Many of our clients have had  personal experience with a relative, or friend, affected with some form of cancer. It is well worth remembering that Cancer is a word, not a Sentence. Our patients can benefit from Integrated Health-care. Many forms of oral cancer can be cured or  palliated, with early identification, surgical removal with adequate margins, and with nutritional  herbal and dietary adjustments  to encourage longer term overall health. 

A recent pubmed archive search listed over 90,000 entries for Oral Tumours. Limiting the published scientific data to “canine and feline” produced over 200 articles, many of these are written by our dental veterinarian colleagues.

Holistic Veterinarians represent a unique skill base having sought further education in diverse fields, such as Herbal medicine, Orthomolecular and Supplemental Nutritional Therapies, traditional Chinese medicine, and Essential oils.

Veterinary Dentistry considers the structure and function of the dentition and tissues of mastication. An Integrative approach to patient care.for oral cancer bridges  fields of Oncology, Dentistry and Holistic Medicine  

Allocating Integrative care principles to a wholistic package of treatment combines Conventional and Complementary Care,  offering the client the best of both worlds. 

This lecture briefly outlines  factors that may contribute to pathobiology of Oral Cancer,  encouraging preventive care, as well as supportive supplementary Herbal, and Nutritional Care for both Pain management, inducing apoptosis, and assisting Immune function. 

 

Complementary and Alternative Veterinary Medicine (CAVM)- Why use it?  CAM (Complementary and Alternative Medicine) use is very common among cancer patients in most Asian countries.  A recent study in China  suggested that oncologists should explore the use of CAM with their cancer patients and work towards an integrated model of health-care  due to the  benefits, and uncommon adverse events using herbal and CAM. Many Australian clients already use CAM for themselves, and seek this for their pets. Clients may even be well versed in CAM, for instance, many of this authors clients are naturopaths holding Masters degrees from Universities on Nutrition and Herbal Medicine. The ability to communicate to an educated client on a  scientific level with respect to their medical research on CAM regarding the relevance to their pet's care builds and supports the client animal bond to YOUR practice! If you are more comfortable with the terminology perhaps use the term “Therapeutic Nutrition” including essential oils, vitamins, supplements and food therapy altering the diet.

Early Diagnosis:

Cancer of the Oral cavity is best diagnosed early, for optimum prognostic evaluation. Veterinary dentists are the bounty hunters of Incidentalomas: when you find a cancer you were not looking for.  This is another excellent reason to get those early grade dental cases into your clinic, under  general anaesthesia and  check under the tongue (a common site for SCC- squamous cell carcinoma) and jaw.

Common oral malignancies:

The three most common oral malignancies in dogs and cats are:

• Squamous cell carcinomas  locally aggressive, but late to metastasize. They commonly affect the underlying bone. The most common tumor in cats, and the second most common in dogs. 
• Fibrosarcoma the next most common. Locally aggressive, appears as a red growth, which can be fibrous or ulcerated. This is often seen in older (>7.5 years) male large breed dogs.
• Melanosarcoma/ Amelanotic Melanoma  is the most common tumor in dogs, but very rare in cats. This tumor is locally invasive, but because it metastasizes early in the disease course has a poor prognosis.

The author has also seen secondary metastases of mast cell tumours, melanomas, and lymphomas.  Surgical Excision is the main therapeutic choice for Oral tumours, however a 2 cm margin is the recommended required to ensure the invasive edges are removed. In a small animal this is a significant part of the facial anatomy. Therefore local radiation, cryosurgery and chemotherapy have been used in conjunction. Holistic and Integrative therapies may be thought of as an adjunctive tool to both support the healing and stimulate the immune function and cancer surveillance abilities of the patient. 

 

EBVM 

Evidence-based Veterinary Medicine  (EBVM) has much clinical data supporting CAVM Herbal Medicine, Nutrition, Essential oil and Nutritional supplementation which can  found by searching Pubmed entrez http://www.ncbi.nlm.nih.gov/sites/entrez. It is helpful to have studied these modalities formally before embarking on such a search, various CE can be found through the AVA/AHV/AVAG (Holistic and Acupuncture SIG's)

EBVM has been described as using clinical expertise with the best available external clinical evidence from systematic  research. 

