INTEGRATIVE APPROACH INTEGRATIVE APPROACH CONCEPT AND PRACTICE FOR CONCEPT AND PRACTICE FOR

CANCER TREATMENTCANCER TREATMENT

Christo Damyanov MD, Ivan Maslev MDChristo Damyanov MD, Ivan Maslev MD, , Elina Dzhurenova MDElina Dzhurenova MD

Medical center “Integrative Medical center “Integrative medicine”medicine”

Sofia 2013Sofia 2013

Medical center “Integrative Medical center “Integrative medicine”medicine”

Despite of the lack of interset and Despite of the lack of interset and committment of the conventional medicine committment of the conventional medicine towards carrying out clinical researches on the towards carrying out clinical researches on the possibilities of the possibilities of the Insulin Potentiation TherapyInsulin Potentiation Therapy (IPT) in tumor disease treatment, the method (IPT) in tumor disease treatment, the method is increasingly and more widely applied in the is increasingly and more widely applied in the practice of more and more doctors and clinics.practice of more and more doctors and clinics.

Although the IPT efficiency is disputed by the Although the IPT efficiency is disputed by the cancer specialists until clinical researches cancer specialists until clinical researches have been concluded, the doctors practicing have been concluded, the doctors practicing the method have no doubt whatsoever of its the method have no doubt whatsoever of its low toxicity and the improved quality of life of low toxicity and the improved quality of life of the patients.the patients.

IntroductionIntroduction

IntroductionIntroduction

The method application in the Medical Center The method application in the Medical Center “Integratve Mdicine” practice goes back to 2006 “Integratve Mdicine” practice goes back to 2006 and more than 650 patients with advanced and more than 650 patients with advanced metastatic tumors have been treated by it, the metastatic tumors have been treated by it, the major part of these following the failure of major part of these following the failure of preceding chemotherapy and radiotherapy. In preceding chemotherapy and radiotherapy. In spite of the advanced illness and failure of the spite of the advanced illness and failure of the previous treatment, there was a significant previous treatment, there was a significant improvement in the quality of life and remission improvement in the quality of life and remission in about 80 per cent of the patients. Our in about 80 per cent of the patients. Our experience from the IPT application undoubtedly experience from the IPT application undoubtedly allows us to accept the IPT as a leading method in allows us to accept the IPT as a leading method in our practice. our practice.

IntroductionIntroduction

During the last year we used researches of During the last year we used researches of the genetic profile of circulating tumor cells the genetic profile of circulating tumor cells in the cases where the previous standard in the cases where the previous standard chemotherapy had failed. Our preliminary chemotherapy had failed. Our preliminary results indicate that in these cases the results indicate that in these cases the treatment efficiency increased and made it treatment efficiency increased and made it possible to avoid unnecessary medical possible to avoid unnecessary medical procedures. Wider researches allow the use procedures. Wider researches allow the use of more precise and suitable nutrients and of more precise and suitable nutrients and immune modulators. immune modulators.

Problems Restricting our Problems Restricting our Therapeutic PossibilitiesTherapeutic Possibilities

Lack of sufficient information and Lack of sufficient information and cooperation on the part of the patients cooperation on the part of the patients

The inability of some patients to change The inability of some patients to change their life style and carry out the prescribed their life style and carry out the prescribed treatment within the allotted time frame treatment within the allotted time frame

Financial restrictions Financial restrictions Limited possibility of using efficient Limited possibility of using efficient

alternative methods of treatment, such as: alternative methods of treatment, such as: ultrasound and photodynamic therapy , ultrasound and photodynamic therapy , hyperthermia, highly intensive focused hyperthermia, highly intensive focused ultrasound (HIFU), the Coley vaccine and ultrasound (HIFU), the Coley vaccine and othersothers

Possibilities to Combine the IPT with Possibilities to Combine the IPT with Efficient Complimentary and Alternative Efficient Complimentary and Alternative

MethodsMethods

1. The holistic approach and principles when treating 1. The holistic approach and principles when treating cancer leads to a great extent to improved results.cancer leads to a great extent to improved results.

