Cancer Therapy

by Chris Piper BVSc MRCVS

This article outlines a holistic approach to cancer utilising a preparation of mistletoe (Viscum album) in combination with other supportive therapies. From the holistic perspective cancer is considered as a disease of the whole organism. The integrity of the organism has been overwhelmed by a combination of insults, deficiencies, and derangements of body metabolism, and organ function. The immune system is particularly affected and fails to recognise self from non-self and to distinguish alien and malfunctioning cells from normal cells.

​The integrity of the cell can also be affected by free radicals generated by metabolic processes. Free radicals are reactive molecules capable of damaging cells, particularly cell membranes. Free radicals can come from external sources (tobacco smoke, pollutants, organic solvents, anaesthetic, pesticides, certain drugs and radiation) or from increased internal production (poor blood supply, inflammation). Protection by free radical scavengers such as vitamin E, Selenium, vitamin C and superoxide dimutase is helpful. An interaction between these antioxidants (scavengers) helps to protect and destroy free radicals. Insufficient intake of these micro-nutrients (antioxidants) may impair the immune defences and allow free radical damage. Therefore careful attention to diet is important not only to ensure adequate micronutrient intake (which may be higher in a diseased animal) but also to minimise the intake of damaged nutrients (rancid fats, denatured proteins) and pollutants.

We recognise several infectious agents capable of causing cancer. However, there are, no doubt, a multitude of contributing factors which predispose to cancer. Immunodeficiency may be primary (congenital disorders of the immune system) or secondary (acquired from some underlying disease - viral, malnutrition, hormone deficiency, free radical damage).

No matter what perspective we use to consider cancer we will always be left wanting. This reflects the insidious nature of cancer and its overt clinical appearance months or years after initiation.

HELIXOR
A preparation of mistletoe (Viscum album) has been used as a cancer therapy since 1921. This preparation, Helixor, combines two distinct actions not found in other cancer therapies. It is selectively cytostatic and an immunostimulant.
The growth of tumour cells is inhibited but not the growth of normal cells. No bone marrow depression occurs; in fact, stimulation of bone marrow function can occur. In addition, enhanced well-being, invigoration and pain relief may occur.

Rudolf Steiner, the founder of anthroposophical medicine, recognised the unusual properties of mistletoe as suitable for the treatment of cancer. Mistletoe is a semi- parasitic plant which grows on specific host trees, shows no geotropism and follows its own seasonal rhythm. Apart from water and mineral salts, the mistletoe takes only traces of organic substances from the host. It is partly heterotrophic and partly autotrophic and is therefore halfway between plant and animal. Its amino acid profile is not specifically plant or animal but has a combination of both. The histone-type proteins of mistletoe are powerful cytostatics which, unlike most cytotoxic agents (which act as anti-metabolites or mitotic poisons), block the reading of definite gene segments responsible for excessive cell division. It is worth noting that this extract is not purified and also contains polysaccharides and lipids with anti-tumour activity. The principal manufacturing step is a natural fermentation of fresh plant juice. This process aims at retaining the efficacy of the ingredients and maintaining a whole balance of activity which minimises side effects. This is a very important attribute of mistletoe extract. Many purified cytotoxic agents used currently have aggressive side effects which have a debilitating effect on the body.

In addition to the cytostatic effect, mistletoe stimulates the immune defences. The extract stimulates non-specific resistance (increased granulocyte and macrophage counts) and promotes specific defence mechanisms through thymus hyperplasia leading to increased production of immunocompetent lymphocytes.This remarkable combination of cytostatic and immunostimulant properties ensures that proliferating cell growth is inhibited and a weak immune system is strengthened.

There are three different mistletoe extracts obtained from the apple tree, pine tree and fir tree. There are no known contraindications although some hypersensitivity has been recorded in humans. A transient fever may occur in the initial stages of therapy. This is expected and may be beneficial, but should be monitored. A local reaction at the injection site may cause some irritation but is expected during the initial stages of therapy. The extract is available in glass ampoules containing from 1-100 mg. Helixor is not registered in New Zealand and is imported from Germany. Owners are advised of this and their permission is requested before commencing therapy with this unorthodox treatment.

