Immune Support and Disease

We are pleased to present here articles and excerpts published by prominent researchers in the field of immune support and diseases involving the immune system.

Integrative Treatment of Cancer in Dogs

Published by:
R.M. Clemmons, DVM, PhD
Associate Professor of Neurology & Neurosurgery
Department of Small Animal Clinical Sciences
University of Florida.

Cancer represents a unique state whereby the body's healing system fails to eliminate cells with damaged or altered DNA. This allows these cells to escape the normal regulatory signals leading to uncontrolled cell growth. While most auto-immune diseases represent a failure of the healing system from an over-active immune system, cancer represents the extreme opposite, whereby the immune system is hypoactive (at least in regard to the tumor). On the other hand, both chronic immune diseases and cancer probably represent outcomes from the failure of the healing system brought about by living within a polluted environment, coupled with the genetic make-up of the dog.

While we are beginning to unravel the complex biochemistry of cancer development and have begun to understand how DNA is damaged and repaired, we still have a long way to go before the cure for cancer will be found. Spontaneous healing of cancer has been documented many times in human beings and animals, suggesting that a cure is possible.

On the other hand, there is a great deal of information about the potential for preventing many forms of cancer. Most of these techniques involve the use of diet and dietary supplements.

We can not control the air we breath, unless we do this as a whole. Using alternative means of transportation, car-pooling and clean energy production are good for the environment and for those living in it. It does pay to fool Mother Nature, she will get even in the end. We can, however, control the food our pets eat and the water they drink; thereby, reducing their pollution load. We can provide our pets with anti-oxidants and bioflavonoids, compounds which help protect DNA and the healing system. We can give them sufficient fiber in there diets to support digestion and protect the gi tract from cellular damage.

Treatment of cancer with traditional Western medicine involves surgery (to remove or de-bulk the tumor mass), ionizing radiation (to expose the tumor to lethal doses radiation, minimizing radiation exposure to surrounding healthy tissue), and chemotherapy (to poison the rapidly growing cancer cells without poisoning the rest of the body). One or all of these methods may be employed in a given patient in an attempt to delay or prevent further cancer growth. On average, the success of Western approaches to cancer provides 1 to 18 months of relief from the cancer. While longer survival times are seen with certain forms of cancer, the long term prognosis for even the best forms of "systemic" cancer is poor to grave. The best chance for a good prognosis is for localized cancer (particularly benign lesions) which can be removed completely with surgery. When surgical removal of the cancer is not possible, or when the cancer has already spread to other organs (metastasized), control of the tumor may not be possible by conventional means and the owner must make difficult choices about the continued care of their pet. Some of these choices are very expensive. Traditional Western diagnostic methods have advanced dramatically in the last few years and provide the best chance to discover the natural of the tumor and to predict its clinical course. Advanced imaging techniques like diagnostic ultrasound, computer-assisted tomography (CAT scans) and magnetic resonance image (MRI scans) have vastly improve tumor diagnosis. Fine-needle aspirates or "true-cut" biopsies of tumors (sometimes performed in conjunction with an imaging technique) can provide cytological confirmation or histological diagnosis of the tumor type, leading to better therapeutic recommendations.

In isolated cancers where "focused" radioablative surgery can be performed (such as in brain tumors), this can be a excellent treatment option. It is not inexpensive, but can be performed at selective veterinary medical facilities and provides stereotaxic precision to the radiotherapy. In addition, all of the radiotherapy can be done at one time, under a single anesthesia. Stereotaxic radioablation also minimizes damage to surrounding tissues. Moreover, the patient's immune system (and healing system) is not compromised outside the bounds of the tumor, allowing the patient greater potential for healing. While stereotaxic radioablation is currently limited to the brain (and, in some cases, the liver), it offers great potential for good. I am, personally, not enthralled with other forms of radiotherapy or with chemotherapy. Chemotherapy uses compounds which are toxic to the body and destroys the animal's immune system, hoping that the tumor is killed before the patient. While animals do not suffer all of the side-effects as human beings undergoing radiation therapy or chemotherapy, these treatments can still have significant and, in some cases, life-threatening side-effects in dogs. Owners must weigh the benefits and the risks carefully before making the decision to put their pet through radiation treatments or chemotherapy.

