Cancer Blood Dialysis ?
When Cecily was first diagnosed, the doctors said that there was no purpose in cutting out the tumor in the lung --- that it would serve no purpose. "The horse is already out of the barn," they would reply. This logic never made sense to me --- even if two horses had gotten out, wouldn't it be safer to keep the other 50 away from the brain?
I then finally came upon a scientific paper that explained why the primary tumor cannot be cut out in the case of metastasized lung cancer --- most of the doctors did indeed know that the official protocol prevented surgically removing the tumor, but they were completely uninformed about the reason.
Cancer cells actually communicate in order to co-ordinate their spread (metastasis) and attack. They do so by releasing tiny molecules into the blood (called proteins) that act as a coded language (or "instruction"). When the main tumor comes under attack surgically, it will frequently send out a protein instructing the cancer cells in other organs to begin growing their own tumors immediately. (view research announcements).
And in late 2003 it was learned from independent scientific studies that cancer cells actually communicate with the local blood vessels, informing them days in advance that they are planning to split into daughter cells (metastasis). With this information, the local blood vessel begins to grow a new vessel to be ready to feed the daughter cell. The blood vessel itself then sends a protein signal back to the cancer cell instructing the cell on exactly where to position the daughter cell so that the daughter cell will line up with the new vessel !
Cancer cells are not "dumb", (as Cecily's first Oncologist had advised her). Most Oncologists know nothing about research beyond summaries in various magazines that they may skim through --- in meeting with potential Oncologists for Cecily at the most major-rated hospitals, even those doctors involved in research got most things about the newest research wrong, and when gently corrected they became very agitated. This included several of the "top-ranked" Lung Oncologists in Los Angeles.
Recent research shows that there is a very precise and sophisticated language of communication in order for Cancer to spread and attack. Cancer cells are indeed advanced organisms. And that is good news. It means that cancer can be intelligently fought on its own terms --- through both biochemical, and maybe mechanical, means. The current thinking is to develop drugs that will mess up this protein communication within the blood. But that will take time.
However there is a "mechanical" means that might prove to be an interim help. It sounds like it is from out of the 19th century ... well, so is anesthesia.
I would propose the creation of a "cancer" blood dialysis machine ... at the very least it would be a make-do answer until better treatment comes along. It would seem that if the "protein messengers" that are transmitted by cancer cells via both the circulating blood system as well as the local blood vessels could be mechanically filtered out of the blood, then the cancer cells would be unable to speak, hopefully less able to do their work. In fact, since this communication seems essential in order for cancer cells to spread (metastasize), then perhaps this "cancer dialysis" would actually severely limit the spread of cancer itself. (This is an idea that if developed and successful, would cost the drug companies billions. Development is unlikely to be funded by government grants. Companies such as The Baxter Company, manufacturer of Dialysis and Blood Separator equipment, would be best in a position to assist in developing such equipment if cancer research dollars were available).
Amazingly, most of the technology to do the above already exists.
Three things should be accomplished, (even if the third comes out later than the first two):
1) REMOVAL OF MESSENGER PROTEINS SYSTEMICALLY: The blood that circulates through the entire body would need to be purified of such messenger proteins, on the assumption that this systemic blood supply allows cancers in different parts of the body to communicate.
2) REMOVAL OF MESSENGER PROTEINS LOCALLY: The local blood vessels that take blood from the circulatory system and feed specific organs would need to be purified, to prevent protein messages that instruct the local blood vessels to create new, microscopic vessels to feed new cancer cells. This should hamper and slow down metastasis ... perhaps dramatically.
3) REMOVAL OF CANCER CELLS SYSTEMICALLY: Ideally, the circulatory blood supply would also be filtered of the cancer cells themselves, since metastasis to the brain is a danger with some cancers such as lung cancer. It should be assumed until demonstrated otherwise that even if the brain has already been exposed to cancer cells, a continuing deluge can only increase the odds of brain cancer developing and should therefore should be stopped.
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THE TECHNOLOGY
1. REMOVAL OF "MESSENGER PROTEINS" SYSTEMICALLY
The Portable Blood Dialysis Machine
Every night, tens of thousands of patients with kidney problems sleep hooked up to a portable machine that removes toxins from their circulating blood supply as they sleep. Being hooked up to this machine is actually easier than being given a flu shot.
