M. D. Anderson Cancer Center
Cancer Newsline Audio Podcast Series
Date: August 25, 2008
Duration: 0 / 15:05
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Welcome to Cancer Newsline a weekly podcast series from The University of Texas M. D. Anderson Cancer Center in Houston TX. The aim of Cancer Newsline is to help you stay current with the news on cancer research, and the rapidly changing advances in cancer diagnosis, treatment and prevention. We also hope to provide you with the latest information on reducing your family’s risk of being diagnosed with cancer. My name is Doctor Leonard Zwelling I am a professor of medicine and pharmacology here at M. D. Anderson.
Today I will be to talking with Dr. Bharat Aggarwal, professor in the Department of Experimental Therapeutics and Doctor Moshe Frenkel an associate professor of integrative medicine in the Department of Palliative Care and Rehabilitative Medicine we will be talking about natural remedies and treatments for cancers and the latest in integrative medicine. Dr. Aggarwal has recently been quoted in article through out the press focusing on research the he’s been doing in the area of natural products and what these products actually do to treat cancer how do natural remedies and integrative treatments fit into traditional treatment programs and how do you talk to your doctor about the possibility of adding a comp or integrative therapy to your cancer regiment. Lets start with Dr. Aggarwal…
Dr. Aggarwal, what do we mean when we say a “natural product or a natural regiment”? What does that mean?
Dr. Zwelling, natural products are nothing new these are essentially the agents derived from mother nature, and they are used for the welfare of mankind. As you know Hippocrates declared almost 25 centuries ago, let food by thy medicine and medicine be thy food so natural products are just derived from mother nature but used for our welfare.
But we already have some natural products in our regiment of cancer treatment at the present time, do we not?
Oh there are lots of them, the list of them is huge. There are natural products that are used for cancer, for cardiovascular diseases, for inflammation you name it. Especially here, we are at M. D. Anderson Cancer Center and in the area of cancer according to David Newman who is a scientist at the NIH where he reviewed the field of natural products and indicated as much as 74% of all drugs that have been approved by the FDA today they have been derived from natural products.
How do you go about finding in mother nature what might be a source of a good cancer drug or any drug, for that matter and how do you extract it once you find it?
That is a real challenge. That is when you go to what is called traditional medicine. That is where shaman doctors practicing in the jungles for ages…and are using these plants for the treatment of different diseases. Mind you we are living today in the era of molecular biology and all kinds of high technology and whatnot so therefore we don’t believe that whatever these shaman doctors are doing…sitting in the jungles that they know what they’re doing. Apparently over the years a lot of smart guys like us have gone and approached these people and watched what they do and have isolated the active compounds and shown that yes indeed they work and they do work for lots of different diseases so there is a chemistry there is a biology there is a clinician there is an entrepreneurship all of kinds of things are involved in bring a drug from the hands of a shaman doctor to actually what we call today modern medicine.
Now do we have natural products that both treat cancer or prevent it, and if we do if we have thing that prevent cancer are there things that people should be eating that really would help them prevent cancer.
That’s an area that is very very interesting and I feel very passionate about it the fact that cancer is a preventable disease, and yet we are doing very little about it. We know that epidemiologically that the cancer incidence around the world is very very different. There are countries that have a lot lower certain cancer for example if you think about prostate cancer and colon cancer and breast cancer and lung cancer in some of the countries like India where I come from is a much as 10 -50 times lower so the question is what these people are doing right or wrong and if we can learn from them then maybe we can prevent cancer.
Are there any specific foods that either of you can remind us of that we should be telling people that they should be eating?
Yes as you know Vasco de Gama in the 15th century he went looking for spices and this is how he ended up in India and spices are something that have been used over the years… it is very tasteful and it preserves the food and does all kinds of things, but I think there is a lot more to the spices that have been used for centuries in countries like India only within the last 50 to 100 years people are starting to realize that spices have a true medicinal value.
Lets talk about one in particular curcumin which is the one that people have identify with you in particular and the work that you have done with it. Where does it come from and should people be seeking it?
Well I am glad that you asked about curcumin because this is a molecule that I have been researching for almost now 20 years because I happen to have a target that plays a very important role in cancer. So therefore I was looking for a spice that could inhabit that particular target and I found that the curcumin that is nothing but turmeric, also called curry powder is the best inhibitor of this target and turmeric is what give the yellow color to this plant curcuma longa actually it is a rhizome, it is like the root of the plant that has this compound and that is what give the yellow color. That’s what is used in mustard on the hot dog that yellow color is because of curcumin.
So even in America have we been taking curcumin without knowing it?
