Podcast Episode 10 – Repurposed Medications

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Speaker1:
Welcome to the Cancer Secrets podcast. Changing the Cancer Paradigm. Hosted by Dr. Jonathan Steagall, a medical doctor and cancer specialist practicing in Atlanta, Georgia, deeply affected by his grandmother's death from stomach cancer, as well as patients he cared for in medical training, he realized there has to be a better way to treat cancer. Dr. Stegall has a unique and innovative approach to treating cancer called integrative oncology, combining modern medicine with alternative therapies personalized to each patient. This podcast is designed to educate, support and give you a positive voice you can trust. We invite you to join us on this journey as we seek to change the cancer paradigm.

Speaker2:
Hi. This is Dr. Stegall. I'm so glad you're enjoying the Cancer Secrets podcast. Do you have a question you would like answered in a future episode? If so, please go to Cancer Secrets dot com and click on podcast at the top of the page. Look for the tab on the right side of the page that says Send voice mail. You can record your question straight from your smartphone or computer with your question. Be sure to tell us your first name, where you're from, and why you listen to the show. I will choose from the best questions and answer them on the air. I look forward to hearing from you soon. Hello and welcome back to the Cancer Secrets podcast. I'm your host, Doctor Jonathan Segall. This is episode number ten. If you're new to the show, please go back and listen to my introductory episode to learn more about me and my vision for this podcast. In today's episode, I'm going to talk about additional treatment options in our quest to beat cancer. More specifically, off label and repurposed medications. You've probably heard me say before, I'm an open minded skeptic. I'm open to any treatment which will potentially help us, which we think is safe and which is also compatible with other treatments. But I also have a healthy level of skepticism. We have to have good science for the treatments we use. The idea of repurposing medications is intriguing to me. In other words, we're using pharmaceuticals which have been approved for another use and subsequently studied for anticancer activity, and we're using them as part of our cancer treatment protocol.

Speaker2:
I love the fact that enterprising researchers are spending time evaluating the possible benefit of existing medications, many of which are extremely affordable to evaluate for an anti-cancer mechanism. If you heard my previous episode on chemotherapy and our discussion of insulin potentiation therapy, you'll recall that we're using insulin in off label fashion. We typically think of insulin being used to treat diabetics by lowering blood sugar. But for our purposes in cancer treatment, we use insulin to lower blood sugar to more effectively target chemotherapy to cancer cells. Contrary to popular belief, off label use of pharmaceuticals is viewed by physicians as an acceptable choice when there is scientific evidence supporting that drug's potential benefit. Of course, coupled with a low likelihood of causing harm. Now, one would think that in oncology, where we don't have the treatment outcomes we would like, especially as it relates to conventional oncology, that we would have oncologists lining up at the door to try any of these potential treatments that could be beneficial. Unfortunately, that's not the case. Cancer treatment is not known for outside the box thinking unless you're in an integrative oncology practice. Of course, the advantage we have in repurposing pharmaceuticals for the purposes of cancer treatment is that these drugs have been in use in many cases for decades. We have a long history for their use and for their safety.

Speaker2:
The ability to repurpose them occurs when we do a small study to see if it has an anticancer mechanism. One of my favorite journal articles comes from a research paper in 2012. It was entitled Hiding in Plain View in this study investigated many existing pharmaceuticals for an anticancer effect. Not surprisingly, researchers found many promising candidates. One quote from the authors was especially striking. They said, We advocate that confirmation of these findings in randomized trials be considered a high research priority as a potential impact on human life. Saved could be immense. As I'm sure you can tell, I share their enthusiasm regarding the value in off label pharmaceuticals for the treatment of cancer. I routinely use many of these agents in my treatment protocols. The first drug I'd like to talk about today is metformin. Now, metformin is the brand name of this medication. The generic name is glucose phage. Now, many of us have heard of metformin for the treatment of type two diabetes. It's actually the first line treatment when people are diagnosed with Type two diabetes. However, an interesting finding occurred over the years in our study on metformin. Diabetics who take metformin are found to have a 54% lower risk of developing cancer compared to diabetics not taking metformin. This is a significantly reduced risk. Now there are several mechanisms for metformin to anticancer effect. The most prominent of these is inhibition of what is known as mTOR that stands for mammalian target of rapamycin.

