Colon Cancer

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Background

Colon cancer (also referred to as colorectal cancer) typically begins as a polyp – a growth in the lining of the colon or rectum.

Diets low in fiber and high in saturated fatty acids (animal fat and red meat) are correlated with an increased risk of colon cancer. As with other cancers, smoking and alcohol increase risk.

Crohn disease and ulcerative colitis also increase risk. The risk of colorectal cancer is increased up to twentyfold with Crohn disease.

Calcium supplementation and higher serum vitamin D levels appear to be related to reduce colorectal cancer risk. We usually recommend Turmeric, Quercetin, Calcium and Vitamin D for polyp prevention. Turmeric and Quercetin have shown polyp reducing benefit in a human trial. 

Screening

Screening is important as colon cancer can occur in the absence of symptoms. Most patients are diagnosed over the age of 50 which is when screening begins if you don’t have risk factors or first degree relative with colon cancer. The Fecal Immunochemical Test (a stool test) is used by most screening programs in Canada for screening at least every 2 years if not yearly.

Carcinoembryonic antigen (CEA) level in the blood is a tumor marker that we run at our clinic to evaluate the efficacy of our alternative cancer therapies in colorectal patients. Usually, a baseline CEA level is obtained before and after surgery and repeat CEA testing every 3 months in the first 2 years and then annually for 5 years.

A rising plasma CEA level is suggestive of tumor recurrence or metastases.

Surgery

Resection of the tumor with large margins and the associated lymph nodes is the preferred surgical intervention for cure of colon tumors. 

Surgery alone is adequate for patients with stage I and most with stage II disease ( both are confined to the colon).  Patients with stage III colon cancer (spread into nearby lymph nodes) should be considered for chemotherapy.

Often times, a colostomy may be performed where the colon is connected to a colostomy bag on exterior of the body that collects waste which can be temporary or permanent depending on the reason for the procedure.

We recommend surgery in most cases where the disease is not yet disseminated with distant metastases. This is often the best chance for cure; however, we support our patients through surgery with natural agents, such as MCP (modified citrus pectin) which has been shown to effectively reduce colorectal liver metastases in a mouse model  – to reduce risk of spread, amongst other agents such as high dose green tea extract.

We also prepare our patients nutritionally to better tolerate surgery and improve immune function and healing with nutritional IVs prior to and after surgery. We use high potency vitamin and mineral IVs with vitamin C. We also give oral immune boosters such as coriolus mushroom which is supported by a multitude of clinical trials demonstrating improved survival when these are integrated with standard therapies.

A 2012 review analyzed Coriolus efficacy from 13 clinical trials and found that Coriolus in patients with breast cancer, gastric cancer, or colorectal cancer treated with chemotherapy, had particularly impactful effects on the overall 5-year survival rate. 

Chemotherapy

Chemotherapy is 5-fluorouracil “5-Fu” based.

We’ve seen nausea, lowered blood counts, fatigue and diarrhea as issues with 5-Fu based regimines.

Stage III: “FOLFOX” (combination of leucovorin/5-fluorouracil/oxaliplatin)

Stage IV: FOLFOX+bevacizumab or FOLFIRI+bevacizumab

FOLFIRI: combination of leucovorin, 5-fluorouracil, irinotecan

**We avoid using Curcumin with Irinotecan.

Radiation therapy to the primary tumor can be used for patients with metastatic disease for palliation or in rectal malignancies.

An integrative protocol can be structured around FOLFOX, FOLFIRI with or without Bevacizumab (Avastin).

leucovorin/fluorouracil/irinotecan (FOLFIRI)

leucovorin/fluorouracil/oxaliplatin (FOLFOX)

We also occasionally see capecitabine – XELODA

A major role we play at our naturopathic clinic in integrating various supplements and therapies to offset the side effects of 5-FU/5-Fluorouracil based chemotherapy.




5-FU compatibility with IV Vitamin C

Reducing Side Effects

Nausea, Diarrhea, and Reduced white blood counts are major issues.