Clinical expertise refers to the clinician's experience, education and clinical skills. A clinician using EBVM assesses the strength of evidence of the risks and benefits of treatments (including lack of treatment) and diagnostic tests.

Dr Wynn states that the practice of EBVM for holistic therapies is achieved by applying the studies that do support the interventions holistic practitioners use in a comparative fashion to traditional medicine. For example doctors are aware that ACE inhibitors are used for treating renal disease,  evidence that is similar in EBVM proof to the using  the herb Rehmannia, a well recognised treatment for Renal Failure or “kidney yin and yang deficiency” in the Asian culture. The decision making process about which drug/or herb to use is due to that practitioner's knowledge and experience. A Chinese doctor is likely to choose Rehmannia over an ACE inhibitor.  They are both correct choices with similar scientific reviews in the pubmed entrez index.

 

Is Complementary Care EBVM? 

Many chemotherapeutic agents were originally based on Herbal medicine, including extracts of plants such as the Madagascar Periwinkle, to obtain Vincristine and vinblastine. Research in Herbal medicine elucidates hundreds of active ingredients in many plant and herbal formulae.

The classification of Evidence-based Medicine is often regarded on four levels, with Random controlled trials ranking as the highest – or first level of evidence, and clinical expertise the  fourth level. Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees  accept most forms of Holistic and Integrative therapies which cite clinical reports of successful (increased longevity, QOL- quality of life scores, palliation) outcomes for Cancer therapies. Veterinarians seeking to use these therapies can avail themselves of the literature   accessible  via web based searches Mercola.com, Dr Weil, CIVT, Dog Cancer-Dr Demian Dressler all referencing  scientific literature, verifiable through pubmed.

The Internet is both a powerful tool and a hinderance to help our patients, the latter occuring when clients are mis-led with faulty information. We must choose our search engines wisely.

Discussion and review with recognised specialists/special interest practitioners in their respected fields of Holistic modalities who practice these Integrative therapies and have multiple case studies,  represents  a review  in a level of EBM.

 

Carcinogenic Factors

Clients do not need to feel guilty about the causal agents when their pet suffers from cancer. However part of an anti-cancer awareness program involves removing potential toxins from both their food and their environment. This includes considering the pet's diet, airspace, and coat. 

It is also beneficial for the owner to be aware of environmental toxicities for themselves and their families.  “You will never get the floor mopped until you turn off the tap that is causing the flooding.”

Whatever is consumed/placed on or in,  is what the body is made out of. 

Acrylamides produced when carbohydrates are cooked to a high temperature are a common factor prevalent in the Pet food industry.  Studies regarding carcinogenic and neurotoxic effects of acrylamide on animal models suggest that acrylamide can produce tumors in the thyroid gland, testes, mammary gland, lungs, brain, and also enhance mutation, a step to cancer (3)

For a more extensive review of carcinogens please refer to Dr Samuel Epstein, a recognised world leader and international expert  on cancer risks of petrochemicals and  consumer products.

Within the oral cavity it is possible that a local  pro-inflammatory precursors to cancer could include periodontal disease and xeno-oestrogenic ingestion/contact of petrochemicals, insecticides (from coat licking and hair caught interdentally) as acrylamide and Bisphenol-A are potential mutagens.

There is also a greater risk of cancer due to oxidative pro-inflammatory stress on obese individuals, therefore a nutritionally complete and balanced but lower calorie diet is recommended. There is adequate EBM data to support CRON, Calorie Restricted Optimal Nutrition diets, as seen in the longevity studies based on the Okinawan, Azurbyzani, Vilcambambans and Georgian populations across the globe. 

  

Weed, Seed & Feed: Nutritional Therapies

Weed: Contributing Factors Environmental Toxins:  Removing, eliminating, and “detoxing” the body is an integral part of  holistic therapy. A recent USA study analysing blood and urine samples of pets showed levels of plastics and food packaging chemicals, heavy metals, fire retardants, and stain-proofing chemicals of 48 chemicals, many of them carcinogenic.  Dogs have much higher rates of many kinds of cancer than do people, according to the Texas A&M Veterinary Medical Center (2008) It is postulated that their risk factors are increased through having a larger surface area/mass ratio, being fed contaminated commercial diets, living closer to the ground where chemicals accumulate and they breathe in, ingest or absorb the carcinogenic chemicals. Chemicals found included high levels of phthalates -Industrial plasticizers, fire retardant chemicals polybrominated diphenyl ethers ( PBDEs), and teflon perfluorochemicals .

