"" Ralph Moss—Cancer Consultant

Monday, February 1, 2016

THE CANCER INDUSTRY, REVISITED

In 1980, I published my first book, The Cancer Industry. It went through many editions and led to my appearance on "60 Minutes," among many other TV and radio shows. Thirty-five years ago it was a radical thesis that "Big Pharma" was milking the cancer field for super profits, and was actually retarding progress in many cases by making potentially useful treatments conform to their need for super-profits. I think recent events (such as the gross overpricing of new cancer drugs) have amply vindicated my point of view.

There are several components to the question of "Big Pharma's" impact on cancer. I will briefly address (a) how much cancer costs society and (b) how much is spent specifically on cancer drugs.

In the US today, cancer is said to inflict an economic cost of around $895 billion annually. This is more than heart disease ($753 billion) and far more than #3 traffic accidents and #4 diabetes (each of which costs society around $204 billion). Cancer is also a major source of lost life and productivity and of course an incalculable "cost" in misery, heartache and loss. In 2008, Americans lost 83 million years of healthy life because of cancer, according to the American Institute of Cancer Research (AICR). New cancer drugs now typically cost $10,000 per month per patient, or around $120,000 per year per patient. Depending on one's insurance, or lack thereof, one can wind up paying individually for much of this cost.

In 2015 the worldwide market for cancer drugs topped $100 billion in sales, according to the IMS Institute for Healthcare Informatics. IHI further states that this figure could reach $147 billion by year the 2018.

Needless to say, it is the consumer (and/or taxpayer) who bears the brunt of these unacceptable expenses. The US pays far more for prescription drugs than other countries because the government is forbidden from fully negotiating the lowest price with the drug companies, as is done in other countries. I believe this can be traced back to the lobbying efforts of "Big Pharma," including the "revolving door" between the the drug company and government agencies. 

Who are the main players behind the rise in the cost of cancer care?

The cancer marketplace functions because of the simultaneous input of many players: patients (of course!), physicians (especially oncologists), politicians seeking approval for endorsing popular “war on cancer” positions, wealthy fund-raising charities, research scientists, and regulators (such as the Food and Drug Administration). However, I would argue that the principal players are the largest multi-national pharmaceutical companies—so-called “Big Pharma.” These include Pfizer, Bristol-Myers Squibb, Roche, etc. While regulators may try to rein in the costs, according to the well-known Web site www.fiercepharma.com, “drugmakers won't be deterred by pressure from payers, doctors, or anyone else. The payoff is too promising for that. And when a market approaches $100 billion, even 5% growth is worth billions.”

Sunday, January 31, 2016

MOST PROMISING CANCER RESEARCH



I was recently asked if real progress was being made in finding a "cure" for cancer. Sure, I said, thousands of people are working hard to find better treatments, even cures. Important advances are being made in the field of cancer immunotherapy, with the development of so-called immune checkpoint inhibitors such as ipilimumab (Yervoy®), pembrolizumab (Keytruda®) and nivolumab (Opdivo®).

The problem is that almost invariably scientific advances must also be highly profitable in order to clear the hurdles of the FDA. This severely limits the number of drugs that can come to market, since unpatentable, out-of-patent, natural or generic medications are automatically ruled out by the demands of the marketplace. This issue, by the way, is almost entirely lacking from discussions of the pace of improvement in cancer treatment.

I was also asked what was the most promising new development.

There is no single most effective remedy for cancer, as the number of possible permutations of cancer is almost limitless. This is the rationale for personalized treatment. However, what I am most excited about now is the work of D. James Morré, PhD and Dorothy Morré, PhD, of Purdue University in West Lafayette, IN. James Morré was founding director of the Purdue Cancer Center. He has published 400 PubMed-indexed scientific articles. He and his wife discovered (among other things) the role of ENOX2 proteins in allowing the enlargement of cancer cells. Unless a cell enlarges to normal size it self-destructs within 3 to 4 days in a process called “programmed cell death” or apoptosis. This knowledge has resulted in a remarkable test for 25 kinds of cancer called ONCOblot.

The Morrés also discovered a variety of agents, natural and synthetic, that will block the action of ENOX2. The most important of these is a combination of green tea extract and red pepper called CAPSOL-T. In a clinical trial, it was found that 94% of those who were positive for ENOX2 became negative after 4 months of this treatment. These are huge claims and require extensive scientific testing at many institutions, not just Purdue. But I see no flaws in the Morrés research or reasoning process.


Thursday, January 14, 2016

REMARKABLE NEW BLOOD TEST FOR CANCER

Once in a rare while a diagnostic test comes along of urgent importance to cancer patients. ONCOblot is such a test.

