As part of an effort to find a solution for a patient whose Ovarian Cancer had metastasized to her brain I reached out to a person who I believe has an extremely comprehensive and global knowledge of current and historical uses of herbal and non-traditional approaches for treating illnesses.

Her name is Ingrid Naiman.

She has many websites covering a multitude of topics, all of which I find interesting, and it is my understanding that she also has been granted multiple doctorate degrees.

When she speaks I listen very carefully, and I then try to translate what she has said into the language of the pharmacist so I can understand and use the information.

I asked her if she was aware of anything that had actually worked to help patients with Ovarian Cancer brain metastasis.

She replied with a comprehensive e-mail, but the bottom line can be found at this web address.

http://www.cancersalves.com/botanical_approaches/individual_herbs/boswellia.html

There she talks about the results of physicians’ and healers’ use of Boswellia serrata (indian frankincense) for the treatment of metastatic brain cancers.

She also provides a link to the website of a Physician who has experience with this application – Dr Dana Flavin-Koenig.

Dr Koenig had previously provided a link to a video interview with a patient who had had breast cancer metastasis to her brain, and who appeared to have had a complete remission after treatment with Boswellia extract capsules.

But, that link is no longer active.

However, the treatment parameters and results of this treatment were detailed in a journal article.

You can find a short excerpt from that article, and a link to the journal it was published in so you can buy a copy, at this location….  http://her2support.org/vbulletin/showthread.php?t=42084 .

I’ve read the article, but don’t think it is worth buying for the general population.

The article defines the dose of Boswellia that the patients were taking. I have reviewed the article and my notes from a conversation with Dr Flavin-Koenig (she actually goes by Dr Flavin), and the most important thing to note is that the dosing is based on boswellic acid content, not total raw Boswellia powder. So, if you want to try it read the label carefully and adjust the number of capsules you take to achieve the same milligram dose of boswellic acids that the patient in the study took.

Look for the term ‘Standardized Extract’, and the highest boswellic acids content you can get.

I will warn you that the way the different companies express their products’ composition is extremely confusing. You can find some explanatory information at http://www.boswellin.com/booklets.html in particular, and at http://www.boswellin.com/introduction.html in general.

When asked, I have recommended these two products and three times a day with food doses.

http://www.savestalife.com/boswellia-60-veggi-tabs.html (two tablets three times a day)

http://www.swansonvitamins.com/swanson-superior-herbs-boswellia-serrata-standardized-200-mg-120-caps (four capsules three times a day)

I prefer the first product, it seems to upset the patients’ stomachs less, but remind you that these products’ contents are totally dependent on the integrity of the manufacturer. These two suppliers are believed to be reliable… but I can’t personally guarantee their contents.

I share this information because I am convinced that it might save the lives of patients. It will not work for all. But it seems to be a pretty low risk and high reward potential thing to try when the docs tell you there is nothing else they can do for you – or, before that time.

Just make sure that your physician knows what you’re doing and is involved in monitoring your physical health and well being. Do not try to go around your doctor’s advice and guidance, but make sure he/she is educated enough to provide guidance before you give up.

Doctors are people too, and they are hard pressed to keep up with the things deluging them in the mainstream, let alone what might be being proposed by crazy pharmacists and physicians who are trying to find alternative options that might help them extend their patients’ lives.

Remember, I’m as crazy as a loon. Just a Pharmacist, not a Physician. You should ALWAYS keep your physician involved in your medication regimen, and never change, stop or start a new medication without her/his knowledge and support.

Pharmacists Pharmacist, Physicians Physician, Oncologists Oncologist, and Cancer Patients pray for a breakthrough every night.

 In April of 2009 a family member was diagnosed as having Stage IV Ovarian Cancer.

After reviewing the realities of the treatment outcomes for ovarian cancer patients, it became apparent to me that we absolutely did not know how to save the lives of the women who develop this cancer.

In response to that realization I began a search for options that might improve the probability of getting these patients into remission, and of keeping them there if remission was achieved.

