The Cancer Solution: Taking Charge of Your Life with Cancer

By Jack C. Westman

This book should be read as a requirement for anyone diagnosed with cancer. It will serve as a tremendous practical guide for cancer patients and their families.
Thomas N. Seyfried,
Professor of biology at Boston College and author of Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer.

This book is a must read for every adult as cancer remains our greatest enemy. If you have experience with cancer, via a family member or friend, once you start reading this book, it will be hard to put down.
Peter L. Pedersen,
Professor of Biological Chemistry & Oncology, Johns Hopkins University.

Dr. Westmans personal experience with cancer led him to extensively research the state of cancer care. Strengthening the bodys own immune system to prevent and control cancer has shown very promising results, but it is largely ignored by mainstream cancer research and treatment. If you care about winning the war on cancer, this book will motivate you to advocate for more funding for this line of research.
Stephen L. Swanson,
Past Chair of the Board of Directors of the American Cancer Society

Dr. Westmans book is amazing, creative, innovative, different, stimulating and outstanding.
Bharat B. Aggarwal, Professor of Cancer Research,
University of Texas M. D. Anderson Cancer Center.

• Language: English
• Publisher: Archway Publishing
• Release date: Jan 15, 2015
• ISBN: 9781480813090

Book preview

Copyright © 2015 Jack C. Westman, M.D., M.S.

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.

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ISBN: 978-1-4808-1308-3 (sc)

ISBN: 978-1-4808-1310-6 (hc)

ISBN: 978-1-4808-1309-0 (e)

Library of Congress Control Number: 2014922399

Archway Publishing rev. date: 1/28/2015

The information, ideas, and suggestions in this book are not intended as a substitute for professional medical advice. Before following any suggestions contained in this book, you should consult your personal physician. Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions in this book.

Contents

Preface

Acknowledgements

Chapter One Our Journey with Cancer

Chapter Two Conventional Cancer Treatment

Chapter Three Navigating the Cancer Care System

Chapter Four Background for Understanding Cancer

Chapter Five How Cancer Cells Form and Multiply

Chapter Six Cancer Research

Chapter Seven Testing Treatments

Chapter Eight Changing the Way We Think About Cancer

Chapter Nine Immunotherapy: Drawing upon Your Body’s Resources

Chapter Ten Nutritional Therapy: Drawing on Nature’s Resources

Chapter Eleven What You Can Do Now to Complement Your Cancer Treatment

Chapter Twelve Taking Charge of Being a Care Recipient or Caregiver

Chapter Thirteen Where Are We Now?

Chapter Fourteen Obstacles to Progress

Chapter Fifteen Where Do We Go from Here?

Chapter Sixteen How Can We Win the War on Cancer?

References

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There will be a major change in the way cancer is treated over the next ten years. If you or a loved one is receiving cancer care, you can take charge of your cancer treatment now by complementing it through diet and nutritional supplements that have been shown to prevent cancer and reverse its growth and by having knowledge about your cancer that you can share with your doctors.

Do not delay seeking advice from a qualified, licensed medical professional regarding treatment for your cancer. The information presented in this book is in no way meant to discourage you from seeking medical care. Nothing contained here is intended to be a substitute for the medical diagnosis, advice or treatment that can be provided by your physician or other qualified health care professionals. This material is provided for your information only and should not be construed as medical advice or instruction. Directions for diagnostic and therapeutic methods are taken from the providers’ instructions. The author assumes no responsibility for outcomes related to information contained in this book. The purpose of this book is to support you and your doctors in order to make your treatment more effective.

Dedicated to

Conrad Alexander Westman

Linda Lee Swanson Branch

Nancy Kathryn Baehre Westman

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Preface

My beloved wife Nancy’s 34 years of life with cancer and ultimate debilitating process of dying from cancer in 2012 compelled me to learn all that I could about cancer research and treatment. The appearance of cancer in two relatives and the urging of friends clinched my determination to share what I have learned with persons affected by cancer and with other health care professionals.

