Transcript Naturopathic Approaches to Triple Negative

Triple Negative Breast Cancer
&
Naturopathic Medicine
Jake Psenka, ND
PMID?
Some of the slides make
reference to a PMID number. This
number can be copied and pasted
into the search bar at
www.pubmed.gov to see the
research article being referenced.
The Principles of Naturopathic Medicine:
Identify and Treat the Cause of Disease
Do No Harm
Doctor As Teacher
Treat the Whole Person
The Power of Prevention
Triple Negative Breast Cancer (TNBC)
Estrogen Receptor Negative
Progesterone Receptor Negative
Human Epidermal Growth Factor Receptor (HER2) Negative
15% of Breast Cancers
Appear at an earlier age
High Histologic Grade
Six TNBC Subtypes:
2 Basal Types
Immunomodulatory
Mesenchymal
Mesenchymal Stem-Like
Luminal Androgen Receptor
Current TNBC Treatment Strategies
Cytotoxic Therapy (Adriamycin/Cytoxan/Taxol)
Radiation
Surgery
Problems Associated with Current TNBC Treatment Strategy
Toxicity
Immune Suppression
Fatigue & Malaise
Depression/Anxiety
Drug Resistance
Lack of Efficacy
Naturopathic Treatment Strategies
1. As a way to support the patient:
Promoting health of patient- both mind & body
Minimizing treatment related side effects
2. As integrative therapy:
Anti-Cancer Therapy
Improving clinical outcomes
Preventing Re-occurrence
Food As Medicine
Dietary habits can play a role in both the development and progression of cancer. A
healthy diet supports the body’s natural processes and functions.
Inhibiting Unintended Weight Loss
Promoting Healthy Elimination
Reducing Treatment Related Side Effects
Anti-inflammatory Action
Energy Balance/Fatigue Reduction
Improving Efficacy of Treatments
Food As Medicine
.
INSULIN-LIKE GROWTH FACTOR-1
These results show that IGFs stimulate cell proliferation and promote cell survival in
triple-negative breast cancer cell lines and warrant investigation of the IGF signal
transduction pathway as a therapeutic target for the treatment of triple-negative
breast cancer. Neoplasia. 2011 Jun;13(6):504-15
Randomized controlled trials indicated that the circulating IGF-I level was significantly
higher in the milk intervention group. Int J Food Sci Nutr. 2009;60 Suppl 7:330-40. Epub 2009 Sep 9.
These data suggest that a plant-based diet is associated with lower circulating
levels of total IGF-I. Cancer Epidemiol Biomarkers Prev. 2002 Nov;11(11):1441-8.
Food As Medicine
“In vivo, the efficacy of blueberry to inhibit triple-negative breast tumor growth was evaluated.
Tumor weight and proliferation (Ki-67 expression) were decreased in blueberry-treated mice,
where apoptosis (caspase-3 expression) was increased compared with controls.”
“In combination with standard treatments, supplementing the diet with (n-3) fatty acids
may be a nontoxic means to improve cancer treatment outcomes and may slow or
prevent recurrence of cancer.”
Lung metastasis of TNBC was reduced (16-70%) by all treatments, significantly in the flax seed
oil group. The distant lymph node metastasis was significantly decreased (52%) only in the flax
seed oil group. The total metastasis incidence was lowered (42%). Mouse study.
PMID: 21228363, 15849746
Food As Medicine
SUGAR/CARBOHYDRATE/GLUCOSE = ENERGY
Higher SUVmax and %Ki67 are associated with higher histologic grades.
Glucose receptors are upregulated in TNBC (PMID 21266827)
Higher sugar uptake by TNBC cells correlates with increased cancer cell
proliferation (PMID: 20012701)
Exploiting Metabolism
Supplements for cancer?
Reasons for using supplements with
conventional therapy:
 Minimize treatment-related side effects
 Promote a well functioning immune system
 Synergize with conventional treatments
Side Effects
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L-Glutamine protects against doxorubicin (aka Adriamycin) heart damage
Glutamine for taxane induced neurotoxicity.
Melatonin inhibits Cytoxan-induced leukopenia and anemia
Melatonin inhibits taxane-related neuropathy
DHA, an n-3 fatty acid, is currently in trials
PMID: 19889810, 14718801, 20035269, 20567633
Immune Enhancement
LifeStyle Factors
Supplements
Exercisebut don’t over exercise
Arabinogalactans
NK function
Stress Reduction
yoga, meditation, guided imagery,
reiki, acupuncture, religion.
Melatonin
T-cell function
Alcohol Elimination
Sugar Elimination
Thymic Proteins
T-cell function
Beta Glucans
NK cells
Synergize
Multidrug resistance (MDR):
Defined as the ability of a tumor cell
to survive exposure to clinically
achievable concentrations of
structurally diverse chemotherapeutic
drugs which act at different
intracellular targets.
Synergize
Propolis (caffeic acid)
 Inhibits TNBC tumor growth, both in vitro and in vivo without much effect on
normal mammary cells.
 Decreased malignancy potential of TNBC stem cells.
PMID: 21570765
Synergize
Inositol Hexaphosphate (IP6):


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decrease proliferation rates in TNBC cells
works synergistically with adriamycin (and Tamoxifen)
inhibits metastasis
activates natural killer cell function
Patient study finds those who took it with chemo had no
cytopenia, lowered leukocyte, or platelet levels,
increased QOL and better functional status.
PMID: 12846414
PMID: 15868430
PMID: 14666664
PMID: 20152024
Synergize
Curcumin (extract from tumeric)
 Modulation of the BRCA1 Protein and induction of apoptosis in TNBC
 Blocker of COX and LOX
 Shown to decrease the MDR1 gene through the PI3k/AKT/NF kappa beta
pathway
PMID: 19809577
Synergize
Vitamin D3
Potentiates the anti-tumor activities of chemotherapy drugs cisplatin,
carboplatin and doxorubicin; 5-fluorouracil, cytarabine, hydroxyurea,
cytarabine and gemcitabine; paclitaxel and docetaxel.
Vitamin D3 enhances the effect of hydrogen peroxide in cancer cells.
Synergize
Indole-3-Carbinol
Inhibits TNBC proliferation
Down regulated PGP transmembrane efflux pumps by 80%.
Decrease TNBC cell motility
Sulphoraphane
Inhibits inflammatory cytokines and pro-angiogenic growth factors in
TNBC
PMID:21767081
PMID:19728765
Synergize
Resveratrol
Sensitizies tumor to chemotherapy drugs including vincristine*,
adriamycin, paclitaxel*, doxorubicin, cisplatin, gefitinib, 5-fluorouracil,
velcade, and gemcitabine.
Resveratrol enhances mTOR inhibitor
PMID: 21261654
PMID: 21168265
Remission
Preventing recurrence: NCCN guidelines for breast cancer state “Evidence suggests
that active lifestyle, achieving and maintaining an ideal body weight (20-25 BMI) may
lead to optimal breast cancer outcomes.”
Detoxification: Get Specific
New Ideas
Metformin
Breast Cancer Res Treat. 2010 Sep;123(2):333-44. Epub 2009 Nov 22.
Dietary energy availability affects primary and metastatic breast cancer and
metformin efficacy.
Phoenix KN, Vumbaca F, Fox MM, Evans R, Claffey KP.
New Ideas
New Ideas
Chemotherapy Sensitivity and Chemo-resistance Testing
Circulating Tumor Cell Studies
New Ideas
Prevention