The resulting protocol resulted from luck, synchronicity, and a lot of very hard work. It has evolved across time and has been debugged through actual implementation.

Although it might be useful as a standalone strategy, I must stress that it was designed to be used as an add on to the therapeutic options Oncologists normally use.

Let me repeat. This protocol is designed to be integrated into your Oncologist’s regular treatment protocol, and as such – you must work with your Oncologist to make sure there are no interferences between what he/she is trying to achieve and the elements of this protocol.

I have been reluctant to publish this protocol because I do not want to propose things to you that I do not feel I can absolutely defend.

I am now as convinced as I can be within the time that has elapsed that this protocol might be useful for achieving remission and prolonging the time of remission for Ovarian Cancer and Breast Cancer patients, and am – in fact – hopeful that it would be useful for many other cancer types.

Although elements of the protocol may help slow the progression and/or metastasis of breast and ovarian cancer tumors that have migrated to the brain, it will NOT stop them once they are lodged on the brain side of the blood brain barrier.

I have posted copies of documents that define the protocol below. Clicking on the red links will bring up a copy of one of two different documents that have been written for physicians and pharmacists about this protocol.

TrialOfOnePPtCrazyDisclaim

ProposalOfRegimenDisclaimer

The trickiest part of implementing them is the timing of using the protocol vs chemotherapy and radiation treatments and the calculation of the target salsalate dose.

If your physician would like to try this protocol please have her/him e-mail me and I will help them calculate a target salsalate dose for you. If you don’t have access to salsalate, aspirin could be used – but it is much more dangerous and the doses and dose timing are different than those for salsalate. I have thought about this often, and would be willing to share my thoughts and dosing calculations with your physician if salsalate is not available. ( crazypharmacist@thatcrazypharmacist.com )

Other details (e.g. how to mix and administer the ginger extract drink) can be found elsewhere in this blog. Please note that it is taken three times a day.

Yes, I have been trying to leave hints as time has passed.

This is a first pass at documenting this protocol on this blog, and I will be coming back to edit it and clarify the protocol.

In reply to those who believe it crazy, I can only say this.. read the literature that details the life expectancy and mortality rates for Stage III and Stage IV Ovarian and Breast Cancer patients. They document the state of the art for saving these patients’ lives. I submit for your consideration that anything I propose will have as good a track record as the current standards of care.

I do not guarantee anything except the fact that I have put my best effort into defining this protocol, and that I believe it has a good probability of helping.

It is most probable that your Oncologist will be reluctant to consider implementing this protocol into his/her treatment plan. There are many reasons for this, and it might be helpful to suggest a team approach that enlists your personal physician to manage the elements your oncologist does not feel comfortable dealing with.

As always, I am a pharmacist. Not a physician, and definately not an expert in oncology. You MUST seek the guidance of your physician before attempting to implement this protocol. Although the substances seem common place, I assure you that their effects are quite real and they can be dangerous if they are not properly implemented.

Pharmacists Pharmacist, Physicians Physician, Oncologists Oncologist, and Cancer Patients pray for a breakthrough every night.

I hope this information will be helpful to you.

Naltrexone is a drug that blocks the cellular receptors that are accessed by opioid pain medicines (morphine, vicodin, percocet, etc…), and it is usually used at a dose of 50mg per tablet for treating several substance abuse problems.

Alpha-Lipoic Acid is an antioxidant nutraceutical supplement that is claimed to be capable of upregulating metabolism, reversing cellular damage, and many other effects.

Most interesting to me is the claim that a protocol called ‘Low Dose Naltrexone’ or “LDN’ can be used to treat several cancer types, and that combining it with Alpha-Lipoic Acid enhances its effectiveness. For this application the naltrexone is given at a strength of 1.5mg to 4.5mg (most often 3mg) every night at bedtime.

Based on my findings so far I must say that I am now a believer.

After casting around for evidence that these claims might actually have merit I stumbled across conference presentations by Burt Berkson, MD that show the results of using LDN and Alpha-Lipoic Acid for the treatment of cancer and various autoimmune diseases.

