Cancer is a scary diagnosis, an awful disease, and the nation's second-leading killer, behind only heart disease. What's more, the World Health Organization predicts annual global diagnoses will grow more than 55% to 22 million from 14 million over the next two decades.
Why the surge? Aside from not fully understanding the causes of cancer -- researchers understand some key risk factors, but explaining why one person gets cancer while another doesn't is still a mystery -- an aging population is largely to blame. Age is one of the more universal cancer risk factors, and if we're living longer around the globe, it's not entirely surprising that cancer incidence rates could rise.
Aside from being a killer, cancer is also financially crippling for patients and their families. The Agency for Healthcare Research and Quality noted in 2011 that the direct medical costs to treat cancer in the United States were $88.7 billion, with 50% of these costs tied to hospital outpatient or doctor office visits and another 11% to prescription drugs. These costs don't account for cancer's economic impact in terms lost productivity or premature death, either.
Traditional cancer treatment involves the use of chemotherapy, which is an anti-cancer drug or group of anti-cancer chemical drugs designed to attack rapidly dividing cells. Unfortunately, you have plenty of healthy rapidly dividing cells in your body too, so while chemotherapy attacks cancer cells it also globally attacks your healthy cells. Because the battle against cancer has no blueprint, the best way to combat it can change from patient to patient.
However, new research from the University of Southern California released earlier this week suggests another combination of treatments may work just as well as chemotherapy, and could allow patients to avoid the potentially nasty side effects that accompany chemotherapy treatments.
Should you forget traditional chemotherapy?
According to researchers at USC, as published in the journal Oncotarget, a pair of studies in mice showed that cyclic fasting in combination with a lower-toxicity type of drug could be just as effective as chemotherapy when it comes to killing lung, colorectal, and lung cancer cells -- the three deadliest forms of cancer by annual death rate.
USC researchers focused on the fact that cancer cells are far less flexible than healthy cells in their need for glucose to survive and keep growing. Cancer cells by nature are dividing faster than traditional healthy cells, so they require more glucose than normal cells. By cyclically fasting during a treatment course of a lower-toxicity class of drugs, a patient could reduce their glucose intake and dramatically slow the rate of cancer cell division.
Furthermore, reducing glucose intake through fasting could cause cancer cells to utilize their kinase pathway -- sort of an energy reserve pathway for cancer cells -- to survive and multiply. But pharmaceutical companies have created drugs specializing in inhibiting kinase, removing the other pathway by which cancer cells get fuel to survive.
USC researchers also believe that kinase inhibitors, which are less toxic than traditional chemotherapy, could be used in smaller doses, since the cyclic fasting would make them more effective, thus reducing their toxic side effects that much more.
To be clear, this doesn't mean physicians are going to prescribe the combination of fasting and kinase inhibitors tomorrow to their cancer patients. This was merely a mice model study, and it'll need to be examined in humans to ensure the same effect is achieved before physicians would even consider making this combo an option for cancer patients.
A potential boon for kinase inhibitors
Assuming that the combination of fasting and a kinase inhibitor does indeed have a similar effect as that of chemotherapy in humans, it's plausible to assume that kinase inhibitors targeting lung, breast, or colorectal cancer could take on even greater importance.
There are more than a dozen kinase inhibitors already approved by the FDA to treat cancer. While I'm certainly not going to list each one, I can propose three kinase inhibitors that I suspect would see an uptick in demand were physicians to opt for the combo of fasting and a kinase inhibitor as the standard of care for cancer treatment.
For breast cancer patients, the type of therapy used depends largely on whether a patient is expressing excess HER2 protein or not, and whether they are estrogen receptor positive or negative. For patients with estrogen receptor-positive, HER2-negative advanced breast cancer, Pfizer's (NYSE:PFE) Ibrance could be a slam-dunk go-to drug. In clinical studies, Ibrance, which inhibits cyclin-dependent kinases 4 & 6, in combination with Femara, practically doubled progression-free survival for patients taking the drug to 20.2 months from 10.2 months in the control group.
Lung cancer patients could be turning to a name that's been something of a staple in advanced non-small cell lung cancer treatment for about a decade: Tarceva. Manufactured by Roche (OTC:RHHBY), Tarceva targets the epidermal growth factor receptor (EGRF) tyrosine kinase, and cuts off the connection that allows a lung cancer cell to receive its "fuel." Having been approved as a late-stage lung cancer treatment since 2004, I'd opine it has a pretty good shot of being used in conjunction with fasting if USC researchers' theory holds water.
Finally, physicians could use similar tactics with colorectal cancer and turn to Bristol-Myers Squibb's (NYSE:BMY) Erbitux, which has also been on pharmacy shelves since 2004. The mechanism of action for Erbitux is the same as Tarceva in that it binds to EGFR on the outside of a tumor cell, thus inhibiting the kinase pathway by which a cancer cell would get energy, eventually leading to its death.
A potentially huge improvement in quality of care
I certainly don't want to get too excited, as additional research needs to be conducted, but USC's findings could imply an important dual benefit for cancer patients.
First, we're looking at a potentially equal cancer-killing benefit that could keep patients largely out of hospitals. There are a number of oral kinase inhibitors, and fasting can be accomplished at home, meaning potentially far fewer hospital or doctor visits. I'm personally no psychologist, but I'm inclined to believe people would prefer the comfort of treatment in their own home as opposed to a hospital room.
Secondly, we could be talking about a major advance in quality of care during treatment. Sans chemotherapy, and with the possibility of a lower dose of kinase inhibitor being used since it'd be taken with the patient fasting, patients could have very minimal treatment-induced side effects.
I'm certainly intrigued to see additional research emerge on this treatment combination, and look forward to whatever quality of life benefits it may provide to cancer patients.