To me, the answer to cancer lies in the immune system. This is the major reason why I have trouble with Western chemotherapy. Spontaneous remission from cancer only occurs when the patient's immune system acts to clear the cancer. Therefore, stimulation of the patient's immune system to selectively attack the cancer seems to be the key to achieving a successful outcome. New methods in immunotherapy and immunotargeted chemotherapy are likely be the Western methods which lead to the greatest advances in cancer treatment over the next few decades.

Traditional Eastern medicine has also been used successfully in the treatment of cancer for thousands of years, long before we understood the basic pathobiology of tumors. It is not a replacement for Western diagnosis and therapy, but may be used with Western approaches to help heal patients. When the option for Western therapy is lacking, there are Eastern therapies which can be employed to help the patient live a quality life, reducing the rate to cancer expansion or, in some cases, leading to remission of the cancer. Eastern medicine may be best suited to prevention of the development of cancer through healthy living. On the other hand, herbal medications have been shown to lead to spontaneous remissions of cancer. In some cases, these herbal products can be used in conjunction with traditional Western therapies, improving the outcome and reducing the side-effects from Western therapy alone. An integrative approach combining the best of both Western and Eastern medicine seems to be the only sensible course of action, providing the best overall care for the patient.

Reducing risk factors for cancer, eating a properly balanced diet (free of pesticides and preservatives), drinking pure water, providing appropriate anti-oxidants, vitamins and minerals, and exercising regularly can help prevent cancer. Once cancer has been found, additional supportive measures are needed. Cancer cells utilize carbohydrates for fuel and compete for the body for amino acids. However, these cancer cells do not metabolize fats. Some data suggests that high fat diets can help the patient overcome the effects of cancer and even reduce cancer expansion. A number of herbal products can stimulate the immune system to attack cancer or block the mediators which the tumor uses to spread to other areas of the body, mediators which the tumor needs to survive. The following is a guide to the integrative treatment of cancer, using those compounds where there is scientific data to support their use in cancer management, helping the patient survive the disease.

Although eating healthy is the best tool in the fight against cancer, once cancer takes hold certain dietary changes may be help the patient fight against the effects of the cancer. Tumor cells rely heavily upon carbohydrates for their energy and rob the body of amino acids. On the other hand, tumor cells cannot utilize lipids (fats) for energy while the rest of the body can. As such, diets with increased fat content may slow tumor growth, allowing the patient to fight against the tumor. Protein content must be maintained a levels sufficient for tissue repair, but carbohydrates should be held to a minimum. For those who prefer to prepare their dogs food, the following diet contains the ingredients important for cancer patients. In addition, it supplies the important nutrients for cancer protection. For those who can not cook for their dog, a commercial food should be of good quality, moderate protein (18-22%) content, low carbohydrate (3-13%) content, and high fat (55-60%) content. One of these is Mighty Dog Bacon & Cheese dog food. Your veterinarian can assist you in finding a food which fits these criteria and is satisfactory to your dog.

Home cooked cancer diet: (for 60-90 pounds body weight)

1. 4 oz Pork Back Fat (boiled, baked or fried in olive oil)
2. 4 oz Tofu (firm soybean curd)
3. 2 tsp Extra Virgin Olive Oil
4. 2 Whole Carrots (boiled and then cut up)
5. 1 cup Spinach (cooked)
6. 4 Tbs Green Bell Pepper (chopped and steamed)
7. 4 Broccoli Spears (boiled and then cut up)
8. 2 Sardines (in olive oil, drained)
9. 2 cloves raw Garlic (crushed and added before serving)
10. 1 tsp dry, ground Ginger (added before serving)
11. ½ tsp dry, yellow Mustard (added before serving)