I have pasted copies of links to various video and audio presentations about Dr Berkson’s work below for your review.

A link to an interview with the m.d. who presented in the videos here: http://www.prescription2000.com/Staying-Healthy-Today-Radio-Interviews/2010-01-22-burt-berkson-lipoic-acid-naltrexone.html

He talks about details and history of his involvement with lipoic acid.

Fascinating presentation of clinical data from physician who practices an integrative health clinic in new mexico. 3^rd video link is to a pharmacist telling her story about using low dose naltrexone for multiple sclerosis…

http://glasgowldn2009.com/2009/04/ldn-conference-video3/ (Berkson – MD)

http://glasgowldn2009.com/2009/04/ldn-conference-presentation-video4/  (Berkson – MD)

http://glasgowldn2009.com/2009/05/european-ldn-conference-video1/  (Pharmacist and data) 

You can find detailed info for Alpha-Lipoic Acid at this Wikipedia link –

http://en.wikipedia.org/wiki/Lipoic_acid

Curcumin is known to exert strong restraining effects on cancer cells.

But it is notoriously hard to get absorbed into your system.

I do not believe in the capsule and tablet supplements. There is just too much opportunity to screw it up. I am also a strong believer in using whole root extracts when possible.

So, here’s a recipe for an oil blended tumeric product that will provide an economic source of curcumin that should be more bioavailable.

Get yourself a piece of raw tumeric root. You will be able to find it at your grocery store. If not, find an asian grocery store.

Vigorously rinse it off  to get everything off of it – twice. Peel it. Then dip it in a strong salt bath for a few minutes.

Now, grind it up in a little extra virgin olive oil – enough to cover the tumeric completely.

BE CAREFUL! Tumeric will stain everything it comes in touch with a brilliant orange color. I’m not kidding.

Once you’ve ground it up with the extra virgin olive oil and then transfer it to a glass container.

Add a little to your soups, stir fry meals, etc… The oil makes it much more palatable – and increases the absorbtion once you eat it.

Store it in the refrigerator. Don’t make more than a few days worth at a time. If you made too much freeze the extra.

As I researched the role of chronic inflammatory states on the incidence of cancer I repeatedly found references to the need to increase Omega-3 Fatty Acid intake.

There are many websites out there that have posts about increasing the amount of Omega-3 FattyAcid you eat or consume in supplement form.

Most of them are also trying to sell you a product that they claim will give you what you need.

As I researched the information that was available I blundered upon products manufactured for Udo Erasmis, PhD. You can find a link to his website here: http://www.udoerasmus.com/index_main.htm . He has also written a book titled ‘Fats that Heal, Fats that Kill’.

At first, I ignored this guy’s products. But, as I continued to research the topic I kept finding more and more support for Dr Erasmis’ claims.

So – I bought his book. After reading it a couple of times I bought some of his oil so my family member who had cancer could integrate it into her regimen.

As I researched Udo’s ingredients and their properties I became very concerned about the possiblity that some of them could act as estrogen receptor stimulants. I want to emphasize, I remain undecided about whether they might cause estrogen receptor stimulation or not. Better safe than sorry, I thought. So, we stopped the oil.

But I really wanted to add the Omega-3 and Omega-6 Fatty Acids in the ratio Dr Erasmis proposed.

Thinking the problem over for several days – and remembering references and comments from Dr Erasmis’ book – I decided to formulate my own version of his oil.

It costs less than Udo’s Oil to make, tastes good, and has a biochemical make up that I judge to be roughly equivalent to Udo’s Oil without the compounds I was worried about.

To make it go to your local health food store and buy some cold pressed hemp seed oil and cold pressed high lignin flaxseed oil. (yes, flaxseed lignins are known to interact with estrogen receptors. but the research seems to support an interaction that does not stimulate estrogen receptors.)

