Off-label, Overlooked or Novel Cancer Approaches: ONCAs
Integrative cancer cancer care involves more than integrating the best of conventional and complementary therapies. It also involves consideration of ONCAs—therapies and other approaches developed by scientifically trained investigators operating both inside and outside mainstream cancer organizations. Defining characteristics of these approaches:
- Off-label (re-purposed) drugs not in standard use for cancer
- Neglected cancer therapies developed in mainstream science
- Cancer therapies with special promise in clinical trials
- Approaches developed by qualified researchers outside the US
- Selected diagnostic techniques in these categories
A therapy or approach may fit into more than one of these categories.
Selection of ONCAs for This Site
BCCT has selected and curated therapies and approaches that fit these categories:
- Approaches that are outside the focus of mainstream research
- Mainstream therapies that may not be mentioned or known by your oncologist
Mainstream cancer medicine is constantly developing new and innovative approaches.
Investigational therapies come in many different forms. Some are developed in mainstream, conventional settings, some in settings that are mainstream outside the US but not in the US, and some in settings outside the mainstream in all jurisdictions. Most are developed by qualified scientists and clinicians. We call these investigational therapies that are marginalized, overlooked or novel "ONCAs" because we know no existing acronym to describe them.
Examples of ONCAs
- Ralf Kleef, MD, has an immunology and integrative oncology practice in Austria where he uses low-dose checkpoint inhibitors in combination with hyperthermia and IL-2 immunotherapy. Kleef also uses a wide range of other German/Austrian/Swiss complementary therapies as part of the mix in the many clinics that cater to both European and American cancer patients.
- M. Rigdon Lentz, MD, impeccably trained in US academic oncology, moved to Germany to pursue his research in a more favorable environment. His International Immunology Foundation has developed a technology he calls OncoPherese:
OncoPherese is an extracorporeal technology that physically removes immune inhibitors from the blood and the tumor microenvironment. When these inhibitors are lowered enough, the immune barrier is broken and a patient’s killer white blood cells are free to attack the cancer cells. The technology allows the treating physician to reduce the level of inhibitors in the body to a specific threshold at which tumor inflammation and destruction occurs faster than new tumor mass is formed, but slowly enough that the body can process the resulting necrotic debris. The technology causes no injury to normal cells and thus no significant side effects. OncoPherese is one type of therapeutic apheresis, which is a common, safe, scientifically valid method of treating various diseases, including multiple sclerosis, lupus, and rheumatic diseases, among others. “Apheresis” comes from the Greek and means “to take away.” OncoPherese is a purely subtractive treatment, meaning nothing is added to the body.1
- Burt Berkson, MD, in Las Cruces, New Mexico, is one of the pioneers of low-dose naltrexone with alpha lipoic acid for cancer and many other conditions. LDN has been used by patients for many years for a wide range of conditions including cancer. Many websites attest to its popularity. Berkson has presented his work to the National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine (OCCAM) and published his case studies as well. He has reported a complete remission of metastatic pancreatic cancer. Many of the alumni in the Commonweal Cancer Help Program have used LDN.
- The role of copper in angiogenesis (creation of new blood vessels to supply tumors) and chelating copper as a nutritional anti-angiogenic strategy has received attention in the research literature. As one researcher wrote:
Copper is an essential element for multiple biological processes. Its concentration is elevated to a very high level in cancer tissues for promoting cancer development through processes such as angiogenesis. Organic chelators of copper can passively reduce cellular copper and serve the role as inhibitors of angiogenesis. However, they can also actively attack cellular targets such as proteasome, which plays a critical role in cancer development and survival. The discovery of such molecules initially relied on a step by step synthesis followed by biological assays. Today high-throughput chemistry and high-throughput screening have significantly expedited the copper-binding molecules discovery to turn “cancer-promoting” copper into anti-cancer agents.2
Our advisor Dwight McKee, MD, is among those who believe copper chelation holds promise.
- Mifepristone is a drug used to end pregnancy. A number of researchers, notably Jerome H. Check, MD, at Cooper Medical School of Rowan University in New Jersey, are publishing papers documenting its benefits for cancer treatment. The theory, in popular terms, is that the biological mechanisms that protect the fetus from the mother’s immune system may be analogous to the mechanisms by which cancer shields itself from immune attack. While vigorously opposed by right-to-life proponents, the Feminist Majority Foundation has taken up the cause of making the drug available.
- Metformin, a diabetes drug, is a good example of an investigational cancer therapy being researched in major cancer research centers that interests integrative oncologists:
Aung Naing, MD, a researcher at The University of Texas MD Anderson Cancer Center, cited two 2009 publications by MD Anderson researchers that alerted him to metformin’s potential anticancer activity:
1. A group in the Department of Breast Medical Oncology noticed that among 2,529 women with early-stage breast cancer, the pathological complete response rate after chemotherapy was higher (24 percent) in diabetic patients who had received metformin than in diabetic patients who had not received metformin (8 percent) and in nondiabetic patients (16 percent).
2. A group in the Department of Gastrointestinal Medical Oncology found that among 255 diabetic patients, the risk of developing pancreatic cancer was 62 percent lower in those who received metformin than in those who did not.
Since that time, researchers at MD Anderson have conducted several retrospective studies looking at outcomes of patients who had concurrent cancer and diabetes. In separate studies of patients who had prostate cancer, colorectal cancer, pancreatic cancer, triple-negative breast cancer, HER2-positive breast cancer and multiple myeloma, the median overall survival durations were found to be longer in patients who had taken metformin than in those who had not.3
- Keith Block, MD, as one example, has been using chronotherapy devices that release chemotherapy at optimal times in the patient’s biological clock, a practice widely used in Europe.4
None of these approaches represent the standard complementary approaches to cancer—the 7 Healing Practices—or indeed the common strategies that go beyond core health promotion, such as contemplative practice, yoga and other psychophysiological disciplines, traditional Chinese medicine, expressive arts and so on. BCCT believes that interest shown by integrative oncologists in these therapies reflects the reality that earlier investigations of complementary therapies unquestionably helped some patients but left many patients in need of practices that were neither complementary nor standard care.
Hundreds of other examples exist. Mainstream cancer medicine is constantly developing new and innovative approaches.
Medical practitioners may disagree about when an emerging innovative approach moves from being classified as marginalized to being mainstream. As this is written, none of the examples listed here are typically offered as options to cancer patients in the US and Canada.
Brian Bouch, MD: Integrative Oncology, Part 2
- Ralph Moss Blog: Lower-dose immune drugs as effective as higher doses
- Low Dose Naltrexone
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- American Academy of Anti-Aging Medicine and Metabolic Medical Institute: Integrative Cancer Therapy Fellowship Modules
- Dominic Hill: Surviving Terminal Cancer
- Clifton Leaf: The Truth in Small Doses: Why We're Losing the War on Cancer-and How to Win It