If such a machine didn't already exist, (and if I were proposing the idea of a human blood filtration machine for the first time), I have no doubt that I would be drowned out by choruses of medical professionals calling it crazy, saying that it isn't possibly feasible. "It could ... could cause blood clots." "There could ... could be bacteria that get into the blood." "The machine could ... could break down and kill you."
Fortunately the machines have existed for decades, and keep millions of people worldwide alive. It is interesting, though, how necessary it is for professionals to immediately justify that new suggestions simply are not feasible. Otherwise --- it already would have been done.
A Kidney dialysis machine does not filter out molecules as small as the protein messengers sent out by cancer cells, however.
But as fate would have it, an attachment for dialysis machines that will do the job has already been invented!
The Molecular Filter
Molecular blood filters have already been invented for attachment to standard dialysis machines --- these molecular filters are also called "Artificial Liver Filters," and are used to help patients with liver problems. There are a few different brands on the market; the following is a German-made unit that seems especially interesting:
AN EXAMPLE OF MOLECULAR BLOOD FILTRATION
MARS® Molecular Adsorbents Recirculating System:
Compatible with standard Dialysis Equipment
Scheme of MARS System with extracorporeal blood circuit,
albumin circuit and additional dialysate
circuit
PUT THE TWO TOGETHER
... and it is possible that the first stated goal, of purifying the systemic blood supply of cancer messenger proteins, might already exist.
There is only one way to know --- try it. No drug company will ever spend the millions of dollars necessary to do a scientific trial --- if successful, this technique would likely lower their stock value!
Now, it may be that there are numerous further refinements that need to be made to the existing equipment to work correctly for this purpose. I am only laying down the initial proposal. For example, the molecular filters may need to be modified in some way to make certain that they are perfectly filtering out molecules of the exact size as the specific proteins sent out by cancer cells (as of early 2004, almost 50 different cancer protein "instruction" molecules were known to exist; they may come in many sizes and shapes).
It also may be necessary to add back to the blood some "good" molecules that may be filtered out, such as the body's natural cancer fighters Endostatin and Angiostatin. Fortunately these reagents are both available synthetically, and the Molecular Filter can be programmed to automatically add them back into the blood after filtration has taken place.
And if Molecular Filtration does prove to help --- at any level --- mass production of "Cancer Dialysis Machines" would push down the price of the units, as well as their size.
Many different companies make portable blood dialysis machines that can be used in the home. Second hand machines from Hospitals that work perfectly can be purchased for $3,000 - $5,000 (US$) through medical equipment brokers (check your web search engine). Usually a machine is rented, with full support.
A recent portable computer-controlled home blood dialysis machine is called the PHD from AKSYS at:
The MARS artificial liver filter (a Molecular Filter to remove small and mid sized proteins from blood) is found at:
www.teraklin.com/index-eng.html
(At the time of this writing, the MARS unit may not yet be approved by the FDA in the US, and may still be undergoing final trials elsewhere. However there are other alternative molecular filters today --- the MARS just seems very attractive when available).
2. REMOVAL OF "MESSENGER PROTEINS" LOCALLY
Catheters
A catheter is any device that can be installed to transport liquids. For the purpose of attempting to remove (or minimize) cancer protein messengers from the local blood vessels, I am referring to a small plastic tube with a needle at one end that would enter an organ at the point where the local blood vessels provide blood to the organ, and the other end would be implanted under the skin in the chest to a tiny metal device that allows the catheter to be filled with fluids via a needle (called a VAP). The catheter would be implanted by a very simple, relatively non-invasive thoracic procedure.
Again, if I were proposing the idea of catheters for the first time, the medical professionals would find the suggestion crazy. "It could ... could lead to infection." "It will never work" "It could be dangerous."
Fortunately --- once again --- this already exists!
In fact, in the case of cancers that have not spread beyond the initial organ (stage 3 or less), this exact technique is sometimes used today to send anti-cancer drugs directly into the organ itself! Cleansing the blood would be the new twist now being added.
In the case of trying to remove at least some of the cancer protein messengers from the local blood vessels, various techniques will need to be created. Here are some ideas that can be easily and readily be tested in the lab:
a) The Feasibility of Extracting some of the protein-contaminated Blood via the catheter
Can a certain amount of the existing blood within the vessels of the organ be suctioned out and discarded? Would the injection of blood thinning medication beforehand, or vessel dilating medication, (or both) assist? How long can the blood be absent and not become problematic for the healthy cells?
b) Injection of Clean Blood into the vessels
In any event, clean blood would be added to the vessels feeding the organ via catheter. Perhaps this blood can be obtained from the patient's own newly cleaned blood supply from within the "cancer dialysis machine" discussed above. Perhaps it might be possible for the "Dialysis Machine" to automatically feed the catheters when necessary. To feed fresh blood into some specific organs would presumably not require a huge volume of blood.
