Kosmos Publications – Publications to increase self-awareness

May 12, 2023 By Angie N Choi, EdD, Author of Whole New Me: Healing From Cancer in Body, Mind, and Spirit “You do not need to do chemotherapy,” I heard my intuition tell me during meditation, despite what my oncologist would later recommend. I decided to listen to my intuition and researched alternatives which led me to the metabolic approach to cancer. This approach saved me from the toxicity of chemotherapy and resulted in remission. Here is my story. In 2021, I was diagnosed with early-stage ovarian cancer. I had a large tumor the size of a cantaloupe on my left ovary. I underwent surgery - a total hysterectomy - and also had 17 lymph nodes removed, but during the tumor-debulking process, spillage occurred. My gynecological oncologist recommended six rounds of chemotherapy, standard protocol when spillage occurs. I had the intuition that I wouldn’t need chemotherapy a week before being told I would. I was crushed to learn that I would need chemotherapy because I was so hopeful to hear otherwise. Initially, I agreed to start chemotherapy infusions within two weeks, but I was deeply conflicted about it. When I asked my oncologist about the repercussions of not doing chemotherapy, she told me that there would be a 35% chance of cancer coming back within five years. It was clear that she thought chemotherapy was the only way to proceed and did not want to talk about alternatives to chemotherapy. In retrospect, I realized that she was recommending what she thought was the right treatment, the standard of care, and that advising otherwise could have made her liable to legal action. Nonetheless, our talk made me feel alienated and hopeless. I knew chemotherapy could be effective, but long-term consequences scared me, especially for a sensitive body like mine that can’t even handle MSG in food. What really worried me about chemotherapy was treatment effects that included a compromised immune system (white and red blood cell loss), gastrointestinal damage, nerve damage, hair loss, loss of taste, metallic taste in mouth, mouth sores, loss of appetite, nausea, vomiting, light sensitivity, weight loss, tinnitus, bruising, peeling of the skin, and fatigue.1,2 I thought chemotherapy would wreak havoc on my system and make living even harder. I questioned, “even if I lived longer, what about quality of life?” Without your health, you really cannot live. I was also concerned about chemotherapy-related secondary cancers and long-term health consequences.3-5 Reasons Why Patients Refuse Chemotherapy Cancer patients refusing chemotherapy or other conventional treatments is a complex issue that has been studied to some extent.6-10 Most patients would choose chemotherapy even for a small benefit,11 but some patients decide to forego chemotherapy for several reasons as listed below.7,12 Quality of life after treatment Poor doctor-patient communication Personal values of or beliefs in holistic healing Emotional impact of the cancer diagnosis Concern over treatment side-effects Strong sense of internal control Pros do not outweigh the cons of chemotherapy Attitudes toward living, suffering, and dying Progression or stage of disease It is important to remember that patients who refuse chemotherapy are not doing so recklessly but making these decisions based upon their personal values and beliefs after consultation with their oncologists. Additionally, patients who decline chemotherapy should not be viewed as being resigned to die; they may still pursue other less toxic treatments. It is important for oncologists to establish effective communication to maintain relationships with their patients and deter attrition as some patients never return. In my case, I wanted to keep my conventional doctors on my team for continued monitoring even as I began working with my nutritionist and naturopath. I was not going to do nothing; I just wasn’t going to do chemotherapy. Fortunately, I found the metabolic approach to cancer. What to Expect When Refusing Chemotherapy When patients refuse chemotherapy or standard treatment after a cancer diagnosis, they are often met with disapproval and pessimism from their team of healthcare professionals which is unfortunate because it deters open communication between patients and their doctors. In my case, when I questioned my oncologist about repercussions of not doing chemotherapy, it was clear that she thought chemotherapy was the only way forward. Patients should recognize that there are standard protocols for cancer treatment, and that oncologists have trained long and hard in a medical system that upholds these standards. It is not surprising that medical professionals react unfavorably toward those who decline chemotherapy. Patients who decline standard treatment may be perceived as irresponsible or doomed. Often the relationship can sour and in worst-case scenarios, become combative. Patients should not have to use precious energy to defend their decisions while fighting cancer, but that’s what often occurs. I recommend being aware of the different perspectives in the room, keeping communication as open as possible, having a close friend or family member who can be there with you for support, and focusing on everyone’s common goal – the patient's well-being. Stay focused on what you need from your conventional doctors while communicating with them if you decide to forgo chemotherapy. Cancer Without Chemotherapy: Using a Metabolic Approach to Cancer Instead If a patient declines chemotherapy, what are other treatment options? The metabolic approach to cancer targets metabolic changes that occur in cancer cells in contrast to traditional chemotherapy which causes side effects due it is non-specific targeting of rapidly proliferating cells. Metabolic abnormalities in cancer cells were first noticed in the 1920s by Otto Warburg, a German physiologist, physician, and Nobel laureate (1931). He observed that cancer cells, unlike healthy cells, fermented glucose (an anaerobic process) at abnormally high rates even when sufficient oxygen was present.13 This metabolic behavior in cancer cells was a highly inefficient way to produce energy (adenosine triphosphate or ATP), which cancer cells