Anti-Worm Drug Holds Promise For Cancer Patients

An drug commonly used to eliminate parasites in dogs and cats has emerged as an unlikely but promising candidate to treat a variety of cancers in humans.  Researchers are optimistic that Fenbendazole, a staple of veterinary practice, eventually will be approved for cancer therapy.

Mounting research on mice has shown that the anti-worm treatment, one of a class of drugs called benzimidazoles, inhibits cancer tumor growth by killing diseased cells.  In addition, Fenbendazole blocks the intake of glucose in cancer cells, depriving them of their primary fuel.

Early animal studies have demonstrated Fenbendazole and its cousin Mebendazole could be effective in treatment therapy for a host of cancers, including prostate, lung, lymphoma, glioblastoma and brain tumors.  Oncologists would have a new weapon in their arsenal in the battle against cancer.

Researchers stumbled upon the the discovery by accident.  In 2014, a Johns Hopkins team was attempting to grow tumors in laboratory mice.  In one set of mice, they were stumped because it was the only group that showed no tumors.  They realized that group had been dewormed in advance.

As researchers dug deeper into the drug, they found that it had been previously reported Fenbendazole has anti-cancer properties.  Word spread about the discovery and soon researchers in various labs were conducting their own experiments with the anti-worm drug.

A 2018 study published in Nature further set the cancer world buzzing.  An article reported that researchers concluded there was evidence that Fenbendazole may be effective in the elimination of cancer cells.  As it turns out, the use of similar drugs was nothing new in the cancer field.

In the early 90's, a drug called Lemaziole was shown as a complementary treatment for colon cancer, which also restored a depressed immune system.  That means this class of drugs could be used in conjunction with chemotherapy and radiation treatments to wipe out the disease.

Various articles have appeared in newspapers and other publications over the years offering testimonies of cancer patients who have claimed to use Fenbendazole or another similar drug with successful results.  However, this anecdotal evidence is no substitute for clinical research. 

The good news is that Fenbendazole has already been used in clinical trials and has been deemed safe for human consumption.  Unlike chemotherapy and radiation, there are no known serious side effects.  However, doctors still are wary about the effects of long-term use.

But that hasn't deterred researchers.  Bin Chen, a faculty member in Pediatrics in the Institute for Computational Health Sciences at University of California-San Francisco, conducted experiments in mice and expressed cautious optimism about the drug's effectiveness in killing cancerous liver tissue.

"We found these disease genes were reversed after six weeks of treatment in a patient-derived tissue in the mouse model," he was quoted on the UCSF website.  Chen said his team reviewed more than 1,000 current drugs before discovering deworming pills were effective.

Chen was able to evaluate that large a number of drugs quickly, using data tools to screen and identify candidates that would target genes in cancerous liver tissues.  He cross-referenced data on genes and common drugs to find the proverbial needle in the haystack.

Chen is at the forefront of a growing field of researchers looking at approved drugs to repurpose them in treating cancer patients. If successful, this will drastically reduce the millions of dollars spent on years of research and speed up the drug's time to market. 

The next step is for human trials, known as Phase I studies.  The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins has begun recruiting patients for research to determine the safety and side effects of large doses of Mebendazole to treat progressive pediatric brain tumors.

Mebendazole has already been approved by the Food and Drug Administration for parasitic infections in humans and has a long track record of human use.  The drug is frequently used in countries with tropical climates at high doses for rare parasitic infections of the brain.

The trial's primary objective will be to determine the maximum tolerated dose of oral Mebendazole in patients with either recurrent or progressive pediatric brain tumors, according to information posted by the National Cancer Institute.

The research will also gauge the safety, tolerance and toxicity of the drug in patients.  Another focus will be determining the overall survival rate of patients treated with escalated dosages of Mebendazole.

As is the case with most drug trials, the study will require at least two years.  The estimated study completion date is June, 2022.  However, an advantage is the anti-parasitic drug is widely available, so if it proves effective, large quantities can be immediately distributed to patients.

