Darwin Inspired New Approach to Cancer Treatment

Cancer patients may have found a new hero in Robert Gatenby, radiologist and head of the H. Lee Moffitt Cancer Center’s radiology department in Tampa, Florida. At least, for those suffering from prostate cancer.

Gatenby has developed a new treatment that not only helps minimize the side effects of the medications used but also the level of dosage and the cost that patients have to pay for.

But the surprising thing was that the adaptive therapy approach he developed was inspired by Charles Darwin’s theory of macro­evolution.

What exactly brought this on?

It was in 1854 when the diamond­back moth was first recorded, after a farmer found them eating through a patch of cabbage. When they caused destruction from Florida to Colorado during the late 1800s, they were treated to huge amounts of pesticides.

It killed a majority of the moth population. But those that survived multiplied and came back more aggressive than ever. For each regeneration, the insects evolved to become resistant even to the most toxic DDT.

It was in the late 1950s when a new strategy was developed by agriculture experts. Instead of total eradication as a goal, they opted to wait until the number of diamond-backs reached a population beyond a certain threshold before pesticides were deployed.

It proved to be helpful even if the moths did not die out. This is because they become easier to manage and crop damage is also minimized.

Cancer cells also develop resistance to the medications the patients are given. A small subset of them that survive the treatment usually undergo genetic changes that make them resistant. This is why patients in advanced stages of cancer often just wait for when cancer cells become unstoppable.

The evolution of the diamond-backs and the cancer cells after aggressive treatment is what Gatenby latched on and used as basis for the new treatment he introduced.

What is adaptive therapy approach?

Gatenby witnessed breast cancer patients go through a combination of extreme treatment—chemotherapy in potentially lethal doses and bone marrow transplant, without any sign of recovering. In fact, they suffer major side effects that range from diarrhea and nausea to liver and lung damage.

As a radiologist, he witnessed how the treatment were failing, resulting to as many as 15% of the more than 30,000 breast cancer patients in the US between 1985 and 1998 dying from the treatment and procedures done.

“What happened was these women suffered horribly, and they weren’t cured,” he said.

Gatenby thought of preventing this deadly outcome by exposing a tumor to intermittent medication instead of constant and continuous.

In the case of prostate cancer patients, they will only receive the chemotherapy drug Zytiga if the tumor shows growth. If not, they will stay on Lupron and similar medication.

Is adaptive therapy effective?

Robert Butler, a retired British oil-exploration engineer and a patient with stage 4, advanced prostate cancer, was one of the patients who agreed to participate in the trial that Gatenby and his colleagues at the Moffitt Cancer Center started in 2014.

His modified Zytiga regimen involved using Lupron as prescribed, monthly PSA level testing, and a full-body bone scan and CT scan every 3 months.

Zytiga will only be administered if his PSA level is under half of the baseline.

This spared him from hypertension, hot flashes, muscle pain, and other side effects of Zytiga.

Early results of the clinical trial showed that, out of the 11 male participants, only one left because his cancer progressed. The rest of them, including Butler, experienced a median time of cancer progression of at least 27 months, almost 11 months longer than those who receive continuous dosing of Zytiga.

In other words, adaptive therapy helps.

But because it’s only been tried to a small number of participants, particularly those with advanced prostate cancer, caution is advised. Many oncologists, however, are gradually implementing adaptive therapy in their practice.

Take it with a grain of salt

With an estimated 1,735,350 new diagnosed cases of cancer in the United States in 2018, according to the National Cancer Institute, most patients would grab to any treatment available to them. Who doesn’t want to be cured and to live longer?

But, like any new treatment and therapy introduced, including CBD oil, being skeptical about it is good. Make sure there are studies to back claims of efficacy and that a good number of cancer patients were already cured before you follow suit.

With cancer as one of the major health problems today, research and studies will continue. There will always be hope.