The extract is given by subcutaneous injection initially using insulin syringes and later, as the dose volume increases, using 2 ml syringes with 25 G needles. The extract should be refrigerated. Although I usually recommend giving the injection at three sites on the animal's back (mostly for ease of application) it is preferable to inject as close as possible to the tumour. Further injections should not be given at a site of previous reaction.

There is no limit to the duration of treatment, although I often impose discrete time spans for evaluation e.g. a debilitated animal whose owners are questioning the quality of life of their pet but who seek to do whatever they can to restore health will need frequent evaluation. Often there is a period of intense response when the fever is pronounced and the animal is lethargic. Sometimes during this phase it is wise to give the injection every second day. This decision can be made in consultation with the veterinarian. Remember this episode of fevers should be regarded favourably and is an indication that the animal is responding. This can also be a difficult time when you (the client) have doubts about the quality of life of your pet and the suffering they may have. I encourage you to see this as a transient reaction which doesn't last.

Once through the reactive phase the dose is given every second or third day and increased by 10 units until a dose of 100-150 units is reached. Thereafter injections are reduced to weekly and then monthly, providing the growth has been arrested.

For inoperable tumours, therapy will usually continue indefinitely. However, for tumours which have been surgically removed and considered unlikely to recur, therapy may stop after 3-4 months. Rhythmical dosage sequence may be used once therapeutic dose has been achieved, e.g. therapeutic dose 150 U - the dose is varied from 100 U to 200 U. Dose 1 100 U, Dose 2 150 U, Dose 3 200 U, and repeated.

RULES OF THERAPY
1. Therapy is usually commenced with daily injections starting with 5 units and increasing in 5 unit increments until a therapeutic dose is reached. The therapeutic dose will vary for each individual and will be determined by the veterinarian.

2. Injections are best given in the morning and the rectal temperature measured eight hours later. Normal temperature is 38.5 ºC, although some animals may have a different "normal temperature" and this can be determined by taking the temperature in the morning. Avoid taking the temperature after exercise or if the animal has been in a hot environment (car, heated room, lying in sun). The expected temperature rise (fever) should reach a peak eight hours after the injection. A temperature of 39.5-40 ºC is considered a response.

3. Dose - if the temperature eight hours after the injection is normal (less than 39 ºC) then the dose given the following morning is increased by 5 units. If the temperature eight hours after the injection is 39.5-40 ºC then the dose given the following day is the same as the previous morning. If the fever persists the day after, then the same dose is given yet again. (If you are unsure of what dose to give, please phone the veterinarian on 620-9319 (work) or 846-3558 (after hours). The rate of increase of the dose depends on: (a) the response, (b) type and malignancy of tumour, and (c) general condition of animal. Each animal must be assessed individually. 

4. Records - careful recording of temperature and dose should be made on the graph sheet provided. This enables the veterinarian to quickly assess the response to therapy.

5. Reactions - any acute reactions should be notified immediately (sudden swellings of skin and face, restlessness, difficulty in breathing, vomiting). Local swelling over the injection side (> 4cm) may occur. Do not give another injection at this site. If swelling persists, advise the veterinarian.
Note - I have not seen any acute reactions during my use of Helixor. This may reflect the fact that we do not have these species of mistletoe in New Zealand.

6. Protocol - during the first two weeks of therapy we expect to see a response (usually around 20-30 units). This response usually persists until 60-80 units have been reached. Thereafter little reaction is seen. Apart from the effect the therapy has on the tumour, there is often a considerable benefit to the animal's general well-being. They are often more alert, have improved appetite, become more active, and do things they may not have done for some time e.g. chase the ball, bark at visitors. 

Cancer therapy is often demanding and emotionally taxing for all concerned. We endeavour to provide support and an honest assessment of therapy. Your commitment and caring is vital to the therapy. Because it is so difficult to predict the progression of this disease and the individual animal's ability to respond to therapy we need to maintain close communication to ensure we protect the quality of life of your pet.