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Sarcoma

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. In fact, evidence based medicine suggests that the only reliable evidence comes from properly run randomised controlled trials. Again, with conventional cancer treatment, there is no evidence from such trials to show that intervention has any effect on deaths..

The following is based on the conventional cancer paradigm with references shown and with CISS comments to balance the narrative.

Sarcomas are a diverse and relatively rare group of malignant tumours that develop in soft tissue and bone. Soft tissue sarcomas form in cartilage, fat, muscle fibrous tissue, blood vessels, and other connective and supportive tissues of the body; osteosarcomas develop in the bone, liposarcomas form in fat, rhabdosarcomas form in muscle, and Ewing sarcomas form in bone and soft tissue. Sarcomas can be difficult to distinguish from other malignancies when they are found within organs; thus, their incidence is probably underestimated.

Soft tissue is the name for all the supporting tissues in the body, apart from bones. They include fat, muscle, nerves, deep skin tissue, blood vessels and the tissue that surrounds joints (synovial tissue). A soft tissue sarcoma is a rare type of cancer that forms as a painless lump (tumour) in any one of these soft tissues. They most commonly develop in the thigh, shoulder and pelvis. Sometimes they can grow in the abdomen or chest (trunk). There are over 70 types (Cancer Council Victoria).

There are more than 30 different types of primary bone cancer. Also called bone sarcoma, the most common types include: Osteosarcoma, which affects cells that grow bone tissue; Chondrosarcoma, which grows in the cartilage; and Ewing’s sarcoma, which affects cells in the bone and tissue that multiply rapidly.

Bone cancer is rare, with about 195 Australians diagnosed each year. More commonly diagnosed is secondary bone cancer, where a cancer that has started in another part of the body has spread to the bones (Cancer Council Australia).

Giant cell tumours (GCT) of bone are one of the commonest bone tumours but are usually benign. They are locally aggressive and may occasionally become malignant.

Soft tissue and bone sarcoma incidence rates have increased over the past 35 years. Soft tissue sarcomas are more common than bone sarcomas. There are several subtypes of both soft tissue sarcoma and bone sarcoma. The five year relative survival rate for both bone and soft tissue sarcoma is approximately 65 percent (National Cancer Institute).

Risks:

For bone cancer,

  • previous radiotherapy, particularly for people who received high doses at a young age.
  • other bone conditions, such as Paget’s disease of the bone
  • genetic factors, such as inherited conditions like Li-Fraumeni syndrome, and a strong family history of certain cancers (Cancer Council Australia).

For soft tissue sarcoma,

  • More likely to happen in people over 55, though can happen in young adults.
  • There is a small risk for people who have had radiotherapy, the risk is higher for people who had high doses at a young age
  • Some rare inherited conditions include Von Recklinghausen disease, Li – Fraumeni syndrome, Retinoblastoma (a rare type of eye cancer mainly found in children) (Cancer Council Victoria).

 

Signs and Symptoms:

Bone cancer:

  • pain in the bones and joints, may be worse at night
  • swelling over the affected part of the bone
  • problems with movement
  • unexplained weight loss
  • loss of feeling in the affected limb
  • tiredness

Bone cancer is diagnosed using x-rays, CT or MRI scans and/or biopsy.

Soft tissue sarcoma:

  • You may develop a painless lump. You may begin to have pain as the lump grows and presses on nerves and muscles.

Please note, most painless lumps are not sarcoma.

Soft tissue sarcoma is diagnosed with blood tests, x-rays and scans. You may require a biopsy (Cancer Council Victoria).

Treatment:

Bone cancer:

Treatment for bone cancer is usually surgery, chemotherapy, radiotherapy or a combination of these.

  1. Surgery –
    • Limb sparing surgery – to remove the cancer but spare the limb is the most common type of surgery. The bone that is removed is usually replaced with either an implant or a bone graft, using a healthy part of bone from another part of the body or from the ‘bone bank’.
    • Amputation – less common, and is only done if it is not possible to remove all the cancer without affecting the arm or leg too much.
    • Other areas of the body – surgery removes the cancer affected bone along with some healthy tissue around it. Bones from other parts of the body may be used to replace the bone that was removed (Cancer Council Australia).