Speaker2:
Mtor is a critical pathway in the way cancer behaves. It's a major player in cancer, cell growth spread and even survival. Now, if we can disrupt the mTOR pathway, we stand a much greater chance of slowing down cancer. So not only does metformin disrupt this mTOR pathway, it also targets something known as insulin like growth factor one or IGF one. Now we know that cancer cells have many insulin receptors on their surface, way more than we find on normal, healthy cells. And this is, of course, what we're doing when we use insulin as part of insulin potentiation therapy, when we deliver chemotherapy. But with metformin, we're actually reducing these available insulin like growth factor one substances. And finally, metformin has been shown in multiple studies to kill cancer stem cells. Now, this is a big deal. Most of the time when we think about treating cancer, we're killing cancer cells, which are rapidly dividing. But what we found is behind the curtain, we have what are known as cancer stem cells. Now, these these are relatively quiet cells that are simply lurking behind the scenes. Now, once those cancer stem cells become more active, they can cause a significant problem. And this is especially true when it comes to promoting metastasis or spread of cancer. And this ability to kill cancer stem cells is significant because we simply don't have any other ways that we know of to kill cancer stem cells.

Speaker2:
Now, you might be asking metformin sounds amazing. Why doesn't. Everyone use it and that's really what I ask regularly as well. It's a very safe medication. Now, sometimes people will have some slight gastrointestinal upset when they take metformin, and this is usually due to people taking the immediate release form, which is typically dose twice a day. Now, when these patients are switched over to the extended release form, which is only taken once a day, those gastrointestinal side effects, such as bloating and diarrhea, go away. But in most people, even those taking the immediate release metformin, these side effects do not occur. Now, one question you might be asking yourself is, well, if metformin is used in diabetes, do I need to worry about my blood sugar being lower too much if I take metformin and don't have diabetes? Thankfully, metformin works with the body and not against it. So even though it will lower blood sugar somewhat, the body won't allow metformin to lower it too much, like we would see if a patient received too much insulin. Another medication I'd like to talk about is doxycycline. Doxycycline is an antibiotic which has been used for over 50 years to treat a wide variety of bacterial infections. But interestingly, it's also been shown in multiple studies to have several anticancer effects. First, it inhibits a key group of enzymes known as Matrix Metallo Protein ACS. Now we abbreviate that map, but matrix metallo proteases are responsible for cancer growth and spread.

Speaker2:
So being able to inhibit that pathway is significant. But in addition, doxycycline has been shown to kill cancer stem cells while also being synergistic with intravenous vitamin C. It actually commits the cellular metabolism of these cancer cells to commit to a specific pathway that makes those cells more susceptible to IV vitamin C. And for patients who are receiving radiation therapy, doxycycline has been shown in studies to make cancer stem cells more susceptible to radiation damage as well. Now, we should have a healthy respect for antibiotics. Many of you who are listening are aware that antibiotic use, especially over the long term, can damage gut health. We don't want to wipe out the good beneficial bacteria in the gut, so we need to be careful in how we use doxycycline. So I typically will cycle doxycycline over a period of time. So patients who are in my office actively receiving high dose vitamin C two or three times a week, I'll leave them on doxycycline for 4 to 6 weeks and then have them take a break. And of course, we want to support the body's gut health by making sure we're on a good, high strength quality probiotic that will help protect the good gut bacteria so it's not wiped out. The next medication I'd like to discuss is naltrexone. Naltrexone was developed over 30 years ago to assist patients in overcoming drug addiction. It actually blocks what's known as the opioid receptor, which is involved actively in the body's perception of pain.

