ABLATION TECHNOLOGIES REVIEWED

Today there are many ablation technologies to fight cancer. Before, we were mainly limited to performing radiofrequency ablation procedures which basically consisted of putting a needle into the tumor. Radio waves were sent into the needle, these heat the tumor and then died.

Likewise, there was cross cryoablation, this procedure consisted of placing a needle in the tumor and freezing it. In my early days of radiofrequency ablation and cryoablation procedures, there were patients who had multiple lesions, the treatments were done at different stages, and it was common that there were areas that could not be treated, however, some lesions disappeared without having the opportunity to treat them. Hence, we realized that ablation had the ability to create an immune response.

Nevertheless, it is a limited procedure, so we are constantly looking for ways to improve. What are the issues? An interesting aspect is that when the cancer is in an advanced stage and the ablation is done, in fact, partial ablations are done, without trying to ablate the tumor completely. If you start the procedure by killing a large amount of the tumor, then all those parts of the tumor, seen by the immune system, become suppressive and the immune system shuts down. In addition, much of the normal tissue begins to be damaged.

Therefore, when a tumor is ablated, a part of normal tissue is obtained around it, as if it were a surgery. Otherwise, with ablation for advanced-stage disease, killing that normal tumor can confuse the immune system. Moreover, having normal tissue dead, you’re also going to get a release of certain factors like TGFbeta and Vega, which are immunosuppressive. We know that by blocking Vega when we block TGF beta with the combined inflation we can significantly enhance the immune response. Nowadays, different procedures are carried out, for example, the intriguing immune therapy that consists of an injection into the tumor, there is also the pulsed electric field, which is a new technique.

References:

Williams, J. (2019, 15th October) The Immunotherapy Revolution. (pp. 56-65)

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The powerful synergy of ablation and immunotherapy

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The “Vaccine” for Cancer Ablation

One of the keys to having successful immunotherapy is to leave the tumor destroyed in the body, in this way the immune system can collect information about cancer and thus fight it more effectively.

The combination of micro ablation and immunotherapy works well to treat cancer in advanced stages. Similarly, this combination is increasingly being considered to treat cancer in its early stages, especially in cases of breast, lung, and liver cancer. Ablation is considered the future substitute for surgery.

In the same way, it is expected that cryoablation will be used more frequently for cancer in its early stages and in turn complemented with measures that improve the immune response to reduce the risk of future metastasis.

When cancer progresses beyond its early stage, it becomes systemic cancer, and it can spread throughout the body. After the primary tumors are removed by surgery, patients are usually told that cancer has been completely removed. However, this is not entirely true, even if the primary tumor is removed, cancer cells remain in the body, so they can proliferate and form new tumors. In advanced cancer cases, when a tumor is ablated, the dead cancer cells act like a vaccine, prompting the immune system to attack foreign bodies including cancer cells that may remain in the body. Nevertheless, this does not happen with recurrence without the help of some type of immunotherapy.

Very few doctors realize that cryoablation can be used to generate a powerful immune response, and is considered one of the most successful cancer treatments out there, particularly in patients with stage III or IV cancer, where treatment options are much more limited. Each year approximately 600,000 cases of advanced cancer are diagnosed in the United States. However, using ablation, combined with immunotherapy, there is the potential to save many lives; avoiding patients from having to go through chemotherapy and radiation. You might consider calling this combination AblationVax therapy because of the way it optimizes the body’s immune system, like how vaccines work.

Medicine today is very focused on profitability, so there is very little motivation for an oncologist to promote cryoablation and immunotherapy (AblationVax) for their patients, plus most cancer patients are uninformed about the achievements that have been made.