Cancer inevitably will affect your life directly or through those close to you as it has mine. This may be why you are reading this book and seeking a perspective on the world’s most devastating disease that will be the cause of death for one of three of us in the United States. I have written this book to be readable for lay persons and yet contain useful technical details for health care professionals. This book essentially is a handbook to be skimmed at first reading and used for later reference as needed.

A growing body of evidence shows that patients who are inquisitive about and actively involved in their health care have better health outcomes and incur lower costs. As a result, many public and private health care organizations are educating people about their conditions and involving them more fully in making decisions about their care. I am following this trend.

I wish that I could be writing about how we are winning the War on Cancer. Unfortunately, I must join the ranks of objective observers of the current state of cancer research and care and acknowledge that we are far short of winning that War.

I wrote this book for you with four aims. The first is to give you a broad overview of the different forms of cancer treatment and cancer research in as understandable terms as I can. The second is to provide enough technical details so that you can use this book as a reference for questions about specific aspects of cancer. The third is to stimulate your interest in complementary cancer care. The fourth is to encourage you as a layperson or a professional to become an informed advocate for federal and private funding of research that focuses on preventing and treating the underlying causes of cancer.

I am a psychiatrist, not an oncologist. I am an academic physician who has written eight professional books and four books for laypersons. I do my own background research to be as sure as I can that my writing is on solid ground. For this book, I have obtained critical reviews of its technical contents by oncologists and cancer researchers.

I believe that my perspective on oncology from the outside and as a firsthand observer of the best that oncology has to offer gives me the advantage of being free from biases that inevitably accompany being an insider in any field. In this respect, I always have appreciated the views that outsiders have of my own field—psychiatry.

Intriguingly for me, when I talk with oncologists, I find that they turn to me as a psychiatrist and share their frustrations. You can imagine what it is like to be in a medical profession in which the most you can do is try to prolong lives in the face of a lethal disease. Fortunately, they find enough rewards in the patients they treat successfully to keep them going. My overall intent is to support their efforts to improve the outcomes of the patients they serve.

My hope is that my perspective as a person who lives with cancer and as a physician will be useful to you. As a caregiver, I know the ins and outs of receiving the diagnosis of cancer and all that its treatment involves. I know the relief that comes from success and the grief that comes from failure. I know what it is like to go through the process of dying from cancer. I know firsthand both the strengths and the weaknesses of our health care system in general and of cancer care specifically.

Acknowledgements

I am indebted especially to two persons. Philip Krause urged me to write this book and critically reviewed its contents from the point of view of a lay person who wants a detailed, but readable, explanation of what cancer is all about. Jim Koelsch participated in my project by keeping detailed records of his life with advanced cancer to assess the impact of specific treatment and life style changes he has made and by helping me explore the literature on cancer.

In addition to reviewing pertinent literature and the 2011 report Accelerating Progress against Cancer and 2012 plan Shaping the Future of Oncology: Envisioning Cancer Care in 2030 of the American Society of Clinical Oncology both of which concluded that cancer research and care can be vastly improved,¹ I have drawn on the paradigm shifting work of the following authors.

Oncologist Guy Faguet, author of The War on Cancer: An Anatomy of Failure, A Blueprint for the Future and the Conquest of Cancer,² credits the National Cancer Institute (NCI) with the nation’s advances in molecular biology and genetics of cancer. He also criticizes the NCI for three decades of stagnation in cancer treatment.

Dr. Michael Sporn, professor medicine at the Geisel School of Medicine at Dartmouth and three-decade staff member of the National Cancer Institute, has been struggling for many years to get fellow researchers to think about cancer not as an invasive group of fast-growing cells but as a process, called carcinogenesis (neoplasia). Sporn calls attention to cancer as a multistage process that goes through various cell transformations and sometimes long periods of latency in its progression.³

Dr. Siddhartha Mukherjee, author of The Emperor of All Maladies: A Biography of Cancer, vividly portrays the history of cancer that culminated with the Cancer Genome Atlas Project.⁴ His perspective as an oncologist reveals an insider’s view of the past and contemporary state of cancer research and treatment.