The vitamins and antioxidants for cancer patients are the same for all dogs, including vitamin E, vitamin C, selenium, beta-carotene, ginkgo bilboa, green tea and grape seed extract. In addition, the membrane stabilizers omega-3-fatty acids, gammalinolenic acid and coenzyme Q-10 are important for cancer patients. Many of the antioxidants help stabilize DNA and help reduce cancer development or progression. Some data suggests that antioxidants can reduce the effectiveness of radiation and chemotherapy, but this is not well documented. It may be best to stop antioxidants 3 days before radiation therapy or at the start of chemotherapy, reinstituting the antioxidants a few days later. Most of the herbal antioxidants are good for preventing cancer, too.

American Indian medicine gave us a useful native plant that is another immune-system booster: purple coneflower, Echinacea purpurea and related species. The root of this ornamental plant is held in high esteem by herbalists, naturopathic doctors, and many lay-people because of its antibiotic and immune-enhancing properties. You can buy echinacea products in any health food store: tinctures, capsules, tablets, and extracts of fresh or dried roots. Although few medical doctors in America are familiar with echinacea, much research on it has been done in Germany, and the plant is in widespread use as a home remedy in Europe and America. Follow the directions for adult dosing.

Another Chinese herbal remedy with similar properties comes from the root of a plant in the pea family, Astragalus membranaceus. This plant is a relative of our locoweed, which is toxic to livestock. The Chinese species is nontoxic, the source of a very popular medicine called huang qi that you can buy in any drugstore in China for use against colds, flus, and other respiratory infections. Recent studies in the West confirm its antiviral and immune-boosting effects, and preparations are now available in most health food stores here. Follow the directions for adult dosing.

Cat's claw (name derived from the pattern of thorns found on the vines), Uncaria tomentosa, comes from the Peruvian rain forest and was traditional used by the indigenous people to threat cancer and arthritis. Recent studies indicate that it contains immune-enhancing substances, including several antioxidant compounds. These compounds may account for the antitumor properties reported for cat's claw. Treatments have been reported to lead to remission of brain and other tumors. While published data is lacking, cat's claw should be considered in tumors of the central nervous system. Use ¼ the adult human dose for small dogs, ½ for medium dogs and the equivalent dose in large dogs.

Like astragalus, mushroom extracts stimulate the patients immune system by presenting unique macromolecules to the intestinal tract, where they alter the immune regulation by intestinal antigen processing systems. In addition, maitake mushroom extract has been shown to activate NK Killer cells which attack tumor cells and to prevent destruction of T-Helper cells. There is no known toxicity from these mushroom extracts. Use ¼ the adult human dose for small dogs, ½ for medium dogs and the equivalent dose in large dogs.

This herbal extract from the inner bark of trees of the Tahebuia genus (found in South American rain forests) contains lapachol which has been reported to induce strong biological activity to cancer. No adverse effects have been reported with the drug. Studies with pure lapachol have not indicated that blood levels are inadequate to provide the anti-cancer and anti-inflammatory actions attributed to Pau D'Arco. On the other hand, its effectiveness may not be related solely to lapachol, but influenced by other phytochemicals in the extract. Use ¼ the adult human dose for small dogs, ½ for medium dogs and the equivalent dose in large dogs.

Milk thistle is an herbal product that help protect the liver from toxic damage. It may be useful in treating chronic active hepatitis or as a prevention of injury from other drugs. It has been used to protect the liver from damage from chemotherapy in human patients. It may help prevent damage from traditional anti-convulsants (phenobarbital). I recommend starting at 1 capsule twice a day.

The Natural Vet's Guide to Preventing and Treating Cancer in Dogs

EXCERPT from the book “The Natural Vet's Guide to Preventing and Treating Cancer in Dogs.” Dr. Messonnier, DVM.

This book is available from us - please refer to the Product and Price list here.

