Terra Sigillata

Via my colleague, PharmCanuck, comes news of an in-depth radio program on dichloroacetate (DCA) that aired this past Tuesday on CBC’s, “The Current.” As a reminder to readers who aren’t already bored senseless of my discussion of this chemical, DCA is a small molecule freely-available in the public domain that was shown to slow the growth of human lung tumors implanted in rats by researchers at the University of Alberta. I’ve posted on this issue a number of times and have been well outposted by my surgical oncology blogging colleague, Orac at Respectful Insolence.

(Real Audio segment: 21:54)

The segment opens with a moving discussion with “Sandra,” a breast cancer patient who comments frequently at thedcasite.com and has foregone conventional treatment for her cancer. She has chosen to take a naturopathic approach and is also taking DCA; given the relatively high cure rates for many types and stages of breast cancer, it pains me to hear her story not knowing whether her staging is one that is highly curable with conventional treatment.

She is followed by Jim Tassano, operator of buydca.com, who comes off as pretty slimy and disingenuous. Nowhere in his interview is his original claim of looking into DCA for his dance instructor friend with cancer. He also brushes off the interviewer’s question as to how much money he is making from the sale of DCA and proposes to “take this thing international.” I don’t pretend to know his intention$, but the interview did him no favors.

Interestingly, U of A researcher Dr Evangelos Michelakis refused to be interviewed for this lengthy segment.

Jo-Anne Nugent is the Director of Communications for the University of Alberta, and she offered us [The Current] a written statement. Below is a section from it:

Dr. Michelakis does not want to appear to be ignoring the emotional status of the patient being interviewed. However, he feels that it is irresponsible for him to appear side by side with a patient taking DCA and someone who may be selling it or prescribing it for the treatment of cancer. Dr. Michelakis believes that self medicating may cause harm and wants to let science decide whether DCA is indeed safe and effective.

Interviewed instead was Dr Chip Doig, Associate Professor in the Department of Community Health Sciences at the University of Calgary and the past Chair of the Research Ethics Board at that University. Dr Doig expresses the understandable concern for Sandra and her decision to forego conventional, potentially curable treatment.

For me, his interview was the highlight of the program in that he tried to place in proper perspective that DCA is an experimental cancer treatment whose scientific promise is being overinterpreted by individuals self-medicating outside the controlled conditions and careful monitoring and documentation of a clinical trial. Doig specifically notes that there are many, many therapies currently at the level of promise of DCA as detemined from animal studies whose real human potential has yet to be seen; he also expresses the concern that DCA’s apparent safety in other settings (as in congenital lactic acidosis) does not mean it will be safe in cancer patients when taken alone or together with other drugs. In addition, Dr Doig also addresses the shortcomings of testimonials that seem to be fueling Mr Tassano’s sales of DCA. As Orac and I have said on a number of occasions, use of DCA outside of a clinical trial may ultimately hamper its long-term potential if it indeed proves useful as a cancer treatment adjunct.

If you have time this weekend, the radio piece is worth a listen: (Real Audio segment: 21:54)

Comments

  1. #1 Bob Smith
    May 13, 2007

    This IS a clinical trial, one done without pharma’s money and the governments blessing. That doesn’t make it wrong. Whats really wrong, is a system that sends 500,000 Americans home EVERY YEAR TO DIE OF CANCER, without giving them an experimental therapy to either take or not. Where are the physician and researcher volunteers stepping forward to help the people taking DCA? And you are wrong about nobody showing preliminary results from DCA. The DCA site clearly shows three that are experiencing improvement. You should acknowledge this. Also, this trial has been going on for a couple months. Would you be demanding results from a conventional trial in 2 months time. NO WAY, you would wait for years, YEARS. These people don’t have YEARS, and they don’t want to die. It is their essential right to try treatments if there is a scientific basis for belief that the treatment will help them. Consult the bill of rights: The right to life, liberty, and the pursuit of happiness…. The system is now in the position of trying to deny people the right to life, after cancer gives them a death sentence. Who are you, or Orac, that POS, to deny these people anything they want to try? Your credentials don’t mean crap when presented with your platform of denial of medical care.

  2. #2 qetzal
    May 13, 2007

    Bob wrote:

    This IS a clinical trial, one done without pharma’s money and the governments blessing. That doesn’t make it wrong.

    It’s not a clinical trial. It’s self-experimentation. But I agree that doesn’t make it wrong.

