The authors, in a previous article, described the long-term survival of a man with pancreatic cancer and metastases to the liver, treated with intravenous alpha-lipoic acid and oral low-dose naltrexone (ALA/N) without any adverse effects. He is alive and well 78 months after initial presentation. Three additional pancreatic cancer case studies are presented in this article. At the time of this writing, the first patient, GB, is alive and well 39 months after presenting with adenocarcinoma of the pancreas with metastases to the liver. The second patient, JK, who presented to the clinic with the same diagnosis was treated with the ALA/N protocol and after 5 months of therapy, PET scan demonstrated no evidence of disease. The third patient, RC, in addition to his pancreatic cancer with liver and retroperitoneal metastases, has a history of B-cell lymphoma and prostate adenocarcinoma. After 4 months of the ALA/N protocol his PET scan demonstrated no signs of cancer. In this article, the authors discuss the poly activity of ALA: as an agent that reduces oxidative stress, its ability to stabilize NF k B, its ability to stimulate pro-oxidant apoptosic activity, and its discriminative ability to discourage the proliferation of malignant cells. In addition, the ability of lowdose naltrexone to modulate an endogenous immune response is discussed. This is the second article published on the ALA/N protocol and the authors believe the protocol warrants clinical trial.

The authors describe the long-term survival of a patient with pancreatic cancer without any toxic adverse effects. The treatment regimen includes the intravenous -lipoic acid and low-dose naltrexone (ALA-N) protocol and a healthy lifestyle program. The patient was told by a reputable university oncology center in October 2002 that there was little hope for his survival. Today, January 2006, however, he is back at work, free from symptoms, and without appreciable progression of his malignancy. The integrative protocol described in this article may have the possibility of extending the life of a patient who would be customarily considered to be terminal. The authors believe that life scientists will one day develop a cure for metastatic pancreatic cancer, perhaps via gene therapy or another biological platform. But until such protocols come to market, the ALA-N protocol should be studied and considered, given its lack of toxicity at levels reported. Several other patients are on this treatment protocol and appear to be doing well at this time.Keywords: pancreatic cancer; naltrexone; lipoic acid; survival J.A. is a 46-year-old man diagnosed with poorly differentiated adenocarcinoma of the pancreas with metastases to the liver. In early October 2002, J.A. started to feel vague abdominal pains as well as complained of symptoms associated with hyperacidity and indigestion. After his symptoms became more pronounced, he presented to the local emergency department where, secondary to his complaint of right lower quadrant abdominal pain, a computed tomography (CT) was performed on October 8, 2002. It revealed a hyperdense mass at the junction of the second and third portions of the duodenum and uncinate process of pancreas (Figure 1).The mass had infiltrative margins, without local adenopathy. Furthermore, within the liver, there were at least 3 hyperdense lesions that were thought to possibly represent hemangiomas; a fourth lesion, 5 to 6 cm in diameter, contained some areas of hypodensity, thus suggestive of a neoplastic process (Figure 2).Six days later, an esophagogastroduodenoscopy was performed, and an ulcerated Ampulla of Vater was biopsied; the pathology report was significant only for acute and chronic inflammation. One day later, magnetic resonance imaging (MRI) of the liver was performed in an attempt to classify the multiple hepatic lesions recognized on CT. The MRI suggested the lesions were not indicative of hemangiomata but rather of metastatic deposits. Subsequently, a 3.9´3.9 cm mass was located associated with the head and Intravenous -Lipoic Acid/Low-Dose Naltrexone shows a hyperdense mass at the junction of the second and third portions of the duodenum and the uncinate process of the pancreas (circled).

No abstract

Alpha lipoic acid (ALA, thioctic acid), among other actions, is an essential coenzyme in the conversion of pyruvate to acetyl co-enzyme A. Therefore, it is necessary for the production of energy for aerobic organisms. Scientists have found that it can be used medically to help regenerate liver tissue, reverse the complications of diabetes mellitus, slow or stop the growth of cancer cells, and chelate heavy metals, among other actions. In this article, the authors describe the cellular mitochondrial damage from excessively high doses of this beneficial agent.

There are no remarkably effective treatments for chronic hepatitis C in general use. Interferon and antivirals have less than a 30% response rate and because of the residual viremia, a newly transplanted liver usually becomes infected again. The triple antioxidant combination of alpha-lipoic acid, silymarin and selenium was chosen for a conservative treatment of hepatitis C because these substances protect the liver from free radical damage, increase the levels of other fundamental antioxidants, and interfere with viral proliferation. The 3 patients presented in this paper followed the triple antioxidant program and recovered quickly and their laboratory values remarkably improved. Furthermore, liver transplantation was avoided and the patients are back at work, carrying out their normal activities, and feeling healthy. The author offers a more conservative approach to the treatment of hepatitis C, that is exceedingly less expensive. One year of the triple antioxidant therapy described in this paper costs less than $2,000, as compared to mor than $300,000 a year for liver transplant surgery. It appears reasonable, that prior to liver transplant surgery evaluation, or during the transplant evaluation process, the conservative triple antioxidant treatment approach should be considered. If these is a significant betterment in the patient's condition, liver transplant surgery may be avoided.