LOS ANGELES, March 27, 2013 — In part two of a three part interview, Dr. Robert Nagourney, M.D. discusses his new book, Outliving Cancer, and looking at cancer in a different way. Dr. Nagourney is board certified in internal medicine, medical oncology and hematology. Read part I of the interview, here and part III here.
Kevin Wells: Have other doctors incorporated your new methods into the treatments of their own cancer patients?
Dr. Robert Nagourney, M.D.: Most doctors relish the prospect of being able to choose chemotherapies without having to administer them. The prospect of a laboratory prediction is extremely appealing. The problem, and we describe this in the book, is that cancer medicine has labored under the misconception that cancer was a disease of disregulated or altered cell growth.
So when the average person is approached and asked what makes a cancer tick, more often than not, they’ll tell you it’s cells that are growing, unbridled proliferation, DNA synthesis, mitosis, all the, sort of, machinery of growth. So cancer drugs were designed and applied to stop cells from growing. In 1972, a paper came out in the British Journal [of Cancer]. [JFR] Kerr, [AH] Wyllie, and [AR] Currie published a landmark paper, I think one of the most important paper of the last century. They said that cells are regularly dying after their birth.
Every time a cell is created through mitosis, that cell is in one way or another dying and it’s only by virtue of a rather strenuous effort that cells are prevented from dying. So, the body maintains itself by keeping cells alive using things like epidermal growth factor and insulin-like growth factor and vascular endothelial growth factor. All these substances are kind of the drip irrigation that keeps cells alive.
Any cell that doesn’t perform normally, any cell that is damaged, any cell that is mutated is no longer allowed to stay alive and that process is known as programmed cell death. Now, programmed cell death is actually the basis of our work because what we realized is that a cancer doesn’t grow too much, but instead dies too little. Then we really need to get away from all the growth inhibition and birth control devices that are being used for cancer at a cellular level and move toward real bullets. Move toward meaningful killing entities.
So the first test for that was the laboratory test that had to show that cells died in the test tube. We weren’t interested in whether they stopped growing. That’s a more arduous effort. You have to propagate cells over periods of weeks and you have to compare the controlled with the tested and all that stuff.
We said, “No, let’s just kill the cells outright,” and if they die in the test tube, that’s likely to tell us if they’ll die in the patient. And that’s what we began to do in the 80s. Now the thing is, I had not really read, nor was I particularly familiar with this basic research on cell’s life-death forces.
It was about 10 years after I started doing all this stuff, that I suddenly read the papers and said, “My god, this is what I have been doing.” I had been measuring programmed cell death. I was just really knocked over that this whole literature, this whole scientific discipline was evolving in parallel with the tissue culture methodology that we had just worked out. It was kind of an accidental discovering.
Once I realized that cancer was adhering to the plan that we were testing, I realized that this would work, that we were right and that our outcomes in childhood leukemia and our growing data in solid tumors was really valid. The problem was that most doctors were only too familiar with the failures of the past methods and were not particularly interested in coming around to learn about new methods.
They sort of said, “We tried that and it didn’t work and we’re on to something else.” And that has been a bit of the rub here because we’re trying to convince doctors to rethink an issue that they had already, in their own minds, resolved. The lab methods, the techniques we use are cell death measures in short term culture using tissue that have been disaggregated to their native state, their sort of, microspheroids. And using that, we’ve consistently doubled response rates and, in many cases, survival rates for most cancers.
KW: The book seems to be geared towards people without medical backgrounds, was that your intention?
RN: I was trying to take complex concepts and put them into understandable terms. The book is supposed to examine pretty sophisticated conceptual frameworks, but to place them into some sort of understandable terminology. I don’t know how well I accomplished that. My feeling is that my audience would be a moderately sophisticated, but non-medical audience.
KW: What kind of response have you received as a result of writing the book?
RN: We sold out in the first on Amazon. I don’t know what that means, but we’re still waiting for them to restock and get this out. We’ve gotten some interesting responses from the people who have read it and reviewed it. I think the response is building and appears very favorable.
KW: Do you plan on writing any more books?
RN: Maybe, you know, it’s interesting. I think this book was an idea to get my story out and more than anything give patients a credible treatise on the principles that underlie the work that we believe they should know about. So what we use the book, to some degree, for is to give patients the instrument to have a meaningful discussion with their physicians and to explain to their doctors that this is a very sound scientific field and that they should be applying it because the patients themselves, with an understanding of this biological principle, want this used in their own treatments.
As to future books from books from me, if I were to develop additional books, it would probably be along the lines of more scientific principles that interest me; the concepts of metabolism as a driving process of cancer biology.
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