Sadly, too often potentially promising developments on the cancer front are dashed in trials that fail to produce evidence to support the optimism.  This time the hope is that the research outcome leads to the implementation of a new treatment to arrest cancer and save lives.

Chemotherapy Ward: Facing My Worst Fears

Shafts of light from rows of windows illuminate the sterile room. A sallow-faced woman hooked up to an intravenous drip slouches in a oversized lounge chair.  Her bald head, cloaked by a crocheted hat, droops on her chest.  A toxic cocktail of drugs surges through her body as she naps.

A tube winds from a plastic bag to a port, a small disk inserted under the skin in her chest.  The drugs sap her strength and drain her energy.  From her looks, she appears to be in her 70's.  It's only a guess because cancer and chemotherapy sabotage the body, affecting your physical appearance.

As I approach the petite woman, I observe the hushed conversations swirling around patients seated in adjoining chairs.  Some patients read to pass the time.  Others watch television or listen to music.  The fortune ones have family sitting in comfortable chairs next to them, chatting quietly.

When I reach the woman, I see a blanket hugs her tiny frame.  She is experiencing chills. However, there are worst side effects.  Vomiting and nausea are the most common.  But the list of reactions is long: fatigue, infection, anemia, loss of appetite, digestive distress, anxiety and hair loss.  And more.

The anonymous woman is in the Infusion Center at the Mays Cancer Center in San Antonio, a facility affiliated with the UT Health Center and MD Anderson. I am present as a volunteer, offering snacks to patients.  It isn't my first visit to a chemotherapy ward.  But I still feel awkward and nervous.

The woman opens her sleepy eyes as I roll the squeaky snack car near her chair.  I tick off a list of snacks and surprisingly she opts for the ice cream.  With seemingly great effort, she stretches out her withered hand to receive the plastic cup.  She offers her thanks and a smile that warms the room.

As I move from patient to patient, I am amazed by their spunk, their grit.  They are determined to battle this cruel disease on their own terms.  One patient is dressed as if she is attending a fancy charity ball.  I remark on her colorful outfit.  "I won't let cancer define who I am," she says.

Some family and friends faithfully accompany patients to each treatment.  These angels of mercy kibitz with their loved ones, providing a welcome distraction. But it is the patients who are fighting alone who tug at my heartstrings.  Who consoles these souls?  I pray they will be comforted.

These patients are hidden from most of society who will never view the inside of a cancer treatment facility.  Their sufferings go unnoticed and unrecorded except by the doctors, nurses and families who care for them.  Perhaps, if more people witnessed, the war on cancer would be our nation's priority.

According to the American Cancer Society, the latest figures show there were an estimated 1,688,780 new cases of cancer reported in the United States in 2017.  That same year cancer claimed 600,920 lives.  It is our nation's second leading cause of death, eclipsed only by heart disease.

Older Americans, like the fragile patient snuggled in the blanket, are especially prone to the disease as they age. Seventy-five percent of all newly diagnosed cancers occur in people aged 60 and over, according to research by the World Health Organization (WHO).

For many patients, chemotherapy is the regimen of treatment.  A powerful legion of drugs is administered to patients to target cancer cells.  Unfortunately, these drugs also affect healthy cells, weakening the immune system.  In the best outcomes, chemo wipes out cancer cells forever.

Those are the lucky ones.  For others, the chemotherapy cannot cure or arrest the spread of cancer. Potent drugs may temporarily shrink tumors, but they often return with a vengeance.  However, if the cancer is detected early enough, chemo saves lives, even as it ravages the body, mind and soul.

I focus on good outcomes as I greet each patient in the Infusion Center. I find hope in this place that once depressed me. Suffering exists but so does healing. I cringe when I contemplate I may end up here one day.  Good health is no guarantee. Cancer is an insidious evil always hunting new victims.

There are even occasions of joy in this antiseptic place.  When patients complete their last course of treatment, they ring a Victory Bell as they exit the Infusion Center.  Often family and friends are there to celebrate.  A loved one usually videos the ceremony to preserve this triumph of life.

Now that I have been roaming the cancer treatment facilities at the Mays center for several years, I have a new perspective.  I see the patients as part of our community, not diseased, anonymous individuals. They are fathers, mothers, sons and daughters.  Their sole purpose is to beat cancer.