When treating a dog with cancer, owners truly have many options. The reason for the large number of options is that there is no one "best" treatment for every pet. I share the holistic belief that each pet is an individual, and must be treated as such. I discuss this philosophy with owners right from the start. What worked for the last dog I treated may not work for their pet. Additionally, each owner is unique and has different wants and a different budget for their pet's medical care. Some owners want to do everything possible for their pet. Money is no object, and they will often allow us to experiment and try quite a number of unique treatments. Others opt for a bit less, and may choose only surgery or one round of chemotherapy. Still others never want any conventional medications, and will opt for only natural therapies such as herbal therapy or homeopathy.

I should point out before proceeding that the truly holistic view, desired by most pet owners, involves looking at all options and choosing what works best with the fewest side effects. I'm a conventional doctor by training and use many conventional therapies in my practice. Whenever appropriate, I like to integrate as many different therapies as possible, as the best results occur when conventional therapies are combined with complementary therapies. Chemotherapy, as used in veterinary medicine, is not as harmful as it is in people, and significant side effects are uncommon in pets. This is because maximum tolerated dosages are used in people, leading to complications in nearly every patient. For pets, most chemotherapy dosages are 10-20 percent lower than the maximum tolerable dosage, leading to fewer than 5 percent of treated pets having significant dose-limiting side effects such as bone marrow suppression (low white blood cell counts leading to increased risk of bacterial infection) or gastrointestinal upset (nausea, vomiting, or diarrhea).

The true goal of chemotherapy is to chemically reduce the burden of cancer and provide symptom-free quality of life. Having no evidence of cancer (by examination or X-ray evaluation) and no symptoms from cancer is called remission.

Once in remission, pets are prescribed supplements to help boost their immune systems as well as to counteract side effects of chemotherapy. In some cases chemotherapy may be the only treatment option, as the cancer patient may not be able or willing to take all of the recommended supplements. Some pets are easy to medicate and can take many herbal and homeopathic supplements several times a day, whereas others will never take anything by mouth, complicating our effort at developing the best treatment plan. The holistic approach simply means looking at all of the available treatment options and choosing what works best for each specific patient.

The best treatment for many dogs with cancer is often a sensible combination of both conventional and complementary therapies. I believe that by offering the two kinds of therapy to owners, I can give them the best of both worlds. By knowing the pros and cons of both types of medical care, owners can work with me to pick the therapies that they are most comfortable with, and that are most beneficial to their pets.

Keep in mind, too, that "holistic" doesn't necessarily mean "alternative." A truly holistic approach tries to heal the entire pet, and not just treat symptoms. A truly holistic approach chooses what's best for the pet, providing the pet relief while minimizing side effects. Conventional therapy can be a part of the holistic approach to the treatment of cancer if the goal is to help the pet become healthier and not just cover up symptoms or ignore the pet's overall well-being.

Combining complementary and conventional therapies offers the best of both worlds.

Here's an example of the harm that can come to a pet with a treatable cancer when owners refuse to be truly holistic and consider conventional chemotherapy. I once treated a friendly shih tzu named Radar for lymphosarcoma, a cancer that is very responsive to conventional chemotherapy with minimal side effects in most instances. In cases like this, I usually prescribe supplements and homeopathy to help boost a pet's immune response to conventional therapy. Unfortunately, Radar's owners were totally opposed to chemotherapy because they could not overcome unfounded fears that he would suffer during chemotherapy. Despite two weeks of supplements and homeopathy, Radar rapidly worsened and was euthanized shortly thereafter. This case was frustrating, as I believe that Radar could have done quite well if only his owners had agreed to a quick round of chemotherapy in addition to other therapies. In this instance, homeopathy and other supplements did not have any chance of success against the aggressiveness of Radar's cancer. The moral: whenever possible, don't decline treatments that work without serious thought and rational judgment. Remember that for many pets with cancer, complementary therapies alone rarely achieve the same results as conventional therapies. It is best to use them as they are intended, to complement the conventional treatments for the pet with cancer.

