The Truth About...Repurposed Drugs to Treat Cancer

Drug repurposing is using a drug previously approved for one condition to treat an entirely different condition (like cancer). In cancer care, repurposed drugs are usually gentler than FDA-approved cancer treatments. They include common drugs for diabetes, high blood pressure, infections, and more. Tina & Leah talk about who should consider this strategy and some of the most commonly used repurposed drugs.

Repurposing Drugs in Oncology- ReDo Project link
The Anticancer Fund
Care Oncology Clinic (we have no affiliation!) - good info & access to repurposed drugs
Thorough review of mechanisms for repurposed drugs in cancer
Cimetidine- early study suggesting benefit in colorectal cancer
Review of cimetidine in colorectal cancer
Review of better blood sugar regulation leading to better outcomes in cancer care
Metformin- early study suggesting benefit in ovarian cancer

Transcript

Pandemic ripples... for better or worse.

LEAH 0:00

Okay. Tina. So I know that you're not seeing as many patients, especially since, you know, like 2020 with the whole pandemic. That

Tina 0:11

mm-hmm.

LEAH 0:12

kind of, you know, people might be familiar with that. Um, but I have found that a number of, I'm gonna call'em pandemic effects or covid effects that I have seen with patients. One of them being patients often saying like, well, I did my own research.

Tina 0:32

Yes. There's always been a subset of folks who do their own research online with, uh, Dr. Google.

LEAH 0:37

Yes.

Tina 0:38

But since Covid, you're right, there's definitely more people finding their own opinion online and educating themselves.

LEAH 0:45

And maybe not using the best, uh, the best, maybe not using the ideal resources. The most legit.

Tina 0:52

Yes, that's a huge issue because there's a lot of information and you, as you know, you can find anything you want to find online. So parsing the information in medicine requires some level of discretion between the sources.

LEAH 1:07

Often there is a vein of truth within the information that they're getting, but then you have some sort of an expert with the big air quotes who. Promotes this and talks about conspiracies Anyways, so what I was gonna ask you about is, do you find there are patients that are coming to you who wanna take a different prescription medication, they want you to prescribe something for them that is not typically used for cancer.

Tina 1:39

Yes.

LEAH 1:39

Like, like I have had a number of patients here who are taking some sort of antiparasitic. I mean, ivermectin is like, I mean that's such, it's such a hot topic, you know, especially like in this covid world that we are, you know, in. But even like mezo, like patients are getting these anti-parasitics and Wanting to take them, wanting to know if it's okay to take in place of their treatment. Not along with even, it's just, you know, they come, they hear about the treatment that they're supposed to get and then they come speak with one of the naturopathic doctors at the hospital and say, well, you know, I really wanna take this instead

Tina 2:18

Yeah. Yeah. So they're going to their local farm and feed store or something to find it because there's versions that are for the large animals that people are using at home and themselves, and yeah, it's an issue. I think there's a time and a place for these drugs that are potentially useful in cancer, but you can't just take them

LEAH 2:36

willy-nilly. Yes.

Tina 2:39

willy-nilly.

LEAH 2:40

Got it. In this episode. Yeah. Um, and I'm not really familiar with the use of, it's known as repurposing drugs. Amongst other names for it, but I'm not really familiar with it. But it is kind of a hot topic

Tina 2:53

I've definitely prescribed drugs or had drugs prescribed with patients, but it's alongside a larger picture. It's not in lieu of conventional treatment so much as

LEAH 3:03

in conjunction,

Tina 3:04

in conjunction.

LEAH 3:05

conjunction junction, what's your function? So that's what we're gonna talk about today, is we're just gonna have a conversation about repurposing drugs. We are not making any specific recommendations. These are not things that I have ever talked with patients about other than, you know, cautioning them regarding side effects and interactions and that sort of thing.

Tina 3:27

And I have had some cases that have been extraordinary and they happen to take off-label drugs, repurposed drugs. Was that why they were extraordinary? I don't know. Maybe, maybe not.

LEAH 3:38

intriguing. Cue music.

Tina 3:41

I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one

LEAH 3:45

and I'm Dr Leah Sherman and on the cancer inside

Tina 3:48

And we're two naturopathic doctors who practice integrative cancer care

LEAH 3:52

But we're not your doctors

Tina 3:55

This is for education entertainment and informational purposes only

LEAH 3:59

do not apply any of this information without first speaking to your doctor

Tina 4:03

The views and opinions expressed on this podcast by the hosts and their guests are solely their own

What are Repurposed drugs?

LEAH 4:09

Welcome to the cancer pod Hey Tina.

Tina 4:28

Hi Leah.

LEAH 4:30

So when we talk about repurposing drugs, what does that even mean?

Cimetidine (Tagamet)

Tina 4:34

Well, it's pretty literal. We're taking a drug that is already used already, F D a approved and finding a new purpose for it. So a diabetic drug or a high blood pressure drug. These drugs that are already out there being used by people are now being found to work on some cancers, perhaps, especially in combinations. Often you don't use one repurposed drug, you do a few, but I wanna say this, there's a lot of synonyms for repurposed drugs. So they also are called off-label use of drugs, meaning it's being used for something other than its, uh, approved use. And the other one that you'll hear a lot, and you'll see a lot in the literature if you're looking this up, is repositioned drugs. Repositioned drugs is really a term that comes from the industry because they're talking to their marketing department. So they're saying, take this drug that's already used for anxiety or depression and we're gonna reposition that drug as a hot flash medication. So that's a really a marketing term when you're repositioning a drug, cuz you're really telling people you need to look at this differently, this and this is why you need it. So I don't like that term so much, but it does get used in the medical literature, so you need to know it if you're looking information up. repurposed really is the best word to use, I think, because it's most accurate and it's commonly used in the medical literature. So it'll bring you the results you're looking for when you're looking for info.