    Where are the physician and researcher volunteers stepping forward to help the people taking DCA?

    They’re trying to figure out HOW to help people taking DCA. That’s what research is for. For instance, nobody knows (yet) what dose of DCA should be used in cancer patients.

    More importantly, they’re trying to figure out whether DCA deserves more attention than the literally hundreds of other potential cancer treatments that have shown equally good results in animals.

    And you are wrong about nobody showing preliminary results from DCA. The DCA site clearly shows three that are experiencing improvement.

    The DCA site may describe three people who have experienced improvement while taking DCA. That doesn’t show that they experienced improvement from taking DCA. Are these people taking anything else for their cancer? There’s no way to tell under these circumstances whether DCA is having any effect, good or bad.

    These people don’t have YEARS, and they don’t want to die. It is their essential right to try treatments if there is a scientific basis for belief that the treatment will help them.

    I agree. People should be free to do what they think is best with their own bodies. I don’t object to people like Sandra using DCA instead of conventional cancer treatments. I think she’s making a huge mistake, but it’s most certainly her choice to make.

    I do, however, have serious concerns about the guy who’s selling DCA. Does he follow any of the normal requirements in making drugs for human use? Does he test each batch for identity, purity, potency, etc? Does he follow Good Manufacturing Practices?

    Such regulations are in place for a reason. Just because DCA shows some promise in cancer and is easily available as a chemical doesn’t mean it’s OK for some guy to whip up a batch in his warehouse and start selling it to desparate people.

  3. #3 Orac
    May 13, 2007

    This IS a clinical trial, one done without pharma’s money and the governments blessing. That doesn’t make it wrong.

    Wrong. It’s not a clinical trial. A clinical trial requires a defined protocol and objective measurements of tumor progression and side effects. As for the people claiming “improvement” taking DCA, that’s mostly a lot of wishful thinking. I just went through the website the other day and could only find one person whose story might–I repeat, might–indicate an objective response. In fact, I’ve been scanning the entire site, and I can’t find a single patient claiming tumor shrinkage on an objective imaging test (CT, MRI, etc.) taking DCA alone.

    There’s a reason for control groups. For example, there’s a statement on the front of the BuyDCA website that states that sarcoma is resistant to DCA. This is apparently based on the experience of one patient, SquareB, for whom DCA clearly didn’t work. His disease progressed on DCA. However, just as we can’t properly judge the effectiveness of a treatment by only one or two patients, we can’t judge the ineffectiveness of a treatment on the basis of one patient. In reality, we have no idea whether DCA works in sarcoma or not. It clearly didn’t work for SquareB, but that doesn’t mean it might not work for other patients.

    This sort of pushing of self-experimentation by Tassano is so utterly irresponsible that it borders on quackery. He’s clearly taking advantage of desperate cancer patients.

    More on this on my own blog soon.

  4. #4 Orac
    May 13, 2007

    Hmmm. Not sure why the second part of my post didn’t show up.

    What I meant to say was that, just as you can’t say that a therapy definitely works based on one patient, you can’t say it doesn’t work based on one patient. In reality, we have no way of knowing whether DCA works in sarcoma without a properly designed clinical trial.

    Tassano and these self-experimenters don’t know what they’re doing, I’m afraid, and that means their experience is unlikely to produce any useful data other than what has already been demonstrated: That DCA is certainly not any sort of “miracle cure,” as it had been touted to be back in January. If it were, even this sort of self-experimentation would have almost revealed some major tumor responses. In reality, it’s behaving much like many other experimental chemotherapeutics, with no obvious responses, except that there are no controls for other things the patients are taking and no real objective evidence.

  5. #5 Abel Pharmboy
    May 13, 2007

    Orac, the second part of your earlier comment got cut off due to a bad html closing tag – I fixed it and it should be okay now.

    Beyond Orac’s clarification of the fact that DCA testimonials do NOT constitute a clinical trial, I might also add other reasons that any self-experimentation results are uninterpretable. There are no clear guidelines regarding dose, dosing frequency, concurrent treatments, and uniform criteria for assessing responses.

    Regarding Bob Smith’s comments about the “right to life” and qetzal’s correct statement that there are hundreds of other agents with more evidence than DCA for investigative use, patients can find information about enrolling in clinical trials for these agents at clinicaltrials.org. In no way do I wish for potentially effective treatments to be withheld from patients but as Orac correctly points out:

    In reality, it’s [DCA is] behaving much like many other experimental chemotherapeutics, with no obvious responses, except that there are no controls for other things the patients are taking and no real objective evidence.

