PTEN5. This tumour suppressor is a protein that halts the growth of cancer cells by inhibiting an enzyme known as PI3K. There are many types of cancer that are dependent on inhibiting the function of the tumour suppressor PTEN. The bottom line is that this drug helps to put the brakes on the growth of cancerous cells by activating PTEN.

As more research accumulates supporting the fact that these antidiabetic drugs can be used to treat cancer, one thing is becoming clear. The anticancer effect from these drugs is due to their influence on several different metabolic pathways. The great thing about these medications is that they have a long history of use and they are well established as safe adjunctive cancer therapies. Like any medication it has to be used in the right context and this therapy is not for everyone. A Naturopathic doctor who focuses in oncology will go through your entire case history to determine if this treatment is indicated. Contact your local naturopathic doctor to see if this therapy is right for you.

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, First Nations Healer, Motivational Speaker and International Best Selling Author.
He currently practices at his clinic, Yaletown Naturopathic Clinic, in Vancouver, BC where he focuses on integrative oncology.

References:
1) Evans, Josie MM, et al. “Metformin and reduced risk of cancer in diabetic patients.” Bmj 330.7503 (2005): 1304-1305.

2) Bauman AE.Updating the evidence that physical exercise is good for health: an epidemiologic review.J Sci Med Sport2004; 7:6–19.

3) Zakikhani, Mahvash, et al. “Metformin is an AMP kinase–dependent growth inhibitor for breast cancer cells.” Cancer research 66.21 (2006): 10269-10273.

4) Hirsch, Heather A., et al. “Metformin selectively targets cancer stem cells, and acts together with chemotherapy to block tumor growth and prolong remission.” Cancer research 69.19 (2009): 7507-7511.

5) Farrow, Buckminster, and B. Mark Evers. “Activation of PPARγ increases PTEN expression in pancreatic cancer cells.” Biochemical and biophysical research communications 301.1 (2003): 50-53.

6) Bunt, Stephanie K., et al. “Rosiglitazone and Gemcitabine in combination reduces immune suppression and modulates T cell populations in pancreatic cancer.” Cancer Immunology, Immunotherapy 62.2 (2013): 225-236.

7) Monami, Matteo, Ilaria Dicembrini, and Edoardo Mannucci. “Thiazolidinediones and cancer: results of a meta-analysis of randomized clinical trials.” Acta diabetologica 51.1 (2014): 91-101.

8) Srivastava, Nishi, et al. “Inhibition of Cancer Cell Proliferation by PPARγ Is Mediated by a Metabolic Switch that Increases Reactive Oxygen Species Levels.” Cell metabolism (2014).

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