You’ll find them in the refrigerator section. If they’re not, go somewhere else. I’m serious. These oils are delicate and need to be refrigerated to retain their beneficial properties. NEVER heat them up to cooking temperatures.

Mix the oils in a ration of three teaspoons of the flaxseed oil to one teaspoon of the hemp seed oil.

That’s it. Simple, eh?

Keep these oils and your oil mix in the refrigerator. Store them in a glass container. If you must use plastic use a plastic bottle like the ones the oils come in originally. Don’t ever cook with them. Shake the container to mix the two oils before you pour the mix out of its container.

Use them in a vinaigrette or added to a soup just before you serve it.

I take somewhere between one to three tablespoons a day of this oil mix. I usually mix it with balsamic vinegar and use the mix as a salad dressing or dip for bread.

Now, to make sure you know what I’m talking about – I am NOT talking about Hemp Oil that people claim to be using to cure cancer and other maladies. You are looking for Hemp Seed Oil. It has the THC removed from it before it’s imported into the United States from Canada.

I do not have any kind of relationship with Dr Erasmis. I do not get any benefit from your buying and using his oil blend. But, I believe he’s darned sharp – and I believe in his oil blend.

If you’re worried about estrogen receptor stimulation I’d use my oil blend.

Oh yeah, stop using other cooking oils. Start using extra virgin coconut oil to fry and cook your foods.

If you want to get a copy of his book and support this website you can click on the ‘Fats That Heal Fats That Kill’ book cover located on the right side of this website. You’ll be taken to Barnes and Noble and if you buy from them at that time they might send me some cash for you buying the book from them. Regardless of how you get a copy of it, I highly recommend you get a copy and read it for yourself. Also read through the postings at Dr Erasmus’ website.

Again, I am a Pharmacist. Not a nutrition expert. Not a Physician. Check with your Physician to make sure he/she supports getting your Omega-3s and Omega-6s in this manner.

I’ve pasted an excerpt from a protocol proposal I wrote for an Ovarian Cancer patient later in this blog.

The goal of the protocol was the prolongation of remission, and it was implemented after the patient had completed her cycles of chemotherapy and surgery.

I strongly believe this is appropriate therapy for patients who have reached this stage – and I believe it would be appropriate as an attempt to extend the lives of those who have not been able to achieve remission or who have relapsed.

It is most probable that your physician will not propose it unless you ask her/him to. So, ask!

It might also be appropriate for patients who are receiving chemotherapy treatments – with the caveat that I would not use an aromatase inhibitor within the week before a chemo treatment and for 3 days after the treatment.

The reasoning behind this position lies in the need to have the cancer cells acting like cancer cells for the chemotherapy to kill them. You do not want their growth and progression suppressed when you’re giving chemotherapy. I believe that the aromatase inhibitors will slow down their growth and progression, an undesirable outcome if you’re trying to kill them with chemotherapy.

Anyway, the aromatase inhibitor choice for this patient’s protocol was made by her oncologist. He/she picked Femara® (aka letrozole). It’s expensive. But, there seem to be some coupon programs that will reduce your cost. You can find info about this drug and the coupon program at http://www.femara.com/ .

Additionally, a review of the information that is provided by Micromedex™ (a drug info service healthcare providers and pharmacists trust and reference frequently) indicates that you could probably get by by taking 1/4th of a tablet every day after you’ve taking the full tablet for a week or so if you had to.

Excerpt:

Estrogen receptors are reported to drive the growth and progression of many ovarian cancer tumors. In fact, it is reported that > 90% of confirmed ovarian cancers have lost their progesterone receptors’ function. This allows unopposed estrogen receptor stimulation of the tumor’s cells, and it has been reported that > 80% have retained their estrogen receptors’ functionality.⁷⁴ Thus, it appears mandatory to incorporate an agent into this protocol to block the effect of estrogen on estrogen receptors. Aromatase inhibitors appear to retain their functionality longer than estrogen receptor blockers, and are reported to be better tolerated by patients. Selection of the agent from this category will be left to the patient’s physicians, as they are undoubtedly more familiar with the tradeoffs that must be considered to make this recommendation.