In his 2010 The New Yorker article Cancer World: the Making of a Modern Disease, Steven Shapin comprehensively summarized the current state of cancer research and treatment.⁵

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U. S. Annual Deaths from Cancer 1900-2013

In his 2012 book Cancer as a Metabolic Disease, Dr. Thomas Seyfried of Boston College makes a compelling case for cancer as a metabolic disease.⁶ Seyfried calls the mutations observed in the nuclear DNA of cancer cells red herrings that are not the primary causes of neoplasia and consequent origin of cancer cells.

Former executive editor of Fortune magazine, Clifton Leaf expressed outrage over the paltry victories against cancer in his 2004 Fortune magazine article Why We’re Losing The War On Cancer…⁷ He elaborated upon and updated this theme in his 2013 book The Truth in Small Doses: Why We’re Losing the War on Cancer—and How to Win It.⁸ Leaf points out that, although the standardized death rate for cancer in America has fallen, the total number of cancer deaths in the country has risen from 12,500 in 1900 to almost 580,000 in 2013 and by 50% since 1970. That difference is explained largely by our growing and aging population, but it stands in contrast to deaths from heart disease that have fallen by 19% during the same time. Cancer now is the leading cause of death in the world. I have drawn heavily on Leaf’s interviews with key persons in the cancer field.

Time magazine editor Bill Saporito performed a great public service in his 2013 Time article The Conspiracy to End Cancer that describes how a team-based, cross-disciplinary approach to cancer research is upending tradition and delivering results faster.⁹

The journalist George Johnson set out to learn everything he could about cancer when his wife received that diagnosis at a relatively young age.¹⁰ In his book The Cancer Chronicles, he explains that the finely crafted regulators intended to keep cell division in check wear down over time and eventually give way. The result is a cancer cell line whose proliferation gets out of control and, worse, dispatches colonists to other parts of the body.

I am indebted to the generosity of the following professionals for critically reviewing aspects of this book that fall within their areas of expertise: Peter Pedersen, Ph.D., for reviewing the chapter on how cancer cells form and multiply; Douglas McNeel, M.D., Ph.D., for reviewing the chapter on immunotherapy; Dominic D’Agostino, Ph.D., for reviewing the chapter on nutritional therapy and Bharat Aggarwal, Ph.D., David A. Boothman, Ph.D., Gaurab Chakrobarti M.D., Ph.D., Farjana Fattah, Ph.D., Julio Morales, Ph.D., Zachary Moore, M.D., Ph.D., Praveen Patodar, Ph.D. and Ling Xiao, Ph.D. for providing comments as well.

I also am indebted to the following persons who reviewed portions of the book from the perspective of the general reader: James Koelsch, John McCollough, David Williams, Philip Krause, Carolyn Swanson, Steven Swanson and Peter Westman.

Chapter One

Our Journey with Cancer

Why I wrote this book.

I was at a meeting in San Francisco in 1978 and received a call from my wife, Nancy: Jack, I just came back from our doctor. He said I have a lump in my left breast.

Nancy had a biopsy of the breast lump. It turned out to be cancer—an adenocarcinoma. We were referred to a surgeon who recommended that Nancy have a radical mastectomy. That meant removing her left breast, a muscle underneath it and the lymph nodes from her left armpit—a disfiguring operation. We wondered if that was necessary. Why couldn’t he just remove the lump in what is now called a lumpectomy. Her doctor said that he could not be sure that the cancer had not already spread. There was no other way to determine if a few or a lot of cells were in the surrounding tissues or in the lymph nodes. We decided to go ahead with the radical mastectomy.

My curiosity as a physician led me to enquire about research that was going on then regarding the treatment of cancer. I learned about chemotherapy and radiation that were being used to supplement surgery. A few physicians were writing about trying what was called immunotherapy and about nutritional approaches to cancer, but they were in a small minority.