On the flip side, there are problems with the strictly conventional approach of diagnosing and treating cancer. Often, by ignoring the holistic approach to treatment, we are treating the cancer and not the pet. As one of the contributors to this book, cancer specialist Dr. Kevin Hahn likes to point out, Don't forget that there is a pet attached to the tumor! The only way to win the war against cancer is to make the pet as healthy as possible while we're treating the cancer. This may mean using supplements to support the liver, the gastrointestinal system, and any other organ or system of the body. Simply choosing conventional cancer therapies without regard for the overall health of the pet is not in the pet's best interest. Nutritional support is important - we must provide the pet with the best diet possible (see chapter 8 for more on the best diet for a pet with cancer). Nutritional supplements may be useful, to boost the immune system and help the pet recover its natural ability to fight cancer. Also, using complementary therapies such as glutamine supplementation may reduce the side effects, such as vomiting or diarrhea, that may occur with some types of chemotherapy or radiation therapy.

Finally, I cannot stress enough the importance of a full diagnosis. Many doctors take a "wait and see" approach when an owner points out a suspicious lump on the pet. A diagnosis is often made by the doctor simply looking at and feeling the lump. Fatty tumor and cyst are the terms often applied to a benign (noncancerous) lesion. While it is true that most suspicious lumps are benign, some are malignant cancers. With rare exceptions (such as commonly observed warts, technically called papillomas, usually seen in older dogs), no one can adequately diagnose a tumor simply by looking at it and feeling it. I have removed too many malignant cancers that were originally diagnosed as fatty tumors or cysts to know that full diagnostic testing is essential, usually by examining under the microscope the aspirate taken from a tumor with a tiny needle.

Not too long ago I made an initial diagnosis of an infected cyst on the abdomen of Lizzie, a five-year-old spayed female black Labrador retriever. At first I was not concerned about this lesion. However, when it didn't get better after two weeks of topical antibiotic therapy, I suggested removal and biopsy. Imagine my surprise when this infected piece of skin was identified as a malignant mast cell tumor - a cancer notorious for looking like a benign cyst or fatty tumor! Thankfully, I had removed the entire tumor with that surgery and no further treatment was needed for Lizzie. Because of this and other similar cases, I have become convinced that mast cell tumors can look like almost anything. (You'll learn more about the ability of mast cell tumors to masquerade as benign fatty tumors and other lumps and bumps on pages 19-21 in chapter 2.)

Unless a lesion is an obvious old-age wart, I recommend removal and testing of all lesions. The lesson is simple: any lumps seen or felt under the skin or above the skin surface should be aspirated or in some way biopsied before a conclusive diagnosis of a benign fatty tumor or cyst is reached.

No one can adequately diagnose a tumor simply by looking at it and feeling it.

It is quite troubling that so many pets I see have not received a proper diagnosis. A good number of these pets have not had any diagnostic tests done. Yet often a simple aspirate of the lesion, radiograph (X-ray) of the abdomen when a suspicious mass is felt during examination, or blood test of a pet with unexplained clinical signs, such as lethargy and a lack of appetite, will reveal the cause of the pet's problem. There is simply no excuse for failing to obtain a proper diagnosis. The bottom line is this: to prevent a misdiagnosis of the true cause of a pet's lumps and bumps, we need proper diagnostic tests to make sure that our treatment choice is correct.

Understanding Cancer

Common questions among owners of dogs with cancer include "What causes cancer?" "Why does my dog have cancer?" "Did I do anything to cause this?" and "Could I have prevented this?" This chapter attempts to answer these central questions. Following this discussion, I'll explain some of the more common cancers that occur in dogs. You can also refer to the index and turn to pages that address the cancer type that is most applicable to your pet's situation.

