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CANCER IMMUNOTHERAPY

WINNING LIFE

COMING OUT FROM THE LOSING WAR ON CANCER

Professor Kecheng Xu M.D.
Fuda Cancer Hospital at Guangzhou, Guangzhou,China


CAN LIFE BE WON

It is the battle of life and death. As we enter into the 21st century, cancer has become the number one killer in the world and it is the main cause of death today. Hence, war on cancer is the major concern of human beings. Billions of dollars have been spent on the long term war on cancer. Conquering cancer, minimizing death from cancer and winning life have become the dream of human beings.

LET’S BEGIN WITH THIS BOOK

In 2006, a book entitled “One out of Ten Thousands Chance” was published in Taiwan. Its author is Mdm. Wu Linlin, one of the top leaders of the Taiwan media. She has been called “The Lady with a strong willpower for life” by Ms Chen Wenqian, a famous emcee within the Taiwan media. The book with its preface by Mr. Ma Yinjiu, the current president of Taiwan, gave a descriptive account of the battle between Ms Wu’s son and the devil of cancer. Ms Wu’s son was then suffering from serious liver cancer.

This was related by Mdm. Wu Linlin:

“In July 2004, I joined a Taiwan Culture Group to tour Lijiang at Yunnan Province, China.……. I brought some silk quilts, a famous product of the province as presents for my two sons. After returning home, I was informed that my eldest son, XiaoMing, had been admitted into Zhenxing Hospital with some illness…….I rushed to the hospital. Xiaoming told me that he had vomited blood and had vertebra pain with unknown reasons.

“On the second day after some medical examinations, Dr Chen, the doctor in charge of Xiaoming, called me into his office. With a serious look on his face, he told me that Xiaoming had end-stage liver cancer; cancer cells had invaded his lungs and vertebrate No. 7 and No.8 causing the formation of two cavities. It was very likely that he would develop paralysis at any time. Dr Chen estimated that Xiaoming had only another two weeks to two months to live. He specifically mentioned that he had prescribed morphine for relieving Xiaoming’s pain. He advised me not to tell Xiaoming about his sickness in order to make him feel comfortable and at ease.

“After hearing all this, I decided to bring Xiaoming to Shanghai for treatment since the doctors in Taiwan could do nothing for him. ‘ I must give it a try!’ I told myself.

“On 7th of August 2004, my whole family including my two sons and their wives, my grandson, and my ex-husband, accompanied Xiaoming and flew to Shanghai where we put our last hope on.”

The next morning, Mdm. Wu Linlin and her family members went to one of the largest hospitals in Shanghai. However, the hospital said that they could do nothing for her son’s disease. However, Dr. Yu, the president of the hospital, suggested to us to try immunotherapy on Xiaoming. Dr. Yu’s eldest sister had end-stage cancer of the bladder. She received a mixed immunotherapy from professor Kong with very good results. Dr. Yu suggested that do give it a try. As the Chinese saying goes, “there is no more risk in trying to heal a dying horse by whatsoever means you can think of.”

“We were astonished to hear that as Xiaoming was born in the year of horse. What a coincidence it was. I told myself that a miracle would happen.

“With end stage liver cancer, Xiaoming’s liver functions had failed almost completely. The white of his eyes had turned almost completely yellowish. His face was dark grey and there were red spots all over his body. His tummy was swollen due to fluid retention. His white blood cells had dropped to less than 500 per cubic mm.


“On 9th August, immunotherapy began. Both Xiaoming’s hands were given injection in both hands once per week for three consecutive weeks followed by a break of 10 days. This made up to one month. The treatment was then repeated until May, 2005. During that period, Mdm. Wu Linlin and Xiaoming had to stay in Shanghai for twenty days per month for Xiaoming. The next ten days they would be back for rest and examinations in Taipei.”