For twenty-six years, there was no evidence that Nancy’s cancer had recurred, and I stopped following cancer developments. We felt that she had made the right decision in having a radical mastectomy. Then in 2002 Nancy’s physician examined her left breast scar and noticed a lump. That led to removal of the lump and radiation treatment of her left chest. This began the second phase of our life with cancer.

All treatments have predictable or possible side effects. The radical mastectomy was an inconvenience, but a tolerable one. The side effects of the radiation were more than that. Nancy’s skin over the radiation site became dry and itching. She developed numbness in her left arm related to damage to her median nerve. As time went on her left hand became clumsy. All of this progressed over the next nine years. But we were grateful Nancy had good health in other respects, and we were content to be followed by our oncologist.

Nancy was supposed to take Tamoxifen for five years, but the side effects were too unpleasant to continue so that she stopped taking it after three years.

In June of 2011, Nancy began to feel short of breath. Over the years, she was an avid walker and had maintained an active life. We went to the emergency room and found that she had fluid in her right pleural space around the lung. Further studies in the hospital revealed that the cancer had recurred and spread from the left chest into the lymph nodes in between the lungs and thence into her right lung. This continued our life with cancer treatment based on the search for and destroy model. We now added chemotherapy to surgery and radiation — the triad of conventional cancer treatment.

Nancy had nine pleural fluid drainages. Because of the risk of infection from the pleural taps, a pleurodesis was performed to seal off the pleural space. Because she was not adequately managed with lung expansion exercises after the surgery, she became a pulmonary cripple and needed oxygen continuously for the rest of her life.

Nancy began courses of chemotherapy based on the principle that destroying growing cells would include cancer cells. She lost hair and developed chemo brain with a loss of recent memory. At first it looked as though the chemotherapy was shrinking the cancer tumors.

In January of 2012, Nancy required hospitalization from complications of the chemotherapy. She received too much intravenous fluid in the hospital and developed swelling in her legs, which receded with the passage of time.

In June of 2012, it became evident that the chemotherapy was not working, and Nancy entered home-based Hospice Care.

Nancy and I talked about death and dying. It was clear that she did not fear death— only the painful process of dying. We talked about what it would be like at the moment of death and how I had witnessed it twice and was familiar with the literature on the near death experience. The first time was with my father when I was in medical school. Dad was in a coma induced by chemotherapy (urethane) for multiple myeloma. I happened to be sitting next to his bed and noticed that his eyes had opened. He stared straight upward for about 30 seconds. Then he smiled, closed his eyes, and stopped breathing. I had the same experience during my internship when I was with a dying woman who also opened her eyes, stared straight upward, closed her eyes and stopped breathing. Nancy and I expressed the hope that we could be together when that time came for her.

Nancy and I reviewed both of our wills and planned our funerals and paid for both of them in advance. We wrote our obituaries, and, since she was an editor, she edited mine. She put the finishing touches on her memoirs entitled Reminiscences. We listened to music together. Television no longer held any interest for us. We cherished phone calls and visits from friends and family.

During the last month of her life, Nancy required increasing dosages of morphine to ease the pain of the cancer spreading in her lungs.

On August 31 at 5:00 AM, I was awakened by the sound of Nancy falling out of her hospital bed with side rails. She was in intense pain as I lifted her back into bed. The pain was so great that she pleaded, Jack, please kill me! I gave her morphine. We laid together for several hours holding hands. After a while I heard her crying and saw her looking straight up. I asked her if she saw anything. She said no with tears.

At around 9:00 AM, I got up and called our hospice team. They came immediately and did what they could to make Nancy comfortable. A volunteer stayed after the hospice nurse left. At 2:14 PM as I was going out the door to get more morphine, she called out to me to come right away. As I approached Nancy, she was looking straight upward. She smiled and stopped breathing at 2:15 PM. I felt a rush of gratitude for being able to be there then. I laid with her holding her hand until the morticians came, crying off and on. They respectfully waited until I felt that I could let Nancy’s body go.

