Posted on by Daniel

Beneficial Drug Interactions to Help the Advancement of Oncology Treatments

Introduction

(by Daniel Stanciu, PhD)

During the past years, the field of re-purposed drugs, has gain an increasing traction in the oncology field. Drugs that are commonly used for various illnesses, are now proposed by scientist at major academic research centres across the world, as new approach to increase the effectiveness of conventional treatment. In some cases, the repurposed drugs can represent relevant alternatives to the conventional treatment approaches, or new treatment options for patients who have no other treatments available anymore.

By now, this is not theory anymore. It’s a fact. Indeed, many studies have demonstrated positive results in humans when the right re-purposed drugs are used in various cancers. Many of these studies, have been addressed in the website during the past years.

The major challenge of our society now is to find effective ways to translate this new knowledge to the medical system, in such a way so that the knowledge is adopted and implemented to improve and extend life of cancer patients. Therefore, we need to find ways to convey this new knowledge to clinicians such that they will not see it as ”alternative medicine” but as additional application of existing drugs. This is one major challenge of our society now.

Dr. Pavia Lumholt, may hold the answer to this challenge.

Dr. Lumholt, is a plastic surgeon in Denmark, with extensive experience in the public health care system. He often helped patients with breast reconstruction after breast cancer and microsurgical reconstruction, including large reconstructions after head & neck cancers and sarcomas.

While searching for ways to maximise the treatment outcome of his dear wife diagnosed some years ago as stage 4 breast cancer, Dr. Lumholt came across the value of repurposed drugs in oncology. Now, about 3 years post diagnostic Dr. Lumholt’s wife is in good health with no signs of cancer, after employing various treatments including chemo-, radio-therapy, food supplements and re-purposed drugs.

Dr. Lumholt, was kind enough to share with us here, his belief on what is the best and maybe the only way to implement knowledge on re-purposed drugs into the medical system, in a way that it will be adopted and applied by most of the general practitioners. And as you will see, that is not by calling them re-purposed drugs.

Please read the message of Dr. Lumholt shared below, and see his great TEDx talk following the link at the end of this post.

If you have the means to help and move this idea towards implementation, please let us know! If not, at least please share this post (via the share option at the end of the post) or the TEDx talk of Dr. Lumholt on your Facebook page in order to help reach as many people as possible and create awareness about this perspective. And hopefully one day, we can reach the momentum (people and money) required to implement the idea of Dr. Lumholt.

Do we want doctors to like alternative treatments, or do we prefer antagonism? Our words make all the difference

(by Dr. Pavia Lumholt, MD)

It’s not hard to get Your doctor into alternative treatments. But You will need to say the right words. And the right words are “beneficial drug interactions”.

You see, most alternative cancer treatments are not…alternative. They are ordinary drugs, that have shown to interact positively with conventional cancer therapy like chemo, radiotherapy, immunotherapy and cancer surgery.

Taking drug interactions into account is a completely integrated part of medical decision making. Usually the focus is on negative interactions – potentially dangerous ones, that can cause harm when certain medications are taken together. But a good example of the opposite; deliberate simultaneous use of drugs, that enhance the effect of each other, is modern HIV treatment. Drug synergy is in fact the backbone of HIV treatment.

I am a strong believer in the value of drug synergy when it comes to cancer therapy. And I know, that one of the obstacles here is antagonism between the medical world and the alternative world.

But is doesn’t have to be like that.

Doctors like myself, will embrace beneficial drug interactions and use them rationally if we have the right tool. To begin with, such a tool will be used to adjust a cancer patient’s daily meds in favor of a better cancer outcome. But I have no doubt, that once the tool is there, doctors will engage in a more proactive off-label use of ordinary drugs with anticancer properties – repurposed drugs.

All it takes is for everyone to say the right words. Plus money of course to fund a beneficial drug effects tool. But the thing is; raising money is a whole lot easier than bringing two worlds together, that sometimes seem to enjoy antagonism.

The alternative world of cancer therapy is vast. And a lot of that will always be in opposition to established medicine.

But when it comes to beneficial drug interactions, there is no antagonism.

There is only one thing: Human intelligence.

Dr. Pavia Lumholt
E-mail: pavialu (at) gmail.com

TEDx Frederiksberg – The surprising secrets of everyday drugs

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16 thoughts on “Beneficial Drug Interactions to Help the Advancement of Oncology Treatments”

  1. Thank you Daniel for your ongoing efforts.

    I think that the cheaper faster alternative might be just creating the “app” for smartphones.

    It sounds like a problem that Doctors and Programmers can solve with the added money flow.
    But then, who or what will give it credibility? Certifications and stuff.

    Best wishes.

