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ORIGINAL RESEARCH PAPER
Medicine
PERSONALIZED TREATMENT APPLICATION IN
INTEGRATIVE ONCOLOGY
KEY WORDS: personalized
cancer treatment, circulating tumor
cells, chemo sensitivity test,
autonomic muscular test
INTRODUCTION
Hundreds of billions USD/Euro are invested in the field of oncology,
especially for new chemical agents elaboration and radiotherapy
equipment in the latest decades. Statistical assessment of mortality
rate deviation for the period 1975 - 2010 is close to 0 %.(1)
Figure1. Morbidity and mortality from cancer for the period
1975-2010 in the US: A Cancer Journal for Clinicians, 2014
Standardized mortality rate due to the oncology diseases as per
100 000 persons (divided by cancer location and annual number of
patients) according to data, published by Bulgarian Cancer
Register for the period 1980 - 2012 is changed as follows: male
mortality year - persons year persons;
female mortality year - persons, year
persons. For the above mentioned period it means that the male
mortality rate is increased by 30 % and the female mortality is
increased by 12 % in Bulgaria.(2)
Scientific data lead to the conclusion, that both oncology
morbidity and treatment effectiveness still remain unresolved.
Standard approach to the oncology patients reveals permanently
deepening medical, social and economic problems all over the
world. Unsatisfactory treatment results in oncology patients are
direct consequence from the conventional medical concepts as
follows:
- The fact, that oncology disease is not local, but systematic
health problem has been ignored.
- The quality of life in treated patients is not a priority.
- Difficult access to the new alternative methods of treatment.
- Lack of personalized oncology treatment.
German oncologist Josef Issels, who is a pioneer in the field of the
integrative oncology states:Cancer treatment will stay in
deadlock because of outdated perceptions used.
The concept, that pathogenesis and etiology must be taken into
consideration is one of the main rules leading to the most effective
treatment. Symptomatic treatment has never been optimally. To
gain best results must be treated the reasons for the diseases.
Issels has believed that cancer is a systemic disease requiring a
holistic therapy. Such kind of treatment is directed not only to the
cancer location but to the overall organism recovery. Thus the
significant long term results can be expected.(3)
The dogmatic perceptions for the local approach in the treatment
of oncology patients lose ground in the last decade. A number of
studies conclude the conventional methods must be combined
with the complementary and alternative once. Integrative
oncology uses both conventional and complementary medicine to
meet the needs of individual patients and to focus on the whole
person. The core principles of integrative oncology include
individualization, holism, dynamism, synergism and collaboration.
Recent tendency that each oncology patient should be cured with
individual manner is ignored by the conventional medicine. The
statement one size fits all the satisfied therapeutic results
cannot be expected.(4) All these facts lead to the bad clinical
results. (5)
Unsatisfactory treatment results in oncology sparkled more and
more oncologists to focus on a new opportunity to improve the
effectiveness of treatment. A new strategy, called Individualized
Cancer Therapy (ICT) has acquired popularity. The main aim and
perspective of ICT is to get significant progress in the next primary
directions: metastatic treatment, tumor cell chemo resistance and
toxicity reduction. Individualized therapy in oncology patients is
used by increasing number of oncologists due to the necessity of
better curative results. (5,6,7).
MAIN BODY
Personalized Approach and Chemosensitivity Tests
The main priority for oncologists in this new ICT strategy proved
use of chemo sensitivity tests. Drug sensitivity compare anticancer
activities of candidate drugs on surgically removed samples or
ABSTRACT
The last 35 years statistical data show that the conventional treatment results are not relevant to the patients' survival rate
improvement. The concept of standard oncology demonstrates a lot of disadvantages, which remarkably limit the therapeutic
effectiveness.
Recently a new approach appears to be more interesting: the so called Personalized Treatment. Hopefully, this is going to be
the basics for achievement of better curable results.
Molecular biology advancement has given the possibility of personalized treatment to be implemented. The use of chemo
sensitivity tests gives the opportunity for anticancer drugs to be tested and each patient to be treated under personal
combination.
Another option for testing of anticancer drugs, food supplements and tumor sensitivity are Autonomic Muscular Tests (AMT). The
American physician Dr. Omura has elaborated and patented the AMT, which has exposed outstanding opportunities for drugs
selection.
Since 2012 we have started to use chemo sensitivity test for circulating tumor cells (CTC) and modified version of Dr. Omura's
AMT.
This article reflects our initial experience in usage of personalized approach in the treatment of cancer patients.
Chr. Damyanov*
MD, Medical Center, Integrative Medicine, Sofia, Bulgaria *Corresponding Author
Vl. Pavlov
Medical Center, Integrative Medicine, Sofia, Bulgaria
Iv. Maslev
MD, Medical Center, Integrative Medicine, Sofia, Bulgaria
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blood samples for circulating tumor cell (CTC), and those
anticancer drugs showing the best responses are selected for use
in succeeding treatments.