Roundup (Monsanto's glyphosphate) has been found to have adverse effects in all standard categories of toxicological testing. Damage to cell membranes and DNA, along with an inhibition of cell respiration has been identified.  The surfactant ingredient in Roundup is more acutely toxic than glyphosate itself, and the combination of the two is even more toxic. 

 

FEED & SEED--Nutritional support: 

Feed: The strategy used in nutritional therapy is based on targeting the stages of Cancer  growth as outlined in John Boik's book Natural Compounds in Cancer therapy, which can be downloaded from Amazon. The stages are : Cellular Differentiation, Apoptosis (or lack of), Angiogenesis, Metastasis, Invasion, Mitosis and Evasion of the Immune system. There are various food factors that complement cancer care and specifically target several of these stages. Overall beneficial support for the immune system to enable it to “seek and destroy” cancer cells involves feeding a healthy diet, and adding supplements.  This field of study is known as Nutrigenomics where  nutrients affect gene expression, which are then able to switch on or off production of immunoglobulins or the inflammatory cascade affecting the immune system. 

Seeding the gut is equally important, as the gut is the largest organ system in the body, with the greatest impact on  inflammatory cytokine release, which can be absorbed through the body via the leaky gut syndrome.  A live probiotic culture taken orally daily with prebiotic food therapy allows the gut health to move towards overall healing.

Ingested micro RNA  exists in plants, and research has shown that eating the wrong plants may transfer this plant 

Organotherapy involves feeding healthy fresh tissue of the type of organ biologically appropriate to the animal that has an unwell organ system.  For instance if there are signs of degenerative myelopathy then spinal cord is fed, if there is hepatopathy then small amounts of fresh organic liver is fed. 

This usually means feeding fresh young offal or organ meat such as lungs, heart, liver and kidney to omni, or carni-vores. In TCM terms the  life force or Jing is a significant aid to health if the ingredients are ingested. For instance if an aged animal has liver cancer, as well as feeding nutrigenomic foods that will decrease the tumour growth, supporting healthy liver tissue by feeding young lamb lliver constitutes organotherapy. Worming for parasites, such as hydatids at the recommended 6 weekly interval must be observed, as is mandated by the New Zealand Agricultural authorities to prevent human infections.

Fresh foods rich in Antioxidants, with balanced trace minerals provide free radical mopping effects and are anti-inflammatory.  As inflammation drives cancer, using as many methods of reducing this process in the diet is recommended. Adding vegetables in proportion to the species appropriate   diet can be useful. Green leafy vegetables such as spinach, romaine lettuce, collards, broccoli, kale, and parsley are packed with nutrients carotenoids and minerals that are co-factors to antioxidant enzymatic pathways. Omega 3, organ meats (liver, heart, tongue, kidney (source of coenzyme q 10) Seaweed (Iodine and Selenium) and coloured vegetables and fruit (beets, carrots, berries) rich in OPC's  are beneficial. Dr Terry Wahls explains the nutritional benefits for the treatments of chronic diseases in 9 cups of vegetables and berries daily in an excellent you tube Tedx video https://youtu.be/KLjgBLwH3Wc?si=dGXFsuc4axVTsvgD

Terry pointed out that her MS, and other chronic diseases can  be reversed by eating well. The extrapolation seen in the veterinary industry has been multiplied by using these principles in many veterinary practices, see Dr Bruce Syme's  pre packaged foods, and TCVM food therapy cookbook ideas which can all lead to an improvement in overall health.

 Animal Wellness.com.au has several diet plans for treatment, which can be tweaked depending on the patient,  integrated with TCM principles. Dr Joanna Budwig, german biochemist a research Scientist invented The Flaxseed (Linseed) oil diet with cottage cheese diet in 1951 which is modified for our patients using fish oil.