LEAH 5:57

I think the first time I heard of a non chemotherapy type drug being used along with certain chemotherapies, with certain cancers, was cine.

Tina 6:09

Yes. It's one of the oldest,

LEAH 6:11

And what that, so that is, that's for gastric reflux. It's, it's a, it's a reflux. Anti-reflux medication. You don't wanna take a reflux medicine. You don't want something that gives you a reflux, but it's yeah, for like ulcers and, and gerd, that sort of thing. And I can never remember.

Tina 6:28

it's, it's tagme.

LEAH 6:29

It's histamine blocker.

Tina 6:30

It's a, yeah, yeah. It, it blocks stomach acid through the histamine pathway. And when they used it, they used it in very high doses. So this is something that with repurposed drugs, we always have to look at are they using it in a dose that's commonly used or are they taking something like cimetidine, which is that acid blocker and giving it in a different dose than you would normally take. And in that case it was, it was a lot. It was like 800 milligrams over the counter. It's only 200. And you know, it does seem to have some information about outcomes improving. In my recollection, colorectal cancer comes to mind as one of the cancers. I think the cimetidine was also given during surgery or not during, but you know, during the time of surgery or immediately after surgery.

LEAH 7:16

Well, well, well, that's, that's interesting because the one thing that I do know about it is that it can really affect the liver enzymatic pathway and so it can interact with drugs. And so yeah, I guess around surgery would probably be more appropriate because it is something that does affect the metabolism of other drugs.

Metformin

Tina 7:35

Yes, cimetidine interacts with so many drugs,

LEAH 7:38

And then I guess, I guess metformin was the other one. You know what's so interesting is that as, as I'm thinking of the list,

Tina 7:45

Uhhuh.

LEAH 7:46

some of these, I have patients coming in taking a lot of these maybe like it's not the dosage and that's not like I'm ever gonna talk to somebody about it. Oh, well you should think of increasing your dosage. Um, metformin can have a lot of side effects that patients. Are very uncomfortable, you know, taking and are trying to manage it on their own at their prescribed dose. but yeah, Metformin was the other one that was kind of like the big hot, I don't know, the hot, big hot number,

Tina 8:08

So Metformin is a medication that diabetics take.

LEAH 8:11

It's for like people who are insulin resistant, blood sugar problems.

Tina 8:16

In particular, insulin resistant diabetes. And what we saw in studies was that people who were taking metformin had better outcomes. So some of the earliest ones, and the ones that really moved the needle and got attention were some large studies and women with ovarian cancer and those who were taking metformin. This was what was interesting. Those who had diabetes and took metformin had better outcomes. Then those who didn't have diabetes, of course they weren't taking metformin cuz they didn't have diabetes. And so what moved the needle is normally diabetes and poor blood sugar regulation is associated with poorer outcomes. So this subset, they're like, huh, these people, this population has diabetes, they should have poorer outcomes. It must be the metformin that changed it. And so that really got everyone's attention. I think that really lit a fire under, you know, what was to date, smaller studies at that time. And since then we have had more and more information on metformin. Not only controlling insulin and blood sugar, but having other mechanisms controlling at least some cancer growth. Um, it's not a magic pill, it's not like a chemotherapy drug where you swallow it and it kills cancer cells. It doesn't work that way. All the repurposed drugs influence the cancer, but none of them that I know of. Wipe it out per se. You know, it's not like that. It's not that simple. It's not a magic bullet. So that's why they're often talked about in combination cuz you're trying to stifle growth

LEAH 9:42

Through different pathways.

Tina 9:44

through different pathways. It's almost like you're, I don't know, like you're like a, like a cat with a mouse. Like you're trying to get it to do what you want it to do, which is not grow. You wanna influence it, but you're not gonna wipe it out. If you wipe it out. It's gonna be mostly your own body that does it. Your own immune system or, or the combination of several drugs at once. That I say stifle cuz of eventually if you stifle enough metabolic pathways at once, then it dies. The cell.

LEAH 10:10

So when I hear you talk about like, patients who were taking metformin, in, in the study had better outcomes. When I think of my own patients, so many are on metformin, but their blood sugar levels are so dysregulated, even before they came in for treatment because of diet or, you know, lifestyle. Maybe because of compliance, because of, you know, metformin causing diarrhea or whatever it is. And then once you're in treatment with the steroids, it's really hard to manage that blood sugar for patients who are on metformin. I mean, I've seen blood sugars go like super high with patients, so that's interesting. I wonder if it was the patients who were on metformin who were able to maintain healthy blood sugar levels, or was it like, it doesn't matter if your blood, if your blood glucose is 600, it's, you're still gonna do better

Tina 10:57

You know what? I think you hit the nail on the head because I just. Did a lecture, that was a research review, and there was a paper. It looked at a blood parameter that measures your three month average of glucose.

LEAH 11:10

like an a1c.

Tina 11:11

Yes, it's called hemoglobin a1c. It's called glycohemoglobin A1c.

LEAH 11:17

Right.

Tina 11:17

So when the a1c, the cutoff was 7%. Now 7% technically is still diabetic. When people had a lower than seven on average, lower than 7% glycohemoglobin a1c, they had better outcomes. And we're talking everything. We're talking cancer recurrence, dying from your cancer, and overall mortality. So if someone can keep that A1C under 7%, this is. With metformin, with whatever drugs, with diet and exercise. Of course, if they can keep it under seven, statistically there's much better outcomes and even longevity, literally more longevity. And this was a systematic review study, so it was a compilation of many studies into one review paper. And so the data is very consistent in that controlling your blood sugar over time is definitely linked to better outcomes. And so maybe Metformin's just one piece of that. And that early study tipped us off to that too.