In the book, Wu LinLin wrote:

“After more than half a year of treatment, Xiaoming managed to pull through the initial critical period of two months he was given to live. His health continued to get better and better from day to day. Medical examinations in Chin Heng Hospital confirmed that his health had improved. Now (referring to 2006, two years after receiving the treatment) both jaundice and fluid retention at abdomen had disappeared completely. Xiaoming’s white blood cells increased to an acceptable level of 4000 per cubic mm, though it was lower than the normal count of 6000 per cubic mm. MRI indicated that tumors at the lung and vertebra had disappeared. The size of liver tumor was reduced to 2.5 cm in diameter.”

“As Xiaoming’s health improved gradually, he felt very much better; his confidence grew and he even began to take alcoholic drinks. We had heated arguments over this matter. I told him if he treasured his life he should quit drinking immediately. But Xiaoming insisted that as an adult of thirty plus years old, he needed no guidance from me anymore.

“On 26th February 2006, we were celebrating the thirty-fifth birthday of my second son, Bei Bei. It was then that Xiaoming complained to us that for the last few days, he was having persistent headache which he thought might had been caused by some food or drinks that he had consumed wrongly. After hearing this, I admonished him for drinking despite of the fact that he was suffering from liver cancer and cirrhosis. At the same time I was dead worried. Xiaoming had not received any injection for the past one month. Could it be that cancerous cells had spread to the brain leading to the headache

“We sent Xiaoming for MRI and blood tests. There was no metastasis but slight capillary bleeding of the brain was detected. However, we were told the capillary bleeding would stop by itself. During the Chinese New Year, Xiaoming was feeling fine and had good appetite. He called me to get him some beef steak which I obligated immediately.”

In her book, Mdm. Wu Linlin wrote that it was cancer, the most devilish of all devils that caused all the nightmares in life. Fortunately, she grasped hold of the slightest opportunity that came the way and held her son by hand firmly and walked through the valley of death. Mdm. Wu with her motherly love for her son and her inborn indomitable character never let go the one out of ten thousands opportunity, looked for a mixed immunotherapy and saved the life of her dear child.

CHASING LIFE

Immunotherapy is one of the conventional therapies for cancer. There are many types of immunotherapy involving hundreds of medicines. As there is no “golden standard” to determine its efficacy as well as the lack of comparative studies, it is very difficult to tell which methodology and medicine is the best. The mixed immunotherapy used in the treatment of Mdm. Wu Linlin’s son has been used since 1991 on several thousands of cancer patients. Are these patients still around

In May 2008, it was near summer in Shanghai. The inside of the taxi we were in was real hot. Professor Kong, a collaborator in Shanghai and I embarked on a journey that we called ‘Chasing Life’. We were going to interview cancer patients who had received mixed immunotherapy and who met the following conditions:
1. They had not been given surgical operation or had recurrence of cancer after operation.
2. During their preliminary examinations, they were estimated to have not more than one year to live;
3. They had not been given other types of treatment.

We decided that if we found the patient that we wanted to interview was not in or had passed away, we would interview his/her family members or neighbors. If this failed, we would interview members of the local community committee. For those former cancer patients who were not in Shanghai, we could contact them through telephone.

We managed to trace the outcome of 38 cancer patients who formerly suffered from various cancers such as gastric cancer, lung cancer, colon cancer, nasopharyngeal carcinoma etc. We found that 11 of them had passed away either due to cancer recurrence or other causes; their survivability ranged from 2 to 15 years. The other 27 patients were still alive and had lived between 3 to 18 years after given immunotherapy. There were another 15 patients whom we failed to contact but according to the records in the affiliated hospital to Nanking South East University, follow-up on these patients in 2001. We examined the follow-up medical reports by a medical professor, who had passed away in 2001, of the associated hospital of XXX University of Nanjing which showed that these patients, on the average, they had survived for more than five years.

Though life cannot be relived, all the patients we interviewed related their gross experience when they were walking through the valley of death.

Hu Guochao, a gastric cancer patient received a surgical operation in Shanghai Ren Ji Hospital in September, 1992. During the operation it was discovered that there was metastasis of lymph nodes. A year later, there was metastasis of liver. He received mixed immunotherapy. We met the 52 years old Hu who told us that he had been given immunotherapy for three years. After the first year of treatment there was no more metastasis of liver. Now he lived a normal life. He sighed and said that immunotherapy had helped him to wrestle back ten over odd years of life from death.

