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Lung Cancer

CISS relies strongly in its evaluations below on impartial analyses by the International Cochrane Collaboration and the British Medical Journal’s Clinical Evidence Group – two groups of researchers who specialise in Evidence Based Medicine.

 

Conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer. Unfortunately statistics show this is rarely the case.

Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy.

Evidence based medicine suggests that the only reliable evidence for efficacy comes from properly run randomised controlled clinical trials (RCTs).

As mentioned below, none of the RCTs evaluating conventional intervention for lung cancer have shown any clear benefit. Therefore the conventional cancer paradigm needs to be questioned.

The following is based on the conventional cancer paradigm.

The lungs are a pair of cone-shaped breathing organs inside the chest. The lungs bring oxygen into the body when breathing in and send carbon dioxide out of the body when breathing out. Each lung has sections called lobes. Tiny air sacs called alveoli and small tubes called bronchioles make up the inside of the lungs. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs.

The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is any type of epithelial lung cancer other than small cell lung cancer. The two types are based on the way the cells look under a microscope. Non-small cell lung cancer is much more common than small cell lung cancer. (NCI)

There are several types of non-small cell lung cancer. Each type has different kinds of cancer cells. The cancer cells of each type grow and spread in different ways. The types of non-small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look under a microscope:

  • Squamous cell carcinoma: cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. This is also called epidermoid carcinoma;
  • Large cell carcinoma: cancer that may begin in several types of large cells;
  • Adenocarcinoma: cancer that begins in the cells that line the alveoli and make substances such as mucus. It includes bronchiolar carcinoma.

Other less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumour, salivary gland carcinoma, and unclassified carcinoma. (NCI)

There are two main types of small cell lung cancer. These two types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:

  • Small cell carcinoma (oat cell cancer).
  • Combined small cell carcinoma.

Signs and Symptoms: Most lung cancer is detected either by the doctor during a check-up, possibly following symptoms such as a persistent cough, blood in the sputum or a pneumonia, or during an X-ray of the chest or surrounding areas.

Lung cancer often grows very slowly. For this reason there is often overdiagnosis and overtreatment as outlined below. (CISS)

Lung cancer accounts for 9% of all cancers and 17% of cancer deaths in Australia, making it the fourth most common type of cancer and highest cause of cancer deaths in both men and women.

Studies have identified cigarette smoking as the main risk of lung cancer. It has been claimed that it results in approximately 85% of all lung cancer cases.

Lung cancer is divided into 6 stages: Occult (not detectable), 0 (carcinoma in situ), and I-IV

Prognosis: SCLC has the most aggressive clinical course of any type of pulmonary tumour, with median survival from diagnosis of only 2 to 4 months. The overall survival at 5 years is 5% to 10%.

Treatment: There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is.

The standard treatments for lung cancer include surgery, radiation therapy, chemotherapy, targeted therapy, laser therapy, photodynamic therapy, cryosurgery, endoscopic stent placement, and electrocautery.

Surgery: A procedure in which a doctor with special training, called a surgeon, removes cancer from your body. (NCI)

This is based on the unproven assumption that the tumour is the disease so removing the tumour removes the cancer. There is no evidence from trials to support this assumption.

This suggests that lung cancer is not a disease that starts locally but a systemic disease, with tumours being only late stage symptoms. (CISS)

References: Benjamin DJ. The efficacy of surgical treatment of cancer – 20 years later. Med Hypotheses (April) 2014; 82 (4): 412–420. http://www.sciencedirect.com/science/article/pii/S0306987714000127 ).

Radiotherapy: The rationale is to kill any cancer cells remaining after surgery.

A large meta-analysis of radiation results for lung cancer showed that after 2 years there were 21% more deaths in the group that had radiation in addition to surgery as compared to those who had surgery alone. The reviews concluded that

“Post-operative radiotherapy (PORT) is detrimental to patients with early stage completely resected non-small-cell lung cancer and should not be used in the routine treatment of such patients.”.