It might also be helpful to mix in a cancer-killing agent with this fresh blood.
There is no question that the idea of cleaning the local blood vessels that feed the infected organs is the most challenging part of developing this procedure. But I also believe that it is strictly a matter of basic Research and Development --- if the money were there, it could probably happen almost overnight. There is no rocket science involved. Just design based on already established science and technology, with necessary lab testing.
And in the meantime, using catheters to inject clean blood could be done manually --- just as using catheters to inject chemo into some specific organs is today done manually. In the case of lung cancer, probably half a dozen catheters would be needed to go to specific organs. So what? If today it is done routinely to a single organ, then why not half a dozen? And if this technique ultimately cuts the cost of cancer care for the insurance companies, they they should embrace the concept. They should invest in its development (if they don't find any horse's heads left in their beds from Drug Company executives and the FDA).
3. REMOVAL OF "CANCER CELLS" SYSTEMICALLY
A later generation of "Cancer Blood Dialysis Machine" could also include a module to remove and/or kill cancer cells in the blood. It doesn't matter that "the horse is already out of the barn." With no cancer cells circulating in the blood supply, one stands a better chance of not developing brain cancer at the very least.
Today there exists a large machine made by the Baxter Company to do just this. Using a centrifuge (a device that spins the blood at very high speed), the machine can separate cancer cells from blood based on the cancer cell's size and density. This is called a "Blood Separator Machine." Normal Blood Separator machines are used by the Red Cross to extract blood plasma. The specialized machine is used to remove Leukemia cells from the blood of patients who are harvesting blood for re-transfusion at a later date. In theory, the machine can be configured to remove any cancer cell based on the cell's size and density.
Perhaps a small "personal" version of this machine could be incorporated into the Cancer Dialysis Machine.
Or even simpler, perhaps the published claim that cancer cells die at lower temperatures than healthy cells could be utilized to send the blood through a heating unit to kill the cancer cells while leaving the healthy cells unaffected. The dead cancer cells could then be filtered out (presumeably) through an appropriate molecular filter in the machine.
Or perhaps the emerging science of injecting photo-sensitizers in the blood to allow cancer cells to be vulnerable to laser light, might be the easiest option of all. If a chamber in the machine filled with laser beams could vaporize the cancer cells without harming healthy cells, it might make for less dead tissue in need of filteration.
While removing cancer cells from the blood would seem to be less urgent in late stage cancer than ridding the blood supply (systemic AND local) of cancer protein messengers, certainly removal of cancer cells altogether should at some point be addressed.
ALSO: With the finding that cancer cells die at a high temperature (104 - 113 degrees F), but one that is still safe for normal cells, might such a machine also provide the temporary heating of blood in an effort to help bring about the death of cancer cells not only in the blood itself, but within cancer infected body-tissue?
The CANCER DIALYSIS MACHINE need not be a pipedream. The fundamental technology is already here, and is used by millions worldwide every day. With the money and the will (ie-PRESSURE FROM PATIENTS, AND MONEY!), this technology could probably be deployed very rapidly if a genuine "Manhattan Project" on cancer were declared ... not just political rhetoric.
What would it take for such a project to be undertaken? Probably a multi-millionaire diagnosed with incurable cancer who wants to live and knows that you can't take your money with you.
Remember, this is basic mechanics, not a high tech project that needs years and years of new science to be developed. It is probably less of a challenge to perfect such technology today than it was to create the first soda pop vending machine. Or to send a lunar buggy to drive men around on the moon.
site menu or continue to read the research below
Information below raises the possibility of mechanical Molecular Blood Dialysis as a potential tool; as of now, there is no known investigational work being done in this area --- yet this is probably the easiest of all methods to test out as a possible means to stop or slow (at least temporarily) cancer metastasis, and with an existing track record of minimal risk ---- millions of of people worldwide already undergo frequent blood dialysis ... many each night at home while asleep.
Currently, there is talk of trying to develop drugs to accomplish filtering the protein messengers. This could take decades, if ever successful.