The reference citation for the info in this excerpt is:

S. Ho 2003. Review – Estrogen, Progesterone and Epithelial Ovarian Cancer. Reproductive Biology and Endocrinology 1:73 1-8.

You can get a free copy of it at http://www.rbej.com/content/1/1/73 .

As always, I am providing info for you to take to your physician for discussion. I do not know the details of anyone’s specific cases and I’m a Pharmacist – not a Physician. These recommendations must be reviewed and implemented by your physician. I have done my best to make sure the info and conclusions I’ve presented are correct. But, it is a theoretical discussion that may or may not apply to any specific cancer.

But, if I didn’t strongly believe in what I’ve said above you know I wouldn’t have taken the time to share it with you.

To get more important information and a different point of view read this post. It’s especially important if you’re post-menopausal.

‘Are Many Ovarian Cancers (Especially Post-Menopausal) Driven By Male Hormones???’

https://thatcrazypharmacist.com/?p=635

Remember, Cancers are Like Snowflakes – each is unique and different from others.

Pharmacists Pharmacist. Doctors Doctor. Patients try to survive. We’re all trying to get to the same goal.

In a presentation that will occur at this year’s annual meeting of the American Society for Radiation Oncology Dr Kevin Choe will present the results of a study that shows that the use of aspirin and other anticoagulant medications is associated with around a 47% decrease in death risk for prostate cancer patients whose tumors have not metastasized.

Of course, aspirin use demonstrated the highest risk reduction.

I’d give you a link to the article, but it hasn’t been published yet.

You can get a preview of what it has to say at these links.

http://www.ehospitalistnews.com/news/nephrology/single-article/astro-anticoagulants-especially-aspirin-seem-to-cut-the-risk-of-prostate-cancer-death/8c0a4bc4f7.html

http://www.webmd.com/prostate-cancer/news/20101025/aspirin-may-cut-prostate-cancer-deaths

The authors propose a mechanism for this effect that involves prevention of platelets surrounding and protecting cancer cells that are entering blood circulation.

This actually might make sense, although I suspect that the superior effect observed for aspirin is the result of their effect combinging with the effect of aspirin on COX enzyme pathways and their stimulation of inflammation and metastasis activity.

Anyway, their observations and theory are very interesting.

Of course, it’s too early to recommend that people take an aspirin a day to cut their cancer risks.

Yeah, right.

I’m going to keep taking mine. You’ll have to decide on your own what you want to do.

Again, Pharmacists Pharmacist. Doctors Doctor. You should NEVER start a medication or alter your medication regimens without talking to your physician first. Be safe.

In May of 2004 JAMA (The Journal of the American Medical Association) published an article titled ‘Association of Frequency and Duration of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk’.

The citation for this article is Mary Beth Terry, PhD; Marilie D. Gammon, PhD; Fang Fang Zhang, MD, MPH; Heba Tawfik, MD, MPH; Susan L. Teitelbaum, PhD; Julie A. Britton, PhD; Kotha Subbaramaiah, PhD; Andrew J. Dannenberg, MD; Alfred I. Neugut, MD, PhD. Association of Frequency and Duration of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk. JAMA. 2004;291:24 2433-2440.

A free copy of it is available at: http://jama.ama-assn.org/cgi/content/abstract/291/20/2433.

In summary, this article says that these researchers found evidence that aspirin use before and after menopause is associated with a significant reduction in breast cancer occurence risk for tumors that are estrogen or progesterin receptor positive, with recent use and frequency of use increasing the apparent risk reduction. They do not discuss doses, but other publications indicate that cancer risk reduction occurs with doses of 81-325mg per day. Estrogen and progesterone receptor negative tumors do not seem to be protected against by whatever mechanism is causing the protective effect.

Interestingly, the researchers also found a risk reduction in post menopausal females who took ibuprofen. But frequency didn’t seem to be a factor in the predictive effect. Perhaps there is another mechanism that is being observed here? Anyway, I remain uncertain relative to how to use the ibuprofen data.