Speaker2:
So when we're treating patients with chronic pain, we block the opioid receptor and they have a decrease in their pain level. Naltrexone use is to block that opioid receptor as well to reduce the addiction potential in the body. However, what they found is they studied naltrexone over the years is that blocking this opioid receptor in the body also inhibits what's known as beta, endorphin and Mette and Cephalon. Now this inhibitory action actually boosts the immune system. Now, what we found is we're able to get away with this mechanism at much lower doses so we can still have this benefit, but not use as much naltrexone. In fact, we're able to use about 1/10 of the normal dose of Naltrexone to get this good effect. So we we term this low dose naltrexone or LDN. Now, from an anti-cancer perspective, the benefit of low dose naltrexone seems to be an increase in the number of natural killer cells. So by boosting the number of natural killer cells, as well as their level of activity, we're enhancing the immune system response and namely the portion of the immune system that is often deficient in cancer in which we must have optimized in order to treat cancer optimally. I feel that LDN or low dose naltrexone has a lot of potential. Now we typically dose this at bedtime and the dose we're talking about, which is usually three or four milligrams, does have to be compounded because the brand name naltrexone only comes in a much higher dose of 50 milligrams.

Speaker2:
So we have to have a good compounding pharmacy to help us out that knows how to make low dose naltrexone the way we need it, but we dose this typically at night. And the reason for that is because the immune system is especially active while we're sleeping. Now, in terms of side effects, we really don't see side effects with low dose naltrexone. Occasionally patients will say that they have vivid dreams when they take it, but these aren't usually nightmares. So very vivid dreams in terms of maybe you usually dream in black and white, and now you're noticing that you dream in color, or you wake up and remember your dreams more often than normal. But patients don't tend to complain about this, so I don't really consider it a side effect. But that's really the only change we see in patients who are taking low dose naltrexone. Hi, this is Dr. Jonathan Stegall, medical doctor and specialist in integrative oncology. And I want to tell you about my new bestselling book, Cancer Secrets. This book is packed with valuable information you need to know about whether you're searching for information for yourself or for a loved one. In my book, you'll learn what cancer is and what it is not, as well as which treatments you should be focusing on from both modern medicine as well as alternative medicine.

Speaker2:
You'll also learn the ins and outs of nutrition and supplementation, as well as important information about having the proper mindset. I'm in the trenches every day with patients and I've shared my secrets in this book with you. Please go to Cancer Secrets dot com and buy your copy now. The next medication I'd like to discuss is aspirin. So aspirin is, of course, derived from willow bark. And it's rumored that Hippocrates, who's known as the father of modern medicine, had his patients chew on the bark of the willow tree to help bring fever down. And, of course, the cardiovascular benefits from aspirin are well documented as well. But studies have shown us that people who take aspirin have a lower incidence of cancer compared to those who don't. And this is especially true in the prevention of colorectal cancer. There was one study which showed that daily aspirin had a 24% reduction in patient's risk of developing colorectal cancer. And this benefit was shown after patients had been on aspirin for at least five years. But obviously, we want to take things that benefit us once we have a cancer diagnosis as well. A recent study evaluated all existing evidence for low dose aspirin in the treatment of cancer and concluded that taking a baby aspirin once a day could increase survival by up to 20% and significantly reduce metastases as well. Now, this is huge. If this were a patented drug that was new, it would be worth millions of dollars to a drug company.

Speaker2:
But of course, aspirin has been around for a long time, so the fanfare surrounding these results is much less than it otherwise could be. Now, the decision whether or not to add aspirin to a protocol is one we need to take seriously. As you know, aspirin is a blood thinner which can interact with other medications. But for a large majority of patients, aspirin is extremely well tolerated, especially at the daily dose of 81 milligrams. And I feel it's an excellent candidate for inclusion in an anti cancer protocol. The next medication I'd like to discuss is propranolol. Now, propranolol is a drug we use to treat high blood pressure. It's in a class of blood pressure medications known as beta blockers. Now, beta blockers block what's known as the beta adrenergic receptor. These receptors, as it turns out, are components of the nervous system. And we talk about the nervous system. We typically divide it into either the sympathetic nervous system or the parasympathetic nervous system. And in this case, we're especially interested in the sympathetic nervous system, because this is the fight or flight aspect of our bodies. These are those acute stressors that our bodies must quickly respond to when adrenaline is released. So the beta adrenergic receptors are a significant part of this sympathetic nervous system response. And by blocking these beta adrenergic receptors, beta blockers, lower blood pressure. So you might be asking, why do we care about this when it comes to cancer? Well, it's interesting because epidemiological studies on men taking these beta blockers like propranolol for high blood pressure were found to have a much lower risk of developing prostate cancer.