Since 1950 clinical trials have developed for in vitro and in vivo
chemo sensitivity assessment. In vitro tests include cytological and
cytochemical drug response evaluation. Most frequently used in
vivo test is Sub renal Capsule Assay (SRC)(5,8)
Initial clinical results were assessed in 1970 when a number of
clinical trials had completed. Practical possibilities of chemo
sensitivity test in terms of drugs and methods administration were
proved. Significant correlation between the test and clinical results
was observed in about 80% of the publications. Increased survival
rate was established in less then 25 35% of clinical reports
despite this improved treatment effectiveness (5,8).
Clinically the test usage was limited by the tumor cells ability to
express its potential for chemo resistance, biological behavior of
tumor and metastases and some technological problems. (5,9,10)
The progress of molecular biology has provided an excellent
possibilities for optimal individualized treatment in oncology
patients.
Theoretical basics for modern genetics use is the fact that there are
specific gene aberrations in different cancer types. Thus, it is
possible the anti-tumor drugs sens itivity and tumor cells
polymorphism to be detected.(5)
Primari ly the molecu lar biology advantages increased the
pharmaceutical industry implementation. A lot of drugs were
developed and inculcated the so called target therapy. That kind
of therapy could not replace a standard one, but a number of
genetic tests were prepared and clinically applied.
Tumor genetics studies give the options the genetic differences,
biologic behavior and the aggressiveness of the primary tumor
and its metastases to be explored.(10).
If we pay attention and testing only the primary tumor chemo
sensitivity possibly its metastases and the disease overall might be
in a progress. The molecular analysis of isolated circulating tumor
cells in the blood now can be done. In that way the metastases
chemo resistance also can be determined and the personalized
treatment will be easily administrated. Moreover, the circulating
tumor cells testing gives an option for sensitivity detection also to
the natural biologics. (11)
Increasing number of laboratories currently propose such kind of
tests in their service list. Research Genetic Cancer Center
(RGCC) in Greece and Biofocus are the most popular European
genetic laboratories.(11)
D-r James Forsythe has represented his 5-years experience at
chemo sensitivity test (RGCC) usage in combination with IPT
th
treatment in oncologic patients at the 11 Annual International
IPT/IPTLD Integrative Cancer Care Conference. The survival rate for
450 patients (G 4) was 59 % for a 33 months exploration
period.(11)
We have started to use chemo sensitivity test for circulating tumor
cells of German laboratory Biofocus since 2012. The test was
administered in 105 patients who were in G3-4 stage and after
failure of chemotherapy and radiation.
Initial results have showed a success in the detection of circulating
tumor cells and good correlation with the treatment results in
above 80 % of cases. After the 10th IPT procedures there is no
significant difference in terms of effectiveness with patients who
have not been tested, but in the first 3-4 weeks chemo resistance
was not reported.
The main issue is that the test is too expensive. The price limits of
widely test administration in patients who need long term
treatment, but the resistance could be expected at the same time.
The molecular biology development gives us a new hope and
perspective for the improved oncology treatment effectiveness
despite we currently cannot use the test as a basic one.
Autonomic Muscular Test (АМТ) and Personalized Treatment
Application in Integrative Oncology
Autonomic Response Testing (ART) is a diagnostic method, which
is basically used in the kinesiology. ART is a biofeedback enhanced
physical exam which uses changes in muscle tone as primary
indicator.
The muscle reaction of Autonomic Nerve System (ANS) is explored
in order different functional disorders to be established or drugs
and food supplements to be selected. The methodology is used by
spe ciali sts, working in the field of integra tive medicin e,
acupuncture, naturopaths, holistic dentists and veterinaries.
(11,12,13)
AMT is known by various names (terms) Autonomic Response
Testing, Neuromodulation Technique, Nutrition
Response Testing and Bi-Digital O-Ring Test.
Since 1964 the Muscle Test is elaborated by Dr. George
Goodheart, who is chiropractic. He has developed diagnostic
system commonly known as Applied Kinesiology. It gives the
opportunity muscle reaction to be tested in order to gain
diagnostic and clinical results.(11)
German physician Dr. Dietrich Klinghardt has developed and
enriched the practical use of kinesiology and has given the term
Autonomic Muscular Test. Since 1980 he has improved his
systematic model and has applied AMT for diagnostics and
treatment of chronic diseases. Theoretically, this model is based on
the understanding that human body's physiological response is a
result from the physical phenomena bio-resonance.(12)
In 2002 Dr. Leslie S. Feinberg has proposed a new AMT model and
concept which is based on the theory for informative medicine.
(14)
In 1993 . Dr. Yoshiaki Omura patented his Bi-Digital O-Ring Test
(new AMT version) which is used for diagnostics and treatment of
chronic and cancer diseases.(15)
Figure 2. Bi-Digital O-Ring test
Dr. Omura is a general practitioner and cardiologist with more
than 50 years long outstanding practice. He is the president and
founder of International College of Acupuncture & Electro
Th era peu t ics and i n ter nat ion a l med ica l ass o cia tio n
International Bi-Digital O-Ring Test Medical Association and
also Director of Heart Disease Research Foundation. After 1993
he has published a lot of articles focused on the diagnostics and
treatment of cancer diseases.(15)
The information is taken from: Bi-Digital O-Ring Test (BDORT) The
Bi-Digital O-Ring Test is applicable for the following topics: drugs
selection and dosage, assessment of sensitivity to foods and food
su ppl e men ts, ev alu ati o n ele ctro mag n eti c fiel d i mpa c t,
acupuncture points location, and energetic meridians location.