LEAH 12:15

So this is gonna lead to people being like, so sugar does feed cancer, and we're gonna say, go listen to our episode on does sugar feed cancer? Because

Tina 12:28

yeah. We have a

LEAH 12:29

we did a whole episode on it. So we're not even gonna,

Tina 12:31

I'm like, I'm like, what episode? Oh, it's literally called that. Yeah. Do you see my face? I'm like, we talked

Aspirin

LEAH 12:38

Yeah. Oh my gosh. This is, what are we up to now? This is episode 64. We've been talking a lot over the last couple years. It's almost our anniversary. but let's keep going because the next one is personal to me.

Tina 12:50

Oh, what is the next one?

LEAH 12:52

The next one's aspirin. Do you remember? It was, I believe it was February, 2020 and there was an oncology, naturopathic oncology. Oh, here you're going is it's going back in time. It's like from Wayne's World. yeah, we had the, on K n p, the oncology, you know, naturopathic physician conference right before the world shut down. there was a, there was a woman who lectured, she was a scientist I believe, And she talked about, aspirin and breast cancer. I was working the, the table for a nonprofit that you and I were working on and I don't know how many of my friends came up to me afterwards and they're like, are you taking aspirin? Are you taking aspirin? Because for those of you who just tuned in and have not listened to one episode, I'm a breast cancer survivor. So, cause I don't mention that enough, but just in case somebody, this is the first episode you've ever listened to, that's what's going on. So yeah. So I had a lot of people coming up and saying, you need to be taken aspirin. And so I did. I started to take a baby, baby aspirin daily until I had such bad GI issues that I had to stop cuz it didn't matter how I took it. And it just kind of like, my stomach did not like it, but So why Tina? Why was I taking aspirin?

Tina 14:06

Why did I do that? Everyone's telling me it was a good idea.

LEAH 14:09

oh, you know what? I think I had taken it before too, and the GI thing happened and then there was the talk and I started to take it again, but I think I asked, what about taking willow bark, which is what aspirin was derived from, and it's got a lot of that same kind of anti-inflammatory action. And then the, I remember the lecturer was like, I'm not sure. So anyways, okay. aspirin.

Tina 14:33

Yeah. So, yeah, let's talk about aspirin. Can we talk, so willow bark and, and other, you know, poplar buds have the. Agent that once upon a time Bear, yes. The bear company that we still have today, like 120 years ago, figured out how to extract the natural agent, which is a salicylic acid, and basically tweak it just a little bit and put into a little pill. And that's what became bear aspirin. So they, they got the medicine from the herbalist because everyone at that time knew that willow bark worked. Anyways, little aside, the willow does come with buffers, which is why if you asked that woman at the lecture, she doesn't know about it. But willow bark not only has the active ingredient, it has natural occurring buffers that would protect

LEAH 15:15

Right that, that one I was familiar with and it's an herb, so there might be potential for that. It could interact with medications, but aspirin, oh my gosh. Look at the interactions for aspirin.

Tina 15:25

Yeah. And you know, there was, there's some interesting information on, now when we say aspirin, this is baby aspirin. So by and large, even when people take it for prevention of the spread of their cancer, and there's some data on baby aspirin help reduce the risk of breast cancer. Yes. And colorectal cancer, there's quite a bit of information on that one. And those two have the most information out there that I know of. There might be others when they looked at this, this is observational data as far as I know. So they look at population-based studies and a lot of countries like the UK or Sweden, other countries have national registries where they watch or they can see every prescription everyone gets over their lifetime. So just so you know, just a baby aspirin, there's no reason to take more than that. Cuz when studies show benefit to anyone as a repurposed drug, it's just a baby aspirin in, it's working on keeping the cells from, um, clustering. So when someone has a spread of a cancer, the cells break loose and then they cluster together. They stick together and make a little micro metastasis. We can't see this on any scans or anything like that. It's tiny, tiny. And it then goes into the limb for the bloodstream and finds its way to those classic organs where metastasis happens. So it'll land literally in the liver, the lungs, the bone, whatever. So what the playlists do, one of the mechanisms, and there's like eight different ways it can happen, is to keep those cells from from

LEAH 16:56

from being sticky.

Tina 16:58

thank you. I couldn't think of a good word.

LEAH 17:00

Yeah. Sticky. Uh, the whole time. I'm thinking Sticky, sticky, um, yeah. Aspirin. And, and

Tina 17:05

That's cuz you, that's cuz, go ahead. I was gonna say, and as I said, it's cuz you, we were just talking about sticky notes and I still couldn't think of

LEAH 17:11

yeah, it's true. No, so, so aspirin in general, like when people take it to prevent, cardiac events, right? I mean, people take it to prevent all kinds of cardiovascular type things. because it makes your blood, your platelets less sticky.

Tina 17:25

Yes. And of course it's an anti-inflammatory and we always harp on this. Anything that's anti-inflammatory in a general sense can have some benefit. So, and there's a few other mechanisms. We won't go into all the, nitty-gritty details, but, I have recommended a baby aspirin for a lot of patients. And I will sometimes say any effects, whether it's GI effects or easy bruising, take it down, do it every other day. Do it three times a Pick your days.

LEAH 17:48

and I tried doing that too, and it just like, I don't know, I have a, for me, it did not work. Um, one of the things I did look up at, the mechanism behind aspirin because it was something that I did take because, you know, everybody was telling me to do it. So I'm my own Guinea pig. it blocks something known as mTOR, which I thought was really interesting because there is a drug it's, it's chemotherapy that, or there are several chemotherapies that actually block that pathway. So I think that, um, that's always really interesting when you look at how these work. Sometimes it's, oh, that, I know that pathway, that pathway is, You know, PD-L1 receptors or mTOR pathway, you know, like those kinds of things so, yeah, so, so I mean that's kind of, I think that's interesting. Again, we're not saying this because that's like, oh, don't take your drug, take aspirin instead. But it's just kind of, I think it's kind of, it's kind of cool that something that people take for pain has all of these other effects.

The big picture (Metro Map?)

