“The Game Changer” - LDN & Cancer (LDN, low dose naltrexone)

“The Game Changer” - LDN & Cancer (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

If you were to ask me does low dose naltrexone kill cancer cells, I would say it supports the actions of your classic cancer-killing drugs, such as your platinum; such as your radiation. These drugs and these modalities do work, and they work well in a lot of patients. However, there are a small fraction of patients that don't respond as well, and what low dose naltrexone can do, is that it can open up to these patients that are non-responsive. The whole idea that yes, you can use these treatments in your case, which  I think is fantastic. And if you were to say, do these patients see that as a cure to their cancer, in that situation, you must say it's helped them, and the help it's given them means the world.

I had a patient who I really thought their advanced cancer should be progressing and was delighted and surprised that she hadn't progressed in a certain time. And I asked her if she was taking anything else that I didn't know about because lots of patients do take all sorts of things, and she told me she was taking low dose naltrexone, and this is well over 12 years ago, if not longer. And I asked her where she got it and the whys and the wherefores, and I learned she was getting it from Dr Bihari in New York. And she told me a bit about the background and said that I should go and visit next time I was in New York, which is essentially what I did. And I realized he came from a proper clinical background, that he had been a narcotics expert and was weaning people off morphine heroin, which is how he knew about naltrexone and had been convinced that at low doses and not at high doses, that a lot of chronic conditions seem to improve.

So that's how I got interested, and I became more interested in it the fact that it might have a role in cancer when I noticed that other patients were doing very well on it. And at the end of that, often when there were no therapeutic options, I started prescribing it myself and being impressed that there seemed to be more to it than a placebo or smoke and mirrors, which is what many doctors regard something at a low dose.

Well, what really excited us is that I've taken the clinical observations from this seriously and because some of the results I saw are being really quite remarkable. For instance, I had a patient who had very serious melanoma of the head and neck, and he'd been on a vaccine program for about four years.

And when he started to progress, he wouldn't take any chemotherapy, but I did discuss with him about my suspected properties of low dose naltrexone. And he did agree to take that and rather than be grateful for taking the low dose naltrexone, he came and complained to me two weeks later that he had broken out in vitiligo, which means you get white patches all over.

And often just in the arms sometimes subtly on the face. In fact, about 5 to 8% of people have some form or other of it, except this appeared quite dramatically a few days after taking the low dose naltrexone. He didn't like the cosmetic aspect of it. I basically said I was delighted because it was a sign that the immune system's responding and had targeted the melanoma, and that's exactly what it is. It is due to the killer T cells recognize a major component of melanoma and the normal melanins taken out and bystander a friendly fire as it were. Well, he is still here. I mean, he had a dramatic clinical response to this. And what that showed me was that low dose naltrexone had to be stimulating part of the immune receptor pathway. And that was the start of our research. I said to the guys in the lab, this strike, isn't just working through opiate receptors, it's working through immune receptor pathway, and we sat down and worked out how to do it, did a strategy, and actually hit gold, and we found a very important, immune pathway was indeed heavily interactive with low dose naltrexone, which explained the clinical observation I think. With vitiligo being switched on; there's no defined time period, it can occur at any time, but with an effect of immunotherapy, this usually takes some weeks, months to occur. And we found out with the new checkpoint inhibitors, we basically don't really look to see if you're getting a response for a couple of months, because it is that slow. So, the fact that the vitiligo was induced very quickly suggested it had just flicked that switch which was already programmed, but the vaccine hadn't done it for four years, it just took the LDN, and it flicked it. Well, obviously we're going to be very focused on researching it; doing it properly. I mean, LDN is being used, anecdotally and off-license for a long time. There are fantastic results out there, but it ought to be taken forward; it really wants to be put it into proper clinical trials and getting it to the right niche. And because there are so many possibilities, we would like to do everything properly; get it properly approved by the FDA, EMEA, et cetera, and then go for a condition that we know the chances of working are very high and don't take very long, and of course, two of the conditions it's effective in are Multiple Sclerosis and Crohn’s, which are very difficult studies to get approval for. They're very hard and expensive trials to do. And you mention about taking it with something; this is what we've found with all of immune modulators, that they're much better in combination with other agents than by themselves. One of the things that we have been researching independently and it fits beautifully is that it is great, with what I would call an endemic, epidemic of a low vitamin D in the population. and it's particularly in the winter months and the further North you go. And this is one thing that we are looking at very carefully because we think that there is a positive interaction here, but that's not a big surprise, because if you're low in vitamin D, you don't respond to a whole range of things, like chemotherapy or whatever, so that's one particular thing. Combining it with another immune modulators/vaccines is the next obvious way to go, as is enhancing the anti-inflammatory aspects of it.