Ablation kills tumors in the body and leaves behind dead fragments, known as antigens, their function is to help the immune system recognize tumors; they provide information to the immune cells and thus to know the process they must follow to find the harmful cells. In addition, the ablation initiates an inflammatory process that also stimulates the immune system, this is known as “Danger Signals”. These signals allow immune cells to locate where they need to initiate a counterattack against harmful organisms. In fact, related to immunity, ablation can be quite an effective boost to the body’s general anti-cancer immune response. Another great advantage of ablation is the reduction of tumor mass, so that immunotherapy and the immune response against cancer have a weaker opponent to attack, by reducing the size of the tumor, the patient theoretically has a better chance of immunotherapy works.

Reference:

Williams, J. (2019, 15th October) The Immunotherapy Revolution. (pp. 40-50)

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VIAGRA AND ITS CONTRIBUTION IN THE TREATMENT AGAINST CANCER

Viagra, whose trade name (brand-name) is Sildenafil, is a medication whose first objective was to treat hypertension (blood pressure) and angina (chest pain); however, it also generated a curious side effect, men who had taken this medicine presented prolonged erections, but what is a side effect in one man is a happy night for another. This drug was patented in 1996 for the treatment of hypertension, in 1998 the FDA approved Sildenafil for erectile dysfunction and shortly after appeared two other similar drugs to treat erectile dysfunction—Cialis and Levitra.

However, the most common questions are: how can this medication help in the treatment of cancer? Is this medication safe for women? How does this medication work on our immune system? does this drug provide a boost to fight cancer?

Viagra, Cialis, and Levitra belong to a class of PDE-5 drugs. This means that one of its “side effects” is the reduction of MDSCs (Myeloid Derived Suppressor Cells), an important aspect for the immune system to attack tumors.

MDSCs are similar to regulatory T-cells MDSCs also interfere with antitumor immunity, and they do so by using L-arginine metabolism to suppress immunity.

Arginine is a critical amino acid for a healthy immune system as it is needed to activate T cells, but when cancer is present, tumors and regulatory immune cells produce an enzyme called Arginase 1 that breaks down arginine in the microenvironment of the body tumor.

Nevertheless, phosphodiesterase-5 inhibitors control this process, also known as PDE-5. PDE-5 inhibitors reduce myeloid-derived suppressor cells and suppress arginase production, that means that tumors have one less ally in their quest to grow and reproduce.

Moreover, the role of MDSCs in the immune response is an important topic in cancer research nowadays. Although there are not treatments available specifically to control them. Currently, the best source of PDE-5 and Arginase 1 inhibitors available are the popular erectile dysfunction drugs Viagra, Cialis, and Levitra.

Likewise, women can safely take these medications. It has not yet been proven that taking these medications increases sexual desire, although cases have been reported in which it seems to happen, but, just as the aforementioned medications, they stimulate blood flow to the penis, they can stimulate blood flow to the genitals of the woman which can increase sensitivity to stimulation. This is not such a bad side effect when the goal is to increase the stimulation of the immune response for a woman who is fighting cancer.

These medications need to be taken under the supervision of a doctor. Drugs such as Viagra, Cialis and Levitra can cause a significant drop in blood pressure. Patients with low blood pressure would not be able to use them.

Nor can we think that Viagra was only good for treating erectile dysfunction, now it is also used as a cancer treatment since it increases the stimulation of the immune response since it has been discovered that phosphodiesterase type 5, or inhibitors of PDE5, can help shrink cancerous tumors, thus becoming an unexpected anticancer drug.

Cancer also tends to get worse faster; this is because the microenvironment (the area directly around the tumor) contains molecules and blood vessels that have become contaminated, these form a protective area around the tumor, making it resistant to treatment.

Due to Viagra and other PDE5 inhibitors appear to make CAFs more sensitive to immunotherapy treatment, this drug could be a reliable and effective anticancer drug that lessens the morbid outcomes seen in earlier studies, therefore, it is known that the effectiveness offered by Viagra as a drug against cancer could open new doors for research and treatment.