 

Please note: there is little evidence that cancer with surgery has any benefit on increased 5 year survival except in cases where the tumour is in a life threatening position such as obstructing the bowel or pressing on the brain (The efficacy of surgical treatment of cancer – 20 years later, DJ Benjamin) (CISS)

  1. Radiotherapy – uses high energy rays to destroy or damage cancer cells. May be given before surgery to help make surgery safer and easier, or after surgery, to reduce the chance of the cancer cells regrowing (Cancer Council Australia).

Please note: radiation has been shown to reduce recurrence with many types of cancer but this rarely results in increased survival. (The efficacy of radiotherapy, DJ Benjamin).

  1. Chemotherapy – the use of toxic drugs to kill the cancer cell or stop them from growing. For certain types of bone cancer, chemotherapy can be used in combination with surgery to either shrink the tumour before surgery, or after surgery to kill any cancer cells left behind (Cancer Council Australia).

 

Research by Morgan et al concludes did not identify any increase in survival following chemotherapy in osteosarcoma. (CISS)

 

Soft tissue sarcoma

Treatment for soft tissue sarcoma may include surgery, chemotherapy and radiotherapy. They may be given alone or in a combination.

  1. Surgery –

Surgery is the main treatment for most types and usually involves removing the cancer and some healthy tissue around the cancer. Most commonly develop in the thigh, shoulder and pelvis, but sometimes they can grow in the abdomen or chest (trunk). So surgery depends on where the cancer is found.

  1. Radiotherapy –

Radiotherapy uses high energy rays to destroy the cancer cells. Sarcoma is known to be very sensitive to radiotherapy. It may be given for the following:

  • If the cancer is too big to remove with surgery
  • If the cancer has spread to other parts of the body
  • After surgery, to destroy any remaining cancer coming back
  • If the cancer is in a place in the body that is too difficult to get to using surgery
  • Before surgery. It can shrink the cancer making surgery easier and safer. (Cancer Council Victoria).
  1. Chemotherapy –

Toxic drugs given to destroy cancer cells. It is most commonly given to treat Ewing Sarcoma and sarcoma in children. Sometimes it is given to help control symptoms or slow down the growth. Chemotherapy may also stop a sarcoma coming back after surgery (Cancer Council Victoria).

 

Note : Research by Morgan et al conclude that chemotherapy for soft tissue sarcoma does not provide any significant survival benefit.

The above therapies all come with risks and side effects which should be discussed in detail by your treating physician. For a complete comprehensive overview of conventional treatments used for sarcoma with up to date information on the effect of each treatment on mortality and morbidity, please follow this link to The Ralph Moss Reports.

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. Another paradigm believes that cancer is a systemic disease and the tumour is in fact 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. In fact those believed to be most effective in controlling cancer – psychotherapy and immunotherapy – also have strong evidence of benefit from randomised controlled trials.

What is important in any cancer treatment is to both understand and believe in your chosen therapy because the placebo effect has been shown to be very strong.

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.

There are several alternative cancer therapies claimed to produce benefits with sarcoma. Those claimed to have the most benefits in most types of cancer include psychotherapy and immunotherapy.

 

  1. Psychotherapy

 

Although there were no patients with sarcoma enrolled in the psychotherapy trials, psychotherapy was found to provide benefits in all types of cancers with solid tumours, so sarcoma would not be expected to be an exception.

 

  1. 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 26-41% increase survival.

 

Randomised studies showed lower effects than non-randomised studies and matched-pair studies gave significantly better results than others.

