Cancer Decisions - Free Newsletter -May 1, 2004

HERE AT THE MOSS REPORTS

It is nice to have good news to report. In this issue I highlight the role of a common food constituent, EGCG, found in green tea, in fighting cancer. True, this is only a laboratory study, but it correlates with a great deal of data showing that people who drink tea have lower rates of various kinds of cancer than those who don't. What is especially surprising is that the mechanism by which green tea works may be the same as that behind some expensive new drugs. As usual, Mother Nature got there first.

Here at the Moss Reports we are always analyzing the latest developments in cancer research to bring you useful information. We continue our campaign to separate the wheat from the chaff and to distinguish those treatments that are truly useful from those that only appear to be so. I have prepared a series of comprehensive and up-to-date reports on 200+ different cancer diagnoses. I also offer phone consultations. To find if these may be helpful to you please visit our website, www.cancerdecisions.com, or call our office at 800-980-1234 (814-238-3367 when calling from outside the US). We look forward to helping you.

THE POOR MAN'S AVASTIN?

Chronic lymphocytic leukemia (CLL) is a malignant blood disease that afflicts about 7,000 Americans per year and kills 4,500. But now scientists at the Mayo Clinic have found a way of killing CLL cells in the test tube that could potentially be developed into a treatment for CLL, and possibly other cancers, in living humans.

The agent in question is called epigallocatechin (EGCG). It is an antioxidant that is found both black and green tea, but more abundantly in the unfermented green variety.

The anticancer activity of green tea has been known for years. Scientists have identified at least one of the mechanisms by which EGCG seems to work to fight cancer: it inhibits a key "signaling pathway," called vascular endothelial growth factor (VEGF), which is responsible for transmitting instructions at the molecular level to cancer cells, prompting them to grow and multiply.

VEGF has been much in the news lately, since it is the same signaling pathway that is targeted by two recently FDA-approved drugs Avastin and Erbitux. However, one glaring difference between green tea and Erbitux or Avastin is the price. The FDA-approved drugs are sold at US $40,000 to $50,000 per patient per year. By contrast, an ample supply of green tea can be purchased for as little as $40 to $50 per year. You might call tea "the poor man's Avastin" - although of course head-to-head comparisons of this sort are not available.

Nontoxic Treatments

"We're continuing to look for therapeutic agents that are nontoxic to the patient but kill cancer cells," said the senior author of the study, Dr. Neil E. Kay, of the Mayo Clinic. "[T]his finding with EGCG is an excellent start. Understanding this mechanism and getting these positive early results give us a lot to work with in terms of offering patients with this disease more effective, easily tolerated therapies earlier."

We can only hope that the Mayo Clinic group will follow up on this and conduct trials comparing the efficacy of low-priced green tea with overpriced pharmaceutical products.

Previous findings from Dr. Kay's group and other scientists have suggested that VEGF is one of the factors that enable CLL cells to multiply and accumulate so prodigiously. In this new study, the researchers measured the effect of EGCG from green tea on both the level of VEGF signaling and on the survival of CLL cells. They wanted to find out if green tea components could inhibit or interfere with these survival signals in CLL cells. They found that the presence of VEGF did indeed make CLL cells more resistant to programmed cell death (apoptosis), a natural process by which the body rids itself of old or defective cells. Exactly as hoped, treatment with this green tea component enabled cancer cells to undergo apoptosis. This resulted in the annihilation of many leukemia cells.

Of course no responsible person would recommend, on the basis of this study alone, that one should avoid or abandon conventional treatment and take green tea instead. Although these findings come from one of the most prestigious medical institutions in the world they are still only test-tube studies, and as such, although they may provide a conceptual framework for future investigations, they cannot yet be extrapolated to form the basis of a new standard of treatment for full-blown CLL. However because of its relatively nontoxic nature, even Mayo Clinic experts agree that EGCG could "be tested in early stage high-risk individuals with B-cell chronic lymphocytic leukemia."

Fighting HPV

In a separate article, which appeared in October, 2003, EGCG taken in the form of a capsule, and also applied as an ointment, showed remarkable activity against the human papilloma virus (HPV) in women who were infected with sores or growths in the cervix. Fifty-one Korean women with precancerous cervical lesions (some of which were quite severe) were placed in four treatment groups. An ointment containing a different green tea derivative, called poly E, was applied to the lesions of 27 patients twice per week. In addition, patients received a 200 milligram (mg) capsule of poly E or of EGCG orally every day for eight to 12 weeks. They were then compared to 39 untreated patients who served as the control group in this clinical trial.