Nausea can be dealt with ginger, which is effective for a range of chemotherapy induced nausea in addition to the standard metoclopramide and dexamethasone prescribed by the oncologist. Teaching patients simple acupressure can be effective for mitigating acute nausea. We can also perform acupuncture if the patient requires in-office nausea reduction.

Oxaliplatin in FOLFOX is notorious for causing peripheral neuropathy (nerve damage) which results in numbness and tingling in the fingers and toes. Our clinical experience suggests that intramuscular B12 can be helpful in reducing the intensity of neuropathy in our patients for a range of chemotheraies, including oxaliplatin. Furthermore, B12 may improve fatigue, brainfog and reductions in blood counts making it a low cost intervention with a broad range of potential.  Various lines of evidence indicate B12 can help in peripheral neuropathy of various origins.

We also give patients the option of both oral and intravenous alpha lipoic acid after cessation of oxaliplatin to hasten nerve recovery. Evidence exists that suggests that intravenous lipoic acid treatments are required in addition to oral to improve recovery. Discussions throughout this website on metabolic approaches to cancer also indicate that Alpha Lipoic Acid may have an independent anti-cancer effect as well. Intravenous glutathione has potential for another platin medication, Cisplatin, as evidenced in a clinical trial however, this does not appear to transfer to Oxaliplatin and FOLFOX as per a 2010 clinical trial.

Various natural interventions have been studied to reduce the side effects of Platin medications which is beyond the scope of this document. It is worthwhile mentioning high dose melatonin is a potential oral option to augment FOLFOX and FOLFIRI. One large study from 2007 in 370 colon cancer patients demonstrated far better tumor regression rates, survival rates and better tolerance of chemotherapy and melatonin was added to Folfox or Folfiri. Furthermore, another study indicated inproved action of irinotecan with added melatonin in far advanced colon cancer.

Diarrhea and blood counts can be mitigated with glutamine and melatonin respectively however we may use oral mushroom extracts, dilute hydrochloric acid injections, and subcutaneous mistletoe injections to offset reduced blood counts. Glutamine may also offset neuropathy however its primary use is for 5-Fu diarrhea; reducing the need for anti-diarrheal tablets.

Mistletoe: In general, we often recommend Mistletoe with a number of chemotherapies to lessen lowered white blood cells counts. In 2001, an article was published looking at 10,226 cancer patients with 1668 patients treated with Iscador (a brand of injectable mistletoe) and 8475 who had taken neither Iscador nor any other mistletoe product (control patients). In a pool of 396 matched pairs, mean survival time in the Iscador groups was roughly 40% longer than in the control groups.

Mistletoe

In general, we often recommend Mistletoe with a number of chemotherapies to lessen lowered white blood cells counts. In 2001, an article was published looking at 10,226 cancer patients with 1668 patients treated with Iscador (a brand of injectable mistletoe) and 8475 who had taken neither Iscador nor any other mistletoe product (control patients). In a pool of 396 matched pairs, mean survival time in the Iscador groups was roughly 40% longer than in the control groups.

In a 2003 randomized, controlled trial compared the post-surgery results for patients with colorectal cancer. 40 Stage III patients and 24 patients Stage IV patients who, beside surgery, received either only 5-FU chemotherapy for 6 cycles or 5-FU chemotherapy combined with Mistletoe (Isorel).

These 64 patients were randomly allocated into three groups:

Only chemotherapy: 21 patients

Chemo and Mistletoe: 29 patients

Surgery only (no chemo or mistletoe): 14 patients

After surgery patients treated with chemo and mistletoe had median survival significantly better than  the patients receiving only postoperative chemotherapy.  