So, all of these things we have been looking at in our research, both in the lab and taking it forward into the clinic. Given how non-toxic it is and how relatively cheap it is compared to other interventions could be applied to, I would say the vast majority of people who have incurable cancers where you can't cut them all out because the anti-inflammatory aspect for most cancers is now well established and the need to boost the immune system when you have cancer. In fact, one of the pieces of research that we did early on, that  I’m most proud to have done, was we showed that even patients with very early colorectal cancer have a major suppression of the immune responses. And we proved that this was due to the bowel cancer patient group we use, because we repeated the assays a month after the tumour had been completely removed, and the immune system all bounces back into the normal range. So after that, and the colleagues elsewhere showed that they got the same sort of thing with other solid tumours, lymphomas, gliomas et cetera. So it means that tumours immune suppress, and if you can't cut them out you want to go some way to correct it.

There are some very fancy, toxic, expensive ways of doing that, but low dose naltrexone provides a lot of those properties without any of the toxicities, et cetera. So as a universal supplement, as well to be an anti-inflammatory, immune booster, I can't see why it would be limited to any particular tumour type.

Low dose naltrexone works on a number of processes in cancer cells. So, if a patient has cancer at whatever stage, if that cancer exhibits the same malfunctions, the same profile for one of the better term, then naltrexone prefers or low dose naltrexone likes, then you should see some kind of responses.

Like the first thing is that there is no drug in the world, and that would include LDN, that is active in everybody. But, if you’ve got advanced cancer and basically don't want to take anything else, but you’re happy to try something that might help you feel better, then to my surprise, I have seen the LDN is very effective in that scenario.

It shouldn't be looked upon as a cure again, to work on everybody, but I'm impressed with people who do have their disease stable after finishing chemo, having given up, and they take LDN, and they feel much better on it, and they request for repeat prescriptions that basically provides the evidence that they're doing really well just on this treatment.

One thing we did, first of all, was to explore the effects that low dose naltrexone had on immune cells, as well as on cancer cells. And I suppose one thing that people tend to forget is that drugs that you give to patients will have an effect on immunity as well as on cancer cells.

So, these so-called indirect effects versus the direct effects, and the beauty of naltrexone, especially at low doses, is that it can have an effect both on the cells in your body, as well as on the cancer cells. So it's like a double-edged sword, I suppose, one edge that kills cancer directly, and one effect which modifies the body's own natural ability to kill cancer cells. So, this drug naltrexone being a potential agent, or at least a semi-synthetic, we could then explore that further. And we showed that in addition to the effects on immunity, which made it a fantastic stimulator of immunity, which allows the body's cells to be re-educated to re-engage cancer cells, low dose naltrexone was also capable of targeting cancer cells directly. How does it do that? And that's the exciting thing. There's lots of data to suggest that it binds to certain proteins on the surface of the cancer cell and in doing so can manipulate the cancer cell to make it much more sensitive to the treatments.

There's also other trains of thought that suggest that it might enter the cell independently of these receptors, but nevertheless what we're finding is that the mechanisms that control cancer, the mechanisms, in fact, that makes a cancer cell, a cancer cell, is being turned off. it's been tweaked in such a way to make that cancer cell much more sensitive to cell death.

So, if you were to go along or come along, treating patients with low dose naltrexone, in addition to other drugs, which are focused on killing, then we have a fantastic partnership where one prime the cell and the other does the killing. And that's, what's exciting about low dose naltrexone.

