The cancer-fighting powers of herbs and natural compounds will be tested in a new program at UCLA's Jonsson Cancer Center designed to determine just how effective popular alternative and complementary medicines are at fighting malignancies.
The Sue Stiles Program in Integrative Oncology, funded with a $1.1 million gift, will employ scientific principles to develop anti-tumor medications from what Jonsson Cancer Center researchers say is an untapped gold mine of plant life and natural compounds that haven't yet been tested as cancer-fighters. Some of the natural compounds being tested in Jonsson Cancer Center laboratories include components of shark liver oil and soy and a plant historically used by Native Americans for healing.
If these plants and compounds are proven to fight cancer effectively, they may one day replace some of the more toxic and debilitating chemotherapies currently in use, said Dr. Richard Pietras, associate professor of hematology/oncology and director of the integrative oncology program at the Jonsson Cancer Center.
"I hope that we will soon be able to treat cancer patients with less harmful and more targeted therapies to fight their tumors and relieve their symptoms," said Pietras, who is both a scientist and an oncologist. "There has been a revolution in molecular biology. We have a new understanding of how cancer comes about at a molecular level and that will help us as we work to develop these new therapies."
About four in 10 Americans currently use some form of alternative medicine, according to recent federal statistics. And it's estimated that patients make more than 629 million visits annually to alternative practitioners, more than twice the number of visits to primary care physicians each year in the United States.
Cancer patients follow the same trends. A recent survey found that more than 70 percent of breast cancer patients used some form of complementary therapy -- dietary supplements, spiritual healing practices, herbal remedies or physical therapies like acupuncture or massage. However, patients often do not tell their physicians what alternative therapies they are using, and physicians don't often ask. It's vital for doctors to know how their patients are augmenting traditional therapies, Pietras said.
"We, as physicians, need to know what are patients are taking and using," he said. "We need to be prepared for any problems these therapies might present."
There are thousands of plants and tens of millions of compounds that need to be tested for their cancer-fighting abilities. Of the 92 drugs approved for cancer treatment from 1983 to 1994, 62 were derived from natural sources, Pietras said. Examples include the chemotherapy agent Taxol, isolated from the bark of the Pacific yew tree and used to treat breast, ovarian, lung, head and neck and bladder cancers; topotecan, a semi-synthetic derivative of an alkaloid extract from the bark of the Chinese camptotheca acuminata or xi shu tree, used to treat ovarian and lung cancers; and vinblastine and vincristine, alkaloids extracted from the periwinkle plant, for lymphomas, leukemias and several solid tissue tumors.
More than 50 million chemical compounds exist that have never been screened for anti-tumor properties. Of the 300,000 land-based plants on earth, less than 5 percent have been investigated for medicinal use, Pietras said.
Dr. Judith C. Gasson, a scientist and the director of UCLA's Jonsson Cancer Center, said this integrative oncology program is vital to the future of cancer care.
"I have no doubt that certain types of alternative therapies will become part of our arsenal against cancer, but we need rigorous testing to ensure that they're safe and effective," she said.
In 1994, the Dietary Supplement Health and Education Act allowed over-the-counter sales of herbs and food supplements without review by the U.S. Food & Drug Administration. The act placed the burden on the FDA to remove products that later proved troublesome. Such a scenario is playing out now with the popular herb Kava Kava, which is being reviewed by federal officials after liver damage was reported in several people taking the supplement. Last year, the FDA pulled two products sold as herbal supplements off store shelves. Supplements PC SPES and SPES, marketed for prostate health, were recalled after they were found to be contaminated with diethylstilbestrol and warfarin.
"Herbal therapies are not yet standardized for safety, purity and efficacy," Pietras said. "What we may find is that natural isn't always beneficial."
The Sue Stiles Program in Integrative Oncology will include laboratory and pre-clinical research of natural products that will lead to human clinical trials with compounds that show promise in the lab. The program also will include community lectures on alternative and complementary care in cancer, a new course on "Integrative Cancer Medicine" designed for medical students, creation of a patient education video and an interactive Internet site about the program, located at www.canceralternatives.mednet.ucla.edu.