    Alex

  2. No certification is needed. Any doctor is allowed to use repurposed drugs off-label as cancer treatment. The doctor takes on some extra responsibility, which may keep some from doing it, but it is completely legal.

    As far as credibility goes, the trick with an interaction tool is, that it could very well be a Trojan Horse. It will start out with doctors adjusting in the meds, the patient already takes. But in the job as a general practitioner, there is a lot of grey zones. The patient will present the doctor with things like “my blood sugar is in the upper range anyway – I might as well take Metformin”. And the sensible GP (most GP’s) will think: “Well, what’s the harm? The patient has a serious cancer and almost diabetes.

    Already one of the GP cooperatives (very common in Denmark) have started using Metformin as secondary prophylax on non-diabetics. Just because they have been presented with scientific articles that they find sufficient together with their common sense.

    I believe common sense will make it’s own impact. GP’s are sitting with patients, that they may know well after several years. They feel the pressure from the patient much more than oncologists do.

    1. The problem is that physicians don’t want to divert from the so-called “approved” clinical therapy protocol for tumors. Just one example when i spoke to physician to try Metformin, she replied that it could result in complications and death. I replied to her that “you already mentioned us only 2-5 months of life, according to the treatment protocol you apply. What will be the difference?” And she replied – we are not the research institution to try things outside of the protocol. She just din’t care about patient but her own comfort. Big part of them don’t see patients as opportunity but as part of the job with written by someone else outcome. Yet add there business mind and hospitals introduced motivations to generate money (not everywhere of course, but where i live – physician get money for in-patient treatment, or at least their performance metrics are connected for the number of in-patients gained)
      Regarding the tool – there should already be (at least experimental) software for diagnosis and for treatment based on patient biomarkers. This one might serve the purpose: https://en.wikipedia.org/wiki/Clinical_decision_support_system
      For consolidation of conservative and alternative approaches this system must be populated with data from clinical trials and private hospitals where both methods are practiced. So software isn’t a problem at all, if there there is a demand and someone willing to pay for it.

      1. Yes, unfortunately oncologists are the least likely to adopt repurposed drugs (RD’s). That’s why it’s a smart move to empower any doctor with this knowledge. Some doctors will be hesitant even with a smooth supportive tool. But a lot will implement RD’s in time. There’s a lot of reasons for this. And in most western economies – yes of course – financial interests is one of them. But I think it’s more complicated than that.

        For one thing, being an oncologist is not an easy job. Doctors are generally good people, they usually want to do the right thing, and are not immune to the suffering of their patients. When treating seriously ill patients, most doctors stick to often rigid recommendations because it is much more difficult and stressful to go beyond. And sadly, because medicine today is becoming more and more defeseive, recommendations are getting even more rigid.

        In Oncology, clinical research and results can very important to one’s career. And the reality is, that varying degrees of repurposed drug-use among patients “pollute” scientific data. Many cancer-patients are included in clinical trials these days. And the more standardised patients are, the cleaner the results are. And the sooner new tretments can be approved for therapy. If some of Your patients use RD’s and some don’t, the quality of Your reseach will decrease. The counter-argument (which I prefer) is: Why sacrifice today’s patient for the benefit of tomorrow’s? If You can help today’s patient with repurposed drugs, shouldn’t that overrule the concern for tomorrow’s patient?

        1. Actually i don’t blame physicians, but the system. We (physicians and non-physicians) are apples dropped onto ground from the same tree.
          Unfortunately my search for physician who is not afraid of implementing ReDO protocol didn’t result in success yet (5 or 6 of them refused already, another one lost interest when i refused for unnecessary inpatient treatment). Said is true for 2 countries outside of Western Europe.

          And of course i fully agree with your statements – if there is a chance, it has to be offered to patient.

  3. Thanks once again Daniel!

    Unfortunately, “alternative therapies” are erroneously related to many pseudo-scientific therapies and bad practices carried out by many charlatans taking advantage of the misfortunes of others.
    But fortunately it is not the case of repourpusing drugs with proven and well-known studies for other diseases. Even more relevant is the cocktail approach, taking advantage of the synergies and “positive pharmacological interactions” of these drugs. These approaches should “sound better” for any oncologist…

      1. Yes, we all want the ideal scenario now.

        But I think first step would be to give patients the opportunity to have their doctor prescribe repurposed drugs – or as a bare minimum optimise the drugs they already take. Most patients interested in RD’s nowadays know more about RD’s than their doctors. A well designed tool would give them common ground. And more RD’s would be prescribed.

        It’s as simple and practical as that.

      2. Hi Friends,

        Very true Manuel, the openness of doctors to listen to a discussion about re-purposed drugs and the related beneficial/positive interactions is there. They are ready to consider that if enough evidence is presented.