You would be surprised that America has known about curcumin for a long long time and the FDA has know about it for a long time and the FDA has approved curcumin actually for human use, and they call it GRAS (Generally Regarded as Safe) so the food industry in the US have been using curcumin to preserve cheese they have been using it in cereals they have been using it in yogurt, they have been using it in mustard as I mentioned. So it is used as a preservative on one hand and a coloring agent on the other.
And what’s its specific target that interested you and what does that have to do with treating cancer?
What fascinated me is that a few years ago we happened to discover a molecule that has become a primary mediator of inflammation. And the molecule is called tumor necrosis factor. We happened to discover this molecule almost now 25 years ago and M. D. Anderson was the first institute in the country to test this molecule, and when it was tested here in our cancer center we found that it was very very active but it was very active in the wrong way. It was at that time that we realized it is not the TNF we want it is the anti TNF it is this TNF that is know to be a primary mediator of inflammation. So anything that inhabits inflammation presumably is a treatment for cancer so with that in mind we began to work on a molecule that can inhabit TNF and can inhabit inflammation so that is our target and we are using that as a target to identify a molecule that can potentially work against cancer.
So is curcumin in human trials yet?
Yes… mind you one thing I wanted to mention before I mention about the human clinical trials that when we began to work on curcumin there were hardly a few dozen publication as of today when you go to the NIH national database there are over 3000 publications on curcumin that means there has been a lot of activity and it seems to have a potential for a lot of different diseases and regarding the clinical trials as of today 35 have been completed with cur cumin and another 35 are ongoing right now as we speak.
Doctor Frenkel one of the things that we are concerned about… that we don’t hear about is that some people may be taking forms of complementary medicine without telling our doctors is it true, is it common?
It's very true we don’t realize that most of the patients we are talking about 50 to 80 perecent depending on which surveys they are using, are using some form of complementary therapy. So it’s a very common thing. The question is doesn't the physician know about it? In somewhere between 30 to 50 percent they know about that means between 50 and 70 percent they don’t know about it and the reason they don’t know about it is that number one they never ask and number two the patient doesn’t feel that the physician can give them any positive reinforcement about this use so they don’t tell their physician.
And there is a possibility that the complementary medicine and the traditional medicine being prescribed by the doctor might interact with one another?
There is this possibility, there is a lot of unknown, there is a lot of uncertainty in this whole field but we have to take things into perspective. Which one has very high danger zone and which one has less? Our role is to do (pre no notre) First do no harm and we have to try to find with the patient what are the things that are not going to harm them and what are the things that have more potential for danger.
So we should be encouraging traditional medicine and the urging the doctors to ask the patients and encouraging the patients to offer the doctors some information with regard to what else they might be taking.
There’s no doubt about it… There’s no doubt.
What about vitamins we hear something about the use of mega-vitamins as another form of cancer therapy or even prevention.
There is so much on the internet…
That was going to be my next question.
…In the lay media but when you look at the science you don’t find a whole lot of real support for mega-vitamins there is some support for certain vitamins - vitamin D was getting a lot of attention lately… so there is some of advancement in it. But you can’t say that there is major advancement in mega-vitamins use in cancer care. At this point we don’t have that knowledge.
Now M. D. Anderson is formally studying some forms of comp and alternative medicine, what kinds of things are we studying here and what kinds of things have we seen so far?
We’re looking for results of complementary therapies like acupuncture and yoga as far as their affect on quality of life. We see acupuncture is very effective in relieving nausea after chemotherapy, relieving pain and interesting study we did here, is finding after radiation therapy where people have side effects of dry mouth, acupuncture is very helpful. We know that yoga is very helpful as far a improving the quality of life improving, sleep improving general well being. So there are a lot of studies that are going on now that do support the use of complementary therapies with some caution.
So somehow we have to get the findings in the laboratory on traditional medicine that may have come from Shamans all the way through an analysis of what the active products are and then integrate them into true clinical trials.
No doubt about that.
Anything else that either of you want to add to this very interesting topic?
I think I would like to say one more thing that we tend to distinguish between prevention and therapy and that is for the right reasons, why because in cases of therapy we can afford to give some very toxic substances to the patients hoping that they will be selective to the tumor cell. I think that it is here that cur cumin has a very special nature which will work both for prevention as well as therapy and the indications are coming from all different directions and I think that is something that people need to keep in mind.
Listeners if you have questions about anything you have heard today about natural products, cancer prevention or screening please contact Ask M. D. Anderson at 1-877-MDA-6789 or online at www.mdanderson.org/ask.
Thank you for listening to this episode of Cancer Newsline. Again, this is a weekly series, please tune in next week for our next episode.
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