Glutamine was at the core of the old Grouppe Kurosawa anti-cancer protocol. Steve Martin had picked up on laboratory evidence that glutamine worked to decrease the anti-oxidant defences of tumour cells while increasing the anti-oxidant defences of normal cells (specifically it changed the levels of glutathione in tumour cells versus non-tumour cells). He suggested that people take high levels of oral gultamine powder as part of h is protocol. While it has been used clinically to try and stop sores in the mouths and stomachs of cancer patients taking chemotherapy, it's use has always been quite controversial.
The problem is that glutamine is also one of the key nutrients that cancer cells depend on - possibly second only to glucose. The fear has been that taking glutamine supplements would end up feeding the tumours rather than helping destroy the tumours. The evidence has never been that clear, and in trials that have looked at using glutamine to fight chemotherapy side effects, the focus has been on that and not on whether it makes a difference to long term survival.
In rats at least, the work of Professor Klimberg and her co-workers has repeatedly shown positive results, including when glutamine is used with chemotherapy. To date, however, there have been no studies that have looked at using glutamine specifically as anti-cancer agent - with and without other treatments.
In the meantime, we can read of another glutamine clinical trial - this time looking specifically at whether it can target peripheral neuropathy (another common chemo side effect) in multiple melanoma patients:
http://medicalxpress.com/news/2011-09-over-the-counter-drug-effect-chemo-side.html
Also of interest is the on-going activity around low dose naltrexone. You can read more about it...
http://www.anticancer.org.uk/2011/09/ldn-aware-voices-dvd.html
and here:
http://www.ldnresearchtrust.org/
Tuesday 20 September 2011
Thursday 8 September 2011
Fuda Hospital - Caution Needed
Many late-stage cancer patients faced with failed treatments and doctors who are giving up, will think of going abroad to seek different or better treatments. In the UK, for example, it often seems that cutting edge treatments – such as cryoablation, photodynamic therapy or newer drugs – are simple not available on the NHS, or else only used in very specific cancers whereas they may be used for a wider range of diseases in other countries. Anyone looking abroad might well be attracted to the Fuda Hospital in Guangzhou, China. The hospital offers late stage cancer patients treatments that may not be available in their home countries, and seems to be especially welcoming to foreign patients. Fuda has a web site in English, is listed in Wikipedia and is generally well known on the internet. This article aims to sound a warning to patients who are considering going to Fuda for treatment. It is based on detailed discussions with three patients from the UK who have been treated at Fuda. It may be that these three patients have been unlucky, but at the very least their experiences might provide a contrast to the glowing reports listed on the Fuda website.
The three patients were all from the UK and suffering from recurrent and metastatic cancers – all had solid tumours that were in multiple locations and resistant to conventional treatments. All three travelled to China despite the concerns raised by their doctors, but they felt that they had nothing to lose as there were no curative options left from the NHS. Of the three one has since died, one is alive but has progressive disease and one I no longer have contact with. Of necessity I cannot identify these patients by name, and because I am involved in charitable activities involving supporting cancer patients I cannot identify myself either. I apologise for this, but feel the information is important enough to share despite this level of anonymity.
Firstly all three patients were attracted to Fuda because of the combination of multiple treatments on offer – specifically: cryoablation of solid tumours, concurrent immunotherapy and the possibility of Cancer Microvessel Intervention (a highly targeted chemotherapy delivery direct into the tumour). They felt that this package offered a compelling treatment plan, which was agreed in advance of their arrival in China. In the run up they had many email or phone conversations with Fuda, and sent scans and other clinical information. However, on arrival they found that they had been assigned to doctors who did not seem to know the history or have much knowledge of their cases. Once they had arrived new treatment plans were worked out, and other treatments were added in: brachytherapy (radioactive beads implanted into or near the tumours), Chinese herbal medicine and in one case acupuncture.
Now there’s nothing wrong with changes to the treatment plans once the doctor has seen the patient, but treatment at Fuda is not covered by health insurance or health service support. These changes all had the effect of increasing the costs of treatment. They also had the effect of lengthening the duration of treatment, which also increased the costs. And at Fuda everything has to be charged for, including, for example the cost of drinking water, food and accommodation.
The treatments themselves seemed to be carried out in a rather ad hoc manner. In all three cases the use of brachytherapy was a cause for concern. The cost of the treatment was based on the number of radioactive beads implanted, not on the number of tumours treated or the number of treatments. All three patients felt that number of beads used were excessive and in two cases there was subsequent nerve damage. Communication with patients also left something to be desired. Fuda provides translators, but often they would not be available when the doctors were around, which was frustrating when the doctors could not speak English very well.