 

Western anti-tumorigenic Herbal blends: The two most recognised mixtures of herbs that are often used in Herbal Cancer therapeutics are the Essiac and the Hoxsey formula. Both of these warrant a full lecture in themselves, as the herbal ingredients have been well studied individually for their anti-cancer properties.  Essiac consists of four herbs: Turkey rhubarb, Sheep Sorrel, Slippery Elm bark, and Burdock root. The mixture is based on the Ojibwa healing herb tea-  an American Indian tribal wildcrafted drink.

Harold Hoxsey supposedly formulated his more extensive herbal brew , now called the Hoxsey formula- when he noticed horses with diseases selecting particular herbs from the paddock. 

 

Eastern anti-tumorigenic Herbal blends: TCVM has  methodology involved in diagnosing and treating the patient based on tongue and pulse and whole body observation.  Treatment aims to strengthen and balance the whole body, using acupuncture, food therapy, tui na and herbal medicine. 

Tumours, or lumps, are treated as Phlegm or Blood stagnation, and the herbal formulaes that are used to “shift” this stasis are referred to as “blood movers”. Like a sommelier tasting fine wine, skilled herbalists developed their trade over centuries and can accurately identify such potent antioxidant chemicals as Berberine, Catechins, Citral  and Sesquiterpines, by smell and taste, choosing balanced blends of herbs to perform the duties required of them.  Balanced formulae suited to the individual patient are created to strengthen an individual's Qi and to move the stagnation.

 

Essential oils- EO

Notable amongst plant products are the extracts previously known as Aromatherpay,  now referred to as Essential oils (EO). EO's are applied in a topical, oral or rectal manner and have a history of being used neat in Europe. They are placed in capsules or mixed in a carrier oil, or  applied topically undiluted.  This therapy is relatively new to Western Veterinary Medicine, and care must be taken, as some EO's are known to have toxicities, particularly the “hot” oils containing carvacol, with know species  toxicities such  Tea Tree oils with cats.  However, the data that has accumulated over the last 10 years supports the use of several EO's found in plants, particularly those high in Citral, Limonene, Boswellic acid as anti-tumorigenic compounds. These compounds are found in lemon, orange, lemon myrtle, lemon grass, Artemisin, and Frankincense. 

Immune modulating substances that boost NF Kappa Beta are also found in antiviral oils such as Basil, Thyme, Melissa officinalis, Clary Sage, Red Sage and St John's wort, which may be especially useful in cases where the cancers are known to have been linked to viruses such as the  papilloma or leukemia virus.

 

Vitamin B 17- Laetrile

Laetrile is found in the seeds of many plants and fruit, particularly high in apricot seeds. It has been shown to inhibit the growth of tumors, stop metastases, relieve pain and act as a cancer preventative.

Dr Kanematsu Sugiura, a well respected Japanese scientist working at the Memorial Sloan Kettering institute showed that the substance taken from the apricot seed kernel slowed metastases. Dr. Sugiura said, "The most interesting part is metastases. Secondary cancer growth to another location. When this mammary tumor grows to about two centimetres in diameter or more, about 80% develop lung metastases. But with treatment with laetrile/amygdalin, it's cut down to about 20%."

 

• Omega 3 oil have beneficial effects in patients with cancer
• Boswellic Acid and Corydalis are effective in controlling pain and inflammation.
• Mushroom extracts- There are numerous varieties of mushrooms which possess immunomodulating factors and stimulate anti-cancer properties. Notably are the Turkey tail Ganoderma, and Shiitake. Five Mushroom extract combines several.
• High Dose IV Vitamin C – Biologicaltherapies.com carries the product required, as well as a significant data base of articles supporting its use. 
• Mannose- Various companies produce these sugars which aid the immune system.
• Resveratrol- Grape seeds and skin act as an antioxidant and anti-cancer agent.
• Catechins- Green tea can be added as a potent source of antioxidants
• Turmeric- This very inexpensive powder or fresh root has many anti-cancer properties.
• Probiotics- Gut health with attention to preventing IBS/IBD and balancing “good bugs” to bad bugs, changing the TH1:2 ratio of inflammation to antiinflammatory and decreasing exotoxins (clostridia) helps the immune system.
• Apoptotics: Scutellaria baicalensis, Bupleurum, Chelidonium-chinese formulae
• Vitamin D3- 15 minutes of sun exposure/day
• Neoplasene or Black Salve- escharotics that preferentially destroy rapidly growing cancer cells contain Bloodroot,Galangal, Gravioli, Chapparel, Zinc Chloride, DMSO and Glycerine.
• Exercise- releases “happy drug” endorphins, boosts immune function.

