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Cancer Treatment 2, 3, 4

More ordinary things, deadly-when-concentrated
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See my original "Cancer Treatment" (linked) Idea for the background. Basically, it proposes that a cancer lump might be treatable with an ordinary substance that is deadly to cells in pure form, but can be tolerated by cells when sufficiently diluted.

Ordinary (but pure) table salt, sodium chloride, was suggested in that Idea. Injected into the middle of a cancer, it should kill cells indiscriminatly (but mostly only cancer cells) until it becomes diluted enough, with ordinary body fluids being the dilutant.

For some reason I (and apparently no one else, in the annotations) didn't bother to think about other ordinary substances that might work the same way. So, here are three more:

1. Alcohol is long known for its ability to kill cells when in concentrated form. It is also well-known to be tolerated when diluted. Ordinary wine, for example, can become up to about 12% alcohol before it kills the bacteria that makes it. Therefore it seems reasonable that a small amount of 100% pure alcohol, injected into a cancer, should be quite deadly to the cells in its vicinity, but become tolerated by other cells as it becomes diluted.

2. Sugar is used as a preservative (jams, jellies, etc) since it is able to kill bacterial cells when sufficiently concentrated (high-enougn percentage). Note that there are multiple varieties of sugar (sucrose, dextrose, lactose, fructose, maltose, ect.), and testing should be done to find out which works best, but for now we can focus on sucrose, since that is the ordinary/common preservative. As with alcohol, a small but pure quantity of sugar, injected into a cancer, should be quite deadly to cells in its vicinity, but become tolerated (more! its FOOD!) by other cells as it becomes diluted.

3. Vinegar (a.k.a "acetic acid") is also widely used as a preservative (any of many "pickled" foods), which means that again it is a substance which is deadly to cells in concentrated form, but can be tolerated when sufficiently diluted. So again, injecting the pure stuff into a cancer should kill cells in its vicinity, but not kill other cells as it becomes diluted.

Alcohol and vinegar have an advantage over salt and sugar in that they are liquids, not solids. This makes them more injectable and may allow them to be used on otherwise-"inoperable" cancers, such as a brain tumor. That is, inserting a fine needle for injecting alcohol will do less damage to healthy tissue than drilling a big hole to add salt.

Finally, just as ordinary cancer treatments tend to use multiple drugs, there is no reason not to consider using the substances suggested here in combination or in sequence.

IF any of them actually work as Theory suggests, of course!

Vernon, Nov 13 2011

Cancer Treatment Cancer_20Treatment
As mentioned in the main text. [Vernon, Nov 13 2011]

The Medical and Surgical Reporter 1882 http://books.google...gar%20tumor&f=false
I have here a bottle of vinegar... if necessary I will inject that. [bungston, Nov 13 2011]

Alcohol into bone mets http://journals.lww...es_under_CT.16.aspx
Here is exactly what Vernon describes! [bungston, Nov 13 2011]

Eggplant extract injected into tumors study http://docsdrive.co...2008/1 008-1017.pdf
Cancer Intralesion Chemotherapy with Solasodine Rhamnosyl Glycosides by Bill E. Cham [chernobyl56, Mar 13 2016]

Environment, not 'bad luck', biggest contributor to cancer http://www.nature.c...ll/nature16166.html
Substantial contribution of extrinsic risk factors to cancer development study [chernobyl56, Mar 17 2016]

Substantial contribution of extrinsic risk factors to cancer development http://sci-hub.io/h...ll/nature16166.html
Yarrrr! [Voice, Mar 17 2016]

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       These are interesting thoughts. Alcohol works exactly as you say and is used for the purpose - mets in the liver can be killed with alcohol injection, nerve blocks are done with alcohol (links the nerve) etc.   