References: PORT Meta-analysis Trialists Group: Postoperative radiotherapy in non-small-cell lung cancer: systematic review and metaanalysis of individual patient data from nine randomised controlled trials. Lancet 1998 Jul 25; 352(9124): 257-63 and Lancet 1998 Jul 25; 352(9124):250-1.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12535431

Chemotherapy: This uses drugs to kill cancer cells. (NCI) The absolute increased survival benefit at 5 years for chemotherapy is ~1.5% representing an increase in 2 months median survival.

References: (Morgan G et al The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies. Clinical Oncology (2004); 16: 549-560.)

 

Targeted Therapy: This is designed to target the changes in cancer cells that help them grow, divide, and spread. (NCI) There is limited evidence for benefit from using this approach to treatment except that it can reduce the harm from using treatments such as chemotherapy unnecessarily. (CISS)

The above therapies all come with risks and side effects that should be discussed in detail with your treating physician.

Before deciding on one of these treatments you would benefit from asking your physician three questions:

Question 1: What are my treatment options? – these should include doing nothing.

Question 2: What are the possible outcomes of those options? – including benefits and side effects.

Question 3: How likely is each of the outcomes to occur?

If you feel your doctor or other health practitioner is not able to answer these questions, or shows that

he or she is not comfortable with you asking these questions, it raises the question as to whether they

are practising evidence based medicine and you should consider getting another opinion.

These three questions can be expanded.

For a complete comprehensive overview of conventional treatments used for lung cancer with up to date information on the effectiveness of each treatment on mortality and morbidity, please follow this link to The Ralph Moss Reports.

Early detection/Screening: Some doctors believe that screening for the presence of lung cancer using X-rays should be used to screen people for early lung cancer. However three Randomised Controlled Trials (RCTs) have found that there are no overall benefits achieved from lung cancer screening of the general population. In fact in two of those studies there was an increase in deaths among those screened compared to those not offered screening. One of the reasons for this is that post screening treatments, especially surgery, cause an increase in the number of deaths. For example about 5% of those who undergo lung cancer surgery die within 30 days of the surgery. – so population screening causes more harm than good.

In recent years a different type of lung cancer screening has been developed called low-dose computed tomography (LDCT). An RCT evaluating the effects of LDCT compared to standard X-rays among heavy smokers showed that there were fewer deaths from lung cancer among those screened using LDCT compared with those screened with X-rays. It did not compare lung cancer deaths after this screening with no screening. So it only showed that LDCT is less harmful than X-ray screening. It allowed less harmful post screening surgery.

The US Preventative Services Task Force (USPSTF) concludes with moderate certainty that annual screening for lung cancer with LDCT is of moderate net benefit in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. (Pack-years = packs per day x number of years smoking. So a person with 30 pack-years smoking history means a person who has smoked 30 packs a day for 1 year or 1 pack a day for 30 years.) (NCI) This claim is questionable because the study did not compare this screening with no screening – the only valid criterion. (CISS)

 

However a problem with this type of annual screening is that, like X-ray screening, over a three year period, about 95% of tumours identified by screening are false positives. That is detection of benign lymph nodes or granulomata, which are non-cancerous inflamed tissue masses. These are usually followed by surgery anyway just in case.

 

The lack of benefit from an increased degree of surgery and the lack of benefit from earlier surgery made possible by early detection through screening shows that the conventional mantra of “Get it all” and “Get it early” is not supported by any evidence. This again suggests that lung cancer must be a systemic disease, not one that starts locally. (CISS)

Overdiagnosis: Another problem relating to lung cancer screening is overdiagnosis resulting in overtreatment. The USPSTF has estimated that 10% to 12% of screen-detected lung cancer cases are overdiagnosed—that is, they would not have been detected in the patient’s lifetime without screening. However this figure is likely to be an underestimate, with the real figure likely to be closer to 50%. For example one way of estimating overdiagnosis is to monitor the incidence of lung cancer over time in those screened and those not screened. The rationale is that screening finds tumours earlier when they are more amenable to treatment. After several years the unscreened group should experience the same ‘catch-up’ tumours (at a more advanced stage). However in the Mayo Lung Study involving 9,000 smokers, after 20 years’ follow-up there remained 50% more tumours detected in the screened group suggesting a 50% overdiagnosis of lung cancer as a result of

screening.

