Intravenous Alpha Lipoic Acid (ALA) in Cancer Care (& more)

In March 2014, I travelled to Victoria, BC to complete my Advanced Clinical Naturopathic Oncology training by Dr. Neil McKinney, ND. Dr. McKinney is one of the leaders in the field of Naturopathic Oncology and is the author of the textbook “Naturopathic Oncology.” In the course I learned the most cutting edge therapies and I am excited to bring these options to the Atlantic. To me, the most valuable part of the training was that he created a prioritization of remedies based on his 29+ years experience of treating people with cancer. For each cancer type he shared which remedies & therapies he finds to be most successful (primary treatments), which he finds to be of secondary importance, of tertiary importance, and of limited importance. I was also lucky enough to spend a few days job-shadowing him at his clinic before and after the course in order to further learn how he applied these principles with his patients. 

 

One therapy, which consistently came up in the primary category for many cancers, was intravenous alpha lipoic acid (IV ALA). IV ALA was ranked as a primary therapy for brain & nerve cancers, breast cancer, carcinoid tumor, colorectal cancer, kidney cancer, liver & gallbladder cancer, lung cancer, multiple myeloma, nasopharyngeal, head & neck cancer, pancreatic cancer, sarcoma, stomach cancer, thyroid cancer, and uterine cancer.  It also had many other important uses with symptom management and side-effect control.  

 

Alpha Lipoic Acid (ALA) is a naturally occurring cofactor found in every cell and is active in an assortment of enzyme complexes that control metabolism. ALA is also a vigorous free radical scavenger that has demonstrated the ability to reduce oxidative stress in a number of disorders, including diabetes, liver disease, and cancer.

 

ALA’s unique benefit is that it is both water soluble and fat soluble. Therefore, it works in both the fatty cell plasma membranes and the aqueous interior (cytosol) of the cell.  Other nutrients are restricted to only work in water (such as vitamin C) or fatty tissues (such as vitamin E).  ALA is estimated to be 100 times stronger than vitamins E and C combined in inhibiting free radicals. Additional evidence suggests alpha lipoic acid may help regenerate these other antioxidants (vitamin C, E, glutathione, etc) and make them active again. Also, unlike vitamin C and other nutrients, ALA is shown to be equally effective against proliferating (growing) and non-proliferating (dormant)  cancer cells– a very important part of preventing cancer reoccurrence.

 

There have been a number of articles suggesting the use of ALA in the treatment of various cancers. ALA is a ‘multi-tasker’ with multiple mechanisms of action and numerous benefits in cancer. Here, I have listed five of the most researched and exciting mechanisms (for the complete list of ALA’s functions please see below in the comprehensive detail section).

1.    Protects DNA from mutations.

2.    ALA inhibits NF k B, considered in many cancer types as the master switch for cancer growth and survival.

3.    ALA transforms the way cancer cells uses sugars and re-activates pathways to allow cancer cell death.

4.    ALA has direct anti-tumor activity and can stimulate prooxidant-driven cell death of cancer cells.

5.    ALA is a powerful therapy for all forms of nerve damage and neuropathy (e.g. from chemo drugs like the platinums or from diabetes).

 

Intravenous alpha lipoic acid is just one of the therapies available to Naturopathic Doctors. Naturopathic doctors have access to a wide-array of treatment options including nutrition, herbal remedies, targeted nutraceuticals, acupuncture, mistletoe injections, other intravenous therapies, and many others.  Naturopathic doctors are trained to choose the most effective therapies specific to your case and to guide you on which to avoid.

 

My favorite course at the University of Victoria was the ‘molecular basis of cancer’. In that course we looked at intricate details of all the pathways that drive cancer growth. Contrary to common belief cancer is not a single disease.  Cancer is actually a collection of 200+ diseases, with each cancer type behaving very differently. At the Moncton Naturopathic Medical Clinic we individualize your treatments based on your type of cancer and the driving factors associated with that cancer type.  For example, in breast cancer, some of the molecular targets include IGF-1, NFκB, EGFR, PI3K/Akt/mTOR, STAT-3, IL-6, VEGF, etc. The cancer cell can hijacked these signaling pathways and overused them to cause uncontrolled cancer cell growth. We use targeted medicines to regulate each of these overexpressed pathways. For example, an extract from green tea given at a therapeutic dose inhibits VEGF, Vitamin D3 at the optimal blood concentration inhibits IGF signaling, and R+ alpha lipoic acid regulates NFkB.  This is called ‘precision medicine’ and I recently completed a course called “genomic and precision medicine” through the University of California to further explore my interest in this growing field.

 

 Naturopathic Doctors are trained to work alongside conventional treatments such as chemotherapy, radiation, or surgery. Integrating naturopathic medicine with conventional medical care can help to:

  • increase the effectiveness of the therapy;
  • speed healing time;
  • prevent any risk of treatment induced tumor spread (e.g. biopsy, surgery);
  • reduce complications or side-effects (e.g. nausea, fatigue, weight loss, bowel disturbances, nerve damage, reduced quality of life, “chemo brain”, depression, difficulty sleeping, etc);
  • keep your body healthy enough so that it can handle the full dose and optimal treatment schedule necessary to kill the cancer; and
  • reduce the chance of re-occurrence or secondary cancers.

 

Both naturopathic medicine and conventional medicine have their strengths. The debate is no longer whether it’s one or the other, but rather moving forward with the integration of both in treating illnesses such as cancer.

 

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ALPHA LIPOIC ACID - IN MORE DETAILS:

The following is a list of some of its actions and a detailed explanation is provided below of some of the most researched mechanisms.