Gastric cancer is one of the commonest cancers in China. Its chance of healing and size of the tumors are highly dependent on whether the lymph nodes outside the stomach have been metastasized and whether the disease has spread to distant organs. Stomach cancer with distant metastasis is categorized as stage IV cancer. According to the American Cancer Society, the cure rate for localized stomach cancer is 50%. But for stomach cancer with metastasis, none of the patients can survive for more than 5 years. Neither chemotherapy nor radiotherapy could alter the outcome.

In the case of Hu Guochao who had metastasis of liver, he was considered to have stage IV stomach cancer. It was indeed a miracle that he had survived for more than 15 years. For Qian Lijuan who lived for another 15 years was indeed a miracle. After she had a surgery to remove her stomach, it was discovered that there was tubular gland cancer at the lower middle portion of the lesser curvature of the stomach. Cancer cells had invaded the mucous membranes with metastasis of lymph nodes at various parts of the abdominal cavity. She was given chemotherapy which was interrupted later due to severe side effects. The clinical note showed that her KPS was only 30. As she put it, she was really in a very bad shape and ghouslish. In May 1993, she received complex immunotherapy. After half a year, she gained 8kg and was able to resume work. Her KPS was 100. She had just returned from a tour of Mt Pu Tuo when we visited her. Her husband died in a car accident the year before while she was having a severe backache. She told us that she was very much better last year before her husband died. After her husband’s demise, she lost weight and was not well. However in recent months she took time off to travel around and had gained back her weight.

The occurrence of colorectal cancer in China is on the increase. The 5 years survival rate of stage IV colorectal cancer patients is 8% only and almost none can survive for up to 10 years. But Zhang Zenling of No. 57, Lane 144, Chang Sha Road, he had lived for 15 years. He received surgery in January 1991 and was diagnosed to have adenocarcinoma which had spread to the lymph nodes at the back of abdominal membrane affecting both the nerves and veins at his buttock and its surroundings. Doctors removed the tumor and gave him one year to live. He did not give up. In January 1993 he received mixed immunotherapy. After half a year, CT revealed that the metastases had disappeared.

For stage IV non small cell lung cancer, the 5 years survival rate is less than 2%. But it was miraculous to find out that those lung cancer patients we interviewed who were given mixed immunotherapy had lived up to more than 3 years. Majority of them lived more than 5 years and some had even lived up to 16 years. One of them was a well qualified medical specialist and another one was a government officer. They were treated in top notched hospitals earlier but found no improvement. They later switched to complex immunotherapy which helped.

A lady patient from Taiwan by the name Huang Xinxin was diagnosed to have cancer of the left lung accompanied with metastases of the right pelvic and left occipital lobe ( size about 3x3cm). There was no improvement after chemotherapy and there was unbearable bone pain. In desperation, she was given mixed immunotherapy in September 2005. Upon re-examination in May 2007, tumors at the lung and brain had disappeared and bone pains long gone. She resumed his normal routines. But the doctors in Taiwan advised her to continue with radiotherapy of the brain as a precautionary measure. Half a year later, she had problem with speech and her consciousness deteriorated. When we phoned her husband, Mr. Liu, he wept over the phone and said “I really regret very much for letting her undergo radiotherapy.” According to Mr. Liu, MRI done on Xinxin proved that tumors at the brain did not recur.

As a matter of fact, every middle or late stage cancer patient has a sad story to tell. In 2007, the most popular book in China was the book “Chasing Daylight” by the late Eugene O’Kelly, the chief executive of the accounting firm KPMG who died of brain cancer at the age of 53. His inoperable brain cancer was diagnosed in May, 2005. He was given three months to live. He received radiotherapy but could not bear the intolerable side effects and dropped the treatment. In the last hours of his life, Eugene O’Kelly decided to write a book on his “Death Planning” and the inspiration of his soul and spirit. A hundred and ten days later he passed away.