References: (H Gilbert Welch et al “Over-diagnosed: Making people sick in the pursuit of health” Beacon Press, Boston, 2011 at p.67.)

Alternative Cancer Therapies

 

As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer. There is little evidence to support this paradigm.

 

Another paradigm states that cancer is a systemic disease and the tumour is only a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:

 

  1. Treatment should cause no harm
  2. Treatment should be wholistic (ie consider the whole person – body, mind, emotions and spirit)
  3. The person with cancer needs to take control of their own health. This latter paradigm is supported by CISS (See Introduction to CISS)

 

Alternative cancer therapies are generally consistent with the above principles.

 

There are approximately 200 alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. The following are those with the most scientific evidence for benefit. What is important in any cancer treatment is to both understand and believe in your chosen therapy.

 

Unfortunately many medical researchers are limited to the use of alternative cancer therapies only after orthodox/conventional therapies have been tried first. This is based on the mistaken belief that the particular conventional therapies are beneficial and alternative therapies are not. Because therapies such as radiotherapy and chemotherapy can weaken the immune system it is often not possible to evaluate an alternative therapy on its own. For this reason most randomised controlled trials evaluate alternative therapies only when added to a conventional therapy. This means that often their benefits are under-estimated.

 

The alternative therapies shown to be the most effective in controlling cancer – psychotherapy and immunotherapy – also have strong supporting evidence from randomised controlled trials.

 

  • Psychotherapy

 

One RCT evaluating a particular type of group psychotherapy randomised 151 late stage cancer patients with metastasised non-small-cell lung cancer into two groups: one received palliative care in addition to standard oncologic care; the control group received only standard oncologic care. Despite receiving less aggressive end-of-life care, patients in the palliative care group had a significantly longer survival than those in the standard care group with a median survival of 11.65 months vs 8.9 months, a 31% increase in survival. They also became less depressed. This confirms the benefits of psychotherapy with lung cancer.

 

References: Temel, JS et al. Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer. N Engl J Med 2010; 363:733-742August 19, 2010.

 

Another trial randomised 48 people with inoperable (terminal) cancer into two groups: one group received individualised psychotherapy in addition to standard care while the control group received only standard care. The groups were made up of 7 matched pairs with bronchiolar (non-small-cell lung) cancer, 5 with colorectal cancer, 5 with cervical cancer, 4 with uterine cancer, 2 with stomach cancer and 1 matched pair with scrotal cancer.

The average survival of the treated group was 5.07 years compared with the control group of 3.09 years, an increased survival of 64%. This increase ranged from 16% for cervical cancer to 71%-81% for uterine, colorectal, stomach and scrotal cancer and 148% (3.7 years vs 1.5 years) for lung cancer.

 

References: Eysenck, HJ & Grossarth-Maticek, R. Creative Novation Behaviour Therapy as a Prophylactic Treatment for Cancer and Coronary Heart Disease: Part II – Effects of Treatment. Behav Research and Therapy 1991; 29 (1): 17-31.)

 

Although RCTs with only 48 participants are rarely reliable because of the difficulty of ensuring properly matched groups after randomisation, those running this trial formed pairs of cancer patients matched according to sex, age, smoking, cholesterol level, blood pressure and personality type from a larger group before randomising them into pairs, thus ensuring properly matched groups after randomisation.

 

  • Immunotherapy

  • Iscador (mistletoe extract)

 

Many clinical trials have shown benefits of Iscador therapy on people with different types of cancer. One analysis of 22 studies included 12 prospective studies, 5 randomised studies and 10 had a matched-pair design from which the authors identified 41 comparisons of Iscador vs no treatment. All but four showed a positive increased survival.