References:

Hawkins, J. (2022, 10^th October). Doctors may have found a secret weapon to fight cancer: Viagra. BGR. Taken from: https://bgr.com/science/doctors-may-have-found-a-secret-weapon-to-fight-cancer-viagra/

Williams, J. (2019, 15^th October) The Immunotherapy Revolution. (pp. 108-110)

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cryoablation versus pulsed electrical field for the trearment of cancer

One important aspect to explain is the difference between pulse electric fields and cryoblation. This cryoblation consists of inserting a needle into the tumors and thus freezing them. Of course, different technologies are used such us argon gas and liquid nitrogen. These are techniques to cause the needle to freeze which in turn freezes the tumor. The process of freezing cracks and breaks the cell membrane. Cells break apart and leave pieces; these pieces help stimulate the immune system.
Likewise, pulsed electrical field (PEF) technology uses an electrical charge, this is discharged very quickly, in a nanosecond. This causes pores to develop in the cell membrane and organelles of the cells. Trough these pores, ions such as calcium rush in a cause cell death. This has no thermal effects so all of the pieces are left intact to be seen by the immune system. Essential more evidence has been left behind for the immune system to catch the criminals.
Cryoablation has a lot of variability in the immune response and can even be suppressive in some cases. PEF seems to be more consistently immune stimulating. In addition, an interesting aspect in most of these ablations is for advanced cancer, it is not necessary to ablate the entire tumor. If the entire tumor is ablated, much of the immune response is lost, this is important for advanced cases where an immune response is critical. In early stage cases your goal is still to destroy the entire tumor like a surgical removal. But if you’re looking to treat advanced cancer and elicit an immune response, it’s a partial ablation that is most effective. This is counter intuitive. This requires great expertise and can be considered an art, especially in cryoablation. Similarly, in many studies in both animals and humans, administration of immunotherapy into the ablation site has been shown to be more effective in generating an immune response. Intratumoral immunotherapy allows for more drug combinations which is needed for many cancers. Cancer treatments are evolving at a rapid pace and the cure has never been closer.

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BENEFITS OF VITAMIN E IN IMMUNOTHERAPY TREATMENT

Vitamin E is an antioxidant that helps fight harmful natural substances known as free radicals, that is, fighting unstable molecules that are made in the cell metabolism.

For a long time, vitamin E has been used to prevent heart disease due to its collaboration with the vascular system. This vitamin is also important for the improvement of muscular and reproductive system. Also, the consumption of vitamin E helps in the peroxidation of lipids in the cell membrane, producing oxidative stress, thus favoring the injuries that we have in the organism and necrosis, which is why it is called an antioxidant vitamin. Besides, it is known that vitamin E fights against cell deterioration and aging, which helps prevent many health problems.

This is how vitamin E contains many properties for patients with some type of cancer since this vitamin blocks a protein in the dendritic cells of the tumor and facilitates the antitumor of the immune cells. Due to this, day to day it is recommended the consumption of this vitamin during immunotherapy treatment because many patients respond more positively when they acquire this vitamin during treatment than when they do not.

There are many more benefits of this vitamin, such as the improvement of vision, the health of the blood, the brain, and the skin. Hence, the absorption of vitamin E in the body should be improved and this depends on fat absorption, and proper biliary and pancreatic function. We must also take care of the diet during immunotherapy, trying to have a very good intake of vitamin E, through foods such as fruits and vegetables, which give us a great contribution of energy and fiber.

Some foods rich in vitamin E are canola oil, olive oil, margarine, almonds, and peanuts. You can also get it from meats, dairy products, leafy vegetables, and fortified cereals. Also, it is available as an oral supplement in the form of capsules or drops.

We must try to eat a balanced daily diet free of saturated fats, lower obesity rates, as well as avoid smoking and consuming alcoholic beverages, since changing these habits generates favorable changes before and after cancer treatment.