Tina 18:49

Mm-hmm. And it's interesting in that, so right now there's a big push to target like that pa, like mTOR. Okay, how do I target that? And you can look up all sorts of drugs, all sorts of natural agents that have been found to target it. A lot of times it doesn't. Pan out the way you would expect. So for me, when I'm looking at repurposed drugs, I'm looking at results first. Are there studies, even observational studies in humans that showed somebody with a a given cancer took a certain drug or combination of, uh, repurposed drugs and had a benefit? That's my first and foremost, and that's the strongest information. There is a lot of people out there trying to create what they call a metro map, right? That book that came out, remember that book?

LEAH 19:40

Nope. No, I don't.

Tina 19:44

There's that book by Jane, I think it's McKellen, how to Starve Cancer. How to Starve Your Cancer.

LEAH 19:50

Oh, I think I know that name. I think that was in that, um, in that article I just read I think they kind of really like tore her apart.

Tina 19:57

Oh sure. But cuz in, cuz it seems okay, I've been doing biochemistry since 1990 something, 92, 94, whenever I got my undergraduate degree. So it seems logical in our minds to say, okay, if I have these aberrations in my cancer, all I need to do is target those aberrations. It seems like if you just target things, it should work, but it doesn't. It's not that simple. It's just, it's not as simple as saying, oh, if I just target X, Y, and Z with these three agents over here, that should stop the cancer growth. It doesn't work that way cuz there's an entire human body immune system factors we don't even know about yet in between. So we can't go from target to treatment, it's really not gonna work that well. You really wanna go from outcomes pan way back, go 40,000 feet up, say, okay, get my given cancer, breast cancer, colon cancer, prostate cancer, whatever. What in the repurposed drug world has some data in humans to show that it's potentially useful. And you go from there and you look at the data and then you look at the strength of the data. Then you look at your own case, pros and cons, what's going on with you personally. And it's always a risk benefit analysis, but I think it's dangerous to go from mechanism. All the way inside the cell down to that gene, you know, some screwed up gene inside the cell and goes all the way to treatment. Nine, I didn't even know, it's probably 99 times out of a hundred, maybe even 999 times out of a thousand. It doesn't pan out. And that's, that is, that is drug discovery. We just defined drug discovery. They pick a target, they take an agent, they're like, oh, that should work. You know, it worked in test tube and then they take it to an animal model and then finally to humans. But most drugs fail along the way, the vast majority. So it's kind of hubris to think that, oh, we can go look at this little pathway and say, oh, well berberine targets that pathway. We should be good taking berberine. I wish it was that simple. If it was, it would be a lot easier to treat cancer. So if you're doing research on repurposed drugs, look at human data outcome data, clinical trial data. Actually there is a, an entity that tracks this called the anti-cancer fund. Anti-cancer fund.org. They're tracking all the clinical data and in a, what is a gigantic Excel type file, so you can look at your cancer or you can look at a given drug. I think they have over 300 drugs on there right now.

LEAH 22:18

And just for to reiterate, like you were saying, just because something works in a lab, in a test tube or Petri dish or whatever it is that they're looking at, they're taking a specific part of a cancer, a cancer cell, whatever they're looking at. And they don't have the complexity of a human being around it.

Tina 22:37

Exactly.

LEAH 22:37

And so that's why when you read articles and they're like, oh, this agent kills cancer in a lab, and then people start taking it, it's the whole like alkaline environment thing, right? cancer thrives in an acidic environment, you know, you're just taking it out of context. You're taking like a word out of a novel,

Tina 22:58

Right.

LEAH 22:58

you know, and trying to explain a story. So that's a really good analogy. Anyways, I just, I just ha, I just always wanna like, like clarify that a lot of things kill cancer in a lab. And unless you're looking at human data, then it's really, I mean, even mice, it's different, but yeah, you gotta look at, you gotta look at human data.

Tina 23:15

Yeah. Yeah. And I know people are gonna wanna research this stuff, and that's fine. I think it's a good idea because I can tell you now, conventional doctors are not gonna bring it to the table. There just very few conventional doctors will ever bring up a repurposed drug or even condone it. unless you have, for example, high blood pressure and you're like, can I do this high blood pressure drug? Because you've got high blood pressure, you need a prescription for it. You may as well do something that could be beneficial in preventing recurrence at the same time. Like that kind of thing. You could probably get them to, you know, talk them into with some, you know, persuasion. But if you just said, oh, I wanna take this metformin, they're gonna be like, you're not diabetic. Why would you take metformin? That's not gonna probably fly with most oncology doctors.

LEAH 23:57

Okay, so let's take a break and when we come back, you mentioned, um, like a beta blocker. I think you mentioned what.

Tina 24:05

What did I talk about? Oh,

Blood pressure drugs

LEAH 24:07

hypertension. Yeah. You talked about um, drugs for hypertension, high blood pressure. So we're gonna come back and talk about more repurposed drugs. Tina, you had talked about anti-hypertensive that, Are repurposed in an oncology setting. And this is something I also have a personal experience with, not for that reason, but my oncologist had prescribed me metoprolol, which is a beta blocker, which kind of slows the heart rate. It's used for, you know, different cardiovascular conditions, AFib, those kinds of things. but he prescribed it to reduce the risk of the potential cardiovascular risks that can come along with adriamycin slash doxorubicin, you know, that is known for,

Tina 24:56

Heart toxicity. So that, that's a good example of an off-label use of a drug. So these terms all blend together a little bit. he wasn't repurposing for the cancer, and it's probably not an approved use to say, oh, beta blockers are an approved drug for preventing cardiovascular toxicity from this chemo. That's not really F D a. Never sanctioned that. and the off-label use of drugs is super duper common. Really common. All the time like, like a lot of drugs are used off label, meaning they're being prescribed for something other than their FDA approved use.

