Presentation on theme: "Triple Negative Breast Cancer & Naturopathic Medicine"— Presentation transcript:
1Triple Negative Breast Cancer & Naturopathic Medicine Jake Psenka, ND
2PMID?Some of the slides make reference to a PMID number. This number can be copied and pasted into the search bar at to see the research article being referenced.
3The Principles of Naturopathic Medicine: Identify and Treat the Cause of DiseaseDo No HarmDoctor As TeacherTreat the Whole PersonThe Power of Prevention
4Triple Negative Breast Cancer (TNBC) Estrogen Receptor NegativeProgesterone Receptor NegativeHuman Epidermal Growth Factor Receptor (HER2) Negative15% of Breast CancersAppear at an earlier ageHigh Histologic GradeDefine Cancer
5Six TNBC Subtypes: 2 Basal Types Immunomodulatory Mesenchymal Mesenchymal Stem-LikeLuminal Androgen ReceptorEach subtype has characteristics which may make it more or less susceptible to a particular type of therapy. Hopefully, as research progresses, it will become possible to use more patient-specific treatment strategies.PI3K- phosphatidylinositol-3-kinase, a signaling pathway, plays a role in growth and survival in many mammalian cancersP53- tumor suppressor gene, mutations occur in up to 82% of TNBCBRCA1MIB-1IGF-1R: Insulin like growth factor receptor, a tyrosine kinase, binds IGF.Ki67: a measure of cell proliferation, higher # ass. With axillary mets in TNBCmTOR:
6Current TNBC Treatment Strategies Cytotoxic Therapy (Adriamycin/Cytoxan/Taxol)RadiationSurgeryChemotherapy is considered a cytotoxic and systemic therapy aimed at destroying rapidly dividing cancer cells.Radiation: kills by ionizing DNA molecule within a cancer cells and the production of free radicals (hydroxyl radicals).At the present time these therapies have a low rate of success and new more efficacious treatments are needed.Adriamycin (docorubicin)Cytoxan (cyclophosphamide)Taxol (Paclitaxel)
7Problems Associated with Current TNBC Treatment Strategy ToxicityImmune SuppressionFatigue & MalaiseDepression/AnxietyDrug ResistanceLack of EfficacyUltimately a lack of efficacy.We need new therapies that provide better outcomes.
8Naturopathic Treatment Strategies As a way to support the patient:Promoting health of patient- both mind & bodyMinimizing treatment related side effectsAs integrative therapy:Anti-Cancer TherapyImproving clinical outcomesPreventing Re-occurrenceNot anti-conventional treatments. Prefer integrative approach.Frequent Question: Can a person use CAM treatments with Conventional? Yes, as long as you use the right ones.How many people changed their diet when they were diagnosed? Yes = using CAM
9Food As MedicineDietary habits can play a role in both the development and progression of cancer. A healthy diet supports the body’s natural processes and functions.Inhibiting Unintended Weight LossPromoting Healthy EliminationReducing Treatment Related Side EffectsAnti-inflammatory ActionEnergy Balance/Fatigue ReductionImproving Efficacy of TreatmentsUnintentional weight loss- either via LOA from treatment, or as a consequence of tumorMany tx’s are toxic- want them in and out, if elimination routes are inhibited (aka. Constipation) this can cause more toxicity issues, may also produce additional problems (impaction), additionally many drugs are nephrotoxic and maintaining good hydration keeps the kidneys safe. Tumor lysis syndrome and hydrationIn addition to bowel and urinary issues, healthy diets can also provide the body with what it needs to process chemicals and remove them from the body(cyp450 system).Some foods promote a decrease in the levels of inflammation present in the body: n-3: PGE2, fish oil: vitamin D3Nutritionally deficient diets do not provide for sustained energy levels. Simple carbs = transient energy followed by a crash.If a patient does not maintain good health through their therapies then an extended chemo break, or dose-reduction is often needed. This can decrease efficacy.