Their lifespan is measured not in years or months or even days.  Each hour is a blessing to be cherished.  My brief encounters with these courageous patients are inspirational.  I forget whatever troubles have squeezed into my life.  They are trivial compared to fighting for another day of life.

When I reflect on the beginning of this volunteer journey, I am embarrassed I was reluctant to venture into the unknown realm of a cancer ward.  However, with introspection and time, now I look forward to seeing these warriors.  I realize I am among heroes and heroines.  That is my reward.

Immunotherapy: New Hope For Treating Cancer

He has been dubbed "The Texas T Cell Mechanic."  For the last 30 years, he has relentlessly studied this particular cell from every angle.  His dogged pursuit of knowledge has produced breakthroughs in the treatment of cancer.  This researcher's name is Dr. Jim Allison, a pioneer in immunotherapy.

The innovator was recognized in December with the Nobel Prize in Physiology and Medicine for his discovery of a cancer treatment that frees a patient's immune system to attack cancerous tumors.  The Nobel committee lauded his research efforts as a "landmark in our fight against cancer."

Editor's Note: Dr. Allison shared the award with Tasuku Honjo, M.D., Ph.D., of Kyoto University in Japan.

Dr. Allison's journey from the South Texas town of Alice to the Nobel ceremony in Stockholm, Sweden, began 70 years ago.  He acquired his interest in medicine observing his father, who was the country doctor in Alice, population 19,100.  His mother died of cancer when he was 10-years old.

Those experiences shaped his passion for medicine, which began at the University of Texas, where he earned a degree in microbiology and then a doctorate in biological sciences.  After college, he pursued his fervor for research in the cancer field, eventually concentrating on T-Cells.

T-Cells, a type of white blood cell, play a key role in the body's immune system.  The cells act as soldiers, patrolling the body, attacking old cells that have reached their expiration date.  But the cells also stalk intruders, such as bacteria, fungi, parasites and viruses, destroying these hostile invaders.

The T-Cell warriors face a formidable task policing an estimated 30 trillion cells in the average human body. And T-Cells are just one of 200 cells living in our body.  Isolating and studying T-Cells was once viewed by experts as nearly an impossible mission.  But Dr. Allison persevered.

Through years of painstaking research, Dr. Allison discovered that T-Cells do not kill every bad guy.  In fact, he found T-Cells have a braking mechanism that restricts it from attacking every cell in the body, the fit ones as well as the diseased cells.  But the brakes allow cancer cells to flourish.

A determined man, Dr. Allison wanted to learn how to ease off the brakes on T-Cells to allow the cells to demolish cancer cells.  The researcher uncovered a protein CTLA-4, found on the surface of T-Cells, which act as the cell's brakes.  Then he zeroed in on how to manipulate the brakes.

Toiling late hours in the lab, he developed an antibody to block CTLA-4, thus removing the brakes and unleashing the T-Cells to attack the marauding cancer cells.  His work paid off with the development of the drug Ipilimumab, the first in a category of drugs known as checkpoint inhibitors.

Dr. Allison, who published a paper on his ingenious finding in 1995, points out that it took "way too long" for the Federal Food and Drug Administration to finally approve the drug in 2011 to treat late-stage melanoma.  There results were unprecedented.

Twenty percent of the patients who took the drug lived for at least three years and many patients survived 10 years and beyond. He remains humble about his achievements, calling it an "emotional privilege to meet cancer patients" who have been successfully treated with the inhibitors.

His pioneering research sparked fellow scientists to study other immune system brakes, which paved the way to the development of drugs to treat other cancers, such as lung, kidney, bladder, gastric, liver, cervical, colorectal, head and neck as well as Hodgkin's lymphoma.

These discoveries have opened a whole new field of immunotherapy, using the body's immune system to battle cancers. Until now, there were basically three ways for doctors to tackle cancer: surgery, chemotherapy and radiation.  Now doctors have a fourth option with fewer side effects.