I learned about this from a scientific book, ECTO-NOX Proteins: Growth, Cancer and Aging (Springer 2013). This eye-opening book offered a detailed and well-organized record of five decades of research by the husband-and-wife team of D. James Morré, PhD and Dorothy Morré, PhD, mainly conducted as professors at Purdue University in West Lafayette, Indiana. James Morré, the Dow Professor of Medicinal Chemistry, was the founding director of Purdue’s cancer research center.

In this groundbreaking book, the Morrés explain the global significance of a class of proteins called “ECTO-NOX,” which is commonly abbreviated ENOX. This protein acts on the surface or exterior of cells (from the ancient Greek ectos, “outside”). ENOX2 is found in cancer of many kinds. It and related ENOXes are crucially involved in cell growth, biological time keeping, cancer, aging and even viral infections. 

These ENOX proteins are unique in a number of ways. For instance, their expression depends on a particular biological clock, or circadian rhythm, that varies from 22 to 26 minutes. They carry out two separate physiological functions in rapid succession.

Particularly thought provoking is the Morrés’ discussions of ENOX2, which has resulted in the revolutionary ONCOblot blood test for cancer. ENOX2 is specific for cancer and plays an indispensable role by allowing an immature cancer cell to enlarge to a normal size. The Morrés spent decades perfecting a practical test for ENOX 2, which is now called ONCOblot. This test can differentiate among 26 different types of cancer. According to the www.oncoblotlabs.com Web site, the test can detect tumors as small as 2 mm in diameter, which represents about 2 million cells. It can find tumors years before conventional scans. This makes it much more sensitive than a typical scan. If cancers can be detected at this early stage, and distinguished as to tissue of origin, then this alone represents a huge advance in the cancer field. It allows for early detection and medical intervention to eliminate small tumors before they become increasingly difficult to treat. 

I hope the reader now senses the enormous potential of this line of research, the fruit of more than 50 years of determined work at Purdue and elsewhere. James Morré himself has published around 400 PubMed-indexed scientific papers. If we now truly have a way to detect very early cancers, differentiate their tissue of origin, and then treat and eliminate them in their preclinical stages, I believe that the Morrés have gone a long way to solving the cancer puzzle! This proposition of course requires further testing. But, at this point, the burden of proof shifts from these remarkable scientists to the large and well-funded government and private agencies, which have the capacity to carry out large-scale testing. The fact that they have not done so is both puzzling and frustrating. One hopes this is not another instance of the determined suppression of a generic and non-toxic approach in the interest of entrenched medical interests.

In sum, since the 1960s, the Purdue University scientists James and Dorothy Morré have produced an amazing body of scientific work, which they have summarized with admirable clarity in a 500-page text and in hundreds of journal articles. It offers a detailed explanation of how and why the detection of ENOX2 provides an accurate diagnosis for many different kinds of cancer.

To access the ONCOblot diagnostic test for 26 different types of cancer:


Tuesday, December 1, 2015

MAITAKE, THE DANCING MUSHROOM



Sam Donato, New Jersey mushroom hunter
(Photo © 2015 M. B. Moss)


Recently, I was on a site visit to the ProCure Proton Beam Therapy center in Somerset, NJ, when I took time out for a walk in that town’s magnificent Colonial Park. On one of the rambling paths through the woods my wife and I almost literally bumped into a local man. We got to talking and he identified himself as Sam Donato. He was now a published author and musician, but for most of his life had made his living as a truck driver and construction worker.

 My wife admired and commented on his corncob pipe. It turned out that not only his pipe, but his tobacco was homemade, in the latter case, grown and cured in central New Jersey! Sam informed us that he was out hunting for mushrooms, and one in particular, the “hen of the woods.” You can usually find them, he told us, growing at the base of oak trees between September and November.

I know “hen of the woods” well. Otherwise known as maitake (Grifola frondosa or Grifola umbellata, it is a mushroom of importance in complementary and alternative medicine (CAM). Like many mushrooms, it has both immune-stimulating and anti-cancer properties. It is also said to help control high blood pressure. Sam was unaware of these medicinal uses, but simply enjoyed the delicious taste of them.

We eventually went our separate ways, but about half an hour later, our trails looped around and we encountered him once again crossing our path. He informed us that he had found a large maitake at the base of an oak tree. He took us to his car and revealed this ten pound fungus, which he was about to take home and sautée in butter. It was indeed a hen of the woods. My wife took this photo of him in the parking lot of Colonial Park, the proud discoverer of one of this elusive but famous mushroom.

The word “maitake” means “dancing mushroom” in Japanese. This is because ordinary Japanese people would dance for joy whenever they found one, since the Emperor offered its weight in silver for anyone who found one. Nowadays, you can buy extracts as a food supplement (such as Grifola’s Maitake D fraction) or even sometimes find fresh ones in the supermarket.

