Experts reserve judgment

Have you heard the latest news from the frontiers of experimental cancer drugs? The media have been buzzing about dichloroacetate, or DCA, a drug that has the potential to be a cheap and effective treatment – even cure? – for some cancers. According to NewScientist.com, “Evangelos Michelakis of the University of Alberta in Edmonton, Canada, and his colleagues tested DCA on human cells cultured outside the body and found that it killed lung, breast and brain cancer cells, but not healthy cells.”

The web-site says this drug has already been used to treat metabolic disorders, and generic (i.e. inexpensive) versions are available. The mechanism for its effect on cancer cells seems to be the way it interacts with cell mitochondria, details New Scientist. Cells in benign growths are starved of oxygen, which causes the cell to change to another method of energy creation. This new method, called glycolysis, shuts down the cell’s mitochondria (metabolism engine of the cell), which is where the cell’s mechanism telling it when to die is found. The cells replicate but none of them die. To make matters worse, glycolysis also produces lactic acid, which breaks down barriers in the body, allowing the cancer cells to migrate. It appears that dichloroacetate turns the mitochondria back on – glycolysis and lactic acid productions tops, and the cells healthy self-destruct switch is turned back on.

Which sounds great, right? Cancer patients across North America are eager to see DCA pushed through the approval process and made available ASAP. There’s just one problem, though: Cancer is complicated, and while a simple solution has endless appeal, it’s also not a sure thing. Len Lichtenfield, MD, an oncologist and the deputy chief medical officer of the American Cancer Society, is urging restraint and healthy skepticism.

“If I had a nickel for every time I have heard such a proposition [i.e. a simple cure has been found and must be used] based on this type of evidence, I would be a rich man.”

In the realm of cancer treatment, the stakes couldn’t be higher, and patients understandably grasp at every glimmer of hope. But the doc thinks DCA needs a lot more testing before we should start getting excited.

“The overwhelming number of promising laboratory experiments have not ended up as effective cancer treatments when they move from the bench to the bedside, if they are even able to get to the bedside in the first place,” Lichtenfield says. He acknowledges that Michelakis’s results warrant further investigation, “but I believe in patience, prudence and caution because my experience has taught me that those are the best guidelines to follow…”

The Canadian Cancer Society echoes Lichtenfield’s caution, albeit in a more upbeat tone. In their view, DCA is “promising,” but it’s important for people to understand that a) “only preliminary research has so far taken place,” b) DCA delayed growth in lab rats but did not eliminate tumors, and c) DCA has side effects when used on humans. And a crucial comment all patients should consider: “People with cancer should not use DCA on their own, as this could be dangerous.”