Work with anti-tumor agents derived from natural sources is already underway in Pietras's lab. A lead therapeutic agent, squalamine, is a component of shark liver oil that has been widely used as a folk remedy for treating cancer. In the lab, a synthetic form of squalamine has shown potent anti-tumor activity by blocking the growth of blood vessels to tumors. This independent blood supply is critical to tumor survival as it carries the important nutrients and oxygen that cancers need to grow and expand. Tests of squalamine in early stage clinical trials are focusing on patients with ovarian and lung cancers. Results of these initial studies are promising and have been reported at recent scientific meetings.
Other herbal extracts and compounds being investigated for anti-tumor activity include genistein from soy, baicalein from the skullcap weed and Yerba Santa, a plant that was often used medicinally by Native Americans in the Southern California region. More investigations are planned using novel screening techniques that Pietras hopes will be more efficient in selecting active compounds from the millions present in the natural environment.
UCLA's Jonsson Cancer Center is launching its new program at a time when more national attention is being focused on alternative and complementary medicines. The National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, is embarking on multi-center, rigorous studies to determine the efficacy of various alternative therapies. Formerly a small program with a smaller budget, the national center has recently widened the scope of its research with a new director and a much bigger budget.
The Bush administration last March was urged to provide more Medicare coverage for alternative remedies. The White House Commission on Complementary and Alternative Medicine spent two years and $2 million to determine what national policy should be regarding alternative medicine. In addition to increased Medicare coverage, recommendations included national backing of research on alternative therapies that have shown promise and teaching of alternative practices to schoolchildren to encourage better nutrition, exercise and stress management.
Dr. James S. Gordon, chairman of the White House commission and director of the Center for Mind-Body Medicine in Washington, D.C., said the Jonsson Cancer Center program will help move research into alternative and complementary therapies forward.
"This kind of research program is very much what the commission had in mind when we strongly recommended an emphasis on studying the therapeutic power of natural approaches to cancer and other life threatening illnesses," said Gordon, who has written extensively on alternative and holistic care. "I look forward to the results of these studies."
The integrative oncology program is funded by a $1.1 million gift from the Sue Maloney Stiles Fund. Stiles was a strong advocate for environmental causes and human and animal rights. After the failure of standard therapy for her advanced cancer, Stiles sought to encourage the discovery of new therapies from natural sources and the development of less toxic alternatives to conventional cancer care. Stiles died in 1991 from complications of advanced cancer.
"Sue Stiles wanted a program that brought together the best scientific methods of modern medicine and the best knowledge of age-old medicine," Pietras said.
UCLA Jonsson Cancer Center researchers, including Dr. Lonnie Zeltzer, co-director of the Sue Stiles program, will be working with other groups at UCLA interested in complementary medical therapies. These include the UCLA Center for Integrative Medicine led by Dr. Emeran Mayor; the Center for East-West Medicine under the supervision of Dr. Ka Kit Hui; the Norman Cousins Program in Psychoneuroimmunology led by Dr. Michael Irwin; the Palliative Care Program at Santa Monica-UCLA Medical Center under Dr. Judith Ford; the Neuropsychology Program in the Department of Neurology under Dr. Rebecca Rausch; and the UCLA Center for Human Nutrition led by Dr. David Heber.
Cancer touches almost everyone's life. One of two American men and one of every three American women will get cancer in their lifetimes. In 2002, more than 1.2 million cases of invasive cancer and more than 1.3 million cases of basal and squamous cell skin cancers will be diagnosed in the United States, Pietras said. In all, more than 555,000 people are expected to die this year alone -- more than 1,500 deaths every day from cancer.
"UCLA's Jonsson Cancer Center is uniquely poised to provide choices to patients seeking alternative and complementary medical therapies," Pietras said. "In view of the high level of national interest in the development of new and less toxic alternatives to current cancer therapy, this is an opportune time to launch this program for the benefit of our patients in Southern California."
To provide additional support for the integrative oncology program, the Wells Fargo Foundation has made a five-year philanthropic commitment in the amount of $125,000.
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