References

Walter, C. N. & Saz, P. (2022, 13^th May). La vitamina E puede ayudar a mejorar los tratamientos de inmunoterapia. Cuerpomente. Taken from https://www.cuerpomente.com/salud-natural/tratamientos/vitamina-e-puede-mejorar-tratamientos-inmunoterapia_9966

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The three most common things that can negatively impact cancer immunotherapy

We have talked many times about all the aspects that can negatively affect immunotherapy. To be honest, I feel that I must constantly repeat this information so that all can hear it. On many occasions, patients do not seem to understand the importance and sadly, their doctors are not aware of this situation. Of course, there has been much discussion about the microbiome since it is the foundation of immunotherapy; a healthy gut microbiome is necessary for immunotherapy to have a better chance of working. This does not mean that the immune system does not work without the microbiome, but it does help tremendously.
Previously I have had, discussions on topics related to the association that bacteria have with the immune response, moreover, on the use of antibiotics that, despite negatively affecting the microbiome, sometimes are necessary. Similarly, the use of Akkermansia , kiwi extract, Bifido breve, Bifido longum and Clostridium butyricum is very important to help counter negative effects . Also ask discussed acetaminophen has adverse effects to immunotherapy. Many times, patients don’t know drugs like Norco and Percocet contain Tylenol. Even, doctors give Tylenol at the time of receiving immunotherapy, which is not a necessary medication especially with immunotherapy. In addition to the aforementioned, using steroids decreased effects of immunotherapy, however immunotherapy adverse events such as, autoimmune hepatitis, where the immune system attacks the liver, thyroid problems, skin problems in the lung, pneumonitis. Unfortunately, patients are usually given steroids for treatment. There are other options such as infliximab or tocilizumab, but those are rare offered.

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VITAMIN D3 AND ITS ANTI-CANCER PROPERTIES

VITAMIN D3 AND ITS ANTI-CANCER PROPERTIES

Vitamin D3, also known as cholecalciferol, is a steroid hormone that is stored especially in the liver, it is also known that it is a vitamin that is not active in the body, so we must activate it to be functional and beneficial for the proper functioning of the body. We acquire this vitamin mainly through the sun’s rays, of course this exposure can also be harmful in greater quantities, so it is more advisable to try to obtain it through food and supplements. This is how it has been discovered that vitamin D3 helps us extract more calcium from food and phosphorus in the bones. Nevertheless, it also fulfills other functions such as helping to control blood pressure, regulating the functioning of the immune system, helping to fight aging, and promoting proper blood coagulation.

It has been found after many cellular and molecular studies, that vitamin D3 has several properties, one of them is to slow down or prevent the formation of cancer, to reduce the growth of cancer cells in people who already have this disease, In addition, it is said that this vitamin also reduced the effect of cancer even at advanced levels and helps prevent patients from reaching metastasis because this vitamin has antiproliferative actions.

It is also believed that a diet with a low intake of vitamin D3 allows tumors to form more quickly. That is why, in addition to sunbathing for a minimum of 30 minutes a day, we seek to obtain this vitamin from foods such as eggs, sins, liver, cheese, mushrooms, etc. We must also seek to complement them with multivitamins to achieve the amount of vitamin D3 that your body requires to obtain its benefits, knowing the amount of vitamin D3 that you need daily depends on your age.

Vitamin D3 helps the body to further potentiate calcium and phosphorus to strengthen bones and teeth, avoiding suffering from bone disorders called rickets in children and osteocalcin in adults, but it is currently widely used in strengthening the immune system. Therefore, it is especially recommended in the treatment of immunotherapy for cancer patients since during the process it is more important than ever to have a healthy immune system as well as to have a healthy and balanced diet, we must also remember that daily dietary supplements can play a role in protecting our body against everything from viruses and bacteria to allergens.

References

Deficiencia de vitamina D relacionada con metástasis de cáncer de seno. (2016, 5^th May). Instituto Nacional del Cáncer. Taken from https://www.cancer.gov/espanol/noticias/temas-y-relatos-blog/2016/vitamina-d-metastasis

Vitamina D y prevención del cáncer. (2013, 21^st October). Instituto Nacional del Cáncer. Taken from https://www.cancer.gov/espanol/cancer/causas-prevencion/riesgo/dieta/hoja-informativa-vitamina-d

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