Speaker2:
Additional studies were done and they revealed that cancer patients who have an active cancer diagnosis and they take a beta blocker have a lower risk of death from cancer. So it raised the question, why does this happen? Why are we seeing this result? And this really reinforces the link between stress and the development of cancer and subsequent death from cancer. So why would a blood pressure medication reduce the risk of developing cancer as well as the risk of dying from cancer? And the answer lies in the mechanism of how these drugs work in the body. By reducing the fight or flight portion of the nervous system, the stress or the perceived stress on the body is greatly reduced. Now, this is interesting because it reinforces our long held belief that stress plays a role in cancer. A recent study actually confirmed this for us stress induced activation of the neuroendocrine system, which is the system that governs the neurological portion of the body as well as the hormonal portion of the body, resulted in a 30 fold increase in cancer spread. So the more stress you're under and certainly a cancer diagnosis is stressful, as is having to make decisions about cancer treatment, as is life in general increases the risk of cancer development and spread by 30 fold.

Speaker2:
So a 30 times increase in cancer spread when people are under a lot of stress, we all have stress in our lives. There's no way to avoid it. But this underscores the need to reduce our stress as much as possible in order to prevent cancer, as well as to reduce the spread and ultimate death from cancer. Daily stress reduction practices such as prayer, meditation, laughter or even spending time with those we love are crucial not only for overall happiness, but also for our health. For those who are already dealing with a cancer diagnosis, who are listening to this. Please make an effort every day to manage your stress. Stress is understandably very high, but reducing stress becomes even more important. That's why you need to make sure you have a team of doctors and medical providers who care about you, who take time to listen to you, who want to help you not only medically but emotionally and spiritually as well. I make this a huge part of my practice and I firmly believe it is one reason why we have such great outcomes from our treatments. I'd like to talk about one more drug known as Celebrex. The generic name for Celebrex is Celecoxib, and it is a class of drugs known as nonsteroidal anti-inflammatory or NSAID. Now, NSAIDs, such as Celebrex, have been shown to have an anti-cancer benefit in several studies.

Speaker2:
Now, by blocking a certain enzyme known as Cyclooxygenase two or Cox two, we have an anticancer effect. This Cox two pathway is known to be highly active in cancer, and by blocking Cox two, we reduce cancer's ability to grow and spread, and we also reduce inflammation. So this is an anti-inflammatory agent. Now, the cool thing about Celebrex is that it selectively affects DNA in cancer cells, but not in normal tissues. In addition, Celebrex has been shown to be effective in relieving cancer related pain, especially when that pain is due to bone metastases. Now, the benefits of Celebrex in the treatment of cancer don't stop there. Celebrex enhances the effect of chemotherapy. And we've seen this in studies. And it's also been shown to be synergistic with several natural compounds as well, including curcumin and green tea extract. So the sum total of the therapies in this protocol is a powerful anticancer effect through a variety of mechanisms. Of course, any time we're talking about prescription medications, we must underscore the importance of having these medications prescribed by a doctor who understands their use and their potential for side effects. I use these medications we've discussed today regularly and I found them to be extremely well tolerated. We're monitoring labs on a regular basis in our patients and we obviously have a lot of treatments going on at once, usually a combination of chemotherapy and intravenous vitamins and minerals and nutraceuticals, and certainly some of these off label medications as well.

Speaker2:
And we see all of these substances which we kind of refer to as an anticancer cocktail, be very well tolerated. Now, assuming you can find an integrative oncologist or at least an integrated physician who's willing to prescribe these medications for you. It's important to also understand the cost of these medications. So thankfully, these are all readily available, typically very affordable substances, things like aspirin, metformin, doxycycline. Really all of the drugs we've talked about today, with the possible exception of Celebrex, are extremely affordable. And these are these are medications that typically are going to cost patients five or ten or $15 a month. These are not expensive medications that cost several hundreds of dollars. Celebrex is the only one that could cost a little bit more. And the reason I say that is because we're using these in off label fashion. And Celebrex is typically prescribed for other inflammatory conditions besides cancer, but always encourage patients to pursue some sort of coupon program like GoodRx. There's an app called GoodRx. It's free. Many physician offices will have good cards they can give you, but really you can just sign up on the app. So I always encourage patients to get good. And what you can actually do is when you've been prescribed a medication, you can put it in their search bar and it will give you pharmacies in your local area based on your location, and it'll actually tell you how much that prescription is going to cost.