 

A random effect meta-analysis estimated the overall hazard ratio at HR = 0.59 (CI: 0.53 to 0.66, p < 0.0001). Simple meta-regression yielded a predicted HR = 0.74 (CI: 0.66 to 0.82, p < 0.0001). This means that Iscador was shown to produce about a 40% increase survival. Lung cancer studies showed slightly better outcomes than others (ratio of HRs: 0.56, CI: 0.00 to 1.10, p = 0.095), ie ~44% increased survival. Randomised studies showed lower effects than non-randomised studies and matched-pair studies gave significantly better results than others.

 

References: Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer 2009; 9: 451-.

 

  • Issels Wholebody Therapy

Although not based on RCTs the most successful therapy for late stage cancers including lung cancer was Issels’ Whole Body Therapy that focussed on restoring the body’s immune systems.

 

It was estimated that a representative sample, 252 of Issels’ patients with late stage cancers of whom 26 (10.3%) had late stage lung cancer, showed a 16.6% five-year survival following his treatment. This compares with less than 5% with standard treatment at the time. They also experienced a 15% 15-year survival compared with less than 2% for standard treatment. Four of those with lung cancer (8.8%) were among the 42 who survived 15 years in good health.

 

References: (Issels, J. Immunotherapy in Progressive Metastatic Cancer – A Fifteen-Year Follow-up. Clinical Trials Journal, August 1970: 357-365 – editorial by Phillips S. Dr Joseph Issels and the Ringberg Klinik. Clinical Trials Journal. August 1970: 355-56.)

 

The above studies, that include RCTs, show that systemic therapies are much more successful than therapies based on the orthodox paradigm.

 

For lung cancer, Ralph Moss, Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention, reports the following alternative therapies have been shown to benefit people with lung cancer in addition to Iscador and psychotherapy:

 

  1. Hyperthermia (Heat therapy) – Hyperthermia is increasingly used in conjunction with other conventional treatments because it has been found to enhance their effects. One effect of hyperthermia is that it simulates the effect of the fever induced by the Coley’s Toxins.

 

It is based on the principle that cancer cells are more susceptible to heat than healthy cells. (NOTE: In the last 25 years since Moss’ book was published there have been many developments in the hyperthermia area with more evidence of benefit of hyperthermia in the treatment of breast cancer – CISS)

  1. Hydrazine Sulphate – This is a common industrial chemical that was used as a component of rocket fuel during World War II. It was first proposed as a cancer treatment in the early 1970s by Joseph Gold MD, of the Syracuse Cancer research Institute, NY.

 

Gold drew on the work of Nobel laureate Otto Warburg, who theorised that cancer derived its energy from anaerobic glycolysis (fermenting sugar) rather than respiring in the normal way. Gold proposed using chemicals to control cancer’s growth by exploiting this process.

 

Gold suggested that by cutting off a tumour’s supply of new glucose, formed in the liver,

the drug could starve the tumour, in turn stopping the cancer from depleting the body’s energy pools and putting an end to cachexia, the terrible wasting process that appears in the final stages of the disease. It is this wasting process that often kills the cancer patient and is estimated to cause ~40% of all cancer deaths.

 

A team of 11 scientists at the N.N Petrov research Institute of Oncology, Leningrad have been working on hydrazine sulphate since the 1970s. The Russians have had the greatest single experience with hydrazine sulphate having treated and evaluated over 740 patients. Thus, in the Russian studies it was shown that hydrazine sulphate inhibited the wasting process and increased survival.

 

References: Chlebowski, RT et al. Influence of hydrazine sulfate on survival in non-small-cell lung cancer: a randomized, placebo-controlled trial. Proc. Am. Soc. Clin. Oncol. 6:175, 1987.

Gold, J. Hydrazine sulfate in non-small-cell lung cancer. J. Clin. Oncol. 8:1117-1118, 1990.

Loprinzi, C.L. et al. Placebo-controlled trial of hydrazine sulfate in patients with newly diagnosed non-small-cell lung cancer: J. Clin. Oncol. 12:1126-1129, 1994.

Kosty, M.P. et al. Placebo-controlled randomized study of hydrazine sulfate in lung cancer. J. Clin. Oncol. 13:1529-1530, 1995.

