What is cancer and how does it affect our body? Video / NZME
To say that Jane McLelland is lucky to be alive would be something of an understatement. At just 35, she was diagnosed with an aggressive form of cervical cancer. Standard treatment failed to halt the disease and five years later she was given the devastating news that tumours had spread to her lungs.
Even given the best medical care, the odds on her pulling through were not good: five women in every 100 with a similar diagnosis live for five years or more. That's a one-in-20 chance of survival.
Yet, here she is, in her 50s and a mother-of-two, radiating health and having been in remission since 2004. So, lucky, undoubtedly. But there is another more intriguing story behind Jane's remarkable recovery.
Jane McLelland, pictured, was diagnosed with an aggressive form of cervical cancer aged just 35 and has been in remission since 2004.
When conventional medical approaches seemed to be failing, she began doing research herself and started taking a daily cocktail of drugs licensed not for cancer treatment but for other common health conditions.
The medications are some of the most commonly taken in the world: type 2 diabetes treatment metformin, cholesterol-busting statins, and aspirin.
She also took dipyridamole, a drug often given to stroke patients for clot-prevention.
Foolhardy? Jane, from Fulham, South-West London, says she had exhausted all other options so she had little to lose. Armed with her own research, she asked her oncologists to humour her and prescribe the drugs that they thought unnecessary.
Remarkably, her case is far from being a one-off. And there is mounting evidence that such 're-purposed' treatments, when used alongside radiotherapy and chemotherapy, may be able to halt the progression of cancer and even stop it from returning.
Last week a landmark study of more than 50,000 women, published in the British Journal Of Cancer, found that long-term statin use can dramatically reduce the risk of a breast cancer returning in the opposite breast.
In the age of eye-wateringly expensive tumour therapies one new treatment, CAR-T, has just been given the green light for NHS funding in the UK at a cost of £282,000 per patient.
These drugs cost pennies, in many cases. They carry few side effects, and, astonishingly, appear to be effective for all types of cancer – bringing hope to millions.
The drugs that starve cancer
Aspirin has been used for thousands of years as a painkiller – the active ingredient, salicylic acid, was first extracted from willow bark by ancient Egyptians and used as medicine. Now it costs just 2p a tablet.
A study of more than 200,000 women published last month found that those taking a 75mg daily dose were nearly a quarter (23 per cent) less likely to develop ovarian cancer. It is thought this is because of the painkiller's inflammation-busting abilities.
And a trial at Vanderbilt University in the US this month showed that patients on anti-diabetes tablet metformin had a reduced rate of liver cancer – suggesting that the pills could prevent the disease developing in the first place.
Statins, traditionally used for lowering cholesterol, could also dramatically cut the risk of dying from breast cancer by 40 per cent by halting tumour growth, say Chinese researchers. These findings are based on data from 200,000 women analysed by the National Cancer Centre in Beijing.
Another drug showing promise in cancer treatment is the 10p- a-day antibiotic doxycycline. According to new British research, these little blue capsules can kill the aggressive cells that cause tumours to return in some people with breast cancer.
To confound any sceptics, there are people in the UK still alive today who have been treated with a combination of these old cheap medicines. In some cases, they are fit and well decades after a bleak prognosis from medical experts that their cancer is incurable and nothing more can be done.
Jane, pictured here with her husband Andrew, asked her oncologist to prescribe her drugs not normally given to cancer patients.
And Jane McLelland is just one astonishing example.
"If I'd not taken these drugs then I'd have died," says the physiotherapist, whose two children, 12-year-old Jamie and Sam, nine, were conceived using a surrogate, with her husband Andrew, after chemotherapy and radiotherapy left her infertile.
"I can never say I'm cured but the longer I remain disease-free, the more confident I am."
Jane's approach is now documented for the first time in a book and has been endorsed by a London clinic. Care Oncology in Harley Street is giving four key re-purposed drugs to its patients, in addition to chemotherapy and radiotherapy. Their prescription includes metformin, the statin atorvastatin and doxycycline as well as mebendazole (sold as Ovex), a treatment for getting rid of threadworms.
All of these treatments have a similar positive "side effect" in addition to their officially licensed uses. The theory is that they block a rapidly dividing tumour cell's energy-making abilities, so the cancer first becomes weak, then either stops growing or dies. As Jane puts it, they "starve" cancer by cutting off its fuel supply.
Could the scientists be missing a trick?
Developing a "game-changer" treatment or drug that cures cancer is an obsession for pharmaceutical giants: it is estimated the industry invests an eye-watering £2 billion in each new potential breakthrough to combat the dreaded disease, including on research and bringing the medicine to market. Yet about 450 people still die of cancer every day in the UK – around 164,000 a year.