(18,19,20,21,22,23)
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The practical results from the application of Bi-Digital O-Ring Teast
for diagnosis and treatment of a cancer have reported in number
of publications and international annual symposia. (16,17,20,23)
In several clinical studies Dr. Omura has shown the possibilities for
tumor diagnostics in earliest stage when the contemporary
diagnostic methods are unable to establish it. Dr. Omura has
suggested the test to be administered regularly for 3 to 7 years in a
raw, when the test is positive in oncology patients. Dr. Omura
states Bi-Digital O-Ring Test provides 90% effectiveness.
(15,17,20).
There is another Dr. Omuras patented technique - "Selective Drug
Uptake Enhancement Method" Its potential is different way drugs,
immune-stimulants and food supplements to be selected.
According t o Usi ng BDORT te st drugs, foo ds and fo od
supplements can be selected. We havent found any written data
for testing of anticancer agents. (15,18,19)
physician Dr. Isaac Goiz Duran method Bio-magnetic Pairs
Therapy.(24,25,26)
Quite surprisingly to us detection of magnetic imbalance by the
method of Dr. Goiz in different areas of the body, which is done
with magnetic pairs may be replaced by which is used verbal
communication with the ANS in. AMT completely correspond to
the theory Bioresonance phenomenon in which the ANS answer
may also include a variety of energetically informattive sources,
including verbal (audio frequency) option in.(24)
Our research for the use of bio-magnetic therapy in patients with
chronic diseases has pointed our interest to incorporate Dr Goizs
AMT version for tumor sensitivity establishment. We currently use
Dr Goizs AMT to determine anticancer scheme for the IPT
procedures.
AMT methodology:
A relaxed patient has lied in comfortable position on couch.
Patients feet are placed outside the couch. A contact with the ANS
has occurred by verbal stimulation.
Figure 3. AMT initial positioning
The patients response is relaxation only for one of the legs. That
reaction means we have a positive reaction to the given
information.
Figure 4. AMT positive response
We assess the muscle relaxation qualitatively it might be very
good, good and mild. That assessment gives an information
about the chemo sensitivity.
Lack of muscle relaxation means that thereaction is negative and
there is chemoresistance to the tested drug.
Figure 5. AMT negative response
Test time duration is about 15-20 min. For the chemo sensitivity
registration we fill in a specific blank.
At the same time in some patients we have used the test for
circulating tumor cells chemosesitivity. It allows both tests results
to be compared. No significant differences were established until
now. The treatment results in patients cured by IPT and tested by
AMT or test for circulating tumor cells chemosesitivity practically
were the same. A punctual statistical analysis for the AMT usage
could be done in the near future.
Our treatment effectiveness was improved by 10% after the AMT
implementation in our practice although patients clinical profile
has got very complicated. These preliminary data should not be
considered as statistically significant.
The administration of AMT demonstrates some advantages low
price, easy to be done and possibility to be used frequently.
Recently we appoint a control test at each 3 weeks during the IPT.
Thus we monitor the anticancer drug used. Thereby we determine
the anticancer drug chemosensitivity permanently. There is a clear
correlation between the test results and subjective state of
patients. We can react immediately by changing the drugs scheme
especially in complicated patients when the chemo resistance is
expected in initial 3-4 weeks.
Having received the first positive data from the AMT use we has
begun to appoint this Dr. Goizs verbal (audio) test also for
oncology diseases diagnostics. The second step is to estimate the
ANS reply to the specific points of magnetic imbalance. Finally we
perform a version of Dr Omuras test and look for the ANS
response for the tumor type by placement a histological material
onto the patients hand or palm.
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Our experience in using AMT for diagnostics has given us some
positive results but definitive conclusions cannot be reported
currently.
CONCLUSIONS
The role of pathogenesis and etiology of oncology diseases is
neglected in the last decades. The conventional oncology
perception that one size fits all doesnt work but the patients
access to the innovations in oncology is seriously limited. That is
the main reason for the lack of treatment results improvement.
Personalized approach in oncology treatment is in the initial
period. Increasing number of integrative and conventional
oncologists who are interested to that methodology.
Molecular biology advancements have given the possibility for
usage of a number of chemo sensitivity tests. They have exposed
outstanding opportunities for the treatment improvement.
Insufficient scientific data, price and some technological problems
significantly limited its administration. Currently the use of chemo
sensitivity test for circulating tumor cells is predominant interest
and clinical application mainly among physicians practicing
Integrative Oncology. Remarkable interest was observed to the
Autonomic Muscular Test elaborated but American physician Dr
Omura. He has patented his own methodology for drugs, food
supplements and immunostimulants selection which can be used
in the treatment of cancer. The test is not expensive and easy to be
done.
Initial results from the application of AMT in the treatment of
cancer in our practice are promising and give us hope for
improving performance. Still limited experience and lack of
meaningful statistical data does not allow us at this stage for
definitive conclusions.
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