11INSULIN-LIKE GROWTH FACTOR-1 Food As Medicine.INSULIN-LIKE GROWTH FACTOR-1These results show that IGFs stimulate cell proliferation and promote cell survival in triple-negative breast cancer cell lines and warrant investigation of the IGF signal transduction pathway as a therapeutic target for the treatment of triple-negative breast cancer. Neoplasia Jun;13(6):504-15Randomized controlled trials indicated that the circulating IGF-I level was significantly higher in the milk intervention group. Int J Food Sci Nutr. 2009;60 Suppl 7: Epub 2009 Sep 9.An unhealthy diet does not provide the same benefits, and instead can have significant negative impactHere is an example of a specific dietary manipulation aimed at inhibiting cancer growth:No dairy on TNBC diet?IGF-1 binds to IGF-1R , a hormone is one of the most potent natural activators of the AKT signaling pathway, a stimulator of cell growth and proliferation, and a potent inhibitor of programmed cell death (apoptosis).These data suggest that a plant-based diet is associated with lower circulating levels of total IGF-I. Cancer Epidemiol Biomarkers Prev Nov;11(11):
12Food As Medicine“In vivo, the efficacy of blueberry to inhibit triple-negative breast tumor growth was evaluated. Tumor weight and proliferation (Ki-67 expression) were decreased in blueberry-treated mice, where apoptosis (caspase-3 expression) was increased compared with controls.”“In combination with standard treatments, supplementing the diet with (n-3) fatty acids may be a nontoxic means to improve cancer treatment outcomes and may slow or prevent recurrence of cancer.”Lung metastasis of TNBC was reduced (16-70%) by all treatments, significantly in the flax seed oil group. The distant lymph node metastasis was significantly decreased (52%) only in the flax seed oil group. The total metastasis incidence was lowered (42%). Mouse study.Ki67, a measure of proliferation, higher expressions of this associated with axillary mets.(PMID: )PMID:PMID: ,
13SUGAR/CARBOHYDRATE/GLUCOSE = ENERGY Food As MedicineSUGAR/CARBOHYDRATE/GLUCOSE = ENERGYHigher SUVmax and %Ki67 are associated with higher histologic grades.Histologic grade is a measure of proliferation, Scarff-Bloom-Richardson system most common rage from 3-9.Recall our definition of cancer.Cell reproduction (mitosis) takes energy. GLUT-1 receptors more expressed in TNBC (PMID: ) GLUT1 trasporters are upreg. When a cell is hungry.What are the effects of a high sugar/refined carbohydrate diet?PMID:Glucose receptors are upregulated in TNBC (PMID )Higher sugar uptake by TNBC cells correlates with increased cancer cell proliferation (PMID: )
15Supplements for cancer? Reasons for using supplements with conventional therapy:Minimize treatment-related side effectsPromote a well functioning immune systemSynergize with conventional treatmentsAre supplements safe with conventional care? Yes, if you take the right ones.Natural does not mean safe.How many capsules can a person eat in one day. Try to maximize effectiveness
16L-Glutamine protects against doxorubicin (aka Adriamycin) heart damage Side EffectsL-Glutamine protects against doxorubicin (aka Adriamycin) heart damageGlutamine for taxane induced neurotoxicity.Melatonin inhibits Cytoxan-induced leukopenia and anemiaMelatonin inhibits taxane-related neuropathyDHA, an n-3 fatty acid, is currently in trialsHormonesGlutamine: PMID: , PMID:Melatonin: PMID: , PMID:PMID: , , ,
18SynergizeMultidrug resistance (MDR):Defined as the ability of a tumor cell to survive exposure to clinically achievable concentrations of structurally diverse chemotherapeutic drugs which act at different intracellular targets.
19Propolis (caffeic acid) SynergizePropolis (caffeic acid)Inhibits TNBC tumor growth, both in vitro and in vivo without much effect on normal mammary cells.Decreased malignancy potential of TNBC stem cells.VEGF/AngiogenesisStem cells implicated with chemoresistance, tumor recurrence, metastasis, and high patient mortality.PMID:PMID:
20Inositol Hexaphosphate (IP6): SynergizeInositol Hexaphosphate (IP6):decrease proliferation rates in TNBC cellsworks synergistically with adriamycin (and Tamoxifen)inhibits metastasisactivates natural killer cell functionPatient study finds those who took it with chemo had no cytopenia, lowered leukocyte, or platelet levels, increased QOL and better functional status.PMID:PMID:PMID:PMID:IP6: P27kip1 tumor suppressor proteinPMID:PMID:PMID:PMID:
21Curcumin (extract from tumeric) SynergizeCurcumin (extract from tumeric)Modulation of the BRCA1 Protein and induction of apoptosis in TNBCBlocker of COX and LOXShown to decrease the MDR1 gene through the PI3k/AKT/NF kappa beta pathwayArachidonate metabolites: cycloxygenase and lipoxygenase: anti-inflammatoryOne study was published stating that found curcumin to antagonize the effects of CTX. Serious methodological errors and misrepresentations of scientific data were found in that study.PMID:PMID:
22SynergizeVitamin D3Potentiates the anti-tumor activities of chemotherapy drugs cisplatin, carboplatin and doxorubicin; 5-fluorouracil, cytarabine, hydroxyurea, cytarabine and gemcitabine; paclitaxel and docetaxel.Vitamin D3 enhances the effect of hydrogen peroxide in cancer cells.
23Inhibits TNBC proliferation SynergizeIndole-3-CarbinolInhibits TNBC proliferationDown regulated PGP transmembrane efflux pumps by 80%.Decrease TNBC cell motilitySulphoraphaneInhibits inflammatory cytokines and pro-angiogenic growth factors in TNBCPMID:PMID:PMID:PMID:
24Resveratrol enhances mTOR inhibitor SynergizeResveratrolSensitizies tumor to chemotherapy drugs including vincristine*, adriamycin, paclitaxel*, doxorubicin, cisplatin, gefitinib, 5-fluorouracil, velcade, and gemcitabine.Resveratrol enhances mTOR inhibitorNFKBPMID:PMID:PMID:PMID:
25Detoxification: Get Specific RemissionPreventing recurrence: NCCN guidelines for breast cancer state “Evidence suggests that active lifestyle, achieving and maintaining an ideal body weight (20-25 BMI) may lead to optimal breast cancer outcomes.”Detoxification: Get SpecificNational Comprehensive Cancer NetworkCoffee enemas/colonics- rectal burn
26New IdeasMetforminBreast Cancer Res Treat Sep;123(2): Epub 2009 Nov 22.Dietary energy availability affects primary and metastatic breast cancer and metformin efficacy.Phoenix KN, Vumbaca F, Fox MM, Evans R, Claffey KP.