Could it be possible, though, that they are missing a trick?
Dr Ndabezinhle Mazibuko from Care Oncology, who is also a clinical research fellow at King's College London, believes so.
Conventional cancer drugs work in a variety of ways. Some, like chemotherapy, are toxic, and destroy cancer cells. There is always 'collateral damage', with the body's healthy cells also affected, leading to the treatment's many side effects.
Radiotherapy is more targeted, using blasts of radioactive X-rays to kill off tumour cells.
Newer therapies target hormonal processes that drive cancer, or reprogramme the body's immune system so it attacks cancer cells which are normally adept at hiding and going undetected.
But the Care Oncology drug protocol has a different mechanism of action. "The common theme with all of these drugs is their metabolic approach," says Dr Mazibuko.
"Cancer cells grow rapidly and consume more "fuel" than healthy ones. These medicines make tumour cells easier to destroy by stopping them using glucose in the bloodstream for energy. Normal cells do not metabolise energy in the same way so are not harmed.
"Other drugs reduce inflammation, which can be a trigger for disease and tumour progression. It's not about replacing radiotherapy or chemotherapy or doing anything without first consulting your doctor, but of having a multi-pronged way of dealing with cancer."
The clinic has treated more than 1,500 patients with cancers ranging from breast to pancreatic, at every stage of tumour development and spread, except those with incurable cancer needing end-of-life care.
Data on 95 of these who took the four-drug cocktail following surgery, radiotherapy and chemotherapy has now been analysed by Dr Mazibuko and his colleagues.
All the patients were diagnosed with a type of cancer that forms in nerve tissue called glioblastoma that had spread to other organs.
Jane, pictured here with her two children Jamie and Sam, who were born with the help of a surrogate as her treatment left her infertile, says without taking the drugs she would be dead.
The results showed that average survival rates for some patients were almost double (27.1 months) those observed in patients having cancer treatments currently considered the best available (14.8 months median). Care Oncology hopes to get the go-ahead for their results to be compared against NHS data on similar patients.
Other British experts are also convinced of the benefit of re-purposed drugs for cancer patients.
The scientist behind the breast cancer trials involving doxycycline is Professor Michael Lisanti at Salford University. A scientist with more than 30 years' experience, his research is based on a discovery that the commonly used antibiotic can kill what are known as cancer stem cells.
Tumours are made up of numerous cell types, and only a few of these have the ability to divide and grow endlessly: cancer stem cells.
The theory is that many cancer treatments kill off the bulk of a tumour, but it has been discovered that if these stem cells are left behind, the cancer can, and will, regrow. Prof Lisanti says: "Scientists have never targeted cancer in this way before with antibiotics. But we've found a way to re-purpose these drugs with a remarkable therapeutic effect. And we can do this with almost zero side effects and in all types of cancers."
Doxycycline works on cancer by suppressing the ability of stem cells to make new mitochondria –the tiny "powerhouse" component in all cells that generates energy. "It's an entirely new way of thinking about cancer," he says.
The 70p malaria drug …for colon cancer
Professor Sanjeev Krishna, who is studying whether the 70p malaria drug artesunate could be used to treat colorectal cancer, said 'huge opportunities' exist to re-purpose medicines such as statins and diabetes drugs.
Prof Krishna, of St George's University of London, says: 'You have to remember, Viagra started as a drug for high blood pressure. I'm not talking about a silver bullet but we know these treatments are cheap and safe.'
Professor Justin Stebbing is involved in studies at Imperial College London into how metformin and aspirin might be useful in the fight against cancer.
He emphasises that cancer patients are vulnerable, therefore re-purposed drugs as well as supplements should be handled with 'enormous caution' outside the context of clinical trials.
It is important to point out that Jane's cancer weapons did also include conventional treatments such as radiotherapy and chemotherapy, which she had in 1994. Doctors gave her another dose of chemotherapy drugs in 1999.
In addition, she was enrolled in trials for a new therapy called dendritic cell vaccine that stimulates the immune system to attack tumours, which she took in 2000.
She consumed an extensive list of supplements, including intravenous Vitamin C, and radically changed her diet.
Her oncologist, Professor Hilary Thomas, formerly at the University of Surrey and now a medical adviser, described Jane's case as very unusual, adding: 'It's impossible to say what was responsible [for her recovery] but as long as a patient isn't taking anything harmful, then I would support it.'
For Jane, cancer no longer holds any fear, and she says this is due to her determination not to let the disease beat her. 'I'm confident that if it did come back, I'd know how to deal with it – I'm armed and ready.'
• All medication taken by Jane was prescribed by medical professionals. Seek the advice of a GP before pursuing experimental treatment. For more details of Jane's story, go to howtostarvecancer.com.