Speaker2:
You can kind of comparison shop using something like GoodRx and you can know where you can get that prescription for the lowest cost. And all you have to do when you go to the pharmacy is show them that app on your phone with a price and they'll honor that. I hope you found today's episode helpful. I truly believe that repurposing existing medications represents a powerful aspect in our fight against cancer. This is a reminder. Please take advantage of the ability to leave a voicemail question for us, which we will be addressing on future episodes. If you go to Cancer Secrets and click on podcast at the top of the page, you'll see a little tab on the right side of that page that says Send voice mail and you can click on that and record your voicemail and it'll come right to us. I'd like to acknowledge one voice mail we received recently that really impacted me, and I wanted to share it with all of you out there as well, because it really illustrates the power of what we're doing. It was from Kate in Utah who stated that she is a breast cancer patient who is combining integrative treatments into her protocol. She's doing chemotherapy and intravenous vitamin C and a lot of other good things. And she was talking about the power of the information we're sharing on the Cancer Secrets podcast and how much it's meant to her and how much it's helped her.

Speaker3:
Dr. Steggall My name is Kate from Utah. I'm 38 years old, and I was diagnosed with stage two triple negative breast cancer back in April. I'm currently awaiting starting chemotherapy through the Huntsman Cancer Institute, and I just want to tell you that your podcast is an absolute blessing to me. I listen to it as much as I can. There's so much information there that I truly appreciate. Thank you so much for taking the time to do a podcast like that. And I know you must be a busy man and with your practice and your book that just came out, I am purchasing it today. I just want to tell you what a blessing it is for me. And I'm currently doing vitamin C injections as well as conventional. Like I said, I'm waiting to start chemotherapy, but I just wanted to say a huge thank you. It is a blessing and your hard work is truly blessing other people out there. So thank you.

Speaker2:
Kate, I just want to say to you personally, thank you so much for sharing your journey and your your diagnosis with us. I'm so glad this has been helpful for you. And I just want you to know, I think you're doing an awesome job with what you're doing. And I want to let you know that I'm praying for you and that your outcome here. Just be wonderful and thank you so much for listening to the show. It means a lot. And if I could just speak a little bit more about your diagnosis specifically, you stated that you are triple negative breast cancer, and many of our listeners are probably aware that triple negative breast cancer is a tough diagnosis because we don't have quite as many targets for treatment like we do with other types of breast cancer. However, I will tell you that that does not mean that we can't have a great treatment outcome just because it's triple negative. There are so many things that we can do that will help us. Chemotherapy, intravenous vitamin C, incorporating some of these off label prescriptions like we discussed or incorporating some key nutraceuticals as well, really makes for a well rounded treatment protocol. And then we, of course, combine that with focus on our emotional health, our spiritual health, and what we have is a really powerful integrative cancer treatment program. So, Kate, I wish you all the best and I'm praying for you. And I look forward to hearing more updates from you as you go through your treatment journey. I hope you'll join me next time for Episode 11, where we're going to discuss the power of positive thinking and stress reduction. This is a huge issue and a huge potential opportunity for us in cancer treatment to harness the power of our mind and our thoughts in our words. I hope you'll join me then. Thank you again for listening. Till next time.

Speaker1:
Thank you for listening to the Cancer Secrets podcast. If you were encouraged by this show, please share it with a loved one or friend. Help support the show by leaving us a rating and review on iTunes. The more reviews, the more friends like you can find the show. Finally, to learn more, visit us online at Doctor Stay Google.com. The Cancer Secrets Podcast. Changing the Cancer Paradigm.

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