Mr. Shen Zailun, 61 years old, was far luckier than Eugene O’Kelly. Shen was the manager of a medium size factory. While he was busily preparing the developing plan of the factory, he had a severe headache that forced him to stop his work. He went to seek treatment in Shanghai Hua Shan Hospital. He was diagnosed to have brain cancer and was given surgery. Pathological examinations confirmed that he had stage 3 advanced glioma. Glioma is fatal and the one year survival rate is less than 10%. He realized its serious consequences. He quickly re-composed himself without submersing in the fear of death. He reminded himself a well known saying, “Life is but a journey to death”.

He faced death boldly. He knew that conventional treatments for cancer were radiotherapy and chemotherapy but they would not provide the cure. His brain tumors would not go away irrespective of how many times surgery was performed. He was then 54 years old, had a virtuous wife and two sons. He did not want his family to share the pain of knowing that repetitive operations could not alter his fate. He sought and found complex immunotherapy and was cured. He had retired by now and was living a fulfilled life, doing things he liked to do. In his house at Unit XX, No. XX Lane 9XX, Zhang Le Road, he shared his feelings from his heart excitedly: “I had walked through the valley of death and gained another 16 years of life. I will live every second of my remaining years meaningfully.”

A doctor must have parental love for his patients. It is really exciting to meet patients who have escaped death. But when the excitement is over, we start to ponder – Why was Mdm. Wu Linlin’s son not cured in that Taiwan hospital that was well equipped with advanced equipment, but instead in a much poorly equipped Shanghai hospital Why those 54 patients that we interviewed and who did not undergo conventional radiotherapy and chemotherapy manage to survive for a much longer period The war on cancer has been raging on for decades, what success have we achieved

A WAR ON CANCER WHICH IS BEING LOSING

The war on cancer has been going on for more than 30 years. President Nixon devoted exactly 100 words of his 1971 State of the Union speech to proposing "an intensive campaign to find a cure for cancer." Up to 2004, Americans have spent more than $200 billion on cancer research since 1971 and more than 1.56 million theses have been written. As Harold Varmus, an American Nobel Prize winning scientist in 1976, said, ‘Within a period of 30 years, human beings have progressed from being completely ignorant about cancer to accumulation of vast amount of knowledge about it. Drugs for chemotherapy and factor targeted medicine have been quickly approved and sold in market. People seemed to think that cancer cure was insight.’

However, after a period of 37 years, the hope to have a cure for cancer has not been realized yet. Though the survival period has been extended, the extension is only for a few months and not years. A high cure rate and long survival period were only found in cancer with low occurring rate like Hopkins lymph node cancer and leukemia. Thirty-seven years ago cancer patients that survived for five years and above amounted to 50% of the total cases. The rate has been slightly raised to the present 63% only. This slight improvement is due to advancement on early detection and diagnosis. Ruth Etzioni, a biostatistician at Seattle's Fred Hutchinson Cancer Research Center, points out that when you break down the Big Four cancers (lung, colon and rectal, breast, and prostate) by stage--that is, how far the malignant cells have spread--long-term survival for advanced cancer has barely budged since the 1970s

Yet somehow, along the way, something important has gotten lost. The search for knowledge has become an end unto itself rather than the means to an end. 80% of researches are done on mice, fruit flies or One of the most frequently used experimental models of human cancer is to take human cancer cells that are grown in a petri dish, put them in an immune-compromised mouse--allow them to form a tumor, and then expose the resulting xenograft to different kinds of drugs that might be useful in treating people. Many of these preclinical human cancer models have very little predictive power in terms of how actual human beings--actual human tumors inside patients--will respond. Robert Weinberg, a professor of biology at MIT and winner of the National Medal of Science for his discovery of both the first human oncogene and the first tumor-suppressor gene, says a fundamental problem which remains to be solved in the whole cancer research effort, in terms of therapies, is that the preclinical models of human cancer, in large part, stink."

The article, “Why we’re losing war on cancer” by Clifton Leaf, that appeared in the Fortune magazine of 22 March 2004, describes a dysfunctional "cancer culture"--a groupthink that pushes tens of thousands of physicians and scientists toward the goal of finding the tiniest improvements in treatment rather than genuine breakthroughs; that fosters isolated (and redundant) problem solving instead of cooperation; and rewards academic achievement and publication over all else.