        This is because here we do not speak about alternative treatments such as B17 but about drugs they use every day, which are very familiar to them.

        Next it’s extremely important to point out again the points that Dr. Lumholt made above:

        1. The target for the POSITIVE-INTERACTION-TOOL are the General Practitioners (not the oncologist, at least not in the first stage of implementation)
        2. And their (already existing ) relation with the patients, often for long time, is the KEY here (which makes it likely they will start to use the tool)
        3. Initially, the tool will be used to indicate drug changes that can maximise the benefits of the patient. For example, the patient already takes Omeprazole for acid reflux, but the TOOL indicated that using Lansoprazole may lead to increased chance of successful outcome for the cancer type of the patient. This knowledge will be enough to make the General Practitioner switch Omeprazole with Lansoprazole, since both can address the same problem but one of them may add extra value to the patient.

        I see medical treatment like a train. It moves on a track and it’s difficult to see its direction changing immediately by 90 degrees. We need to start changing step by step towards the right direction.

        The same is with the proposal above. First start with GPs. Once they start becoming aware that they can help the patient more than they thought and use the TOOL, which will happen, the TOOL will start to get roots in the medical system.
        After that we can move to the next step, i.e. to the oncologists.

        I actually know some oncologist will take it up faster than we think – I already have in mind good oncologist who think every day about how to help more their patients.

        Of course, creating such a TOOL and implementing it takes time. Good things take time. But the change starts with us.

        The challenge now is to think how to move forward from here. If you have any idea please let me know.

        On my side, here is how I think I will contribute:

        1. keep my eyes opened for opportunities on starting up the TOOL (essentially it requires financial support and a good framework, e.g. and European project)

        2. the food supplement company that I am working on now intensively to start-up, will donate 50% of it’s profits to projects meant to improve and extend life of cancer patients. When a product is ordered, the person buying the product will be able to chose where the 50% related to his order will go. There will be several projects listed there as options, and this will be one of them.

        Kind regards,
        Daniel

          1. Thanks asafsh. Difficult to judge if this would be suitable. In any-case, the most work will be on consolidating the data and agreements on what’s in and what’s out of the system.

            I received your e-mails and will respond asap in the first part of the week (tomorrow I will be the whole day out and in meetings).

            Kind regards,
            Daniel

  4. You are welcome, Daniel.
    Yep, i see.
    First time i have heard of such tool was 1993 when few guys i knew tried to make an expert system based on FoxPro in one of the research institution.
    Second time i came across – when we tried to design health assessment product based on measurable biomarkers (blood pressure, blood tests, weight, body temperature ….) using off the shell products, where the patient’s biomarkers are measured on remote station and sent to the web based app for analysis, visualization and simple rule based decision making to advise patient about his/her medical conditions and urge physician contact in case of abnormalities in measured data are found.
    I never worked with CDSS kind of system, just briefly googled the functionality when tried to figure out web/server part of the product.
    My guess the CDSS software is a bit complex system. Some implementations may have built in (AI element based) learning facilities, incorporate medical history including those of relatives for risk assessment etc… And getting to know this tool may require some learning curve as well.
    As you mentioned trying to incorporate ReDO protocol means experience consolidation and agreement.
    Also, not all medical organization own CDSS (guess it is quite expensive).
    And adding ReDO logic to such tool means tool (re)certification (perhaps months, years) for the affected part (if it is designed in modular way). You know, changing a byte in critical applications software (automotive, air transport, medical…) means certifications including pre and clinical tests for specified duration (time and money).

    Instead of going that way, ReDO practicing physicians may try to reinvent the wheel and do a fast prototyping using let say Python script language and share share as experimental treatment scripts to others. this approach will need considerable time when experience consolidation will be required.
    Or treatment protocols can be shared in symbolic form using some kind of flow chart visualization software. The drawback is that complex protocols may tend to increase in size exponentially.

    p.s. Thank you very much. Yes, i understand this, we still have a couple of days.

  5. “How to Starve Cancer” published in 2018 by Jane McLelland ( survivor of 3 episodes of stage 4 cancer) is an amazing resourse for off label drugs and synergistic botanicals to treat most cancers. She also references the scientific research.

    1. Hiu Josad50,

      Jane’s book is a very nice one, indeed. Thank you for your post.
      The question now is how to get that type of knowledge to the clinical space so that doctors start to implement it more often.

      Kind regards,
      Daniel

  6. i wrote a simple script to generate automatic prescription from libreoffice calc (free alternative to MS Excel).
    Let me know if there are interested in extending its functionalities (drug interaction, cycle scheduling …).

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