The policy at Fuda is to use PET/CT scans as the primary imaging tool, but this is not available at Fuda and has to be performed at another hospital in Guangzhou. While Fuda are keen that this is done at the beginning of treatment (and the patient has to pay for it to be done), they did not perform a follow up to see whether the treatments had had any effect. When questioned the patients were told that that inflammatory changes following treatment meant that there needed to be a delay before follow up scans could be interpreted properly. This is true, but it meant that often multiple treatments were being performed and then the patients were asked to go home and get themselves scanned to see if anything had worked. The approach was – you have late stage cancer, nobody else will treat you, we’ll throw some treatment at you and then hope for the best. And in the mean time please pay for all of these additional extras.
A common theme reported by these patients, and one they had heard from other patients while in China, was of costs escalating, of promises of effectiveness being down-scaled and of treatments being tried for which there was no real evidence of effect. This last was particularly true of the immunotherapies being used at Fuda – which are both very expensive and which are lacking clinical trial or even best case evidence. In almost every case patients complained of having to stay longer than promised and having to pay more than expected.
This is not to say that Fuda does not do any good. There may be cases where Fuda does a great job and which saves people – or at least significantly prolongs life. But in the cases I have examined in some detail that is not the case.
Recently an article in the journal Nature reported that:
Unfortunately Fuda gives precisely that impression. If you are considering going to Fuda then exercise caution and as we’ve said before on this site, do not expect miracles, despite what Fuda says about itself.
If you have personal experience of Fuda than please post details here to share with others. Please include an email address so that it can be followed up.
The three patients were all from the UK and suffering from recurrent and metastatic cancers – all had solid tumours that were in multiple locations and resistant to conventional treatments. All three travelled to China despite the concerns raised by their doctors, but they felt that they had nothing to lose as there were no curative options left from the NHS. Of the three one has since died, one is alive but has progressive disease and one I no longer have contact with. Of necessity I cannot identify these patients by name, and because I am involved in charitable activities involving supporting cancer patients I cannot identify myself either. I apologise for this, but feel the information is important enough to share despite this level of anonymity.
Firstly all three patients were attracted to Fuda because of the combination of multiple treatments on offer – specifically: cryoablation of solid tumours, concurrent immunotherapy and the possibility of Cancer Microvessel Intervention (a highly targeted chemotherapy delivery direct into the tumour). They felt that this package offered a compelling treatment plan, which was agreed in advance of their arrival in China. In the run up they had many email or phone conversations with Fuda, and sent scans and other clinical information. However, on arrival they found that they had been assigned to doctors who did not seem to know the history or have much knowledge of their cases. Once they had arrived new treatment plans were worked out, and other treatments were added in: brachytherapy (radioactive beads implanted into or near the tumours), Chinese herbal medicine and in one case acupuncture.
Now there’s nothing wrong with changes to the treatment plans once the doctor has seen the patient, but treatment at Fuda is not covered by health insurance or health service support. These changes all had the effect of increasing the costs of treatment. They also had the effect of lengthening the duration of treatment, which also increased the costs. And at Fuda everything has to be charged for, including, for example the cost of drinking water, food and accommodation.
The treatments themselves seemed to be carried out in a rather ad hoc manner. In all three cases the use of brachytherapy was a cause for concern. The cost of the treatment was based on the number of radioactive beads implanted, not on the number of tumours treated or the number of treatments. All three patients felt that number of beads used were excessive and in two cases there was subsequent nerve damage. Communication with patients also left something to be desired. Fuda provides translators, but often they would not be available when the doctors were around, which was frustrating when the doctors could not speak English very well.
The policy at Fuda is to use PET/CT scans as the primary imaging tool, but this is not available at Fuda and has to be performed at another hospital in Guangzhou. While Fuda are keen that this is done at the beginning of treatment (and the patient has to pay for it to be done), they did not perform a follow up to see whether the treatments had had any effect. When questioned the patients were told that that inflammatory changes following treatment meant that there needed to be a delay before follow up scans could be interpreted properly. This is true, but it meant that often multiple treatments were being performed and then the patients were asked to go home and get themselves scanned to see if anything had worked. The approach was – you have late stage cancer, nobody else will treat you, we’ll throw some treatment at you and then hope for the best. And in the mean time please pay for all of these additional extras.
A common theme reported by these patients, and one they had heard from other patients while in China, was of costs escalating, of promises of effectiveness being down-scaled and of treatments being tried for which there was no real evidence of effect. This last was particularly true of the immunotherapies being used at Fuda – which are both very expensive and which are lacking clinical trial or even best case evidence. In almost every case patients complained of having to stay longer than promised and having to pay more than expected.
This is not to say that Fuda does not do any good. There may be cases where Fuda does a great job and which saves people – or at least significantly prolongs life. But in the cases I have examined in some detail that is not the case.
Recently an article in the journal Nature reported that:
China does not want to be known as the Wild West of unproven medical technologies.
Unfortunately Fuda gives precisely that impression. If you are considering going to Fuda then exercise caution and as we’ve said before on this site, do not expect miracles, despite what Fuda says about itself.
If you have personal experience of Fuda than please post details here to share with others. Please include an email address so that it can be followed up.
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