Here are some of the results of that study:

20 out of 27 patients (74 percent) who received poly E ointment therapy showed a beneficial response;
Six out of eight patients who received poly E ointment plus poly E capsule therapy (75 percent) also showed a beneficial response;
Three out of six patients (50 percent) under poly E capsule therapy showed a response.
Six out of 10 patients (60 percent) who received EGCG capsule therapy showed a response.
Overall, a 69 percent response rate (35/51) was noted for treatment with green tea extracts, as compared with just a 10 percent response rate (4/39) in untreated controls. The difference was statistically significant.

The authors conclude that "green tea extracts in the form of ointment and capsules are effective for treating cervical lesions, suggesting that green tea extracts can be a potential therapy regimen for patients with HPV infected cervical lesions."

Could tea or its constituents be used to fight cancer in humans? Research moves ever so slowly in that direction. It is now over 15 years since Dr. Hirota Fujiki, a chemist at Japan's Saitama Cancer Center Research Institute, first analyzed green tea and isolated EGCG as the main source of its apparent anticancer activity. He presented his findings to the Fourth Chemical Congress of North America in New York. Some may remember the excitement when this was written up favorably in the New York Times (March 14, 1991).

How goes the research? At www.clinicaltrials.gov, a comprehensive database of trials that include nearly 2,500 entries on cancer, there is mention of only one clinical trial of green tea. For the record, this trial is titled "Polyphenon E (green tea extract) and low-dose aspirin in preventing cancer in women at high risk for developing breast cancer." This trial is being carried out at the Jonsson Comprehensive Cancer Center of UCLA in Los Angeles. Some of the patients in the trial will receive green tea extract, some will receive aspirin and others yet will receive an inert placebo "sugar pill." The study will continue collecting data for ten years - a time period during which an estimated five million or more Americans will die of cancer. I have not found any other American clinical trials relating to green tea. In Canada there is a trial of green tea as a preventative in former smokers with lung dysplasia. (The principal investigator is Stephen Lam MD of the British Columbia Cancer Agency 2003.) There may be a few others, but they represent a minuscule proportion of expenditure in the faltering war on cancer.

This failure to move full-steam-ahead to develop such a promising treatment might seem inexplicable to those who are new to the cancer field. But it does not surprise those of us who have long studied the institutional structure of drug development, especially in the United States. The Tufts Center for the Study of Drug Development, Boston, has estimated that the cost of developing a new pharmaceutical drug now averages US $802 million. This astronomical cost rules out all but the major pharmaceutical companies, with their big budgets and stringent profit requirements. Regardless of whom you blame for this appalling situation, it is clear that no one will invest in new drugs if they cannot be assured not only of recouping their initial investment, but also of making a substantial profit. Patented drugs, such as Iressa, Erbitux and Avastin, fit that profile. Unpatented green tea does not. It therefore remains in the realm of "unproven therapy," beyond the pale of orthodox procedures. Until something fundamental changes we medical consumers will have to extrapolate from the scanty data that a few dedicated scientists continue to uncover, all the while enjoying what author Thomas Garvey called in 1658 "that Excellent and by All Physicians approved China drink."

I myself favor organic and decaffeinated teas. To buy one good brand:

[CLICK HERE]

--Ralph W. Moss, Ph.D.

References:

Ahn WS, Yoo J, Huh SW, Kim CK, Lee JM, Namkoong SE, Bae SM, Lee IP. Protective effects of green tea extracts (polyphenon E and EGCG) on human cervical lesions. Eur J Cancer Prev. 2003 Oct;12(5):383-90.

Canadian clinical trial:
http://www.ccac-accc.ca/news.asp?frontpage=94

Lee YK, Bone ND, Strege AK, Jelinek DF, Kay NE. VEGF receptor phosphorylation is modulated by a green tea component, epigallocatechin-3-gallate (EGCG) in B cell chronic lymphocytic leukemia. Blood. 2004 Mar 2 [Epub ahead of print]

Tufts Centers for the Study of Drug Development:
http://csdd.tufts.edu/About/

Warden BA, Smith LS, Beecher GR, Balentine DA, Clevidence BA. Catechins are bioavailable in men and women drinking black tea throughout the day. J Nutr. 2001 Jun;131(6):1731-7.

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IMPORTANT DISCLAIMER

The news and other items in this newsletter are intended for informational purposes only. Nothing in this newsletter is intended to be a substitute for professional medical advice.