For the third time, I had the opportunity to be there at the moment of mortal death and personally witness that moment as reported in the near death literature.

Both Nancy and I were most grateful for the Hospice support we received in Florida and Wisconsin. In our view, the nonprofit Hospice systems were the most efficient and compassionate that we encountered during our journey though many medical facilities. The people working in these Hospice systems were clearly dedicated to their work, which they carried out with remarkable empathy and concern for us. This extended into the time when I took advantage of their grief counseling. That experience included reliving and re-enacting my last hours with Nancy.

We had a thirty-four year battle with cancer—or more accurately thirty-four years of living with cancer. Nancy’s immune system kept her cancer free for most of her life. In her later years, it failed to recognize cancer cells on two occasions and ultimately became completely blind to them. In one way, we were extremely fortunate. We outlived the usual outcome with breast cancer.

In another way, we lived through an era that lost decades of potential benefit for people with cancer. The focus of cancer funding and research was not on how cancer cells develop and spread. It was on search for and destroy cancer cells. It was on eliminating cancer cells… not on treating their underlying causes.

In 2013 two of my close relatives were diagnosed with potentially life-threatening cancers.

Conclusion

I have the nagging feeling that, if I had known in 2011 about the complementary therapies for conventional cancer treatment described in Chapter Eleven, Nancy would be living today.

My hope is that our experience will inspire others to take charge of their lives with cancer and become advocates for changing cancer research and care from focusing on killing cancer cells to preventing and stopping neoplasia.

Chapter Two

Conventional Cancer Treatment

The conventional surgery/radiation/chemotherapy approach to cancer treatment, its methods and its results are described.

People react to bad news in different ways. The diagnosis of cancer can be emotionally devastating for some who become emotionally debilitated. Others appear to take a cancer diagnosis in stride. Most feel helpless and depend completely on their doctors to direct their treatment. Some are inquisitive and try to learn as much as they can about their particular form of cancer and to do all they can to help their treatment process. The fact that you are reading this book suggests that you are one of them. A few take matters into their own hands and try alternative treatments outside of the conventional cancer care system.

This book is designed to help you understand the basic characteristics of cancer and how to take advantage of the options that are available to you. First of all, the main categories of cancer are:

• Carcinomas–begin in the skin or in tissues that line or cover internal organs.

• Sarcomas–begin in bone, cartilage, fat, muscle, blood vessels or other connective or supportive tissue.

• Leukemias–start in blood-forming tissue, such as bone marrow, and cause large numbers of abnormal blood cells to be produced and enter the blood stream.

• Lymphoma and myeloma–begin in the cells of the immune system.

• Central nervous system cancers–begin in the tissues of the brain or spinal cord.

The stages of cancer are:

• Stage 0 - The earliest, most treatable forms of cancer are when abnormal cells are only detectable in the top layer of cells within the affected body region. Such forms of cancer are often referred to as carcinoma in situ, which means that abnormal cells are only located at the site where they originated.

• Stage I - Abnormal cells clump together and begin penetrating beneath the top layer of cells only within the organ of origin.

• Stage II - Cancer cells grow into a small tumor within the organ of origin. Typically, cancer in this stage has not spread to other tissues or organs within the body.

• Stage III - As the cancer tumor grows, cancer cells spread into the lymph nodes and surrounding tissues.

• Stage IV - Cancer cells spread beyond the surrounding lymph nodes and tissues to other parts of the body. This stage is metastatic cancer.

Conventional cancer treatment consists of surgery, radiation, chemotherapy and hormone therapy for some cancers. Surgery and radiation are used to remove or kill cancer cells directly in specific locations. Surgery can result in long-term recovery when a cancer tumor can be completely removed. However, when the cancer cells have gone beyond the original tumor, surgery may facilitate their spread. Targeted radiation techniques, such as multidimensional conformal therapy, intensity-modulated radiation therapy, stereotactic radiosurgery, proton beam radiation therapy and radioimmunotherapy are becoming increasingly available. Brachytherapy involves implanting radioactive pellets, seeds or catheters in or near cancerous tissue.