“It's like a Greek tragedy," observes Andy Grove, the chairman of Intel and a prostate-cancer survivor who, for years has tried to shake this cultural mindset as a member of several cancer advisory groups. "Everybody plays his individual part to perfection, everybody does what's right by his own life, and the total just doesn't work." said Andy. The Fortune Magazine article concludes that we are far from winning the war. So far away, in fact, that it looks like losing.

THE CRUEL CLINICAL FACTS

Once I was in the laboratory of Beijing XX University Cancer Hospital having a heart to heart talk with a friend, a famous oncologist. He pointed at the multi-level hospital wards and said to me, “Look at those wards. Everyday tens of patients come in to receive chemotherapy and radiotherapy. Yet at the same time, other tens of patients are carried out, leaving for heaven.” He sighed. Even though people realize that despite chemotherapy and radiotherapy, death is still inevitable, they still rush in to register for admission. They even pay heavily for a registration number.

Cancer treatment has fallen into a strange logic. Firstly, though they are fully aware that conventional treatments for cancer would not help, doctors still apply them on cancer patients. They have little considerations whether these treatments will bring any benefits to the patients or whether the patients will win nothing but lose both their life and money ultimately. This is because they believe that conventional treatments are “legalized”. Secondly, tumor regression is looked at as the main evidence that a treatment works. Tumor shrinkage is considered as “success”. Even though the patients died afterward, doctors will unhesitatingly write and publish theses on authoritative medical journals on their “success”.

Thirdly, both doctors and patients, doctors in particular, are inclined to use new, expensive and so called “wonderful” medicines. Though these medicines may extend the life of patients by a median of 1 to 2 months, they would rather spend money on these new medicines which are many times more expensive than the old medicines. Fourthly, doctors, as well as some patients, believe and trust blindly on authoritative organizations, symposiums and forums. To them, any treatment that can prolong life of patients but has not been reported in highly acclaimed journals is not worthy of any notice, it is just a coincidence and of no academic value. In their eyes, academic authorities are far superior to life’s value.

Cancer treatments have fallen into a vicious circle – chemotherapy-radiotherapy-death.

Of course there are some doctors who are sensible and honest. As mentioned above, Mdm Wu Linlin brought her son to a top notch hospital in Shanghai for treatment. The president of that hospital frankly recommended her complex immunotherapy which had not been practised in his hospital. Eugene O’Kelly, the author of the book “Chasing Daylight”, gave praises to a very honest neuro-chemotherapist. Eugene asked that neuro-chemotherapist whether it was advisable for him to receive chemotherapy. The doctor said “Yes.”. Eugene then asked how long he could survive with chemotherapy, the doctor answered “10 weeks.” He further asked “If not given chemotherapy, how long can I survive” The neuro-chemotherapist replied, “12 weeks.”

In a meeting of doctors and patients in our hospital at 2006 year end, some patients who had survived for 5 years and above gave accounts on their fight for life experiences. After their sharing, a middle aged man went on the stage and said: “I am the director of the oncology department of XXX hospital. I am a PhD in medicine holder. I am very ashamed that whenever patients are admitted, we would give them courses of chemotherapy until they finally die without considering its suitability…” His eyes were wet.

Next came on stage a doctor who was more senior in age. He said “I am the head of the radiotherapy department of XX hospital which is affiliated to XXX University. Whenever patients are admitted, radiotherapy is given even if the patients are unsuitable to be given radiotherapy. Radiotherapy is our conventional weapon, a legalized therapy. Whether the patients could survive through the ordeal is not important. As doctors, we could take charge of “sickness” but could not take charge of “life”. Upon hearing the speeches by those patients, I fully understand a doctor must have a clear conscience.”

We have no right to oppose conventional treatments. Surgery is still the main means for cancer cure. Chemotherapy and radiotherapy can be excellent or more effective or even cure certain types of cancer. But if we are fully aware that a certain type of cancer does not respond to chemotherapy, yet we apply it without any restrain just because it is conventional and legalized, the outcome is predictable.