2. The overwhelming part of alternative and 2. The overwhelming part of alternative and complimentary methods applied for cancer complimentary methods applied for cancer treatment need a longer period of impact which is treatment need a longer period of impact which is insufficient in the cases with advanced metastases.insufficient in the cases with advanced metastases.

3. The Insulin Potentiation Therapy is the fastest, 3. The Insulin Potentiation Therapy is the fastest, efficient and non toxic method for achieving efficient and non toxic method for achieving remission, making it possible at a later stage to also remission, making it possible at a later stage to also successfully include other alternative methods of successfully include other alternative methods of anti-tumor efficiency in order to increase the final anti-tumor efficiency in order to increase the final treatment results. treatment results.

4. The complimentary therapy within the interval is an 4. The complimentary therapy within the interval is an important element of the treatment and selection of important element of the treatment and selection of suitable methods and is substantively important to suitable methods and is substantively important to improving the treatment results. In the full remission improving the treatment results. In the full remission cases the complimentary therapy could successfully cases the complimentary therapy could successfully be used to prevent relapses.be used to prevent relapses.

Possibilities to Combine the IPT with Possibilities to Combine the IPT with Efficient Complimentary and Alternative Efficient Complimentary and Alternative

MethodsMethods

5. The complimentary methods improve the results of 5. The complimentary methods improve the results of the IPT application, however, the treatment as a the IPT application, however, the treatment as a whole following remission also needs the whole following remission also needs the application of additional methods, such as: application of additional methods, such as: intravenous therapy with high Vit. C doses , intravenous therapy with high Vit. C doses , ultrasound photodynamic therapy, hyperthermia, ultrasound photodynamic therapy, hyperthermia, high-intensity focused ultrasound (HIFU) and high-intensity focused ultrasound (HIFU) and others. others.

6. Well informed and cooperative patients, their full 6. Well informed and cooperative patients, their full commitment to the treatment as well as regulating commitment to the treatment as well as regulating the psycho-emotional state of the patients are the psycho-emotional state of the patients are important elements of the entire treatment important elements of the entire treatment process. process.

7. Researches of the genetic profile of the circulating 7. Researches of the genetic profile of the circulating tumor cells offer new possibilities to increase the tumor cells offer new possibilities to increase the treatment efficiency. treatment efficiency.

The Medical Center Integrative The Medical Center Integrative Medicine Concept for Integrative Medicine Concept for Integrative

Approach in the Treatment of CancerApproach in the Treatment of Cancer

Treatment is based on the holistic approach with Treatment is based on the holistic approach with leading principles:leading principles:

Interaction and cooperation between doctor and Interaction and cooperation between doctor and patient;patient;

Application of suitable conventional and alternative Application of suitable conventional and alternative methods helping the recuperating abilities of the body;methods helping the recuperating abilities of the body;

Not ignoring the possibilities of both the conventional Not ignoring the possibilities of both the conventional medicine and the alternative medicine and not medicine and the alternative medicine and not accepting indiscriminately the alternative methods accepting indiscriminately the alternative methods offered;offered;

Paying the necessary significance of factors as body, Paying the necessary significance of factors as body, mind and spirit in the progress and outcome of the mind and spirit in the progress and outcome of the disease;disease;

The Medical Center Integrative The Medical Center Integrative Medicine Concept for Integrative Medicine Concept for Integrative

Approach in the Treatment of CancerApproach in the Treatment of Cancer

Treatment is based on the holistic approach with Treatment is based on the holistic approach with leading principles:leading principles:

Optimum results from the treatment can be expected Optimum results from the treatment can be expected by capable application of the scientific achievements by capable application of the scientific achievements and openness towards new methods and possibilities;and openness towards new methods and possibilities;

Application of natural non-invasive methods;Application of natural non-invasive methods; Wide application of the integrative oncology to Wide application of the integrative oncology to

improve the health of all and prevention of cancer;improve the health of all and prevention of cancer; Committing those practicing integrative oncology to Committing those practicing integrative oncology to

the research problems in the field of CAM and the the research problems in the field of CAM and the continuous development of knowledge and abilities.continuous development of knowledge and abilities.