·      protects DNA from mutations

·      NFkB inhibitor - a master switch for cancer growth and survival

·      inhibits pyruvate dehydrogenase kinase - switches the way cancer uses sugars and re-activates pathways to allow cancer cell death

·      powerful therapy for all forms of nerve damage and neuropathy (e.g. from chemo drugs like the platinums or from diabetes).

·      essential for production of immunoglobulins and proper functioning of the immune system.

·      reduces cellular inflammation

·      very supportive of detoxification from drugs and poisons, chelates toxic metals that have accumulated in the body, and reduces angiogenesis by chelating excess copper.

·      improves insulin function and decreases insulin resistance

·      recycles vitamin C and E

·      increases glutathione activity

·      protects the mitochondria and increases its energy production by squelching oxidative stress

·      blocks heat shock proteins

·      neuroprotective

·      reduces fibrosis by down-regulating an iso-enzyme of transitional (transforming) growth factor beta (TGFβ) responsible for fibroblast matrix deposition.  Very important in restoring kidney filtration.

·      allows toxic homocysteine to accumulate in cancer cells.

 

ALA stabilizes NF k B – a master switch for cancer growth and survival.

One mechanism whereby ALA may discourage the growth of cancer cells is its ability to stabilize NF k B (nuclear factor kappa B). NF k B is a protein complex that controls the transcription of DNA and is commonly hijacked by cancer cells. Once activated, the protein complex will move into the nucleus and will launch the induction of more than 200 DNA genes responsible for uncontrolled cancer cell growth, invasion, metastasis, inflammation, resistance to chemotherapy (chemoresistance) & radiation (radioresistance), cancer cell survival by preventing apoptosis (i.e. prevents cancer cell death), and much more.

 

Additionally, Th1- and Th2-mediated immune system cells react to pathogenic insults with various cell membranous receptors. Many of these receptors start a cascade of events that activate transcription factor NF k B. Because of this, NF k B plays a significant role in the regulation of inflammatory-induced gene function. High doses of ALA, when added to cell culture have been shown to inhibit the activation of NF k B.

 

ALA switches the way cancer uses sugars and re-activates pathways to allow cancer cell death.

Moreover, NF-κB can help to promote a metabolic switch in cancer cells from oxidative phosphorylation to glycolysis (the Warburg effect) by inducing the expression of glycolytic enzymes while also directly repressing mitochondrial gene expression. When cancer cells are stuck in glycosis, programmed cell death (apoptosis) is inhibited. ALA works by jump-starting the cancer cells back into oxidative phosphorylation and therefore allows the possibility for them to undergo apoptosis.

 

ALA turns off genes responsible for cancer cell proliferation and resistance to cellular death.

One article reported that ALA induced hyperacetylation of histones. Histones are proteins that are active in the proliferation of many types of cancer cells. Inhibition of such can drive a cell toward the apoptotic cascade. In this study, human cancer cell lines became apoptotic after being exposed to ALA, whereas the same treatment of normal cell lines did not induce apoptosis.

 

ALA has direct anti-tumor activity and can stimulate prooxidant-driven cell death of cancer cells.

Another article showed evidence of a mechanism by which ALA might be helpful in cancer therapy because of the fact that it can stimulate prooxidant-driven apoptosis in human colon cancer cells. This process is activated by an increased uptake of oxidizable substrates into the mitochondrion. In another study, ALA was shown to increase homocysteine concentrations within cancer cells in certain established cancer cell lines.  The increased homocysteine concentrations were toxic for the malignant cells. An additional publication reported that ALA helped the proliferation of normal human lymphocytes and slowed down the proliferation of 2 leukemic T-cell lines.  The discriminating toxicity of ALA was because of the induction of apoptosis in the leukemia cells. ALA also noticeably increased the induction of interleukin-2 (IL-2) mRNA and IL-2 protein secretion in cancer cells. The authors stated that the differential effects of ALA on normal and leukemic lymphocytes may specify a new pathway toward the development of therapeutic agents for cancer.

 

ALA works synergistically with vitamin C.

In another study, ALA synergistically improved vitamin C cytotoxicity against cancer cells in tissue culture. Unlike ascorbate alone, ALA was equally effective against proliferating and nonproliferating cells.

 

ALA can correct functional defects in the immune system.

Mantovani and Maccio demonstrated the ability of ALA to correct functional defects in peripheral blood mononuclear cells isolated from advanced stage cancer patients. Twenty patients with advanced cancers of the lung, ovary, endometrium, and head and neck were examined. The serum levels of IL-1b , IL-2, IL-6, TNF-a , and sIL-2R were significantly higher in cancer patients than in patients with no known cancers. The addition of ALA into the cell cultures significantly increased the response of cancer patient mononuclear cells. Also with the elevated markers the authors observed that patients with advanced cancer exhibit a chronic inflammatory state with high-grade oxidative stress. The article also suggested that antioxidant agents such as ALA can stimulate the development and maturation of cancer fighting lymphocytes. Therefore, in this way, ALA can promote the functional restoration of the immune system in individuals suffering the oxidative stress that results from advanced cancer. This report therefore demonstrated that ALA has a beneficial effect on immune cell function in advanced-stage cancer patients.

 

Back to Dr. Anhorn's full list of articles.   

     

Related Articles:

Intravenous Vitamin C in Cancer Care
Dual Approach to Integrative Cancer Care -- Step 1: Improving your outcome
Dual Approach to Integrative Cancer Care -- Step 2: Preventing Cancer Re-Occurrence
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PCA3 - the new gene-based urine test specific for Prostate Cancer

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