When Your Chemotherapy Fails and Your Cancer Comes Back
Many of my patients, who were initially placed on chemotherapy, find that within 6 months to a year, or sometimes longer, their cancers come back. Patients do not usually die from the primary cancer, but instead succumb to their disease after it spreads to a vital organ.
The problem with traditional maximum tolerated chemotherapy and radiation is that it does not take into consideration the population of circulating cancer stem cells. Circulating cancer stem cells are not killed by conventional high dose chemotherapy and radiation. These cells spread and cause metastasis and new tumor growth in different areas of your body. These cells reestablish a new tumor due to their ability to multiply and migrate into new areas. These therapies also cause increase tumor resistant cancer cells which do not respond to your therapy. The tumor responds through evolution and its need for survival. This is why your high dose chemo has failed.Read More
Chemoresistance occurs through the multi drug resistant protein 1 MDR-1 or the P-glycoprotein “porter system” which pump the chemotherapy out of the cell so it doesn’t have a chance to work. As cells become resistant they upregulate P-glycoprotein and become more glycolytic. This means they use more glucose to generate energy. Because they use aerobic glycoloysis they can no longer undergo cell cancer apoptosis, which is cancer cell death.
To get a better response and prevent failure we need to target the stem cell tumors. Strategies include, inhibiting TGFbeta1, which is an epithelial cell growth factor inhibiting all the cancer cell pathways, blocking the ABC transporters, blocking P13kinase pathway and blocking the blood supply of the tumor. The only way to see what causes chemo resistance is to measure it and the only way to target stem cells is through natural substances to inhibit the cancer pathways.
Chemoresistance can also occur depending on the cell cycling rate of the cancer.
The cell cycling rate of the cancer influences its sensitivity to chemo and radiation. If the primary cancer is rapidly dividing then the chemotherapy may be sensitive if chosen correctly, but the problem here is that most chemotherapies are chosen in a retrospective manner. If the cancer cells are in a G0 quiescent phase then they are not rapidly dividing and the chemotherapy would be ineffective. Remember, every cancer has a different set of genes and bio markers and no two cancers are the same. By performing sophisticated chemotherapy, natural substances, and sensitivity testing, I can develop a personalized protocol using only what works for you.
Chemoresistance can also occur through tumor evolution. How quickly can we perform the therapies before the cancers decide to mutate.
Chemoresistance is induced after high dose chemotherapy as the cancer adapts to its environment. Most patients have a good initial effect from the chemotherapy, assuming they are administered the correct chemotherapy. The patient later develops resistance and the tumor reocurrs.
A recent study at the Moffitt Cancer Center in Tampa Bay, Florida demonstrated that low dose chemotherapy can keep the tumor burden stable, and not allowing the chemo resistant cells to rise. This means you can live with the cancer. This is known as the adaptive theory of cancer. The chemo sensitive cells v the chemo resistant cells and you can maintain a low tumor burden. The aurthor states you can live with cancer.
Since maximum tolerated doses of chemotherapy induce circulating cancer stem cells and metastasis I have a proprietary, low dose, genetically targeted, based on your test administration protocol. I have never seen any significant side effects from this therapy.
As mentioned above these resistant pathways need to be measured which chemo and natural substances work, and which immuno therapy needs to be used.
If you would like more information about this topic, please call the office at (480) 860-2030 to discuss your case in greater detail. We welcome all stage 4 cancers. Dr. Silver is a Cardiologist and Critical Care doctor and can handle all emergency needs.
Dean R. Silver M.D., M.D.(H)