geoff
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I was wondering whether we could get another slant on DC therapy by looking at clinical trials.
I noticed that there was a Ph1 clinical trial of DC therapy at Duke Uniiversity in N Carolina, it covered various cancers including gastrointestinal. Seems like the trial completed in June 2006. Although a Ph 1 trial, the objectives included a preliminary assessment of clinical response. Is it possible in the US to gain access to initial results ? Here’s the trial:
http://clinicaltrials.gov/ct/show/NCT00027534
I’m not aware of any other DC trials in the US but maybe I didn’t search properly. I am aware of a couple of planned Ph1 DC trials here in the UK but these are some months away. I’m not eligible for any UK trials due to my low platelets. Hence my interest in what’s going on in Germany.
Geoff
Hi
I’m slightly confused about what Dr Gorter (based I believe at a clinic in Cologne (Germany) is doing compared with what the “Institute of Tumour Therapy” at Duderstadt (near Goettingen in Germany) is doing in the area of Dendritic Cell research and therapy.
The website:
http://www.dendritic.info/DCTreatmentCenters.html
states: “Europe – The Institute of Tumor Therapy in Duderstadt under the direction of Dr. Thomas Nesselhut in collaboration with Professor JH Peters of the U. of Gottingen in Germany have pioneered the clinical use of DC Therapy in cancer and has treated over 1000 patients to date”
I noticed That Dr Gorter was a co-author of the ASCO 2004 paper “Cancer therapy with unloaded monocyte-derived dendritic cells in patients with inoperable pancreatic and gall bladder cancer”, the lead author was Dr Nesselhut (Duderstadt). Suggests that Dr Gorter collaborates with the clinic at Duderstadt ?
The reason I’m raising this question is that I live in UK and a trip to Germany (for an initial consultation) would not be a big deal but I’m wondering which might be the best place to go, Cologne or Duderstadt.
By the way the ASCO 2004 paper describes DC treatment of 23 patients (17 with pancreatic, 6 with gallbladder) and quotes the following outcomes:
– clinical response in 5 pancreatic patients incl 2 stable disease, 2 minor remissions and 1 mixed response, with overall survival 4-32 months (I’m not sure that I understand this – does it mean that all 5 patients died within 32 months ?)
– clinical response in 1 gallbladder patient (stable disease after 18 months)
It would be interesting to find out what experience they have had since 2004. Perhaps this is a question which Marion could raise with Dr Gorter ?
Geoff
Hi Jeff
Your story is truly an inspiration to us all. My CC was diagnosed in 2005 and was resected. Mets (in lymph nodes plus 1 lung) were diagnosed in April 2006 at which time I was given 3-6 months. 6 months later I feel fine and my mets are stable. I did have chemo for 3 months but it was supended due to its affect on my immune system – my body just doesn’t tolerate chemo very well. Having stopped the chemo I now feel much better and my mets remain stable.
I’m now focussing on diet + supplements but am still developing my approach (in the face of inconsistent advice from different sources). But it sounds like you are 6 years ahead of me – amazing!
I’d be very grateful if you could provide a bit more detail on your nutritional regime and on some of the foods/supplements you mentioned ie:
special tea – is that green tea or something else ?
soup – what kind of soup ?
IP-6 – what’s that ?
multivitamins + minerals – which ones and what daily doses ?
Regarding sleep, I agree that it’s crucial and it’s been a serious problem for me, at the moment I’m using melatonin which seems to help me without any next-day hangover which I always get with other sleep aids. Melatonin is also said to be an anti-oxident and immune system booster.
Geoff
Hi Maryanne
I haven’t tried the H Acres diet but I am in the process of modifying my diet to avoid meat (I still eat oily fish), sugar, salt and fats (incl dairy products – eg I use only soya milk now), and I am eating more wholemeal foods (incl brown rice) and lightly cooked vegetables, green tea (no black tea) etc. Also I’m taking some supplements incl Omega-3 products for my immune system.