Even more promising, Dr. Allison believes the T-Cells will continue working long after the treatment has ended.  "The immune cells remain in the body.  If the cancer comes back, the immune cells will attack it," he was quoted on the MD Anderson website.

Dr. Allison's success led to his appointment as director at the Parker Institute for Cancer Immunotherapy at the University of Texas-MD Anderson Cancer Center in Houston.  He captains a team dedicated to expanding the uses of immunotherapy to not only treat but one day cure cancer.

By disabling the T-Cell brakes, Dr. Allison has toppled one more barrier in the war on cancer. As his career illustrates, breakthroughs often take decades.  But with an estimated 609,000 cancer deaths last year alone in the U.S., time is not an ally for those suffering with the disease.

More research and experimentation urgently needs to be done.  But the FDA also must dispense with regulatory red tape to speed up approval of drugs.  Allowing potential life saving drugs to languish in research laboratories robs cancer victims of an opportunity to extend their lives.  

Dogs Have A Nose For Detecting Cancer

Cancer researchers are finally going to the dogs.  After decades of anecdotal evidence, studies now confirm that canines' keen sense of smell can detect cancer in humans. The challenge for scientists is to figure out how to harness dogs' ability to sniff out cancer to detect the disease in its earliest stages.

Over decades, many stories emerged about dogs discovering cancer in their owners.  Scientists mostly dismissed the accounts because there was no research to validate the episodes.  However, a growing number of studies have verified that trained dogs can indeed spot many types of cancer.

That finding doesn't surprise dog owners with first-hand experience with the phenomenon.  For instance, a San Antonio woman noticed her golden retriever began drooping his head in her lap.  He repeated this every day.  The women went for a check up and was diagnosed with kidney cancer.

A Rochester, Minnesota, woman was studying for a university test when her golden retriever-St. Bernard mix-breed began nosing at her left side.  The dog became agitated.  When the woman wiped away the dog's slobber, she felt a lump.  She was later diagnosed with breast cancer.

A Hollywood actress reported a similar experience with her German Shepherd.  She discovered that she had breast cancer too.  So what enables a dog to be able to sense the disease?  The answer is dog gone simple.  Canines have a nose for it.

Dogs have about 300 million odor receptors, compared to about six million for humans.  They also are equipped with a second smelling apparatus, the vomeronasal organ.  It has sensors near the back of the nasal cavity that detect certain chemical substances.  But dogs have another advantage.

The section of the dog's brain devoted to analyzing smells is 40 times larger than a human's brain capacity.  By some estimates, scientists claim that the dog's sense of smell may by 10,000 to 100,000 times more sensitive than we lowly human beings.

Law enforcement officers may have been the first to employ dogs to sniff out illegal paraphernalia.  They trained canines to find hidden drugs and contraband using their sense of smell. Dogs have been deployed by security and the military from airports to war zones to detect concealed bombs.

A few years ago scientists began investigating another application: using dogs to detect cancer in humans. Oncologists generally agree that cancer tumors emit unique odors, which cannot be recognized by humans or even the latest detection technology.  Could dogs smell cancer?

That question triggered a series of studies in the United States and abroad.  Among the most exciting was an Italian study which showed that two German Shepherds analyzing urine samples from nearly 900 patients correctly identified cancerous specimens with almost 100 percent accuracy.

The findings generated headlines but also skepticism among some scientists, who can be stubbornly resistant to new ideas.  They needed more convincing.  Veterinarians came to the rescue.  The Penn Vet Working Dog Center the University of Pennsylvania demonstrated the power of dog's nose.

Dogs at the center were trained using what they refer to as a "scent wheel"--a round table hung with bread-loaf sized, perforated steel boxes around the perimeter.  The boxes are stuffed with odor samples.  A few boxes include cancerous urine, tissue and blood samples.

If the dog smells cancer, it sits in front of the box.  As part of the training, researchers put decoy boxes with blood samples that are noncancerous.  After intensive training, the dogs learn to spot cancer with surprising accuracy.  The demonstration convinced even some skeptics.