  6. #6 Apreche
    May 14, 2007

    I saw a very pro-DCA story elsewhere on the Internet, and alarm bells starting going off. Using Google I came across this page. Thank you for sharing the straight scientific dope and not some crazily optimistic conspiracy theory.

  7. #7 ivancho
    May 16, 2007

    che muy lindo tus documentos pero no entiendo ni jota, please inserta un traductor asi puedo leer tus notas que parecen muy interesantes

  8. #8 kristi
    May 16, 2007

    i am wondering what company makes the dca that is used to treat metabolic disorders. i am assuming doctors prescribe it for the metabolic disorders. i ws not able to find anything after a google search. thanks

  9. #9 kristi
    May 16, 2007

    i am wondering what company makes the dca that is used to treat metabolic disorders. i am assuming doctors prescribe it for the metabolic disorders. i ws not able to find anything after a google search. thanks

  10. #10 Bob Smith
    June 3, 2007

    Orac,

    Here again, why should anyone trust your judgement with regard to DCA? You send 500,000 home to die of cancer every year. Let me tell you why, so maybe, when you overcome your ego someday, you can correct the problem.

    From the inception of a drug, usually from a plant molecule that is changed to make it patentable,,, and sometimes more effective,, the drug is tested against one pathway, and used alone, or increasingly using 2 compounds, one new, one existin. Horribly, that is how it is required to be tested and used throughout its clinical reign. Further, it almost never targets cancer stem cells, the very cancer cells that result in the patients death.

    The end point of any trial should be to cure the celss, rats, dogs, monkeys, or man, woman or child of the disease,, not to see how effectively you can target a single pathway. Yet, that is how the drugs are created, in a mold, as if they were stand alone curative agents, when they are not. You must target cancer stem cells to kill cancer. Active cancer stem cells run on glycolysis, like a fetus. DCA, at least, may target them, as well as daughter cells.

    So, Orac and others who oppose the walking dead trying to save their own life, in light of the system I shed light on above, why are you sending 500,000 home to die each year. How can you be so arrogant and profess to be so right when you give your patient a 50% chance of becoming worm food?

    Under any nations law, you have the right to kill if it is the only way to save your life. These people aren’t trying to kill anyone, just get a tiny pinch of powder every day, to see if it can help them or someone else.

    Your pure arrogant bull responses to my previous post, are not intelligent enough, or even understanding of cancer and death enough, to warrant a response. Nicpick with your nose, but please, with me, lets talk about the 500,000 dead each year, and the cancer stem cell. If you can’t address that, then you shouldn’t be in oncology.

  11. #11 Ken
    June 5, 2007

    I think the people who speak against DCA in this instance tend to overrate themselves as protectors of our lives. Docs at Alberta I think to an extent have confessed that DCA was an accidental finding rather then applying their minds. Thanks a ton to them for letting us all know about it, but they are so scared to back their findings. The people at FDA and ACS are all failure ridden clumsy people who only know how to raise money and spend it on nothing. Offcourse, I don’t have the proof of their illegal and corrupt relationship with the big pharma. I think the small revolution that is now happening with DCA is a big win for cancer sufferers over their qualified idiotic people heading the organisations I mentioned. I think it is only because of the internet that we could sink the distances between us and discuss the truth threadbare. I’m not thinking that DCA will end cancer once and for ever, but I’m sure the DCA episode will bring forward enough of already existing cures to the fore front and offer cancer patients the necessary hope and solace. I firmly believe that there is a cure already and it is just a matter of a few months or years before it is discovered. Cancer will become a easily managable condition.

    I hope we can gather enough support and resources to get the corrupt medical people of our country head straight to hell, like they did to the ex FDA boss in China. Hell with the patents. It is only real concern towards patients that can bring out proper treatments / medicines and not some bookworm or a sidekick of some big pharma create what it takes to cure cancer.

  12. #12 Brian Woz
    June 30, 2007

    Wow, I�m glad we are all talking about it at least. I have malignant melanoma, stage IIIc, its in my lymph nodes. The best doctors the area, ucsf / John Muir, still are living in the stone ages. The have given my 6 months to live a few times now, but i just keep fighting. I think that if i had a choice, I would rather just die quickly, instead of this slow thing I live day, to day. My daughter is 2 � , and my other daughter is due today. I love them, It makes me sad to think they will grow up with out me.

