An increasingly integrative cancer treatment is worth striving for. There is more and more evidence for this in the literature. Liquid biopsy with drug testing can provide a basis. We have tried to make an optimisation with the help of ranking lists of on the one hand chemical and on the other hand natural remedies. The most frequently positive and thus effective complementary remedies are listed. Some of them are well-known, others are relatively new or even controversial. However, if efficiency on individual tumor cells has been demonstrated in the laboratory, this should be taken into account. Patients can receive a benefit from this. 

Recently, author Dr Jun J. Mao from Memorial Sloan Kettering Cancer Center in New York has developed evidence-based recommendations on integrative procedures in breast cancer [1]. These have now appeared in a joint guideline of the Society for Integrative Oncology (SIO) and the American Society of Clinical Oncology (ASCO). This is based on a trend that is becoming more and more significant, namely the desire of about 40% of cancer patients to have integrative methods applied to them. This mainly concerns the treatment of pain, but also the side effects of chemotherapy, and finally a general desire to prefer a holistic approach. The success rate of pure chemotherapy is still far from 100%, which a practising doctor, but also every person in his or her environment, can register. 

In Switzerland, we can see that about 20% of cancer patients completely reject the conventional medical triad (chemotherapy, surgery and radiation) and go to alternative medical therapists instead. The reasoning is rarely rational, but rather based on emotional and experiential attitudes, such as the phrase after death : "she fought for a long time and finally lost the battle". There are also patients who have a spiritual or religious attitude, according to which the decisive factor of their wholeness is not the body but their soul. And this obviously suffers under conventional treatment.

Dr Mao reviewed a number of existing integrative methods such as acupuncture/acupressure, yoga, massage, reflexology, guided imagery, meditation, hypnosis, injections and infusions of orthomolecular substances. Different qualities of evidence and strengths of recommendations emerged.

So far, so good. However, the question arises whether there are not still more effective means and methods that have not been investigated. 

We send the blood of each of our cancer patients to a laboratory that performs a liquid biopsy [2]. In the results, we not only find the cancer diagnosis, but also tests of a variety of chemotherapeutic agents (all on the market) for their effectiveness in killing the patient`s cancer cells. And about 60 natural substances are tested to see if they are able to do so or in some other way. This results in lists of what efficiency one can expect when using them. 

Provided with this valuable information, one can combine the three most effective chemical remedies, preferably in the form of infusions. The tests make it possible to reduce the dosage - compared to usual regimens - to 50%, i.e. as low dose chemotherapy. This avoids the unpleasant side effects such as hair loss. The 4 to 6 top natural remedies are also administered intravenously, if possible, e.g. as high-dosevitamin C infusions (i.e. 30 to 60 g/day). Other remedies are administered orally.

After having performed the Liquid Biopsy in this variant in more than 100 cases of breast cancer, a ranking of frequently positive means resulted. 

At the top was clearly the extract from the Sea Cucumber (on the market as Angiostop, among others). The active ingredient is Philinopside A. This extract is able to reduce or prevent the formation of new blood vessels by the tumour for the purpose of improving its supply [3].

Second is Artesunate (ART), a semi-synthetic derivative of artemisinin, the active principle of the herb Artemisia annua. ART reveals remarkable activity against otherwise multidrug-resistant Plasmodium falciparum and P. vivax malaria. ART has now been analyzed for its anti-cancer activity against 55 cell lines of the Developmental Therapeutics Program of the National Cancer Institute, USA [4].

The following are : 

Agaricus Blazei Murill : ABM (subrufescens) is an edible, medicinal mushroom that has traditionally been used against a wide range of diseases, including cancer, chronic hepatitis and diabetes. It’s also known under the names of Almond mushroom, Cogumelo de Sol, da Vida or de Deus (mushroom of the Sun, Life and God) in Brazil or Himematsutake (princess matsutake) in Japan. Because of its high β-D-glucan content, Agaricus subrufescens is used in alternative cancer therapy [5].

Amygdalin (Laetrile) is a partly man made (synthetic) form of the natural substance amygdalin. Amygdalin (ancient Greek ἀμυγδάλη amygdalis) is a cyanogenic glycoside that splits off hydrocyanic acid (HCN) in the presence of water and the enzyme mixture emulsin. Amygdalin is a plant substance found naturally in raw nuts and the pips of many fruits, particularly apricot pips, or soft kernels [6].

Curcumin has a long history of use for maintaining a healthy inflammatory response, via its effects on cyclooxygenase, prostaglandin and leukotriene metabolism. It also appears to maintain healthy cell cycle function and provides important antioxidant defense. Furthermore, it supports the body's natural detoxification system and helps maintain healthy hepatic function. These actions are associated with its beneficial effects, including support for healthy liver, colon, musuloskeletal and cellular function. Most recently, it has demonstrated the potential to maintain healthy tissue in the brain by supporting macrophage activity and has been associated with powerful support for cellular health in separate trials [7].

Quercetin is a type of flavonoid (a plant pigment) that acts as an antioxidant and serves as the structural building block for many other members of the flavonoid family, including rutin, quercitrin and hesperidin. Research suggests a supportive role for cellular, immune and cardiometabolic health. Quercetin is an oxidation product of the anthocyanin dye cyanidin. [8] By the way : Quercetin could have an inhibitory effect on the SARS-CoV-2 virus responsible for COVID-19, as it inhibits the protease 3CLpro responsible for the replication of the virus [9].

Hydroxychloroquine allows viruses to attack cancer cells while leaving healthy cells [10]. It is a drug analogue to chloroquine for the oral treatment of rheumatoid arthritis and collagenoses such as systemic lupus erythematosus, as well as for the treatment and prevention of malaria tropica. Chemically, it is structurally related to quinine [11].

Genistein is a high-quality nutritional supplements and contains the natural isoflavone genistein. It is obtained from the soybean. Like all isoflavones, genistein is a so-called secondary plant substance and belongs to the family of "phytoestrogens". In tumour research, it is also being investigated whether the substance or the application of e.g. soy extracts has a positive effect on tumour growth, since genistein inhibits FGF-2-induced angiogenesis due to the inhibition of tyrosine kinase, uPA (urokinase) and upregulation of PAI-1 [12]. A tumour-inhibiting effect of genistein could be demonstrated in both hormone-dependent and hormone-independent breast cancer cell lines [13]. 

In addition to the classic cancer remedies, other methods and means are increasingly coming to the fore. These can be used additively or, in justified individual cases, specifically.  The basis for our use of complementary remedies is the liquid biopsy. It provides clear data on the effectiveness or efficiency of the agents, both chemical and natural. This can reduce the side effects of chemotherapy, which increases its acceptance by patients and takes away their fear of it. In our experience, this results in evidence-based treatment of cancer patients, the frequent use of schemes can be replaced. 

Thanks : The author thanks Mrs. Ornella Manca for her contributions to this article.