       The issue here is that if the cancer is discrete enough to inject it with something you expect will kill it, why not just cut it out? Nonspecific killing must kill a rim of normal tissue too, and leaves a crater instead of an incision. If cutting is too risky because of adjacent important structures (for example,in the brain), nonspecific cellular toxins would be just as risky to those adjacent structures. Maybe they would. One would think that the physicians of 100 years ago would have tried these sorts of things for cancer - maybe Google Books can turn up some ancient case reports. I found some interesting stuff on topical copper sulfate for human use this way.   

       Really, though, your idea is for regional delivery of toxins so that they are more concentrated near the cancer. This is behind the use of intraperitoneal chemotherapy for ovarian cancer, which despite being proven more effective that IV chemo, was and is resisted because it is seen as cumbersome. There may be other simple interventions such as you describe which are not done because of cumbersomeness.
bungston, Nov 13 2011

       It seems to me that there are circumstances in which a solid lump of, say, sugar, would be better than a liquid such as vinegar. That's because a liquid naturally flows everywhere fairly quickly, while a solid just sits there. So, the solid has longer time to work on nearby cells, than the liquid. I THINK this might also mean the solid would have less effect than a liquid on healthy cells, if they are located at any reasonable distance from the center of the tumor, where the injection is done.   

       [bungston], I think I'd like more info about "cumbersome". Isn't any surgical procedure cumbersome? So, what makes this more cumbersome than that, in the long run?
Vernon, Nov 13 2011

       Ridding the body of cancerous cells is a straightforward treatment, but only that--a treatment. There are already plenty of toxic substances used to kill off cancerous cells, the administration of them generally being referred to as chemotherapy. Are we simply trying to add to that list?
Alterother, Nov 13 2011

       The problem with a soluble solid like sugar is oncotic pull - the sugar will pull in water which will cause the area where it is to swell. That pull is also how something like sugar or salt would kill cells: honey is toxic to microorganisms because it dehydrates them.   

       Re chemo: no-one will make any money off of schemes like Vernon's, so there is no motivation to develop them. But that doesn't mean they wouldn't work.   

       Re cumbersome: the injections described here would require a physician. Surgeons want to cut things out, not inject things. Doctors who inject things inject them by vein, and have nurses do it - any special routes of injections requiring special apparatus or expertise require the doctor or someone with extra training to do it or to place the apparatus: cumbersome because nonstandard.
bungston, Nov 13 2011

       I searched for vinegar inject cancer in google scholar and found some hair-raising accounts from 1882 - linked.   

       Some of the super old fashioned treatments held on until present day because they worked so well - potassium iodide for certain fungal infections, for instance. I suspect others never worked very well and were done more or less out of desperation.   

       I do think there may be something to the alcohol idea. Some mets are very painful. Alcohol kills nerves and is used in nerve blocks. If one could inject the cancer with alcohol and stun or kill the adjacent sensory nerves that could only be good. Alcohol too would not last very long in a given tissue - both diffusing out and fluid would come in. More hydrophobic substances would not have this problem (for example large alcohols) but I think a large part of the cellular toxicity of alcohol is due to the oncotic effect.
bungston, Nov 13 2011

       It seems that deuterium-enriched water would be an excellent chemotherapy agent. It apparently affects eukaryotic cell division but little else (Wikipedia: Heavy water).   

       //Sugar is used as a preservative (jams, jellies, etc)// Bee venom is another possibility, since its effects are mainly local. If, say, I had a bone tumour in my leg, these treatments could be combined. The bee venom could use a live delivery method, much as the use of live maggots and leeches for wound treatment is now being rediscovered. The required external bone-supporting leg brace could incorporate wires under tension stretched over a membrane, to be plucked to provide healing musical vibrations delivered right to the bone...   

       I'll get my coat.
spidermother, Nov 14 2011

       The thing is, none of these treatments disciminates between malignant and normal cells. If you've got a big, benign encapsulated tumour then you might be able to kill the bulk of it this way (but, equally, you could just whip it out).   