There is a considerable amount of research on maitake mushrooms—285 PubMed-indexed articles. Of these, 82 concern cancer. The most recent comes from Kobe University—for historical and cultural reasons, most of the research on maitake originates in Japan. It is generally conceded that maitake is an “immune stimulant.” But what exactly does this mean? The Kobe scientists showed that the soluble beta-glucan-rich “D fraction” of maitake “acts as a potent immunotherapeutic agent” and specifically that (together with another immune stimulant) iincreased dendritic cell activity against cancer, “resulting in tumor regression via an antitumor T helper cell 1-type response.”

“Our findings provide the basis for a potent antitumor therapy using a novel combination of immunologic agents for future clinical immunotherapy studies in patients,” Yuki Masuda and colleagues wrote. This confirms what has been known for decades—that mushrooms such as maitake, shiitake, Trametes versicolor, etc. contain immune modulating compounds. Now that immunotherapy is popular in oncology, one would expect increased attention paid to these time-honored and virtually non-toxic methods of boosting immunity.





THE SURPRISING HISTORY OF CRYOTHERAPY

Dr. James M. Arnott of Brighton, England


Have you heard about the "new" treatment for cancer called cryotherapy? This is the use of extreme cold to destroy tumors, and hopefully cure the disease. I put the word "new” in quotes because cryotherapy is actually an old treatment. A mid-nineteenth century surgeon named James Arnott (1797-1883) began using "cryo" in Brighton, England in 1845 and even published a book on the subject six years later (Arnott 1851). Arnott exhibited his apparatus at the Great Exhibition in London—the famous Crystal Palace Exhibition of 1851. 

 
The famous Crystal Palace, home of the 1851 Great Exhibition in London, England


Arnott's work would thus have been accessible to tens of thousands of visitors, including such famous Britons as Prince Albert, Charles Dickens and Charles Darwin. James Arnott was assisted in his work by his older brother, Neil Arnott, FRS, of Baker Street, who (among many other things) invented the waterbed.

That’s right—“cryo” was already well-known and practiced ten years before the American Civil War! For cancer, Arnott used salt solutions containing crushed ice to attain temperatures of -18º to -24º C (i.e., - 0.4º to – 11º F). He used this apparatus to freeze advanced cancers of the breast and cervix. This resulted in a decrease in the size of the tumor, a reduction of drainage and an amelioration of pain (Gage 1998).

At the time, Arnott wrote these prophetic words:

“Congelation [freezing, ed.] arresting the accompanying inflammation, and destroying the vitality of the cancer cell, is not only calculated to prolong life for a great period, but may, not improbably, in the early stage of the disease, exert a curative action.”

Arnott was certainly ahead of his time. Freezing a tumor seems intrinsically safer than removing it by surgery. What then happened to cryotherapy? Why wasn’t it instantly and universally adopted as a superior method of destroying tumors. First of all, Arnott’s apparatus was bulky and cumbersome. Second, a tumor had to be essentially external in character to be successfully treated in the era before asepsis and anaesthesia. Finally, the temperatures that were attained by the Arnott apparatus were probably not cold enough to thoroughly destroy the tissues in question. A historian of this question has stated:

“Though the usefulness of cold application was acknowledged by Arnott’s contemporaries and physicians of the time began to use local freezing techniques, further development of cryosurgery had to await advances in technology, especially the development of better cryogenic agents.”

The use of cryotherapy to treat cancer of the prostate gland only began in earnest in the 1960s (Wilson 1966). Drs. Ward A. Soanes and Maurice J. Gonder of Kenmore, NY, are credited with developing modern apparatus for the trans-urethral freezing of the prostate gland. In 1966, these two Upstate urologists told the American Urological Association (AUA) that they had treated 150 patients with "no mortality and minimal morbidity” (JAMA 1966). It was the beginning of a new era in prostate cancer treatment, although progress has been undeniably slow over the past few decades.

Cryotherapy continues to be an option for many cases of prostate cancer and other malignancies and is offered at dozens of medical centers around the US and the world. To find an oncologist or urologist who uses this technique one can conveniently consult the Web site of the Endocare company:


References

Arnott J. On the treatment of cancer by the regulated application of an anesthetic temperature. London: J. Churchill, 1851.

 JAMA. Cryosurgery on prostate reported. JAMA. 1966;196(13):29-29. doi:10.1001/jama.1966.03100260019007.

Gage AA. History of cryosurgery. Semin Surg Oncol. 1998;14(2):99-109. doi:10.1002/(SICI)1098-2388(199803)14:2<99::AID-SSU2>3.0.CO;2-1.

Wilson CB, Winternitz WW, Bertan V, Sizemore G: Stereotaxic cryosurgery of the pituitary gland in carcinoma of the breast and other disorders. JAMA 1966; 198:587–S90.