Other trials have quantified that dogs can be trained to sniff urine, blood and even biological samples to detect a range of cancers, including bladder, breast, colorectal, lung, ovarian, prostate and skin.  Dogs can't identify the particular cancer, but do smell the presence of the disease.

Scientists are warming to the idea of training dogs to sniff cancer screening samples.  However, the humans in the white lab coats consider it a logistical nightmare to train thousands of dogs.  But what if a machine that could mimic a dog's sense of smell?  There must be an app for that, right?

The Monell Chemical Senses Center, a nonprofit that collaborates with the University of Pennsylvania, has begun to tackle the issue of designing a computer chip with enough capacity to match the canine's olfactory ability.  Scientists admit it it may be an impossible feat.

However, there are devices (i.e. electronic noses) that are already used in breath tests administered by law enforcement officers.  Other devices have been engineered to detect one particular smell.  But to be effective, the new technology must be able to distinguish hundreds of different smells.

In the future dogs, perhaps will work along side instrument-based cancer detectors. This approach may yield earlier detection for some cancers.   If it does, dogs will no longer be just a human's best friend.  Canines could be a humanity's best chance for surviving cancer.

A Survivor's Story: Riding Rings Around Cancer

America's celebrities are lionized in the media.  They are idolized by an adoring public. But there are far more courageous people who deserve the spotlight.  One such man is Allan Kokinda.  He absorbed every crushing punch the pugnacious disease cancer delivered and survived.

The 54-year old San Antonio motorcycle repairman suffered through 34 brutal operations, debilitating chemotherapy treatments and endless medical setbacks for eight agonizing years. No one would have blamed him if he had given up.  But Allan refused to quit.  He kicked cancer's butt.

In 2007, Allan was diagnosed with Osteosarcoma, a rare form of bone cancer that attacked his head. What began as persistent rash on his forehead nearly ended his life.  Three metal plates were inserted into his head.  Infections dogged him, leading to more surgeries to embed new plates.  

The surgeries left Allan's head disfigured.  He draped covers over the mirrors in his house.  He avoided looking at his reflection in any surface. He remembers that despair was his constant companion during cancer's siege. His mental and physical suffering were crippling.

"It just wore me out," Allan recalls.  "I had no energy.  I gained a lot of weight because I was inactive. I was shocked one day when the doctors told me I wasn't going to die.  I was shocked because I never thought that I was going to die."

Doctors at the UT Health San Antonio/Cancer Center treated Allan's disease.  Their care and expertise helped Allan survive the dreadful trial no human should be asked to endure.  Allan stubbornly shunned surrender.  "I won't forget the day they told me I was cancer free," he smiles.

He received the good news in 2015.  During his exhaustive treatments, Allan often daydreamed about riding his bicycle during high school and college years.  He had no car back then, so the bike was his only mode of transportation. He literally grew up on a bike.

After some soul searching, Allan decided to get back on the bike.  His sister picked up a bicycle for $100 and Allan was set.  He began with leisurely rides around San Antonio.  The exercise, along with an improved diet, paid off. He shed 50 pounds.  For the first time in years, he had energy.

With each day, Allan boosted his endurance.  Then one day he struck out for the Big Bend area near El Paso, a daunting round-trip challenge of 1,000 miles.  After successfully completing the jaunt, he dreamt big. Less than a year removed from cancer, he would undertake an epic journey.

He plotted a route that would take him through 24 states and included visits to 18 National Parks. His plan was to go all the way up to Niagara Falls and into Canada. It was an incredible leap of faith for a guy who had no formal long-distance bike training.

He outfitted his bike with fatter tires and equipment for a more efficient gear ratio  He added saddlebags.  He stuffed the bags with clothes, provisions and camping gear.  After a few goodbyes, Allan embarked on a grueling trek across America's midsection.  Just Allan and his bike.

He pedaled.  And pedaled.  And pedaled.  It took him four days just to cross the Texas state line.  He kept pumping his legs until he had racked up 7,052 miles during an arduous four-month journey that circled back to San Antonio. He had few creature comforts, camping out under the stars.