IV Vitamin C

A 2015 journal article looked at 14 patients whose treating oncologist judged that standard-of-care chemotherapy offered less than a 33% likelihood of response. These patients were given IV Vitamin C combined with chemotherapy seven of which had advanced colorectal cancer. One of seven experienced transient stable disease with IVC and chemotherapy (irinotecan, bevacizumab and capecitabin/xeloda). Therefore, it is not our preference to use IVC as a standalone in colorectal cancer therefore our preference is to use IVC paired with a wormwood derivative in colorectal.

Advanced Therapies: DCA

For Colon cancer we often suggest referral to one of our allied practitioners for DCA (dichloroacetate) or IV Vitamin C with Artemesinin.

A 2014 Journal article named “A Novel Form of Dichloroacetate Therapy for Patients With Advanced Cancer: A Report of 3 Cases” outlined response of an 80 year old male with liver metastases, who demonstrated a rapid and robust response to IV DCA. This patient was originally treated with FOLFIRI before it became ineffective and side effects were profound. The patient began on twice weekly IV Vitamin C however, the disease progressed under this treatment. A single DCA treatment resulted in a rapid decrease in both CEA and liver enzymes with CEA decreasing from 150.2 to 95.1 from a single infusion.

In 2009 Medicor Cancer centre, a cancer clinic in Toronto, run by Dr. Akbar Khan MD, released their DCA treatment data gathered from 347 patients they treated with DCA. Of 22 Colon cancer patients treated, 17 (77%) showed a positive response. As evidenced earlier in the section, FOLFIRI + Bevacizumab can be interspersed with DCA treatments with a case of metastatic colon cancer demonstrating stabilization for 4 years. There is prelimary evidence that FOLFOX and Bevacizumab might also be eligible for this sort of combination with DCA.

Integrative Treatment Case Report

A 2016 Case report demonstrated how DCA and IV Vitamin C and integrative treatments can be extremely cleverly intermixed with FOLFIRI + bevacizumab in the aptly named: Long-term stabilization of stage 4 colon cancer using sodium dichloroacetate therapy.

In summary, after receiving conventional chemotherapy FOLFIRI for approximately 18 mo, the patient received intravenous dichloroacetate DCA therapy with concurrent chemotherapy for approximately 6 mo, followed by intravenous and oral DCA therapy with no concurrent conventional cancer therapy for nearly 4 years.

High dose oral vitamin D, 50g intravenous vitamin C, oral metformin (to improve chemotherapy outcome) and DCA were the main protocol parts; an excellent demonstration of integrative cancer care. 

Infusions were planned around chemotherapy infusions (separated by at least 2 d from chemotherapy) to avoid any potential interference or drug interactions.

CEA Response to DCA

Disclaimer: Trumed, Edmonton Integrative Cancer Treatment, and Dr. Eric Muradov ND do not directly prescribe DCA. We make DCA treatment available through close relationships with allied health care practitioners.

Advanced Therapies: Artesunate

Artesunate is an IV administered extract derived from Wormwood (Artemesia): it is used as an anti-malarial medication around the world. Because of its widespread use, the safety of it as an oral and IV agent is well known. We work with the parent compound Artemesinin. 

A Randomised, Double Blind Placebo-Controlled Pilot Study looked at Artesunate Therapy for Colorectal Cancer. Patients planned for surgery of biopsy confirmed colorectal cancer to receive preoperatively either 14 daily doses of oral artesunate or placebo. 20 patients (9 taking artesunate and 11 taking placebo) completed the trial. During an average follow up of 42 months, 1 patient in the artesunate group and 6 patients in the placebo group developed recurrent colorectal cancer. 

Artesunate reduces colon cancer recurrence

Our clinic has experience in various colorectal cancer patients with IV vitamin C being used as an additive therapy as these treatments have compatibility and the efficacy of IV Vitamin C in colorectal cancer as a standalone treatment is not well supported.

We’ve seen liver metastasis and CEA stabilization in a few cases but not all treated cases. Therefore we run serum CEA every four to eight weeks alongside our Artemesinin treatments to monitor efficacy and disease activity.

Do You Have Questions?

Call Us 780-757-8378