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Triple Negative Breast Cancer&
Naturopathic Medicine
Jake Psenka, ND
PMID?
Some of the slides make reference to a PMID number. This number can be copied and pasted
into the search bar at www.pubmed.gov to see the
research article being referenced.
The Principles of Naturopathic Medicine:
Identify and Treat the Cause of Disease
Do No HarmDoctor As TeacherTreat the Whole PersonThe Power of Prevention
Triple Negative Breast Cancer (TNBC)
Estrogen Receptor NegativeProgesterone Receptor NegativeHuman Epidermal Growth Factor Receptor (HER2) Negative
15% of Breast Cancers Appear at an earlier ageHigh Histologic Grade
Six TNBC Subtypes:2 Basal Types
ImmunomodulatoryMesenchymal
Mesenchymal Stem-LikeLuminal Androgen Receptor
Current TNBC Treatment Strategies
Cytotoxic Therapy (Adriamycin/Cytoxan/Taxol)RadiationSurgery
Problems Associated with Current TNBC Treatment Strategy
ToxicityImmune Suppression
Fatigue & MalaiseDepression/Anxiety
Drug ResistanceLack of Efficacy
Naturopathic Treatment Strategies
1. As a way to support the patient:Promoting health of patient- both
mind & bodyMinimizing treatment related side
effects
2. As integrative therapy:Anti-Cancer Therapy
Improving clinical outcomesPreventing Re-occurrence
Food As Medicine
Dietary habits can play a role in both the development and progression of cancer. A healthy diet supports the body’s natural processes and functions.
Inhibiting Unintended Weight LossPromoting Healthy Elimination
Reducing Treatment Related Side EffectsAnti-inflammatory Action
Energy Balance/Fatigue ReductionImproving Efficacy of Treatments
Food As Medicine
Randomized controlled trials indicated that the circulating IGF-I level was significantly higher in the milk intervention group. Int J Food Sci Nutr. 2009;60 Suppl 7:330-40. Epub 2009 Sep 9.
These data suggest that a plant-based diet is associated with lower circulating levels of total IGF-I. Cancer Epidemiol Biomarkers Prev. 2002 Nov;11(11):1441-8.
These results show that IGFs stimulate cell proliferation and promote cell survival in triple-negative breast cancer cell lines and warrant investigation of the IGF signal transduction pathway as a therapeutic target for the treatment of triple-negative breast cancer. Neoplasia. 2011 Jun;13(6):504-15
.
INSULIN-LIKE GROWTH FACTOR-1
Food As Medicine
“In combination with standard treatments, supplementing the diet with (n-3) fatty acids may be a nontoxic means to improve cancer treatment outcomes and may slow or
prevent recurrence of cancer.”
“In vivo, the efficacy of blueberry to inhibit triple-negative breast tumor growth was evaluated. Tumor weight and proliferation (Ki-67 expression) were decreased in blueberry-treated mice, where apoptosis (caspase-3 expression) was increased compared with controls.”
Lung metastasis of TNBC was reduced (16-70%) by all treatments, significantly in the flax seed oil group. The distant lymph node metastasis was significantly decreased (52%) only in the flax seed oil group. The total metastasis incidence was lowered (42%). Mouse study.
PMID: 21228363, 15849746
Food As Medicine
SUGAR/CARBOHYDRATE/GLUCOSE = ENERGY
Higher SUVmax and %Ki67 are associated with higher histologic grades.
Glucose receptors are upregulated in TNBC (PMID 21266827)
Higher sugar uptake by TNBC cells correlates with increased cancer cell proliferation (PMID: 20012701)
Exploiting Metabolism
Supplements for cancer?
Reasons for using supplements with conventional therapy:
Minimize treatment-related side effects Promote a well functioning immune system Synergize with conventional treatments
Side Effects
L-Glutamine protects against doxorubicin (aka Adriamycin) heart damage Glutamine for taxane induced neurotoxicity. Melatonin inhibits Cytoxan-induced leukopenia and anemia Melatonin inhibits taxane-related neuropathy DHA, an n-3 fatty acid, is currently in trials
PMID: 19889810, 14718801, 20035269, 20567633
Immune Enhancement
LifeStyle Factors
Exercise-but don’t over exercise
Stress Reductionyoga, meditation, guided
imagery, reiki, acupuncture, religion.
Alcohol Elimination
Sugar Elimination
Supplements
ArabinogalactansNK function
MelatoninT-cell function
Thymic ProteinsT-cell function
Beta GlucansNK cells
Synergize
Multidrug resistance (MDR):Defined as the ability of a tumor cell to survive exposure to clinically achievable concentrations of structurally diverse chemotherapeutic drugs which act at different intracellular targets.
Propolis (caffeic acid)
Inhibits TNBC tumor growth, both in vitro and in vivo without much effect on normal mammary cells.
Decreased malignancy potential of TNBC stem cells.
Synergize
PMID: 21570765
Synergize
Inositol Hexaphosphate (IP6):
decrease proliferation rates in TNBC cells works synergistically with adriamycin (and
Tamoxifen) inhibits metastasis activates natural killer cell function Patient study finds those who took it with chemo
had no cytopenia, lowered leukocyte, or platelet levels, increased QOL and better functional status.
PMID: 12846414PMID: 15868430PMID: 14666664PMID: 20152024
Synergize
Curcumin (extract from tumeric)
Modulation of the BRCA1 Protein and induction of apoptosis in TNBC Blocker of COX and LOX Shown to decrease the MDR1 gene through the PI3k/AKT/NF kappa beta
pathway
PMID: 19809577
Synergize
Vitamin D3
Potentiates the anti-tumor activities of chemotherapy drugs cisplatin, carboplatin and doxorubicin; 5-fluorouracil, cytarabine,
hydroxyurea, cytarabine and gemcitabine; paclitaxel and docetaxel.Vitamin D3 enhances the effect of hydrogen peroxide in cancer cells.
Indole-3-Carbinol
Inhibits TNBC proliferation Down regulated PGP transmembrane efflux pumps by 80%.Decrease TNBC cell motility
Synergize
Sulphoraphane
Inhibits inflammatory cytokines and pro-angiogenic growth factors in TNBC
PMID:21767081PMID:19728765
Resveratrol
Sensitizies tumor to chemotherapy drugs including vincristine*, adriamycin, paclitaxel*, doxorubicin, cisplatin, gefitinib, 5-fluorouracil,
velcade, and gemcitabine.Resveratrol enhances mTOR inhibitor
Synergize
PMID: 21261654PMID: 21168265
Preventing recurrence: NCCN guidelines for breast cancer state “Evidence suggests that active lifestyle, achieving and maintaining an ideal body weight (20-25 BMI) may lead to optimal breast cancer outcomes.”
Remission
Detoxification: Get Specific
MetforminBreast Cancer Res Treat. 2010 Sep;123(2):333-44. Epub 2009 Nov 22.Dietary energy availability affects primary and metastatic breast cancer and metformin efficacy.Phoenix KN, Vumbaca F, Fox MM, Evans R, Claffey KP.
New Ideas
New Ideas
New Ideas
Chemotherapy Sensitivity and Chemo-resistance Testing
Circulating Tumor Cell Studies
New Ideas
Prevention