       If it's not encapsulated then it's unlikely to be a nice spherical mass. 'Cancer' gets its name from 'crab', because many cancers have weird shapes and long straggly 'legs' like a crab. They often follow complex shapes, conforming somewhat to the pre-existing structures in the body. Their edges may be sharply-defined (but irregular), or diffuse. Also, they're often well vascularized, which means any toxin you inject will probably get washed out into the bloodstream before it's penetrated a long way into the cancer itself.   

       Ultimately, this sort of treatment is a lot less precise than surgery, which can usually remove the great majority of a tumour.   

       In the link dealing with alcohol injection into bone metastases, the aim seems to be to debulk the metastasis for pain relief in terminal patients, and I can see where that would work and might be possible in a situation where surgery isn't. But there's no suggestion that it's significantly slowing the progress of the disease (which, if it's metastasized, is probably beyond successful treatment anyway).   

       Local administration of anti-cancer drugs (and of radiation, whether in the form of an injected isotope or by irradiation from an external source) is indeed beneficial, but I don't think local administration of an indiscriminate toxin would be very helpful.   

       The idea of injecting successive or combined toxins is good in the case of selective chemotherapy agents which exploit an inherent weakness in the cancer cells; because they act in quite a specific way, it's easy for resistant clones to emerge, and these might be hit by a second agent. But, with things like sugar, salt, vinegar - because they have fairly drastic and un-subtle effects, I don't think it's likely that resistant sub- populations would develop. So, if it worked at all, you might as well stick to one such agent.
MaxwellBuchanan, Nov 14 2011

       Thought I'd add to this - there does seem to be some readily available compounds like eggplant extract (in particular Solasodine rhamnosyl glycosides) that seem to differentiate between *some* kinds of cancer and normal cells when injected.   

       There was a study done in 2008 where the eggplant extract was injected into various tumors titled "Cancer Intralesion Chemotherapy with Solasodine Rhamnosyl Glycosides by Bill E. Cham".
chernobyl56, Mar 13 2016

       Practically all cancer therapy is just wrong. Cancer is a genomic disease, yet all treatments target the biology, which is messy, complex, different for every cancer and never very selective. Wrong, wrong, wrongity wrong.
MaxwellBuchanan, Mar 17 2016

       True, every cancer is different, but the most recent studies show that the majority of cancers, and their progression, are due to extrinsic factors (i.e. environment) and not genetic. I've linked the latest study.
chernobyl56, Mar 17 2016

       // I've linked the latest study.//   

       No, you've linked to a paywall.
Voice, Mar 17 2016

       //the majority of cancers, and their progression, are due to extrinsic factors (i.e. environment) and not genetic//   

       That is completely correct, except insofar as it is wrong, which is almost completely.   

       Yes, environmental factors add greatly to the rates of mutations that initiate cancers and allow them to evolve and progress. "Genetic" factors also determine how likely those mutations are to arise and survive, and how likely the body is to eradicate the nascent cancer.   

       However, cancer is _always_ a genomic (not genetic) disease - cancer cells have genomic mutations, always. There is no purely epigenetic cancer.   

       The mutations, of course, differ for every type of cancer and even, in detail, for every individual cancer. And the biology caused by these mutations is equally diverse.   

       But genomic mutations, unlike biological differences, are all written in the same code. A tool that can selectively kill cells based on their genomic sequence is as close as we will ever get to a universal approach to treating or curing cancers.   

       Put it another way. You have a thousand robots, each with a different error in its programming. One robot walks around hitting people (so, you built padded gloves for it to make it safer). Another robot has a tremor (so, you keep its joints well oiled to stop it wearing out). Another one has no vision (so, you bolt on a radar to stop it bumping into things). A thousand problems, a thousand imperfect solutions.   

       OR you build an app that can check the robot's software and delete or re-load any bad bits. One tool, applicable across the board, to solve all the problems.
MaxwellBuchanan, Mar 18 2016

       //OR you build an app that can check the robot's software and delete or re-load any bad bits//   

       I'm offering 500 shares in my company if you stop talking about that app.   