 

 The Answer to Cancer- undoubtedly lies in prevention in the first place, holistic therapies can add to quality of life, (QOL) life extension, and may aid in cancer remission.

 

It is worth remembering that "All truth passes through three stages: first it is ridiculed, second it is violently opposed, third it is accepted as being self-evident." Arthur Schopenhauer, German philosopher, (1788-1860) 

 

For those interested in progressing their holistic knowledge this can be achieved through the following:

Animal Wellness runs regular seminars with invited guest speakers– befriend us on Facebook!

AVA Annual conference has an Acupuncture Stream alternating annually in conjunction with a Holistic Stream.

Australasian College of Medical Nutrition: http://www.nutritioncollege.org 

Australasian College of Nutritional and Environmental Medicine: http://www.acnem.org

Australian College of Holistic Medicine  http://www.nutritionmedicine.org

TCVM AustraliaTCVM Australia | Courses - www.tcvm.com.au

Integrative Veterinary Therapy | Veterinary Courses | Veterinary Medicine - www.civtedu.org

 

Studying Acupuncture in Australia:

• International Veterinary Acupuncture Society (IVAS) course in Australia:
• Details on website and Facebook page of:
• College of Integrative Veterinary Therapies (CIVT): www.civtedu.org
• Coordinated by CIVT, Australian Veterinary Acupuncture Group (Special interest group of the AVA) and IVAS
• Held every 2-3 years since 1991
• Next course starting in 2012
• Around 350 IVAS qualified veterinary acupuncturists in Australasia
• Full details on website:
• www.civtedu.org

 

Australian Veterinary Acupuncture Group:

• A Special Interest Group of the Australian Veterinary Association (AVA)
• Monthly e-newsletters, quarterly Journal and seminars and conferences
• Student membership only $20 annually
• Pay direct to AVAG Treasurer or through AVA
• Website: www.acuvet.com.au

 

Text books

• Veterinary Acupuncture: Ancient Art to Modern Medicine by Dr Allen Schoen
• Xie’s Veterinary Acupuncture by Dr Huisheng Xie
• Traditional Chinese Veterinary Medicine: Fundamental Principles by Dr Huisheng Xie
• Dr Xie’s books and other educational aids through: www.tcvm.com

 

 

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34)Comment on "Pharmacologic ascorbate synergizes with gemcitabine in preclinical models of pancreatic cancer," i.e., all we are saying is, give C a chance.

Cullen JJ, Spitz DR, Buettner GR.

Free Radic Biol Med. 2011 Jun 15;50(12):1726-7. Epub 2011 Apr 1. No abstract available.

 

35) Intravenous ascorbic acid to prevent and treat cancer-associated sepsis?

Ichim TE, Minev B, Braciak T, Luna B, Hunninghake R, Mikirova NA, Jackson JA, Gonzalez MJ, Miranda-Massari JR, Alexandrescu DT, Dasanu CA, Bogin V, Ancans J, Stevens RB, Markosian B, Koropatnick J, Chen CS, Riordan NH.

J Transl Med. 2011 Mar 4;9:25.

 

 

36) Vitamin C and cancer: what can we conclude--1,609 patients and 33 years later?

Cabanillas F.

P R Health Sci J. 2010 Sep;29(3):215-7. Review.

 

 

37) H(2)O(2)-mediated cytotoxicity of pharmacologic ascorbate concentrations to neuroblastoma cells: potential role of lactate and ferritin.

Deubzer B, Mayer F, Kuçi Z, Niewisch M, Merkel G, Handgretinger R, Bruchelt G.

Cell Physiol Biochem. 2010;25(6):767-74. Epub 2010 May 18.

38) Ascorbate induces autophagy in pancreatic cancer.

Cullen JJ.

Autophagy. 2010 Apr;6(3):421-2. Epub 2010 Apr 15.

 

39) High dose of ascorbic acid induces cell death in mesothelioma cells.

Takemura Y, Satoh M, Satoh K, Hamada H, Sekido Y, Kubota S.