    So when you talk about quack doctors, lets talk about the ones who deal the most quak. These are the people you are supposed to trust, the ones that tell you, its cancer. The ones who say, you only have 6 mo. left. The ones who say, you need a port, and we are going to give you high dose interferon, alpha 2-b. Then say, after a year of self injecting horrible thing into my self, oh, this drug won�t work because of your blood type. ???? Yeah great work Doc, maybe if you had checked that a year ago, I would still have a kidney, and my liver fully intact. F�in Quack

    But you know what, He made is money, and probably sleeps well at night, you know why, because he is only a sheep, a puppet for the drug companies, he doesn�t even think he�s doing anything wrong. Hell, just following protocol. Oh yah, when are doctors going to stop irradiating people, hasn�t that been proven worthless??? I didn�t to that, no way

    Traditional medicine is a joke. We are in the stone ages with cancer research. The pharmaceuticals don�t want to look for a cure, they want to look for a treatment. I don�t trust anyone that even remotely sounds like they back the Parma�s bad medicine, Its obvious, they are greedy, and if I die, hell there will be more just like me to fill their piggy banks.

    And another thing�.. I�m trying dca because it wasn�t prescribed to me (along with 10 other drugs) by some overpaid drug pusher. I have done the research, tested the chemical, and am fully aware of the dangers. My research, along with all of the other people with cancer, is carried out, not for profit, but for survival.

    Maybe its time for The People to smarten up. I mean really,

    1) Oil companies + greed = dirty politicians, pollution, lung cancer, death
    2) Pharmaceuticals + greed = dirty politicians, fake drug studies, addiction, death

    I guess I�m just amazed that people in this day and age can be so blinded, by the media ,into thinking its all ok. I don�t have the answer

    I�m just scared
    32 yrs old,
    matastic melanoma, diagnosed 3/04

  13. #13 A
    June 30, 2007

    Brian-
    I am so sorry about what you are going through. It sounds horrible.

    Unfortunately, cancer is an extremely difficult illness. Its not just one illness, but probably thousands, with each persons tumor having its own individual mutations. This, and because cancers continue to mutate make them even harder to nail.

    Cancer researchers ARE working hard to find effective treatments, and ideally a cure. I am a cancer survivor myself, with a blood cancer that is more treatable than many solid tumors like melanoma, but still not curable. Without traditional medicine, I would be dead, instead of in remission for 8 years.

    As I live with a cancer researcher, I understand that these guys are doing the best they can against a very formidable enemy (enemies). If a pharma co found the cure, they would quickly become one of the richest companies in the world, so I do not buy your theory that they are supressing a cure or not looking for one!!

    And, oncologists are doing the best they can.

  14. #14 Shawn
    July 2, 2007

    Good Day
    I have a very close freind that is fighting for his life
    Brain Cancer he has tried every treatment avaiable was treated by the supposed most important brain surgeon of north
    america he was given hopes and was told that they will never give up on him and there is always hope he tried also other experimental treatments that was invented by certain pros of medicine and was backed by huge financing
    Im pretty sure that if There treatments would of had some kind of success the world would of known and THEY would of received alot of support and surley would of taken all the glory for it its sad to say but there treatments did NOT work and no one preaches about it and the money went probably somewhere like down the drain or in someones pockets anyways conclusion is taht money can do and savey an awful lot but were talking about Human lifes here and I beleive in the power of up above but I also beleive that the Lord is stil patient and provides us the chance to be given hope by the intelligence of Man men and women that are trying and doing to find the famous something to either cure or control the devastig disese called cancer that destroys millions of lifes beleive what you want we are using DCA but we are also receiving help and hope from the Lord that permits our faith in HIM to persit in hoping that we still can be marvelized by hunain intelligens that can really come up with something positive Jim Tassano does not seem to be looking for glory and he seems to want the DCA to remain avaiable to everyone not just the rich as soon as the goverments authorize the DCA some day I am a little worried on the price and I am awfully worried just imaging a patient stuck facing death waiting to see a doctor and being on a patient list bureucratic problams and ouffff the time it will take pretty scarey I wish and pray for everyone like my freind and families out there waiting waiting but time is just not what they have

    God bless you all
    Shawn

  15. #15 A
    July 2, 2007

    Jim Tassano may not be looking for glory, but, he sure knows how to prey on the vulnerable to make some cash.