LEAH 25:28

Well, yeah, so, so beta blockers, I remember learning this in school, in pharmacology, that people will take a beta blocker before they go out on stage or like have to make a speech. Like people who have super high anxiety have been known to take beta blockers it kind of chills'em out. It helps to regulate their heart rate.

Tina 25:44

Yeah. I think what the beta blocker does is make it impossible to have a sympathetic nervous reaction to have that adrenaline rush. I was talking to somebody who was put on a beta blocker and they do these incredibly difficult, not even double diamond skiing, but like off the beaten path, over the rocks. Crazy skiing. And normally when you sit on the precipice of that and you're looking down, you're about to like launch. He said, everyone's like, you go. You go. You like it's, it's super scary. You're looking straight down, took a beta blocker. Looked straight down. I was like, nothing. He's like, I'll go first.

LEAH 26:17

Yeah, but at least in, okay, so I don't know about skiing, but I know in theater you need a little bit of anxiety If you know you, you need that. Otherwise, you know you're gonna like throw yourself down a mountain that maybe you shouldn't have. So, so, so, so, but maybe not in the oncology setting. I mean it so, And there are side effects of taking this. I know people who have taken, um, beta blockers and they do have, you know, different side effects of their blood pressure going too low. And, you know, these are all things that you need to, to, consider. And they were prescribed it for whatever reason and they were on it and they're like, Ugh, my blood pressure drops too low. But, um, and all of these things that we're talking about have interactions and side effects, and that's why it's not something that is to be taken

Tina 27:03

Willie Nelly. So, On this point of beta blockers, before we move on, there is certain, cancers, ovarian cancer subtypes come to mind, have receptors on them that cause anxiety and really a high stress level to promote the growth of those cancers. And so I think of o ovarian as one of those that I would look at these beta blockers and somebody who's highly anxious especially if they're taking something else for their hypertension, I would say, well, let's talk to your cardiologist about changing that over to a beta blocker and getting a couple benefits from it. The earliest studies that I can remember were done on lung cancers, and they found that people who were taking beta blockers were having better outcomes. And so a lot of times were tipped off by these observations or retrospectives where they do a chart review retrospective at a, particular hospital, cuz some astute clinician, medical oncologist notices, huh, how can I have this particular subset of patients who are doing better and they'll do a chart review. Um, doesn't happen so much anymore, but that's how, that's the old fashioned way of figuring it out.

LEAH 28:07

Well, now everybody collects data, right? I mean, I was having. Conversation with some people last night about how to access this data from patients' charts to, you know, to do things like that for, chart reviews or for outcomes or whatever.

Tina 28:21

Yeah. And this is where I will say socialized medicine where. A single entity, like the entire country is tracked on a registry, does help with data collection, but data is only as good as it goes in, right? Somebody's inputting the data, so it all starts with data input and for whatever reason, I would say the majority of charts that I look at, if the patient reads their own chart, they're like, well, that's not true. That's no longer valid.

Doxycycline

LEAH 28:46

Oh, yeah, no, I deal with that all the time. Whether it's the medications that they're taking or like, oh, wait a minute, this person has osteoporosis. It's nowhere in their history. But any who? Um, okay, so another drug that I think is kind of interesting is Doxycycline, which is an antibiotic. I mean, Oftentimes patients are prescribed doxycycline because it's commonly used for skin issues. And so if someone is given a targeted agent and it's affecting their skin, one of the side effects is a rash. Doxycycline is something that patients are given so that they can continue taking the medication and not have this adverse side effect

Tina 29:24

and there was, there was some information. I remember a clinical trial, of course, interesting to me as a naturopath in that they combined doxycycline with high dose intravenous vitamin C, and saw that I, it was potentially. Helpful for reducing stem cells Anyways, it may be working on the cancer similar to how it's working on the bacteria in that it's disrupting some of the D n A, replication, the ability of the D n A to split and make a new cell. And so it may be similar. Now this goes back to my theory that, you know, there's also something called an onco where we talk about bacteria that are inside some cancer cells, and what is that all about? Are we targeting the actual bacteria with doxycycline at times? that's completely theoretical, but know.

LEAH 30:14

And when I looked it up, cuz I did do a little glance at the, the information that's out there, it can affect fatty acid. I think it was fatty acid oxidation that's not even something I would think an antibiotic would do, but it affects something having to do with fatty acid. yeah, I thought that the whole antibiotic thing was, was interesting cause people would be like, antibiotic. It's like, well, some chemos are antibiotics. So, so there

Tina 30:37

there is that case with pancreatic cancer and they gave an antibiotic and they could see less growth. But there's also some bacteria involved in pancreatic cancer.

Statin drugs

LEAH 30:46

I can't remember which episode, but yeah, you have talked about that before. It's all coming a blur. It's all one long episode that we've been doing. Ah, you know, statins. Statins I think are really interesting because, um, so many of my patients take statins

Tina 31:04

Mm, mm-hmm.

LEAH 31:05

and some people can't tolerate taking statins, and that's something that they were prescribed. statins were derived from a natural agent as many drugs are, red yeast, rice,

Tina 31:15

Mm-hmm.

LEAH 31:16

and both of those have been known to cause muscle cramping, muscle pain.

Tina 31:20

and you, and you can, on your lab test put, a parameter called ck.

LEAH 31:25

Calvin Klein,

Tina 31:27

uh, you can see if there is any damage to the muscle through that lab test. Regardless. We will often give coenzyme Q 10 just a smidge just to make up for any downside of the statin.

LEAH 31:39

Yeah, so. That one also kind of involves, you know, I mentioned about the doxycycline and the fatty acids. This also its target may be by reducing the blood supply of cholesterol to the cancer cells which provide cancer cells with energy because not just sugar gives them energy. Cholesterol does too. They are cells, they are deranged outta control, doing their own thing. Anarchy cells. But the things that feeds a healthy human non-cancer cell also does the same thing to a cancer cell. I just wanted to put that in there. Anarchy cells, rock.