If these ideas help bear fruit toward successful approaches, I hope that the technique will bear Cecily's name. Cecily was the kindest soul to ever live, and she felt genuine pain when she would observe circumstances in the world that made no sense to her. The slowness to act on possibilities that might save lives because of the danger of cutting into profits of some companies would have been incomprehensible to Cecily. In her own world view, she imagined that she lived in a kind, just, and more sensible place. There is not a person who knew and loved Cecily who would not have gladly exchanged their own life to save hers.*
*I wish that when Cecily's battle ended due to a fluid build-up in the pleural lining of the lung, leading to cancer breaking through to the inner lining, I had been quick enough to think of having a tissue match done between myself and Cecily --- the transplantation of the just the lower lobe of a healthy left lung into Cecily's body might in principle have bought her months of added life to give the already-successful Targeted Therapy the time needed. And what she needed the most was just 2 more weeks, to obtain the drugs Erbitux and Avastin when they were released. I profoundly regret not having thought of this ... even well in advance, to obtain a list of possible donors if I were not of the correct tissue match.
Reuters
WASHINGTON
-- Researchers said on Friday they were starting to find clues left by cancer
when it begins to spread, and hoped to develop them into tests that may save the
lives of future patients.
"People don't become ill
because they got cancer. People become ill because they got cancer and we
couldn’t do something about it," Dr. Andrew von Eschenbach, head of the
National Cancer Institute, told a news conference.
Joan Massague, a Howard Hughes
Medical Institute researcher at the Memorial Sloan-Kettering Cancer Center in
New York, and colleagues have been making a painstaking search for the products
used by cancer cells to spread.
The tumor cells must first
travel around the body, find the bone or tissue they will invade and then
literally break in. Each process will require different genes and proteins.
Researchers identified 48 genes
and their protein products that seem to help tumor cells spread, Massague said.
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Blood Vessels Enable TumorsBy Serena Gordon
HealthDay Reporter
MONDAY, Dec. 22, 2003 -- Blood vessels near cancer cells appear to help them grow by "telling" them where to go for nutrition and oxygen, say researchers from Duke Comprehensive Cancer Center.
The researchers say blood vessels signal cancer cells, essentially directing them where to get the nourishment they need to grow. According to the study, this can happen even before new blood vessels grow to support the cancer cells.
"We've demonstrated a give-and-take relationship in which cancer cells release signals to nearby blood vessels to stimulate new vessel growth, and in turn, blood vessels release signals that sustain the migrating cancer cells as they try to establish themselves in new tissue," Mark Dewhirst, a cancer biologist at Duke, says in a statement.
Results of the study appear in the Dec.19 2003 online issue of the Federation of American Societies for Experimental Biology Express .
Scientists had already known that tumors release proteins that cause new blood vessels to grow. What they didn't realize was that cells in the blood vessels were also sending signals to the tumor cells that let the cancer cells know where to grow.
Using cell cultures and animal models, Dewhirst and his colleagues looked at how certain chemical signals affected the growth of cancer cells and blood vessels.
They found that a signal called bFGF didn't affect cancer cells in a test tube. However, that same signal in the human body helps to promote the survival of cancer cells. The researchers further discovered that cancer cells don't even have receptors for bFGF. Without a receptor for this signal, cancer cells can't communicate with it, suggesting this chemical signal must be acting on another part of the body to help sustain cancer growth (ie-on blood vessels).
The researchers also did experiments blocking either the protein known as VEGF or a protein receptor called Tie2. Both aid in blood vessel growth. When either wasn't able to express normally, cancer cells couldn't thrive, which suggests this protein and protein receptor aren't just aids in blood vessel growth, but in tumor survival.
"This is a very elegant study," says Dr. Jay Brooks, chief of hematology and oncology at Ochsner Clinic Foundation Hospital in New Orleans. "It shows the relationship of tumor cells and blood vessels and how they interact, and how proteins in the blood promote the growth and spread of tumors."
Disrupting this process, he says, "will hopefully lead us to ways to prevent cancers from spreading or slow their progress."
He does caution, however, that these experiments are in the very early stages. The goal would be to create a chemical that could disrupt this process, he adds.
CUTTING-EDGE CANCER INFO
Finding
a 'true' Cutting Edge Oncologist
The
Early Formula for "Cecily's Oil"
The
Need For New Drug Approval Laws
60
Minutes Story: The FDA and Politics
AP:
FDA Silences Internal Critics