needed to fuel their rapid growth. Why would cancer cells use this inefficient method? Warburg proposed that they had damaged mitochondria and could not use oxygen (respiration) to produce energy and had to rely on fermentation instead. Metabolically speaking, cancer cells, like bacteria, use fermentation to produce energy, but less energy is produced in this incomplete form of oxidizing glucose. Cancer cells use this workaround to fuel their growth. It may not be an efficient way to make energy, but it is viable. However, if the main sources of fuel were cut off or drastically reduced, then cancer cells become especially vulnerable to arrested cellular growth and destruction because they need more fuel to produce energy since they are forced to use an inefficient process. This is where a therapeutic ketogenic diet could be an effective strategy to create an “energy crisis” in cancer cells while not harming healthy cells with toxic treatments like chemotherapy.14 There are other metabolic therapies that may also be used in combination with each other or with standard treatment. Fasting with Chemotherapy For those that decide to do chemotherapy, research has indicated that fasting prior to infusions makes chemotherapy more effective in destroying cancer cells while also protecting healthy cells.15,16 From a metabolic perspective, fasting helps healthy cells go into “shielding” mode from chemotherapy while tumor cells become more vulnerable to the toxicity of chemotherapy. This difference in susceptibility between healthy and cancer cells is called “differential stress resistance.”17,18 Fasting upregulates DNA repair and autophagy (the body’s process of cleaning out old or damaged cell parts), and it limits insulin-like growth factor-1 (IGF-1) signaling which curbs cell growth and proliferation.19 Cancer cells however are insensitive to signals to reduce proliferation, and when you start fasting, they become more vulnerable to chemotherapy. For patients considering chemotherapy, several research studies support short-term fasting combined with chemotherapy to protect healthy cells while destroying cancer cells.15-18 Chemotherapy or Not: An Individual Decision Deciding whether or not to do standard treatment is a personal decision based upon many factors and conditions. My head understood that chemotherapy could be effective in destroying cancer cells, but my heart did not want to do it. I needed to find a treatment that both head and heart could agree upon. In my case, I declined chemotherapy, but I didn’t just do nothing. I did a metabolic approach that consisted of a therapeutic ketogenic diet, anti-parasitic medications, and supplements. This approach targeted cancer cells’ metabolic weaknesses and worked beautifully for me. I went into remission from cancer. Presently, I still get biannual lab work as I continue to be monitored. It was listening to my intuition along with researching other treatment options that protected me from the toxicity of chemotherapy. References 1 Kerckhove N, Collin A, Condé S, Chaleteix C, Pezet D and Balayssac D. Long-Term Effects, Pathophysiological Mechanisms, and Risk Factors of Chemotherapy-Induced Peripheral Neuropathies: A Comprehensive Literature Review. Front. Pharmacol. 2012;8:86. 2Chemotherapy Side Effects. American Cancer Society. https://www.cancer.org/cancer/managing-cancer/treatment-types/chemotherapy/chemotherapy-side-effects.html. Accessed May 4, 2023. 3Aidan JC, Priddee NR, McAleer JJ. Chemotherapy causes cancer! A case report of therapy related acute myeloid leukemia in early stage breast cancer. Ulst Med J. 2013;82(2):97-99. 4Vega-Stromberg T. Chemotherapy-induced secondary malignancies. J Infus Nurs. 2003;26(6):353. 5Boffetta P, Kaldor JM. Secondary malignancies following cancer chemotherapy. Acta Oncologica. 1994;33(6): 591-598. 6Frenkel M. Refusing treatment. Oncologist. 2013;18(5):634-6 7Verhoef MJ, Rose MS, White M, et al. Declining conventional cancer treatment and using complementary and alternative medicine: A problem or a challenge? Curr Oncol. 2008;15(suppl 2):s101–s106. 8Huchcroft SA, Snodgrass T. Cancer patients who refuse treatment. Cancer Causes Control. 1993;4:179–185. 9Puts MT, Monette J, Girre V, et al. Characteristics of older newly diagnosed cancer patients refusing cancer treatments. Support Care Cancer. 2010;18:969–974. 10Levin M, Mermelstein H, Rigberg C. Factors associated with acceptance or rejection of recommendation for chemotherapy in a community cancer center. Cancer Nurs. 1999;22:246–250. 11Levin ML, Stubbs L, Plant, HJ, Wilson P, Gregory WM, Armes PJ, et al. Attitude to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public. British Medical Journal 1990;300:1458–60. 12Huijer M, van Leeuwen E. Personal values and cancer treatment refusal. Journal of Medical Ethics 2000;26:358-362. 13Koppenol, WH, Bounds, PL, & Dang, CV (2011). Otto Warburg’s contributions to current concepts of cancer metabolism. Nature Reviews Cancer, 11(5), 325-337. 14Zhou, W., Mukherjee, P., Kiebish, M.A. et al. The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer. Nutr Metab (Lond) 4, 5 (2007). 15Sadeghian M, Rahmani S, Khalesi S, & Hejazi E. A review of fasting effects on the response of cancer to chemotherapy. Clinical Nutrition. 2021; 40(4):1669-1681. 16Lee C, Raffaghello L, Brandhorst S, Safdie FM, et al. Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Sci Transl Med. 2012 Mar 7;4(124):124ra27 17Raffaghello L, Lee C, Safdie FM, Wei M, Madia F, Bianchi G, et al. Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy. Proc Natl Acad Sci U S A. 2008;105(24):8215–20. 18Lee C, Longo VD. Fasting vs dietary restriction in cellular protection and cancer treatment: from model organisms to patients. Oncogene. 2011;30(30):3305–16. 19Koppold-Liebscher, D., Kessler, C.S., Steckhan, N. et al. Short-term fasting accompanying chemotherapy as a supportive therapy in gynecological cancer: protocol for a multicenter randomized controlled clinical trial. Trials. 2020. 21, 854.

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A Metabolic Approach to Cancer: Wrecking Cancer's Metabolism with Diet

The Ketogenic Diet Starved Cancer Cells of Glucose

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