Individual Cancer Treatment Individual Cancer Treatment ProgramProgram

1. Methods for specific therapy: Insulin Potentiation 1. Methods for specific therapy: Insulin Potentiation Therapy (IPT), infusion therapy with high doses of Therapy (IPT), infusion therapy with high doses of Vit. C, photodynamic therapy, hyperthermia Vit. C, photodynamic therapy, hyperthermia combined with IPT.combined with IPT.

2. Basic therapy:2. Basic therapy:a) reducing the impact of the risk factors for the a) reducing the impact of the risk factors for the

disease origin:disease origin: Elimination of focal infections and inflammation. Elimination of focal infections and inflammation. Limiting the effect of toxic environmental factors.Limiting the effect of toxic environmental factors. Diet therapy Diet therapy Detoxication Detoxication

b) Stimulating the immune systemb) Stimulating the immune systemc) Regulating the dysfunction of different organs and c) Regulating the dysfunction of different organs and

systems. systems. d) Regulating the psycho-emotional state of the d) Regulating the psycho-emotional state of the

patient. meditation, yoga, technique for patient. meditation, yoga, technique for emotional freedom anti stress therapy. emotional freedom anti stress therapy.

Presentation of the CasesPresentation of the Cases

First CaseFirst Case

I.T., a I.T., a male patient of 75 ymale patient of 75 y. was . was diagnosed and operated in March 2011 of diagnosed and operated in March 2011 of low differential ductile low differential ductile adenocarcinoma of the pancreas.adenocarcinoma of the pancreas.

Result from Surgery: when inspecting the Result from Surgery: when inspecting the abdominal cavity a tumor formation was abdominal cavity a tumor formation was discovered covering the head and body of discovered covering the head and body of the pancreas and ductus holedohus. The the pancreas and ductus holedohus. The case was considered as inoperable and case was considered as inoperable and directed for symptomatic treatment. A gall directed for symptomatic treatment. A gall derivation was performed. derivation was performed.

Presentation of the CasesPresentation of the Cases

First CaseFirst CaseThe laboratory Test Results Before the The laboratory Test Results Before the

TreatmentTreatment

Hb -131Hb -131 g/l ( g/l ( NN 120-175);; 120-175);; WBCWBC- 20 G/L (- 20 G/L (NN 4-10); 4-10); RBC- 4.63 T/L (RBC- 4.63 T/L (NN 3,9- 6,5); 3,9- 6,5); PLTPLT- 630 G/L (- 630 G/L (NN 140- 140-400); ALAT- 45 U/I (400); ALAT- 45 U/I (N up toN up to 40); ASAT- 40U/I( 40); ASAT- 40U/I(N up N up to to 40), GGT- 186 U/I(40), GGT- 186 U/I(N up toN up to 39); 39); APHAPH- 404 U/I (- 404 U/I (N N up toup to 270); LDH- 114 U/I ( 270); LDH- 114 U/I (N up to N up to 450); 450); BIL - BIL - totaltotal 45.4 mkmol/ l (45.4 mkmol/ l (N up toN up to 21); 21); CholesterolCholesterol - - totaltotal 4.64 4.64 mmol/ l (mmol/ l (NN 3,33- 5,70); 3,33- 5,70); UreaUrea- 13.7 mmol/ l (- 13.7 mmol/ l (NN 2,8- 2,8- 8,1); 8,1); CreatinineCreatinine- 181 mkmol/ l (- 181 mkmol/ l (NN 44-110); Ferritin 44-110); Ferritin -272 mg/(-272 mg/(NN l20-200); CRP- 48,5 mg/ml( l20-200); CRP- 48,5 mg/ml( N up toN up to 5); 5); FibrinogenFibrinogen -12.6 g/l ( -12.6 g/l (NN 2- 4,5); 2- 4,5); СЕАСЕА-132,4 4 -132,4 4 IU/ml ( IU/ml ( N up toN up to 3,4), 3,4), СА-19-9СА-19-9-132,4 IU/ml (-132,4 IU/ml (NN < < 39 ).39 ).