Tina 32:15

here's my recollection too, I. I go back to some of the original reasons we even looked at these drugs and there's an oncogene, the RAs, k r a s, oncogene. when there's an oncogene, it basically means that the, the gene has been turned on and it refuses to turn off. So K R A S is one of those oncogenes, it turns on, and it has to do with cell proliferation. And most of the times our cells have on off switches for their genes. our genes go on. They go off, they go on, they go off like, you know, like a light switch.

LEAH 32:46

what I always talk about. What's the, what's the thing that flips the switch? Maybe it's not one thing, it's probably a conglomerate of things known as life, but

Tina 32:55

Yeah.

LEAH 32:56

yes, I, that's how I often talk about flipping the switch. So there you

Tina 32:59

yeah. So genes are turned on and turned off, and just like an oncogene is turned on, tumor suppressor, genes are permanently turned off. So, you know, people are like this tumor suppressor gene, blah, blah, blah. They'll talk about, well, if you turn off something that suppresses a tumor, Then you can also end up with cancer. And there's usually a combination of of those. So my whole point here, I know that's probably too deep, but the whole point here is this K R A S In conclusion, the, the targets of some of these repurposed drugs can be some of these oncogenes when you're looking, at the targets for them K R A S and statins go together.

Anti Parasitic drugs (Mebendazole, Ivermectin)

LEAH 33:38

And that moves us on to the next category, which are the anti parasitics, because those not only kill parasites, um, but you know, parasites in your gut. But, they can also affect cell signaling. maol I guess is one that, I have heard of patients who are coming in, taking maol, hoping to not have to do conventional treatment. Wherever research they found online, whoever they talked to recommended this. Um, so that was a little bit on my search of like, why are people asking about Ivermectin for cancer? Mazo came up and kind of interesting. It's not necessarily being used as an anti-parasitic. I think it was, it was just looked at with like colorectal cancer when it was looked at humans. I think everything else, like many of these drugs, um, are either, you know, they're, you're saying a lot of these are observational, many of these have in vitro or in the lab studies behind them.

Tina 34:40

Yeah, Melendez, it's always part of a multi-drug. Cocktail that they use, that targets several things at once. So I've, I've seen, and I've had patients use Ezzo and they were colorectal cancer patients. There was a review paper on colorectal cancer and repurposed drugs relatively recently, looking at all the data. So we can put a link to that. But it's generally been a four drug combo that I've always seen Ezzo used with, and it's Metformin, A statin, Ezzo and doxycycline. And so I've seen, I've had several patients do that cocktail and they happen to be colorectal cancer patients. I've had a breast cancer patient do that cocktail too. There's a, there's a entity that originated in the uk. They're now in the United States that will oversee this.

LEAH 35:25

The Care oncology clinic.

Tina 35:26

And I will say, I think that, okay, so these guys are coming over. They're doing the four drug combination. Cause they're like, can we stop cancers with this four drug combo? And I think primary brain tumors, glioblastoma was their claim to fame and then they broadened it to breast and colorectal and other things. They wanna know if those four drugs work now, are they the best four drugs for any given cancer? Maybe, maybe not. That anti-cancer fund that I referred to will do a free consult with patients. we can put a link to that too. If you call them and you contact them, they'll actually have you talk to a physician. It's not a second opinion, but it's basically like, oh, given your cancer and where you're at, here's the drugs with the best evidence to date. And so I think that that makes more sense to me. I mean, the thing out of the uk, the whole care oncology thing is okay, but if you can get it customized, if you can have someone tell you, and you have a primary care physician who says, you know, I've known you for 30 years. I'm willing to prescribe anything for you that could help. Cuz I find primary care physicians, primary care clinicians, I don't care if it's a PA or np, whatever. Whatever you have as your primary care you have a good relationship with them. If you have a close enough relationship and they care about you, they're more likely to prescribe repurposed drugs than any oncologist,

LEAH 36:47

many of your patients are in Oregon and possibly in the Portland area. So there are more, I don't wanna say open-minded, but I don't really see that would be something that doctors would do out here in the, Midwest. You know, I think it's more, um, it might be a more like, I don't wanna say western.

Tina 37:09

Yeah.

LEAH 37:10

Western US type thing just because it, you know, there are a little bit more ways of thinking out there. I don't know what I'm trying to say. I just don't know if, what I, what I think is interesting about what you're saying is that somebody can get the research presented to their oncologist at least

Tina 37:23

Yeah, I've never met an oncologist who will prescribe it.

LEAH 37:26

Not defer it to be prescribed, just to have, you don't do any of this stuff, you know, nobody do any of this without talking to their doctors. Um, there are potential for interactions with certain chemotherapies or medications you take day to day or certain conditions that you have. And so just, you know, this is not something that we are recommending people to do, but if it is something that someone is interested in, yeah, I think getting a customized. Plan is much better than going with, well, these are the generic four drugs that we recommend for everybody because as we know, no two cancers are alike.