Preventing Cancer

In most cases, you did not cause your pet's cancer nor could you have prevented it. However, using holistic preventive care is the best approach to minimize the chance of your pet (or you, for that matter) developing cancer or any other diseases. One important step is vaccinating your pet on an "as-needed" basis, rather than giving your pet every possible vaccine every year. It's also important to feed your pet a healthy diet free of by-products and chemicals, supplemented with quality nutritional supplements called nutraceuticals (Healthy Diet + Nutraceutical Supplementation = Health). Keeping your pet at an ideal weight may also reduce the incidence of cancer and other health problems, as obese pets are more likely to develop medical problems, including cancer, than pets maintaining a normal weight. If you find a lump on your pet, insist that your veterinarian aspirate it with a tiny needle and syringe so it can be tested for cancer; if the test indicates cancer, have the lump removed as soon as possible. Using more natural insecticides, when possible, to control fleas, ticks, and other parasites will lower your pet's exposure to carcinogenic toxins. In short, doing all of these things, which define the term holistic, will minimize your pet's chances of developing cancer.

Many types of cancer, such as ovarian, breast, and testicular cancer, are preventable by early removal of the reproductive organs. Specifically, early spaying and neutering (ideally between four and six months of age) reduces the incidence of or prevents most genital cancers. Some skin cancers, such as squamous cell carcinoma and cutaneous hemangiosarcoma, can be prevented by minimizing a dog's exposure to the sun, especially in breeds with lighter skin and sparse hair. For a holistic approach to increasing longevity for our pets, we may also consider natural therapies that have been shown to inhibit cancer during the aging process. We will explore these therapies further in chapter 6.

The holistic approach to cancer is concerned with prevention as well as treatment, and maintaining a good quality life until the very end of that life. By adopting a holistic approach to the care of your pet with cancer, you can be assured that it is the most loving approach to the care of your special friend.

Healthy Diet + Nutraceutical Supplementation = Health

Holistic healing supports the immune system and nutritional needs of patients from the very beginning of their fight against cancer. Holistic care includes providing natural supplements, antioxidants, herbs, and homeopathics in addition to proven conventional therapies.

Unfortunately, cancer is common in pets, killing up to one-half of those more than ten years old. When cancer develops in a pet, the battle to save that pet's life will require a combination of efforts.

What Causes Cancer in Dogs?

In most pets, the exact cause of cancer is not known. Basically, cancer is often a fatal disease that is caused by mutations in the genes of certain susceptible cells (see boxed text on pages 10-12). These genetic mutations, usually caused by inflammation or excessive oxidation, convert normal cells into cancer cells that divide rapidly and grow uncontrollably, pushing their way into the surrounding tissues composed of otherwise normal cells. Because oxidation and inflammation can lead to the development of most if not all cancers, an important part of cancer therapy includes prescription of medications and/or supplements that decrease inflammation and oxidation. Any preventive measures that reduce inflammation and oxidation, such as feeding natural diets and using nutritional supplements, may also help reduce the incidence of cancer in your pet.

The battle against cancer is often won or lost at this microscopic stage; if the pet's immune system is functioning well, it can identify and eliminate these altered cancer cells. Most cells are programmed to live for a limited period of time, but this is not always true with cancer cells. For example, studies have shown that a gene called Apaf-1 that causes cell death (a normal aging process called apoptosis) is inactivated in cancer, allowing the cells to live, reproduce, spread, and eventually kill the patient.

With a healthy immune system, cancer cells are killed at this early stage before they start growing and begin spreading, also known as metastasizing, throughout the body. However, sometimes the immune system, for reasons not always apparent, fails to wipe out these abnormal cells. If the abnormal cells are allowed to continue dividing, they may develop into small cancerous lumps that create tumors, which may be located anywhere in the body.

Cancers of the blood cells may prevent the bone marrow from developing normal cells, predisposing the body to infection, anemia, and blood-clotting problems. For cancerous cells that form solid tumors, the most obvious tumors appear in the skin, on the surface of the skin, or just under the skin. Cancer may also take the form of ulcers or nonhealing sores or red spots anywhere on the pet's body.