I had a painful experience in facing a patient, a well known philosopher. She was found to have lung cancer in 2006. Her university sent her for treatment under reputed lung cancer specialists in several cities. She was transferred from one hospital to another. The best and most expensive medicines were used. After several months, her condition deteriorated. Her husband came to our hospital several times and finally decided to seek treatment in our hospital. Her hair had all dropped off and her face pale. There was pain at her chest and back and she was unable to sit up. Her white blood cells count was less than 3000. My heart was in great pain when I saw her, one who had been given the ‘best’ treatment. I said to her husband “There is nothing we can do to treat her cancer. Her immune system is completely down. A slight flu would lead to a severe infection which will be fatal.” Sure enough, after two weeks, she suddenly developed fever. The second day she got pneumonia in both lungs. The third day, her lungs failed and she was transferred to the respiratory research institute of Guangzhou Medical College for intensive care. Two weeks later, her husband informed that she hoped to spend the final hours of her life in our hospital. We obliged to it.

What that lady philosopher had gone through testifies what that honest neuro-chemotherapist mentioned earlier had said. Should oncologists not search their heart and ensure that their conscience is clear

I am always convicted by my own conscience. Once I went to see an end stage colorectal cancer patient who was given Avastin treatment. This factor target medicine is the most precious gem stone on the top of a crown. It is the newest medicine approved by FDA in 2004. We all hope that this new medicine would bring hope to cancer patients. But after been given Avastin for three weeks, that patient had an uncontrollable severe hemorrhage of the intestines. The patient died. His family members were Christians, they did not blame me but instead they held my hands and said: “Thank you. You had tried your best and God has called him home.” My heart was engulfed in pain. Avastin has been experimented in USA for more than 10 years. Billion of dollars had been spent. 400 end stage colorectal cancer patients were tested with the drug, and the average survival period was extended by 4.7 months as compared to those who were not given the medicine. This figure might be meaningful to researchers. But to end stage colorectal patients whose average life would not exceed 16 months, how significant is that figure Furthermore, 70% of patients would experience various side effects. Worse still, the expenses incurred amounted to tens of thousands RMB per week.

We have to learn the lesson of life and blood. As the Fortune article points out, clinical trials are focused on the wrong goal--on doing "proper" science rather than saving lives. It is not that they provide bad care--patients in trials are treated especially well. But the trials' very reason for being is to test a hypothesis: Is treatment X better than treatment Y And sometimes--too often, sadly--the information generated by this tortuously long process doesn't much matter. If you've spent ten-plus years to discover that a new drug shrinks a tumor by an average of 10% more than the existing standard of care, how many people have you really helped For the two widely publicized drugs, Erbitus and Avastin, the article points out: “Neither drug will save more than a handful of the 57,000 people who will die of colorectal cancer this year.”

The cruel fact has brought an awakening among doctors and researchers. Two Italian pharmacologists pored over the results of trials of 12 new anticancer drugs that had been approved for the European market from 1995 to 2000, and compared them with standard treatments for their respective diseases. The researchers could find no substantial advantages--no improved survival, no better quality of life, no added safety--with any of the new agents. All of them, though, were several times more expensive than the old drugs. In one case, the price was 350 times higher.

WE CANNOT WAIT ANY LONGER
How are we to win the war on cancer Sidney Farber, the Boston physician known as the godfather of cancer research says: “We cannot wait for full understanding; the 325,000 patients with cancer who are going to die this year cannot wait; nor is it necessary, in order to make great progress in the cure of cancer, for us to have the full solution of all the problems of basic research," Farber testified in congressional hearings that fall. "The history of medicine is replete with examples of cures obtained years, decades, and an even century, before the mechanism of action was understood for these cures--from vaccination, to digitalis, to aspirin."
Oncologists and academicians have joined force in the once-lost war on cancer. By adopting a new group thinking and new concept in their research to conquer cancer, they fight hard to deal a fatal blow on cancer in order to reverse the outcome of the war.

How do we prolong lives of mid and late stage cancer patients How do we reduce and prevent the recurrence of cancer I asked a well known hematologist and a fellow of the China Engineering Faculty, Professor Wang Zhenyi. His reply was, “Innovation!”