Filov, V, et al. Results of clinical evaluation of hydrazine sulfate. Vopr Onkol 1990; 36: 721-6.

Filov, V, et al. Experience of the treatment with Sehydrin (Hydrazine Sulfate, HS) in the advanced cancer patients. Investigative New Drugs 1995; 13: 89-97.

Chlebowski, RT. Hydrazine sulfate in cancer patients with weight loss. A placebo-controlled clinical experience. Cancer 1987; 59: 406-10.

 

  1. Warfarin – This is an anti-coagulant designed to stop blood clotting

 

In a controlled study warfarin prolonged survival in lung cancer patients who were also receiving conventional therapy Survival for those on conventional therapy was 24 weeks while for those also getting warfarin it increased to 50 weeks.

 

References: Zacharski LR. et al. Effect of warfarin on survival in small-cell carcinoma of the lung. Veterans Administration Study No. 75. JAMA 1981; 245: 831-5.

 

Other therapies mentioned by Moss include BCG, benzaldehyde, caesium and rubidium, chinese herbs, particular vitamins and electrotherapy for which anecdotal reports suggest benefits.

 

Other therapies currently producing positive results are

  • Antineoplastons by Stanislaw Burzynski who uses a particular type of targeted therapy for non-small-cell lung cancer at his clinic in Houston, Texas.

 

References: Burzynski, S.R, Nagy-Kubove, E. Treatment of esthesioneuroblastoma and non-small cell lung cancer with phenylbutyrate. Journal of Cancer Therapy 2011; 2 :518-522.

 

  • Immuno-Augmentative Therapy (IAT) developed by the late Lawrence Burton at his IAT clinic in the Bahamas.

Efficacy: Among more than 1,000 terminal cancer patients:

– between 15-18% 5-year survival overall;

With 277 terminally ill patients treated in 1977:

– more than 18% in good health 5 years later

With 11 patients with peritoneal mesothelioma:

– 50% 5-year survival

 

References: Richard Walters, Options, Avery Publishing Group, New York 1993, p.60;

Jane Riddle Wright, Diagnosis Cancer – Prognosis: Life, Albright & Co, Hunstville, AL 1985.

  • Coley’s Toxins developed by the late William Coley and continued by his daughter Helen Coley-Nauts. (more recently known as Mixed Bacterial Vaccines)

With 896 advanced cancer patients, 523 inoperable, 373 operable

  • 46% 5-year survival with inoperable tumours
  • 50% 5-year survival for operable.

 

References: Nauts, H. Bacterial pyrogens: beneficial effects on cancer patients. Prog Clin Biol Res 1982; 107: 687-96.

 

If you or someone close to you has just been diagnosed with lung cancer it is important that you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical , mental, emotional / psychological and spiritual treatment.

 

For more information on some more common evidenced based alternative treatments please go to the alternative treatment tab. If you don’t know where to begin in your journey to wellness then we suggest you read Where to start.

There are different terms to describe non-conventional or unorthodox cancer therapies but they often have different meanings:

Alternative: a term denoting that the therapy is use instead of conventional treatment. It is usually based on the paradigm that cancer is a systemic condition;

Complementary: a term denoting that the therapy is used in addition to conventional treatment, sometimes to alleviate its side effects. It usually accepts the conventional cancer paradigm;

Integrated: a term denoting that the therapies used by the practitioner or clinic include treatments based on the different cancer paradigms;

Traditional Medicine: a term referring to Chinese, Ayurvedic, Tibetan, or other indigenous medical systems;

Natural medicine: A term denoting a part of alternative medicine designed to alleviate ill health using individualised treatment modalities in harmony with the laws of nature. It is similar to naturopathic medicine.

(W)holistic medicine: Similar to natural medicine in that it stresses the need to use individualised treatments to treat the body, the mind, the emotions and the spirit but can include therapies not used by naturopaths because they are not considered natural.

For further information go to “What is alternative therapy?” where you can read the article “Understanding the Differences Between Conventional, Alternative, Complementary, Integrative and Natural Medicine”

 

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