Chemotherapy and radiation have less positive long-term recovery rates than surgery because they use toxic methods that harm normal cells that divide rapidly—most commonly cells in the bone marrow, digestive tract and hair follicles—and accordingly cannot be used continuously. The most typical side-effects of chemotherapy are myelosuppression (decreased production of white blood cells with suppression of the immune system), mucositis (inflammation of the lining of the digestive tract) and alopecia (hair loss). A patient must recover from these methods before repeating them, and the methods themselves can be carcinogenic, especially radiation. They can kill cancer cells, but those that are not killed continue to grow and spread. This kind of resistance also is seen with the overuse of antibiotics, which creates strains of microbes that are resistant to treatment. Chemotherapy also weakens the immune system, which is the body’s natural defense against cancer. This is why chemotherapy and radiation are not seen as cures for cancer.

Because the drugs used to kill cancer cells are toxic to neighboring healthy cells, researchers have long sought a drug delivery method that targets only cancer cells, bypassing the healthy ones. Examples currently available are 1) using Functional Magnetic Resonance Imaging (fMRI) to guide placing drug-filled magnetic nanoparticles in the area of a tumor and 2) using nanoshell particles to protect the enzymes that starve cancer cells as part of chemotherapy.¹¹ According to the National Cancer Institute, six such nanoparticles are currently approved for use on the market worldwide. So far, they seem to improve the safety of chemotherapy.

Conventional cancer therapy has produced spectacular results. A noteworthy example is Lance Armstrong who survived a battle with cancer that ravaged his testes, lungs and brain. Treatment reduced him to a slip of a man, his bald head scarred by surgery. However, in 1997 he was declared cancer free. Soon thereafter he was cycling up mountains and plunging down their slopes.¹²

Armstrong was treated with Cisplatin—a unique anti-cancer agent. Its development began in the 1960s purely by accident. During an experiment to see what happens to bacteria in electrical fields, it was noticed that the bacteria had stopped multiplying. It seemed they had been poisoned by something that was leaching out of one of the electrodes used to create the electrical field. The substance was identified as platinum. Cisplatin (which contains platinum) was tested against a number of tumors. Overall, it proved of little long-term value, except against testicular cancer, illustrating the fact that no single chemotherapeutic agent in use at this time kills all kinds of cancer cells.

Unfortunately, the general experience with conventional cancer treatment led Ezekiel Emanuel, professor at the University of Pennsylvania School of Medicine, to write a New York Times editorial in 2013 on behalf of twenty oncologists critical of the existing cancer care system titled A Plan To Fix Cancer Care.¹³ The editorial stated that many cancer patients, after getting a diagnosis of a frightening disease, pursue any potentially promising therapy regardless of the cost. But the main cost driver is the fee-for-service payment system. The more doctors do for patients, the more reimbursement they receive. Surgeons earn more for every procedure. Oncologists typically make more money if they use newly approved drugs and the latest radiation treatments than if they use cheaper, older alternatives that work just as well. Some of these new therapies are rightly heralded as substantial advances, but others provide only marginal benefit. Of the thirteen anti-cancer drugs the Food and Drug Administration approved in 2012, only one may extend life by more than six months. Two extended life for only four to six weeks. All cost about $6,000 per month of treatment.

The editorial concluded with the statement that we need better incentives for research. Many expensive tests and treatments are introduced without evidence that they significantly improve survival or reduce side effects and with little information about which patients should receive them. For example, while more than 800,000 robotic surgeries, mostly for cancer, were performed from 2011 to 2013, there is no reliable evidence that the robots either improved survival or reduced side effects…despite the fact that they cost more than traditional