As outlined in part one of this series [July 15 DC], a standard way to classify chemotherapy agents is to put them into one of two categories: cell cycle (phase-specific) and non-cell cycle (non-phase-specific). The cell-cycle (phase-specific) drugs, discussed in detail in part one, have their greatest killing effect when a cell is dividing whereby certain drugs target specific cell phases. Non-cell-cycle (non-phase-specific) drugs often remain in the cell and wait for cell division to occur, upon which they exert their anti-cancer effects, or bind to key enzymes inhibiting their function. The following are some of the commonly used non-cell-cycle-dependent chemotherapy drugs:
Alkylating Agents impair cell function by forming covalent bonds with amino, carboxyl, sulfhydryl and phosphate groups in biologically important molecules. The most important sites are DNA, RNA and cellular proteins. These are also known as intercalating agents. Examples: nitrogen mustards, which bind to DNA (e.g., cyclophosphamide); nitrosureas - lipid soluble, can enter brain (forms free radicals)(e.g., streptozocin); platinum agents (heavy metal complex producing inter-strand breaks of DNA with cross-linking adducts, thus inhibiting DNA synthesis (cispatinum, carboplatinum, oxaplatinum); alkyl sulfonates (e.g., busulfan); triazines (e.g., Dacarbazine; and ethylenimines (e.g., hexamethylmelaninine).
Anthracyclines (tumor-killing antibiotics) interfere with enzymes involved in DNA replication. They work in all phases of the cell cycle and thus are used widely in various cancers. They can permanently damage the heart if given in high doses. Lifetime dose limits are often placed on these drugs for this reason. Concurrent supplementation with coenzyme Q10 has been shown to protect the heart muscle in cases of Adriamycin use. Examples of anthracyclins include:
Targeted Agents: Some of the newer chemotherapy drugs are classified as targeted agents. Examples include monoclonal antibodies, small molecules and endocrine therapy agents. Here is a brief discussion of each, including a few examples:
Monoclonal antibodies target specific protein antigens (receptors, signal transduction enzymes or proteins) that are dysregulated in a cancer cell. These drugs destroy the dysregulated protein (in some cases a protein receptor on the cell surface that is over-expressed or overactive and is sending messages into the cell to encourage continued cell division). Examples include Rituxan, which targets CD20 antigen found on B-cell lymphocytes in non-Hodgkin lymphoma; herceptin - targets HER-2 receptor on breast cells that is over-expressed in up to 40 percent of breast cancer patients; Campath - targets CD52 antigen in B-cell and T-cell lymphocytes in chronic lymphocytic leukemia; and Avastin and related MAB's - destroys receptors on blood vessels to prevent stimulation of new blood vessels growing to feed the tumor.
Small molecules inhibit some of the key pathways that drive cancer cell division (particularly tyrosine kinase inhibitors): Examples include:
Endocrine therapy: Tamoxifen and Raloxifen are selective estrogen receptor modulators (SERMs) that compete with estrogen for binding to estrogen receptors - slowing cellular proliferation. Aromatase inhibitors block aromatase enzyme (estrogen synthase) in fat cells, stromal cells, breast cancer cells, which converts androstenedione into estrone.
Relevance to Your Practice
Understanding the influence these drugs have on killing cancer cells or interrupting their mitotic potential is critical when deciding what dietary or supplementation practices are synergistic to or in conflict with the action of the drug. In addition to these chemotherapy agents, there are also other oral drugs used (often off-label use) in the management of these cases, which should also be factored in to the nutrition and supplementation advice provided to a patient. (A future article will address the off-label use of these drugs in cancer management. )
One of the highlights of my professional career has been to teach a course on the adjunctive nutritional management of cancer to medical doctors and oncologists who are candidates in the Fellowship In Integrative Cancer Therapy Program taught through a division of the American Academy of Anti-Aging Medicine. These doctors have been most receptive and appreciative of the evidence-based protocols, and many use this information for the purpose of incorporating targeted nutritional and supplementation practices into the management of their cancer patients. In return, I have learned a great deal about medical cancer therapy from these practitioners and other speakers at these conferences, including much of the information presented in this article.
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