Tina 37:59

Yes. And that, you know, that whole thing brings up risk and benefit in my mind. So before we talked, I was actually thinking to myself, when do I, when have I resorted to repurpose drugs or recommending that for my patients? Most of my patients have been advanced, like metastatic for combinations of repurposed drugs. I've certainly done it in primary brain tumors, pretty much always. and then metastatic cancer patients where there's not, you know, maybe the treatments out there aren't ideal. And sometimes we just talk about it a lot. And I say, if as long as you're stable, don't change anything. It's really, you know, if someone's stable or has no evidence of disease, but they know that they had metastatic cancer and now there's no evidence of disease, meaning that it doesn't show up on any scans, their tumor markers look fine. I would not change anything. I don't just treat just a treat. But we start talking about this and saying, okay, if this advances, if there's any changes, let's be ready to pull this trigger. So start talking to your doctors. And so I always think about it as a risk versus benefit thing, right? So I think of yours as, as low risk possible benefit. That's aspirin, low dose. you can take higher risk and possible benefit if you're more advanced cancer and you need, you need treatment options and they don't exist. And so it depends on the case. Cause my patients, I'm thinking of the colorectal cancer patients, you know, there's only so many treatments that they can get. Before they exhaust all options. Each time you have a regression, you wanna hold that state of stability as long as possible. So let's just stay, go through your treatment. You know, you have metastatic colorectal cancer to your liver and it shrinks and you went through whatever courses of conventional treatment during that interim. When they let you heal from that and give you some time to, recover, is when I would insert this and say, can we take what they thought was gonna be three months and make it into three years? I mean, that's really the goal is to stretch out those interims in my world.

LEAH 39:46

you know, I wanna bring this full circle, back to Ivermectin, because that's kind of what, what started the, the talk, and I don't know if I've mentioned it before, but I did have, a patient who had metastatic prostate cancer who was refusing all conventional treatment, didn't want any conventional treatment, just wanted the oncologist to follow their psa, which is like their marker. And wanted to just do ivermectin because somebody. Not a scientist, not a friend, could have been an internet person that they found. It was because I, I probed. I was like, is this a doctor? Is this, you know, a scientist? Who is this person? It was just a random person that somehow they found through the internets had told them that Ivermectin cures cancer. and wanted me to approve it and to back it up. And I had just heard Ivermectin, covid and all of these, you know, all of that controversy around that.

Tina 40:36

Mm.

LEAH 40:37

And I guess there is some information out there of Ivermectin being used, where it can possibly, um, help with chemo resistance. Um, how there are some cancers not so much in the US but in other countries that do originate from parasites. Um, so, I think my, I think my ish with Ivermectin is just that it's something that people just talk about and just will take randomly because they heard something, someone told them something and it, you know, it's, it's one of these things where it's, I don't know, it's apple flavored.

Tina 41:15

It's apple flavored. You know, it's one of those things that was under the radar. We've always talked about ivermectin in naturopathic oncology. I mean, it's always been there as a repurposed drug possibility. So that anti-cancer fund has it as one of its, you know, 300 compounds that they're looking at collecting the data on. Since covid, it became politicized. And once you politicize something, people feel emotional about it, and once they get emotional about it, they stop thinking. And so there's a little bit of a, okay, let's just get through all the dust and the smoke and the nonsense about it, and just what does the evidence say? And I would look per cancer again. I would be like, okay, in my given cancer, Do we have any outcomes? I will tell you a story of a gentleman I had as a patient. He was 72 I think when he, his prostate cancer was found and it was biopsy proven prostate cancer. It was a low Gleason score, which means it wasn't highly aggressive, but it was extensive. if they took 18 biopsies, it was in 12. I mean it was throughout the, the prostate. And he really didn't wanna do conventional therapy. Well, long story short, I work with him for years. He sees a biological dentist who removes all his mercury. He does everything I say that could be possibly anti-cancer. Cuz I said, well, it's early stage, technically, you know, watchful waiting is an option generally.

LEAH 42:36

So it was like a Gleason six.

Tina 42:38

Yeah. Um, but despite that it was still, he's 72, so, and he. He has autonomy so he can do what he wants. Um, that's my belief is that people should do what they wanna do with their bodies. But, um, he's still my patient. That was, he at 72. His, his prostate cancer went away in three years. We did everything one could do, including testing for parasites. He happened to have a job that had him around animals. And so we tested for parasites. He did have a parasite that required strangely enough, those two drugs, ivermectin and Ezzo. So he went through a course of that for two weeks, and by the time he did his last biopsy, he was 75 years old. they put him through another biopsy. He finally agreed to it, nothing. It was gone. His PSA was controlled along those three years, I mean, we didn't watch the PSA go up. It stayed down. So that's why we felt safe continuing on. He finally gets a biopsy for the last time at 75. And I say last time, because he's like, why would I get a biopsy on a normal prostate? So we've watched his PSA and I think he's right now.

The bigger picture

LEAH 43:41

So he took the ivermectin and maal specifically to address a parasite. It's not like something that he's on, like a maintenance type drug

Tina 43:49

Oh gosh, no. We did a course of it for the, for the parasite that we found, and he did everything else. And the kitchen sink alongside it

LEAH 43:57

So, and, and I think that's one of my, concerns when somebody talks about I wanna do this in place of conventional cancer treatment, and they're not changing their diet or exercising or, you know, modifying their lifestyle. It's just like, I wanna sub one thing out for another. And I mean, I'm all for people modifying their diet and exercising through conventional treatment as well. Like, I just think that, All of that, works synergistically. So if somebody is like, I'm not doing any conventional treatment, and then you talk to them about diet and it's like, that's your diet. You know, somebody doesn't want to, uh, give up their, their pop or their alcohol or you know, they don't wanna include any fruits and vegetables. Um, they wanna continue with their regular lifestyle and then take something in place of a conventional treatment.

Tina 44:53

That's not gonna work. I can tell you right now.

LEAH 44:55

Yeah. And it's not, it, it, you know, I don't know. I just, so, so that's my, that's my, that's my ish.