From the status –From the status –KPSKPS-60. Symptomatic index -60. Symptomatic index according to according to BERETTABERETTA – 45 points. – 45 points.

Presentation of the CasesPresentation of the Cases

First CaseFirst CaseIPT therapyIPT therapy

IPT therapy (30 March 2011) with 5-FU and Gemcitabine – one IPT therapy (30 March 2011) with 5-FU and Gemcitabine – one application a week. application a week.

Within the interval – antiangiogenetic therapy, anti oxidants liver Within the interval – antiangiogenetic therapy, anti oxidants liver protectors, enzyme protectors, enzyme preparations, electro-therapy and ozone therapy.preparations, electro-therapy and ozone therapy.

Following the third IPT application a significant improvement of his Following the third IPT application a significant improvement of his status was observed. The symptomatic index values reached 19 status was observed. The symptomatic index values reached 19 points. points.

The total number of the IPT applications reached 19. The The total number of the IPT applications reached 19. The symptomatic BERETTA index – 0 points after the 19th therapy in symptomatic BERETTA index – 0 points after the 19th therapy in January 2012. January 2012.

Control CT - disease stabilization.Control CT - disease stabilization.

Presentation of the CasesPresentation of the CasesFirst CaseFirst CaseFollow upFollow up

The patient is in a remission until July 2012 (13 months).The patient is in a remission until July 2012 (13 months). Surgery (August 2012) - two large cysts on the pancreas Surgery (August 2012) - two large cysts on the pancreas

were evacuated while the cytologic test indicated the were evacuated while the cytologic test indicated the presence of inflammatory and atypical cells.presence of inflammatory and atypical cells.

Following the operation: antioxidants, hepatoprotectors and Following the operation: antioxidants, hepatoprotectors and enzyme preparations. The pains completely disappeared.enzyme preparations. The pains completely disappeared.

In December 2012 control CT - persisting tumor formation In December 2012 control CT - persisting tumor formation on the pancreas head and local lymphadenomegalia was on the pancreas head and local lymphadenomegalia was discovered. discovered.

An intravenous therapy with Vit. C-20 combined with 600 An intravenous therapy with Vit. C-20 combined with 600 mg ALA applied twice weekly were added to the treatment. mg ALA applied twice weekly were added to the treatment. Totally 9 applications were carried out. Totally 9 applications were carried out.

The complaints decreased significantly and the patient was The complaints decreased significantly and the patient was stabilized. stabilized.

After February 2013 the patient was lost from observation. After February 2013 the patient was lost from observation. The total remission was over 18 months.The total remission was over 18 months.

Presentation of the CasesPresentation of the Cases

Second CaseSecond Case

A 64 male with pains in the lumbar area with diagnosed A 64 male with pains in the lumbar area with diagnosed (April 2008) metastatic tumor of the prostate with a (April 2008) metastatic tumor of the prostate with a histological result: adenocarcinoma-Gleason 7/2+5/.histological result: adenocarcinoma-Gleason 7/2+5/.

Hormone therapy was prescribed for one year with Hormone therapy was prescribed for one year with Goserelin (Zoladex), Buserelin (Superfact) and Goserelin (Zoladex), Buserelin (Superfact) and biophosphates (Zometa) as a result of which the patient biophosphates (Zometa) as a result of which the patient is in remission until June 2009 when it was found that is in remission until June 2009 when it was found that the ailment had progressed. the ailment had progressed.

In June 2009 a bilateral orchidectomy was performed, In June 2009 a bilateral orchidectomy was performed, however, in spite of that fact the suffering progressed. however, in spite of that fact the suffering progressed. The PSA and ALP values reached PSA-8395,0 and ALP-The PSA and ALP values reached PSA-8395,0 and ALP-5264 respectively as of June 2009. The patient was 5264 respectively as of June 2009. The patient was offered a painkilling treatment. offered a painkilling treatment.

The symptomatic index (The symptomatic index (BERETTA)BERETTA) before the before the treatment was 31 points; treatment was 31 points; KPSKPS-70. -70.