Along the way, he had the opportunity to meet other cancer survivors. They swapped stories and shared the scars that only cancer survivors can comprehend.  "I hope my story was an inspiration to other people," he modestly says.  "That was one of my motivations."

Allan Kokinda is already sketching plans for his next biking trip.  "I love the freedom of the road and I am healthier than I have been in decades," he reveals.  His bout with cancer remains fresh in his mind. But each day Allan draws strength from his terrible ordeal.

"I get so much joy from biking," Allan tells people.  "Riding through America blew me away. Each new vista was more beautiful than the last."

America has always needed heroes.  We bask in their feats of greatness. However, there are many heroes hidden among us who remain invisible. That describes Allan Kokinda.  His inspirational battle against cancer has earned him the right to be called a genuine American hero.

Cancer: The Emperor of All Maladies

There are few things in life more dreaded than hearing a doctor's diagnosis of cancer.  The mere mention of the word evokes emotions of fear, anxiety and panic.  It is an invasive disease that not only ravages the body but saps the human will to live.  Cancer can be a swift killer or it can linger for years.

Cancer's toll is not only physical.  It also exacts a high financial cost from patients.  Based on a report issued last year by the American Society of Clinical Oncology, the price tag to treat cancer is expected to skyrocket 40 percent to $175 billion annually by 2020.  The cost was $88.7 billion in 2011.

As costs spiral, the number of new cancer cases in the United States is expected to continue to rise.  The American Cancer Society estimates that 1,658,370 new cases will be diagnosed this year.  In its most recent report, the society forecasts 589,430 Americans will die from the disease in 2015.

Worldwide, cancer cases are exploding.  By 2030, the society projects there will be 21.7 million new cases and more than 13 million cancer deaths.  The growth and aging of the population are multipliers that will impact the numbers of new cases.  

Cancer is the second most common cause of death in this nation, exceeded only by heart disease.  Nearly one out of four deaths in the country will be attributed to cancer.  The most common cancers are those that attack the digestive and respiratory systems as well as the breasts and prostate.

However, cancer no longer is a death sentence.  The good news is that recent advances have increased the survival rates.  The five-year survival rates for all cancers diagnosed from 2004 to 2010 was 68 percent, according to the American Cancer Society.

In its previous study, the survival rate was 49 percent, which suggests consistent progress.  But while cancer deaths have decreased 12 percent since 1970, heart disease mortality rates have declined by 62 percent. The explanation for the difference in progress may be as simple as money.

A report by the Institute of Medicine, an arm of the National Academy of Sciences, documented that cancer funding has stagnated.  At a time when the opportunity exists for significant strides in improving cancer treatment, the funding has not kept up with the urgency for new research.

The report also identified other challenges including excessive and complex government oversight, long delays in the launch of clinical trials and the difficult recruitment of new scientists.  In addition, the survey noted the need for more clinical researchers to conduct ground-breaking trials.

Those clinical trials represent the front lines of the cancer battle.  A prime example is the nationally acclaimed Institute for Drug Development at the Cancer Therapy and Research Center (CTRC) in San Antonio, which  has developed 20 new cancer drugs, revolutionizing patient treatments.

With public and private funding, centers such as the CTRC are able to conduct the scientific research with patients enrolled in new treatment studies.  These clinical trials often pave the way for innovative treatments which improve outcomes for patients with cancer.  

But money alone won't kill cancer.  Americans also must do more. One study found that the steepest drop in cancer mortality rates were for those types where screening and prevention are readily available. Many insurance companies pay for these tests, but well-meaning people vacillate or resist screenings.

There are other measures people can take, including maintaining a healthy weight, avoiding smoking, increasing physical activity and adopting wholesome eating habits.  These common sense remedies are too often ignored.  Americans would rather gulp down a magic pill to prevent cancer.  None exists.

But even if people embrace new habits, it won't stop cancer in its tracks.  More funding is required to underwrite robust clinical trials that give birth to new treatments.  The country owes it to every citizen to make cancer funding a top national priority.

If not now, when?  How many deaths must occur before the nation acts?

Cancer must be wiped out, not just contained.  Whatever the cost, it will not be too steep a price to pay.