 

One study involved 20 patients free from disease after second metastatic relapse. They were randomly assigned to either Iscador or Oral Etoposide (standard chemotherapy). The goal was to compare 12-month Post-relapse disease–free survival (PRDFS) rates with an equivalent historical control group. At the time of publication the median PRDSF was 4 months in the Etoposide group and 39 months in the Iscador group. Patients getting Iscador also reported a higher quality of life due to lower toxicity.

 

References: Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer (Dec 18) 2009; 9: 451-.

 

Longhi, A et al. A Randomized Study on Postrelapse Disease-Free Survival with Adjuvant Mistletoe versus Oral Etoposide in Osteosarcoma Patients. Evid Based Complement Alternat Med. 2014; 2014: 210198.

 

  • Issels Wholebody Therapy

 

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

 

It was estimated in 1970 that a representative sample (252) of Issels’ patients with late stage cancers (of whom 15 had sarcoma) a 16.6% five-year survival following his treatment. This compared 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. This long-term surviving group included 4 of those with sarcoma, (melanosarcoma, endothelioma and cerebral sarcoma).

 

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 Sarcoma Ralph Moss (Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention) reports that the following alternative therapies have also been shown to benefit.

  1. Coley’s Toxins

These are mixed bacterial vaccines developed by William Coley MD in the 1970s after he observed that many people with cancer went into remission after having an acute infection that caused a fever. They are effective with a wide range of cancers. For example

 

Survival among 896 advanced cancer patients, 523 inoperable, 373 operable:

46% 5-year survival with inoperable tumours

50% 5-year survival for operable, including:

giant cell bone tumours – 79% (87% operable) 5 year survival

 

All of these survival figures were well above those achieved with conventional treatments at the time.

 

Reference: Nauts H. Bacteria and cancer – antagonisms and benefits. Cancer Surv. 1989; 8: 713-23.

 

  1. Sulindac

This is a common prescription Non-Steroidal Anti-Inflammatory Drug (NSAID). While it was originally marketed to fight arthritis, gout and other rheumatic disorders, it is now believed to exercise a beneficial role against precancerous conditions and possibly against cancer itself.

 

Desmoid tumours are slow growing sarcomas that sometimes invade local tissue but rarely spread to distant parts of the body, according to William R. Waddell and Wolff M, Kirsch of the department of surgery, University of Arizona at Tucson Arizona. Sometimes these occur spontaneously, but more often they are associated with Gardner’s syndrome, in which about 55 percent of the patients develop such growths.

 

Smaller growths can be removed but large tumours – for example those found in the abdomen, neck, pelvis, thigh or shoulder – often cannot be excised. These scientists have spent 17 years treating this king of tumour with various agents. Their conclusion is that almost all cases can now be controlled by a combination of sulindac and other drugs such as indomethacin (another NSAID), warfarin with vitamin K1, tamoxifen and the hormone testolactone. Sulindac may work by inhibiting the hormone prostaglandin.

References. Huskisson E and Franchimont P. Clinoril in the treatment of rheumatic disorders. New York: Raven Press, 1976.

Waddell WR, Kirsch WM. Testolactone, sulindac, warfarin, and vitamin K1 for unresectable desmoid tumors. Am J Surg. (Apr) 1991;161(4):416-21

 

  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 needs from anaerobic glycolysis (fermenting sugar) rather than respiring in the normal way using oxygen. 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 and slow down its growth. In would also stop the cancer from depleting the body’s energy pools and put an end to cachexia, the terrible wasting process that often 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 in 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, including 37 with sarcomas. All patients in this study had already received conventional treatment without effect and were practically in the terminal phase of their disease.

 

This study of the effects of hydrazine sulphate on 740 cancer patients found that 40% experienced shrinkage or stabilisation of the tumour. Of the 37 patients with sarcoma the figure was 59% with 3 showing more than 50% shrinkage, 4 between 25% and 50%, 2 less than 25% and 13 had tumour stabilisation. 67% experienced pronounced or moderate reduction in cachexia. All but one of these were soft tissue sarcomas. The single osteogenic (bone) sarcoma stabilised with a pronounced reduction of cachexia.