Presentation of the CasesPresentation of the Cases

Second CaseSecond CaseIPT therapyIPT therapy

In July 2009 - IPT with Insulin (0,3/kg) and In July 2009 - IPT with Insulin (0,3/kg) and Docetaxel (8.6 mg/m2) and 20 per cent glucose Docetaxel (8.6 mg/m2) and 20 per cent glucose i.v within 5 day intervals. By January 2010 18 IPT i.v within 5 day intervals. By January 2010 18 IPT applications have been performed. applications have been performed.

Within the interval antiangiogenetic and Within the interval antiangiogenetic and antioxidant therapies were prescribed and LHRH antioxidant therapies were prescribed and LHRH agonist (Zoladex 3,6 mg) in monthly agonist (Zoladex 3,6 mg) in monthly subcutaneous injections.subcutaneous injections.

Second CaseSecond CaseResultsResults

The pain syndrome went away after the 4th application. The The pain syndrome went away after the 4th application. The patient fully restored his quality of life and working capacity. patient fully restored his quality of life and working capacity. The symptomatic index following the treatment – BERETTA The symptomatic index following the treatment – BERETTA was 1 point. At the control examination the biochemical was 1 point. At the control examination the biochemical indices after the 18th therapy were within the normal values. indices after the 18th therapy were within the normal values. The control PSA test following the treatment indicated close The control PSA test following the treatment indicated close to normal values – 3.33 ng/ml (Ref. 0.0-4,0 ng/ml).to normal values – 3.33 ng/ml (Ref. 0.0-4,0 ng/ml).

Treatment was discontinued for four months. Treatment was discontinued for four months. Later on due to clinical and laboratory data for activation of Later on due to clinical and laboratory data for activation of

the suffering the patient again was accepted for treatment. the suffering the patient again was accepted for treatment. The PSA– 139.50 ng/ml. The PSA– 139.50 ng/ml.

The IPT - new scheme: Epirubicin-(8.8 mgThe IPT - new scheme: Epirubicin-(8.8 mg//m2), Vinkristin - ( 0. m2), Vinkristin - ( 0. 4444mgmg//m2m2), ), EndoxanEndoxan – (240 – (240 mgmg//2)2)- 14 applications. - 14 applications.

The patient again improved his general status and working The patient again improved his general status and working capacity, and PSA as of August 2011 reached 4.48 ng/ml. The capacity, and PSA as of August 2011 reached 4.48 ng/ml. The BERETTA - 5 points.BERETTA - 5 points.

The examinations that followed established a remission with The examinations that followed established a remission with a fully restored working capacity until January 2013.a fully restored working capacity until January 2013.

Until August 2013, the patient’s complaints were insignificant Until August 2013, the patient’s complaints were insignificant and his working capacity was preserved. The total remission and his working capacity was preserved. The total remission amounted to 62 months. amounted to 62 months.

ConclusionConclusion The results achieved from the treatment of more The results achieved from the treatment of more

than 650 patients with highly advanced cancer, as than 650 patients with highly advanced cancer, as of now, justifies our conclusions that the of now, justifies our conclusions that the presented integrative approach with a leading presented integrative approach with a leading IPTLD method represents a real possibility for IPTLD method represents a real possibility for solving one of the most serious problem in solving one of the most serious problem in oncology connected with the toxicity of the oncology connected with the toxicity of the standard chemotherapy. standard chemotherapy.

The case presented demonstrates serious The case presented demonstrates serious possibilities for achieving a long term remission possibilities for achieving a long term remission even when treating highly advanced tumors. even when treating highly advanced tumors.

Undoubtedly, the merit of this approach in our Undoubtedly, the merit of this approach in our opinion together with the treatment results is the opinion together with the treatment results is the significantly improved quality of life of the significantly improved quality of life of the patients treated in the prevailing number of cases. patients treated in the prevailing number of cases.

The holistic approach and suitable selection of the The holistic approach and suitable selection of the complimentary methods are the guarantee and complimentary methods are the guarantee and perspective for improved results when treating perspective for improved results when treating the most serious cancer pathology. the most serious cancer pathology.

Thank you for your attention !Thank you for your attention !