Changing diet is not easy but I’m getting used to (and enjoying) the new regime. I am also taking carrot + apple juice and find that it gives me a real energy boost. I think what’s really important is that, as you say, it means I’m doing something about my cancer and starting to take a more active role, that alone makes me feel better. And you are absolutely right, most oncologists dismiss nutrition as a valid approach towards beating cancer. But there are plenty of reported cases where adoption of (say) the Gerson diet or a macrobiotic diet has had highly beneficial effects (I never looked into the H Acres diet).
But maybe you shouldn’t write off systemic chemo at this stage. It seems to work incredibly well for some people (eg see the post by Juster on the “What’s Working/Good News/Unbelievable PET Scan” thread). For others it may not work at all or may not work as well. In my case it hammered my blood count (haemaglobin, white cells, platelets), reduced my quality of life, and at the moment it is suspended whilst my body recovers. I discussed the future chemo options with my oncologist last week and he says that I have to decide on the balance between quantity and quality of life – the problem is of course that he can’t tell me whether, or by how much, the chemo will extend my life.
Geoff
Woody
You say that the XL119 Ph3 trial is being changed to open status. Please could you provide a link to the source of that information ? Reason I ask is that I live in the UK and there is an XL119 trial here too but I declined to participate because half the participants get 5FU rather than XL119 and of course being a blind trial they don’t know what they are getting (not sure how you managed to find out). If the US trial has changed to giving all participants XL119 that could imply that the results so far show significant benefits from XL119, as you say very good news.
Thanks
Geoff
Hi Caroline
Excellent news re your stable tumors. Good to hear that the Gemzar + Xeloda combo seems to be working. I think I mentioned before that here in the UK this combo is referred to as GemCap and a recent trial for patients with advanced pancreatic cancer showed the combo to be more effective than Gemzar alone.
Best wishes
Geoff
Kel
Many thanks for your very comprehensive list of supplements. Gives me plenty to research.
Best wishes
Geoff
Caroline
Good luck with the scan, it’s a very stressful time waiting for scan results isn’t it. Lets hope that your GemCap combo is working, please keep us informed. Also we’ll be very interested to hear whether your oncologist decides to add Avastin.
Regarding Davanat, I recently spoke with Pro-Pharmaceuticals and they confirmed what you said ie the Ph2 CC trial would not accept patients who already had chemo. But I got the impression that in some months time this restriction may be lifted. It’s one to watch.
Best wishes
Geoff
PS just had the results of my latest scan which shows my LN metastatic tumours are stable, I’m therefore continuing on my GemCarbo regime. I guess that I’d rather have shrinkage but I’m happy to settle for stable – I’d been told at the start that based on previous results the chemo would have around 30% chance of success. so I was particularly nervous whether I’d be in that 30%.
Hi Kel
You wrote:
“She (your naturopath) has me taking three other natural herbs that have been proven beneficial in stopping the tumor in my liver from growing, if not reducing it”
I’d be very interested to hear what these supplements are, could you perhaps post this on the “Alternative Treatments” section ?
Regards
Geoff
Stacie
Re: Davanat
Did you notice that the manufacturer (Pro-Pharmaceuticals) is initiating a Ph2 trial of Davanat for cholangiocarcinoma:
http://biz.yahoo.com/bw/060725/20060725005275.html?.v=1
This is a US-based multi-centre trial so not available to me (I’m in the UK).
Geoff
Stacie
When your naturopathic Dr says “she has seen two people in her practice healed using it (ie Avemar)” what exactly does she mean ? Did you ask whether these people were also taking other treatment and what their clinical background was ? Certainly everything I read about Avemar sounds good. It isn’t cheap (about $160 per month) but if it works that’s peanuts. The ER by the way refers to “estrogen receptor”.