Thirty years ago, acute leukemia was a horrific disease. The survivability of a leukemia patient would not exceed one year. Though there were many theses that came up with various combinations of chemotherapy, the median survival time could only be extended merely by a few months. For a patient with only one more year to live, this extension serves no purpose. “As leukemia is caused by the mutations of normal white blood cells, why not we try to convert these mutated white blood cells into normal cells (re-mutation)” Professor Wang pondered. He noted that all-trans retinoic acid possesses such property. Together with his student, Fellow Chenzhu, the present health minister of China, they researched further into this and discovered that arsenic, a traditional Chinese medicine could cause death of leukemia cells. The present cure rate of 95% is a result of the studies by Professor Wang and Fellow Chenzhu. This innovative therapy which changes the highly fatal malignant cancer of the blood into a highly curable one astonishes the whole world.

“I actually started work on this at the age of 60,” says a humble Professor Wang. “In treating cancer we must think out of the box. All existing treatments are unable to cure the patients.” By ‘work’ Professor Wang refers to the work to come up with innovative and creative treatments.

The hallmark of a cancer cell is its genetic instability. The cell's DNA is not fixed the way a normal cell's is. A normal cell passes on pristine copies of its three-billion-letter code to every next-generation cell. But when a cancer cell divides, it may pass along to its daughters an altered copy of its DNA instructions--and even the slightest change can have giant effects on cell behavior. The consequence is that while cancer is thought to begin with a single cell that has mutated, the tumors eventually formed are made up of countless cellular cousins, with a variety of quirky traits, living side by side. That heterogeneity of tumors is the major obstacle to easy therapy.

Complex immunotherapy adopts various vaccines and medicines to deal with hematological malignancies which are related to the immune system. The elimination of the cancer cells is not by chemotherapeutic drugs but by the immune cells. But there are a great variety of immune cells that can destroy cancer cells. Different vaccines can stimulate different immune cells to act against and destroy different types of cancer cells and bring about synergic effects. Clinical observations reveal that many cancer patients live with cancers. Though cancer is present, the patients can live normally for a few years. It has been proved that cancer cells can remain dormant for a long term in our blood, lymph nodes, bone marrow and abdominal cavity. Cancer dormancy in human body is not confined to hematological malignancies such as lymphoma and leukemia but also to other solid tumors such as mammary gland cancer, colorectal cancer, prostate cancer, pancreatic cancer, melanoma, non-small cell lung cancer, and soft tissue tumors. The immune system plays a very important role in ‘forcing’ cancer cells to stay dormant.

I presented Professor Wang the book “Cryosurgery for Cancers” that I co-authored with Professor Niu Lizhi. He scanned quickly through the pages and said, “Cryosurgery for cancer! Yes there is truth in it.” A few months later, I visited Professor Wang in Shanghai again. When he saw me, he told me excitedly that he was greatly inspired by the book. He continued: “Cryosurgery is highly promising in cancer treatment. It is far superior to surgery. This is because the dead tumors in situ after cryosurgery will cause the release of antigen and stimulate the body immune system to fight against cancer.”
The academic circle has expressed greater and greater interest in cryo-immunology. It is proven that tumors which are killed in cryosurgery and left in situ will stimulate and uncover the potential of tumor antigen leading to a qualitative and quantitative change of the antigen. The concentration of cell membrane protein will increase to stimulate lymphoma cells to destroy cancer cells.

Some scientists in America have conducted experiments with animals as the liver cancer model. One group of animals had 30% of their liver surgically removed and another group was given cryosurgery. Both groups were observed and monitored for a few weeks for recurrence of tumors. The result showed that there was 100% tumor recurrence in the group with part of their liver surgically removed whereas there was no recurrence at all for the group that was given cryosurgery. The factor that stimulates cancer growth was found to have increased in the blood of the first group of animals while there was no such increase in the group under cryosurgery.