Tina 45:01

No, it's a lifestyle. I mean, I will say this gentleman who is my one and only I had prostate cancer and now I don't case I mean, the managing cancer is something that we do in naturopathic oncology pretty well. I think we can stabilize disease, we can work with conventional oncologists when it's needed to knock back the disease. When there's too much disease burden, too much cancer in the body in knock it back with conventional, you try to stabilize it with integrative oncology methods. That means everything natural and it's diet and it's exercise, it's mind body medicine. It's, it's like you can't just pick and choose the easiest parts. You can't just trade with one pill for another. It doesn't work that way. It, it will not work that way. Which is why the book Radical Remission is useful for people to see when people have, what are what she dubbed Radical remissions. These are stage four cancer patients that, the author. Interviewed around the world trying to find the commonalities between people who have various cancers but all have what can be dubbed a radical remission. They all did massive changes to lifestyle,

LEAH 46:07

I remember when I was in Arizona, one of my first patients was, I didn't see her when she was initially diagnosed. I was seeing her for follow-ups when she would do her, you know, three, six month follow-ups with the oncologist. she had had uterine cancer and when I met her, she, I think she was like a lifestyle coach and a personal trainer, which she became after her cancer diagnosis because she was told she needed to lose weight to reduce her risk of recurrence, and this woman was fit.

Tina 46:36

Mm.

LEAH 46:36

Like she went with it. She completely overhauled her diet. She worked out and like, oh my gosh. Again, it was early stage uterine cancer. Her only treatment was, surgery. And she went and just changed her whole, her whole lifestyle.

Tina 46:56

Mm-hmm.

LEAH 46:56

Yeah. Every time she would see me, I always felt so bad about my lifestyle because she, I mean, she did the whole thing. Like she got the lifestyle coach training and she, uh, probably did some, like nutrition training. You know, it was, it was really, yeah, it was really impressive.

Tina 47:12

Yeah. Yeah, and I, I think that's a really important point that we can't emphasize enough is that you have to. Really live a very healthy lifestyle, high nutrient, low toxicity in every sense of that word, including relationships that are toxic. I find that the emotional plane in my patients is one the toughest one to work with. Especially cuz sometimes your toxicities or your stressors are coming from people who you are closest to, of course.

LEAH 47:39

It's coming from inside the house

Tina 47:41

Right, right. I mean, it's really hard. Um, so anyways, we digress a little bit, but,

Wrap up

LEAH 47:48

and, and neither of us are saying that we live these perfect lifestyles. I think this is something that I know I have to keep working on. But, um, yeah, so I think that's kind of, that's, that's our talk today that this is our take on repurposed drugs. The truth about repurposed drugs.

Tina 48:04

You know, and with artificial intelligence and machine learning, I do think we're gonna advance much, faster and farther. But we have to also remember that we only find out in information about drugs where the light is being shined and the light is not shining on this because there's not a lot of money in this Old drugs are inexpensive in the general scheme, so,

LEAH 48:26

Not if you rename it, not, if you do give it some fancy new name, then you can charge more money for it.

Tina 48:32

Yes. If you rename it and find another way to make it proprietary, then yes, you can make, you can we'll get, we'll be informed about those, but the vast majority of them we won't find out about. And so you do have to do a little bit of sleuthing And we gave a couple of resources, which I think will be useful for people to follow that

LEAH 48:49

So, um, I do wanna, I do wanna say that we did get another review.

Tina 48:53

Oh yeah,

LEAH 48:54

Yeah. We got another Apple Review. we'd like you to give us feedback, whether it's sending us an email at the cancer pod gmail.com or leaving us a review and a rating on Apple Podcasts. Or maybe there are other places to do that, um, in the podcast streaming world. But yeah, I'm gonna read this to you. This is from Happy Trails. Yay. And they say a must listen. These two are trustworthy, dynamic, and give us an information that we can use and refer back to again and again. Highly recommend.

Tina 49:29

Nice. Thank you. you.

LEAH 49:33

that's really nice. Happy trails. Yay. So we will read your review if you leave one. And if you don't like us and you leave a bad comment or send us an email kind of telling us what you think, just just be kind about it. Just, you know, we, we we're good at it taking, constructive criticism, which we have in the past. We have had full conversations about things that people thought, you know, maybe we should do a little different. And I think we did it different for a while and then we went back to our old ways.

Tina 50:04

I, yeah. Old habits

LEAH 50:06

Yeah. So, um,

Tina 50:08

Can I, can I just because you just said that, just reminds me, you know what, what the biggest criticism, and, and I would say it's true and we both work on this, is we tend to sound like we're not. A hundred percent or 110% convicted in our opinion. And that's because I think we're too well aware that we carry with us opinions. And as much as people shout and act like their opinion is fact, we are actually all expressing our opinions. And so sometimes you and I are too honest about that and we'd probably get farther if we just were more dogmatic about our own opinions. Made them sound factual.

LEAH 50:41

But even a lot of the information that we talk about, it's, I don't know. I mean, things change all the time.

Tina 50:47

Well, that's because we're old enough when we know that. I mean, if we were young and brash and bold and thought we knew everything, we'd sound different.

LEAH 50:53

We would be like, this smoothie is gonna cure you of everything.

Tina 50:59

Stop what you're doing.

LEAH 51:00

Buy my product now. And we're not, we're not like that.

Tina 51:04

No. So sometimes that I think honestly are, are more our measured, more mature tone sometimes comes off as wishy-washy. That was the complaint.

LEAH 51:13

like you said, it's our opinions. We're not out here telling anybody what to do cuz y'all aren't our patients.

Tina 51:19

And it's not black and white. I mean, you can't say, I mean, most of it is nuanced. most cancer, most decisions in cancer care are nuanced, and so you can't be too dogmatic about anything you have. Just be open-minded no matter what your opinion is. Be open. helps.

LEAH 51:34

on that note, I'm Dr. Leia Sharman

Tina 51:37

And I'm Dr. Tina Caer.

LEAH 51:38

and this is the Cancer Pod.

Tina 51:39

Until next time,

51:40

Thanks for listening to the cancer pod. Remember to subscribe, review and rate us wherever you get your podcasts. Follow us on social media for updates, and as always, this is not medical advice. These are our opinions. Talk to your doctor before changing anything related to your treatment plan. The cancer pod is hosted by me, Dr. Lea Sherman. And by Dr. Tina Caer music is by Kevin McLeod. See you next time.