Biochem Biophys Res Commun. 2010 Apr 2;394(2):249-53. Epub 2010 Feb 19.

 

40) Ascorbate inhibition of angiogenesis in aortic rings ex vivo and subcutaneous Matrigel plugs in vivo.

Mikirova NA, Casciari JJ, Riordan NH.

J Angiogenes Res. 2010 Jan 18;2:2.

 

41) [Vitamin C in complementary oncology--update 2009].

Gröber U.

Med Monatsschr Pharm. 2009 Jul;32(7):263-7. Review. German.

42) Depletion of L-ascorbic acid alternating with its supplementation in the treatment of patients with acute myeloid leukemia or myelodysplastic syndromes.

Park CH, Kimler BF, Yi SY, Park SH, Kim K, Jung CW, Kim SH, Lee ER, Rha M, Kim S, Park MH, Lee SJ, Park HK, Lee MH, Yoon SS, Min YH, Kim BS, Kim JA, Kim WS.

Eur J Haematol. 2009 Aug;83(2):108-18. Epub 2009 Mar 5.

43) Pharmacologic concentrations of ascorbate are achieved by parenteral administration and exhibit antitumoral effects.

Verrax J, Calderon PB.

Free Radic Biol Med. 2009 Jul 1;47(1):32-40. Epub 2009 Feb 28.

 

44) [Therapeutic effect of intravenous high-dose vitamin C on implanted hepatoma in rats].

Peng LJ, Lu DX, Qi RB, Zhang T, Wang Z, Sun Y.

Nan Fang Yi Ke Da Xue Xue Bao. 2009 Feb;29(2):264-6. Chinese.

 

45) Synergistic potentiation of D-fraction with vitamin C as possible alternative approach for cancer therapy.

Konno S.

Int J Gen Med. 2009 Jul 30;2:91-108.

46)The controversial place of vitamin C in cancer treatment.

Verrax J, Calderon PB.

Biochem Pharmacol. 2008 Dec 15;76(12):1644-52. Epub 2008 Sep 30. Review.

Vitamin C and cancer revisited.

Frei B, Lawson S.

Proc Natl Acad Sci U S A. 2008 Aug 12;105(32):11037-8. Epub 2008 Aug 5. No abstract available.

 

47) Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice.

Chen Q, Espey MG, Sun AY, Pooput C, Kirk KL, Krishna MC, Khosh DB, Drisko J, Levine M.

Proc Natl Acad Sci U S A. 2008 Aug 12;105(32):11105-9. Epub 2008 Aug 4.

48) Docosahexaenoic acid: A natural powerful adjuvant that improves efficacy for anticancer treatment with no adverse effects.

Siddiqui RA, Harvey KA, Xu Z, Bammerlin EM, Walker C, Altenburg JD.

Biofactors. 2011 Oct 28. doi: 10.1002/biof.181. [Epub ahead of print]

49) n-3 PUFAs in cancer, surgery, and critical care: a systematic review on clinical effects, incorporation, and washout of oral or enteral compared with parenteral supplementation.

van der Meij BS, van Bokhorst-de van der Schueren MA, Langius JA, Brouwer IA, van Leeuwen PA.

Am J Clin Nutr. 2011 Nov;94(5):1248-65. Epub 2011 Sep 21.

 

50) http://www.avds-online.org/info/oraltumors.html Accessed 2/12/11

 

Environmental Working Group, Vermont: April 2008  High Levels of Toxic Industrial Chemicals Contaminate Cats And Dogs

By Olga Naidenko, Rebecca Sutton, Jane Houlihan, April 2008http://www.ewg.org/reports/pets

51)http://articles.mercola.com/sites/articles/archive/2012/01/10/herbicide-poison-groundwater-supply.aspx?e_cid=20120110_DNL_art_2 accessed 9/1/12

http://www.care2.com/greenliving/bacon-processed-meat-linked-to-pancreatic-cancer.html

 

52) Pers com Dr Ihor Basko, Kauai Hawaii, Internationally recognised Holistic Veterinarian

 

53) http://www.hsl.unc.edu/Services/Tutorials/EBM/ebp_tutorial.pdf Duke Medical School, accessed Jan 2012.