       Incidentally, we're moving our adjuvant combination boxing glove-oil therapy into Phase 2 trials for end stage pancreatic cancer. We're hoping it's the least fail-y one yet!
bs0u0155, Mar 18 2016

       //Practically all cancer therapy is just wrong. Cancer is a genomic disease, yet all treatments target the biology, which is messy, complex, different for every cancer and never very selective. Wrong, wrong, wrongity wrong.//   

       Heh! I think you can safely remove the word "cancer" there. It's an intrinsic human quality to hit things that have software problems. Perhaps hitting the hardware that's running the regulatory and safety software might work?   

       [Vernon] However, regarding the original idea. You're onto something. Sugars, vinegar (the acetate bit), salts even alcohol are all things that are totally non toxic within certain concentration ranges. If you manipulate those concentrations up OR down you can kill cells. Killing cells with SOME selectivity is the only way cancer therapy has worked in the past. Now, sugars and acetate are metabolites, fuels. Cells use a lot of fuel moving salts around. Interestingly, most cancer cells love glucose. You could manipulate the circulating glucose in a person downward, replace it with say, acetate and kill some cancers/slow others.   

       Neurons are also annoyingly hooked on glucose. But almost all other cells are fine. But we achieved some selectivity there. Neurons aren't dividing, cancer cells often are, so if we lower glucose to the point where neurons don't die, and target cell division to the point where the normally dividing cells don't die we might get some synergy on the cancer cells. Clinicians like the word synergy, they heard it at a management workshop once. Now, the thing to do is to keep going down that road. If you were really clever about it, you'd know a lot about the individual cancer so you could continually stack the deck against it. They're starting to get the idea with combination therapy of different drugs. In theory, you could take cancer cells from a patient, sequence the genome, identify vulnerabilities and administer a series of tweaks that really get to the cancer cell survival strategies.   

       That's only a little less dumb though. The clever thing is to find the mutation(s) and cut it specifically. CRISPR will do that. Delivery is solved by replication-deficient adenoviruses. All we have to do is wait while the regulatory and safety people take 15 years to realize none of the counter arguments make sense, or they retire. Gravy trains have poor turning radii unfortunately.
bs0u0155, Mar 18 2016

       //CRISPR will do that.//   

       Right idea, wrong method. CRISPR is still orders of magnitude too non-specific. Unless you can deliver it solely to the cancer cells (in which case you've already got your magic bullet), you are hitting all 100 trillion cells and hoping that you won't cause an off- target, carcinogenic event in any of them.
MaxwellBuchanan, Mar 18 2016

       //hoping that you won't cause an off- target, carcinogenic event in any of them.//   

       Good point, we'll stick with the systemic radiation and known mutagens.
bs0u0155, Mar 18 2016

       Well, I never said conventional therapies were any good either.
MaxwellBuchanan, Mar 18 2016

       / You have a thousand robots, each with a different error in its programming./ You have a thousand malignant cells, each with a different error in its DNA. You have a thousand mass murderers, each with a different defect in his psyche.   

       Learning the differences is useful if you think you might address them proactively, and prevent the development of problematic behavior in the future. In the present it is the behavior that is the problem. Addressing that is tricky only if you want to address it nondestructively and keep the robot / malignant cell / mass murderer. Destructive solutions are limited by your tolerance for collateral damage.
bungston, Mar 19 2016

       //There is no purely epigenetic cancer.//   

       Sorry, quick comprehension check:   

       If I've understood this, the counterfactual case, which you're excluding by the statement above, would be a case where, let's say, a gene expresses a particular protein, the protein meets up with, as it might be, cigarette smoke, or a bad sunburn, and then protein-plus-stimulus together somehow make a cancer. </counterfactual>   

       Whereas, if I've understood this, the actual case, which you refer to by //cancer cells have genomic mutations//, is the case where the stimulus (smoke, sunshine or whatever) hits a strand of DNA and makes that DNA cancerous in and of itself, irrespective of anything expressed by it.   

       Is that the relevant distinction here, or is there some other distinct distinction, that I've missed?
pertinax, Mar 20 2016


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