Clinical studies have been conducted whereby patients with tumors at various parts of the body had one or several (not all) of the tumors undergo cryosurgery. It was noted that those remaining tumors which had not been given cryosurgery vanished gradually. It has also been noted that while it is not possible to completely remove large tumors and all the tumors located at awkward positions, many of these cryosurgery patients manage to survive for 4 to 5 years. Take the example of pancreatic cancer, a malignant cancer with poor prognosis. The surgery rate for pancreatic patients is less than 5% and the survival rate is very low. The China Medical Academy’s statistics show that prior to 2005, none of pancreatic patients treated with conventional therapies could survive for more than 3 years. Our hospital’s statistics show that during the last four years, 23% of the 49 patients with advanced pancreatic cancer who were given cryosurgery survived for more than 3 years and a patient had lived up to 4 years. This is definitely much better than those given conventional therapies. Besides, we mainly apply cryosurgery percutaneously and the resulting wounds are far smaller than those of surgery.

According to our statistics, 840 non-small cells lung cancer patients, majority of them with metastasis of lymph nodes, were treated with cryosurgery. The five year survive rate was 26%. For the past 7 years, more than 1000 patients with non-resectable liver cancer (king of cancers) were given cryosurgery in our hospital. The five year survive rate was 45%. Some patients also had liver cancer with inferior vena cava thrombosis with severe ascites as the indication. After cryosurgery, the thrombosis disappeared and had recovered almost completely. They have been living for 5 to 7 years. It looks like cryosurgery carries two important functions. In one hand it can eliminate tumor tissues and reduce tumor burden and in the other hand it can stimulate tumor immunity.


NEW CONCEPTS AND STRATEGIES

The fact is: Surgery is applicable only when cancer is detected at an early stage. Radiotherapy is a localized treatment and will be unable to destroy cancer cells that have metastasized; new anti-cancer drugs and various regimes of chemotherapy are unable to treat and destroy cancer cells, not to mention their inability to cure advanced cancer. Though theoretically molecular targeted therapy looks promising, up to present, it is found to be of little effect to prolong survival of cancer patients. How do we reverse our current losing situation in war against cancer and help to prolong life of advanced cancer patients in order to gain survival benefits We believe that, we must embrace new concepts and strategies.

Traditional Chinese medicine emphasizes on establishing “Harmony between Heaven and Human Beings” and stresses on the importance of enhancing the overall immune system. Chinese physicians place great importance on “strengthening the spleen and nourishing the lungs” which, in actual fact, refers to strengthening the immune system. We apply cryosurgery as the main therapy for localized treatment for cancer. We also combine various immunological treatments to form what we call ‘combined immunotherapy for cancer ‘or CIC in short and adopt it as a holistic approach in the treatment of cancer. We combine and adopt cryosurgery and CIC as the main strategy in treatment of cancer. This enables them to supplement and compliment one another to treat cancer both locally and holistically.

References
1) Clifton Leaf. The War on Cancer: Why We’re Losing the War on Cancer-and How to Win It. Fortune 9 Mar. 2004.2) International Union Against Cancer, Concerted Global Action Is the Only Answer to Rising Cancer Deaths. 3 Jun. 2003.
3) World Health Organization and International Union Against Cancer.Global Action Against Cancer 2005.
4) American Cancer Society. Cancer Prevention and Early Detection: Facts and Figures, 2004. 2004.
5) J. Chang-Claude et al. Mortality Pattern of German Vegetarians After 11 Years of Follow-Up. Epidemiology 3: 389-391,1992.
6) Gardiner Harris. New Drug Points Up Problems in Developing Cancer Cures. The New York Times 21 Dec. 2005.
7) Andrew C. von Eschenbach. The Nation’s Investment in Cancer Research: A Plan and Budget Proposal for FY 2006,” National Cancer Institute, Oct. 2004: 54.
8) Jerome Burne. Danger Mouse. The Times [U.K.] 30 Jul. 2002.
9) Christopher Anderegg et al. A Critical Look at Animal Experimentation. Medical Research Modernization Committee, 2002.
10) Kerri Smith. The Human Guinea Pigs. The Times [U.K.] 17 Dec. 2005.11)Julio A. Aguirre-Chiso. Models,mechanisms and clinical evidence for cancer dormancy. Nature Reviews. Nov (7:834-846).

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