In the August 2020 Current Molecular Pharmacology, researchers say they demonstrated that amygdalin can kill certain breast cancer cell lines and that amygdalin may prevent those cells from spreading throughout the body. They also state that it wasn’t toxic to healthy skin cells.
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Blaheta RA, et al.
Proponents of laetrile claim that the cyanide it releases in the body causes apoptosis in cancer cells without damaging healthy cells. This idea has especially been promoted for several types of cancer, including:
There’s no harm in including these foods in your diet as long as it’s in healthy amounts. Be sure to include your doctor in any dietary changes you make.
No convincing evidence showing that amygdalin induces rapid, distinct tumor regression in cancer patients, particularly in those with late-stage disease, is apparent.
Perhaps most provocative is the recent report that 40% of Americans believe that use of CAM is sufficient for the management of cancer (National Cancer Opinion Survey, 2019). In addition, 22% of Americans with a history of a cancer diagnosis and 38% of family caregivers share this belief. However, a recent study evaluated overall survival and adherence to treatment in patients receiving conventional cancer treatment with or without CAM for cancers considered curable. Patients who used CAM had significantly decreased overall survival when compared to those who did not, and also had higher rates of refusal of standard therapy (Johnson et al., 2018). Notably, this risk of death is linked to the refusal of therapy and not to the use of CAM itself. This demonstrates the importance and need for transparent, open discussions with patients regarding current available therapies, expected outcomes, and alternatives that patients may be seeking or have not yet disclosed.
In this case report, we present a woman with LGSOC who declined primary systemic chemotherapy followed by interval surgical resection and opted for CAM therapy with Laetrile (amygdalin) and cannabidol (CBD) oil. The patient has granted permission for this publication.
Cannabidiol (CBD) is a compound naturally derived from the cannabis plant. The anti-cancer effects of CBD have been evaluated predominantly in the laboratory setting. Interestingly, ovarian cancer cell lines express GPR55, a target that is inhibited indirectly by CBD and that plays a role in prostate and ovarian cancer cell proliferation (Piñeiro et al., 2011). Mouse model studies have also demonstrated cannabinoids inhibit tumor cell growth and induce apoptosis in gliomas, lymphomas, prostate, breast, lung, skin, and pancreatic cancer cells (Sarfaraz et al., 2008). Despite this theoretical benefit, there is not clear evidence that it has more or less activity than standard treatments in cancer patients.
An 81-year-old woman presented to her primary care physician with an umbilical mass that was suspected to be a hernia in March 2017. She was taken to the operating room in April 2017 for planned herniorrhaphy. The surgical findings were notable for a solid, peri-umbilical mass, as well as diffuse intra-abdominal nodularity. Final pathology of the resected umbilical lesion demonstrated a serous carcinoma, likely mullerian primary based on immunohistochemistry staining. Her Ca-125 was found to be elevated at 77.
In addition to standard treatments, an increasing proportion of patients are exploring and incorporating complimentary alternative medicine (CAM) for the management of their cancers. Use of CAM is common among gynecologic cancer patients, although many patients may not disclose use to their treating physician. Women who are older are more likely to use CAM either in conjunction with standard treatment or alone, as compared to their younger or male counterparts (Gansler et al., 2008). These therapies may or may not be recommended by their primary oncologist, and many have not been evaluated in a clinical trial setting.
In an effort to improve oncologic outcomes, investigators have attempted to capitalize on molecular aberrations identified in LGSOC specimens. Most recently, the utilization of MEK inhibitors have been explored due to noted activation of the mitogen-activate protein kinase (MAPK) pathway in LGSOC. A phase II trial evaluating Selumatib activity in women with recurrent LGSOC (GOG 0239) demonstrated a 15% overall response rate, catalyzing the development of phase III trials examining alternate agents in this setting (Farley et al., 2013). A phase III study evaluating Trametinib vs. physicians choice chemotherapy in patients with recurrent or progressive LGSOC (GOG-281) has closed to accrual and will help guide further management with these targeted agents. Furthermore, efforts to identify appropriate patient subsets based on molecular profiling are ongoing. In context of the above, optimal management of these relatively chemotherapy-resistant tumors due to their low-grade nature remains an active area of investigation.
Low grade serous ovarian cancer (LGSOC) is a rare subtype of serous epithelial ovarian cancer, comprising approximately 10% of all cases of serous carcinoma. The majority of women are diagnosed with advanced stage disease, despite its slow growth. Treatment options for advanced disease include neoadjuvant chemotherapy followed by interval surgical cytoreduction or primary surgical resection followed by adjuvant therapy as well as maintenance hormonal therapy (National Comprehensive Cancer Network, 2019). Adjuvant therapy traditionally consists of combination platinum and taxane based chemotherapy, although response rates are limited, and may include concurrent/maintenance hormonal therapy. Even with advanced stage at diagnosis, patients with LGSOC have an improved prognosis when compared to their high grade serous counterparts, with median overall survival of approximately 100 months reported, reflective of a protracted clinical course (Gershenson et al., 2015).