 

References: Filov VA et al. Results Of Clinical Evaluation Of Hydrazine Sulfate. Vopr Onkol 1990;

36 (6): 721-726.

 

  1. Urea

Urea is the most abundant chemical found in urine other than water. Urine has been used in medicine almost since the beginning of history. Today, it is employed in diagnosis, prevention and even therapy.

Eight patients with cancer of the eye were successfully treated with urea, Danopoulos reported in 1975. One of them had a malignant melanoma, one Kaposi’s sarcoma, and six had squamous cell carcinomas. At least 4 of these 8 would have been subjected to removal of their eyeball as the standard treatment.

Reference: Danopoulos ED, et al. Urea in the treatment of epibulbar malignancies. Br J Ophthalmol.1975;1:341-50.

  1. Heat therapy/Hyperthermia

This is the scientific use of heat for the treatment of cancer. Some doctors believe that fever is a natural healing mechanism of the body, stimulating the immune system, while disarming microbes and cancer cells.

 

It is a very promising aspect of sarcoma treatment. Rolf Issels, MD, PhD, professor of medical oncology at the Klinikum Grosshadern Medical Center, University of Munich, presented the results of regional hyperthermia (RHT) at a press conference in Berlin on September 23, 2009. This was part of Europe’s largest cancer congress.

 

The final results were surprisingly robust. Issels reported on 341 patients with high-risk sarcomas who received a standard chemotherapy regimen consisting of three drugs: etoposide, ifosfamide and adriamycin. Half of the patients were then randomized to receive hyperthermia before and after their chemotherapy. The median follow-up time was 34 months. Adding regional hyperthermia to chemotherapy reduced the risk for recurrence or death by 42 percent. Patients who were assigned to the combination treatment survived an estimated 120 months before progressing compared to 75 months for those who were assigned to chemotherapy alone.

 

There were other signs of the benefit of adding heat to conventional treatment. After two years, 76 percent of patients assigned to the combination therapy were alive without local progression compared with 61 percent of those assigned to chemotherapy alone. Tumour shrinkage occurred in just 12.7 percent of patients assigned to chemotherapy alone vs. 28.8 percent assigned to combination therapy. In addition, tumour growth occurred in 6.8 percent of those assigned to combination therapy vs. 20 percent of those assigned to chemotherapy alone.

 

Issels described this as “the first—and the only completed—randomised study on neoadjuvant chemotherapy in high-risk soft tissue sarcoma showing that the addition of regional hyperthermia significantly improves the overall response rate, time to progression, local progression free survival, and disease free survival.”

 

Reference: (Lindner LH, Issels RD. Hyperthermia in soft tissue sarcoma. Curr Treat Options Oncol. 2011;12:12-20).

 

  1. Caesium & Rubidium

 

Caesium and Rubidium are rare alkali metals widely distributed in tiny amounts throughout the earth’s crust. Radioactive caesium has been used for many years in conventional cancer therapy as radioactive seeds implanted in cancer patients. The non-radioactive form has also been used with rubidium, selenium and other minerals and vitamins as a relative non-toxic treatment for advanced cancer.

 

The rationale for this approach is that cancer cells thrive in a low pH (acidic) environment and die in a high pH or alkaline environment.

 

After confirming the efficacy of the treatment with mice Caesium had been tried with 50 terminal cancer patients by the mid 1980s. There was a 50% recovery observed with various cancers including Ewing’s sarcoma of the pelvis. These patients also experienced a disappearance of pain within the first 3 days of the caesium treatment.

 

Autopsies of other treated patients who had died of other causes showed an absence of cancer cells in most cases.

 

References: Sartori HE. Cesium therapy inn cancer patients. Pharmacol Biochem Behav. 1984; 1: 11-13.

 

Ralph Moss also refers to the benefits of Phototherapy in the treatment of Karposi’s sarcoma.

If you or someone close to you has just been diagnosed with sarcoma, it is important 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 treatments.

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.

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