Regarding AHCC this is a Japanese product derived from mushrooms. A Japanese trial on 222 liver cancer patients has been reported:
http://web.cancernutritioninfo.com/main.cfm?id=1490&display=yes&RequestTimeout=500
This wasn’t a proper clinical trial in that the recipients of AHCC were “self select” ie everyone was given the choice (of the 222, 113 opted to take AHCC). Nevertheless the results indicate a positive influence on post-surgical recurrence (34% of those taking AHCC had recurrence, 66% of the others had recurrence) and on overall survival (80% of those taking AHCC survived, 53% of the others survived). Given the self-select nature of the trial, my oncologist dismisses these results as being meaningless. However, as noted in the report, “more patients who appeared to be sicker, based on blood test results, decided to take AHCC …. in other words, the group taking AHCC may be expected to do worse outcomes than the group not taking AHCC …. despite this the group taking AHCC did better”
I’d be interested to hear what your naturopathic Dr thinks about AHCC. By the way, American Biosciences Inc (who manufacture Avemar in the US) also supply AHCC which they call ImmPower and they describe as an immune system booster.
Geoff
Stacie
Any more thoughts or research regarding Avemar ? And what about AHCC, I seem to remember that you were investigating (but I can’t find the thread).
My oncologist is very lukewarm about these products but he doesn’t think they’d do any harm. But I guess that many oncologists have a mind-set towards chemo and only chemo.
I noticed that on the Sloan-Kettering website:
http://www.mskcc.org/mskcc/html/11571.cfm?RecordID=748&tab=HC
about fermented wheat germ extract (WGE) they say “because it potentiates estrogen receptor activity, patients with ER positive cancers should avoid WGE”. Any idea what an “ER positive cancer” means ?
Geoff
Alison
I wish you well in your consulatation with Prof Lodge, he is a great guy and really easy to get on with, and he’s a brilliant surgeon. I believe that resection is probably the only route to cure, from what I remember reading from Jon’s posts his tumour is at a fairly early stage so I would hope for both of you that is is resectable.
Regarding chemo, I’d just mention that Gemcitabine+Cisplatin is recognised as being more effective that Gemcitabine alone (this is also shown by early results from ABC02). And you don’t need to get these via a trial, my oncologist put me on Gemcitabine+Carboplatin as the first-line chemo regime (he says that carboplatin is a 2nd generation cisplatin). And my latest scan shows slight shrinkage of my Lymph Nodes (metastatic disease – my tumour, which Prof Lodge removed, was very advanced and he was unable to get to all of my Lymph Nodes).
Anyway good luck
Geoff
Hi Mybro’sSis
I believe that Capecitabine (Xeloda) is an oral version of Fluoroucil (5FU) with less side effects and obviously more convenient to take as a pill than having 5FU by IV. In 2005 the US FDA approved its use, alone, as a therapy for metastatic clorectal cancer. (It seems that drugs used for digestive tract cancers, eg CC, often start off as colorectal cancer drugs).
But I’ve read that 5FU has been found to be much more effective (again for colorectal cancer) when combined with oxaliplatin (and presumably Capecitabine + Oxaliplatin may also be a superior combination). For example, see:
http://www.cancer.gov/clinicaltrials/results/capecitabine0705
You might wish to discuss this with Dave’s oncologist who may have good reasons for wanting to use Capecitabine alone.
Geoff
Hi Caroline
I read your latest post with great interest. It’s good to hear about someone who , despite this awful disease, manages an active lifestyle. You obviously have a very positive attitude.
Regarding Sorafenib which apparently didn’t work for you, are you aware of the success rate in the trials which have been (or are being) carried out ? As I understand it Sorafenib has been particularly succesful with kidney cancers but I’m not sure about others eg CC. The reason I ask is that I’m seeing my oncologist next week and I am preparing a list of issues to discuss.
Also regarding supplements I’m already taking green tea extract and Omega-3 (in the form of flax oil), could you explain what Co-Q-10 does ?
I look forward to hearing how you get on with Avastin, hope it works. My oncologist believes that this is one of the most promising drugs around.
Best wishes
Geoff