As I’m sure you understand, there are many, many articles out there that discuss the association of aspirin and NSAID use and breast cancer risk reduction. Not all of them agree that there is a reduction benefit. Wanting to present you with an unbiased set of data to evaluate I suggest you take a look at this article to get a feel for the other point of view.

A. Heather Eliassen, ScD; Wendy Y. Chen, MD, MPH; Donna Spiegelman, ScD; Walter C. Willett, MD, DrPH; David J. Hunter, MBBS, ScD; Susan E. Hankinson, ScD. Use of Aspirin, Other Nonsteroidal Anti-inflammatory Drugs, and Acetaminophen and Risk of Breast Cancer Among Premenopausal Women in the Nurses’ Health Study II. Arch Intern Med. 2009;169(2):115-121.

You can find a copy of it at: http://archinte.ama-assn.org/cgi/reprint/169/2/115. It’s free.

Then again, there are a lot of articles that support the belief that aspirin and/or NSAIDs have a breast cancer chemoprevention effect. Like this one.

Bahi Takkouche, Carlos Regueira-Méndez and Mahyar Etminan. Breast Cancer and Use of Nonsteroidal Anti-inflammatory Drugs: A Meta-analysis.JNCI J Natl Cancer Inst (2008) 100 (20): 1439-1447. doi: 10.1093/jnci/djn324

You can find a copy of this article at: http://jnci.oxfordjournals.org/content/100/20/1439.full. There is no cost for this document either.

We’re going to keep taking our 325mg of aspirin per day in my house.

As always, talk to your physician before starting or changing any medication regimen. Pharmacists Pharmacist. Doctors Doctor.

I write this post for those who do not believe that the ‘traditional’ medical system holds the cure for their cancers.

Unfortunately, they may be right.

As far as I can tell, our fight against Cancer has been an almost complete failure if achieving long term ‘cures’ is used as the definition of success.

We may not kill as many with our therapies as they used to, but I do not believe that we can claim significant across-the-board cure rate improvements either.

Frankly, we have not gotten our money’s worth from the research that we have been funding.

These beliefs did not come easily. But, hard analysis of what I have known but refused to admit and what I have seen but refused to see has led me to consider all possibilities in my search for a way to extend my family member’s life.

Thus, I have found myself having to read and consider proposals and claims that are difficult to wrap my head around.

The contents of this book – ‘Cancer Salves – A Botanical Approach To Treatment’ –  is a good example of what I am talking about.

The author, Ingrid Naiman, is a rich source for information about alternative medicine’s cancer treatment techniques and the history behind them.

She details one thread of that history in this book – the history of the use of escharotic salves and pastes and tonics to treat cancers.

It is an extremely interesting book, and an amazing series of stories and information that she shares.

Although these techniques are probably most effective when used to treat non-metastatic tumors that are close to the surface, I cannot guarantee that this is the limit of their utility.

I assure you, this is information you will not find being provided to you in your doctor’s office.

She provides a historical backdrop for the reader while explaining in great detail how the salves and tonics are believed to work, and how to use them. A wealth of practical advice and information relative to the strengths and weaknesses of the various products and techniques is also woven into the book’s narrative. Additionally, there are recipes for different versions of these salves, pastes and tonics in the back of the book – information that it would be difficult for most people to track down in time.

Now for a caveat. These salves can be dangerous in the hands of someone who does not know what he/she is doing. You can see the results of not knowing what is going on and how to properly apply them at this web address: http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/eschar.html .

I have exchanged several e-mails with the author. She is an amazing fountain of information – and I would encourage anyone looking for alternative paths to go to her website, read the information that is posted there, establish communications with her.

The link to one of her websites is http://www.cancersalves.com/ .

It is possible that what you are looking for is there.

As always, Pharmacists Pharmacist. Doctors Doctor. Don’t try to deal with these salves on your own. Get your physician involved – and be very, very careful.