So it was in about 2007, 2008 that I first discovered LDN, and we started using it immediately as a cancer treatment because there was some promising data presented by Dr Bahari. So, when we started using LDN for patients with stage three or stage four cancer with low disease volume, in other words, small tumours, or patients who had had surgery already but were not completely cured, we started seeing better results. One of our earliest patients that we used LDN on was a 65-year-old gentleman with bladder cancer. He had a tumour in the bladder, which was treated by conventional means, which means surgery, so they would go in and removed the tumour; they would burn where they had removed it from with a cautery and inevitably the tumour would return some months later.

So this gentleman had a few surgeries and the doctors had told them it was an aggressive type of cancer, which is called high grade, and that because of the depth of the growth of cancer into the bladder wall, it was growing into the muscle, they felt that he was at risk of cancer spreading in a short time.

So, this fellow was offered an aggressive surgery, which meant the removal of the entire bladder, and he declined that. At that point, he came to us and we started him on LDN. And he did very well on it, he had a little bit of sleep problem, but that was easy, we just gave him a little sleeping pill with that, and he did very well. And at the same time, his conventional doctor gave him a single course of an immune therapy called BCG. It's a bacteria that they instil into the bladder, and it can trigger an immune response. So while he had the one course of BCG, he was on LDN, and he took LDN for about four months, and then he had gone back to see the surgeon; they took a look in the bladder, and the cancer was completely gone. So, this gentleman continued LDN for about a year. He had no further conventional therapies, and cancer remained in full remission, and it's been about seven years now, and this gentleman is still in full remission. So, in his case, he did extremely well, and I believe that the LDN and the immunotherapy worked in unison, and one synergized with the other in order to give him an excellent result, which in this case would be considered a cure.

Another one of our earlier cases that really intrigued me was a 58-year-old gentleman that came to see us for rare cancer that was present in the base of his tongue.

He had about a three-centimetre tumour in the tongue, which was an adenoid cystic carcinoma; that's just the type of cancer, but it's an unusual type of cancer of the mouth. So, this gentleman went to see his specialist and he was told that in order to cure his cancer, the entire tongue would have to be removed surgically, and because of the location, in order to really give them the best chance of cure, they would have to remove his voice box as well. And then there was discussion about possible chemotherapy and radiation after all that surgery. So naturally, this gentleman was upset because of the dramatic change in his quality of life that would follow after cancer treatment.

So, he declined conventional therapy. He came to see us requesting a therapy that had no side effects. So, the first thing I told them was there's no such thing that has no side effects, however, immediately I thought of LDN because it's one of the gentlest therapies I know. So, he ultimately started LDN, and he combined it with vitamin D because that's considered to be a medicine that can potentially enhance other cancer therapies. It can work on the immune system and improve anti-cancer immunity. Vitamin D can also change the behaviour of cancer cells into more harmless behaviour so that they don't grow and aggressively spread. So, this fellow has started taking the treatment with the LDN combined with vitamin D, and within a few months he felt that the tumour was shrinking, and so continued therapy, and we didn't hear from him for a while until about two years after he started treatment., and he sent us a new MRI report, which is a scan of the tongue that showed complete disappearance of cancer. So, he continued on LDN and vitamin D and he has now over five years cancer-free. His specialist is quite surprised and pleased, to the point that he no longer repeats his scans frequently, and he just sees him once a year for a regular checkup.

A couple of years ago, a 53-year-old gentleman came to see me requesting treatment for bowel cancer. It was present in the sigmoid colon, and it was believed that cancer formed as a result of his inflammatory bowel disease called colitis.

So, this fellow was offered surgery by his specialist that would have been the standard treatment and potentially curative. However, he was afraid of surgery. He was afraid of the complications. So, as a result of his concerns, we offered him a few treatments, and he ultimately chose LDN. So, he started LDN, and we were monitoring him with a blood test for colon cancer called CEA, and in addition, we also monitored him with colonoscopies. So, his specialist would have a look within the colon and see what was happening with the tumour. It took about four months to see some improvement. We actually started to see the CEA, the cancer blood test numbers fall, and it was falling progressively over about a period of about three to four months subsequent to that.

And then it was maintained at a steady value of about 30% below the original value. In addition, he did have a follow-up colonoscopy, which confirmed that the cancer was stable or smaller, and his symptoms of bleeding in the bowel actually improved as well. Now this fellow did decline traditional surgery, which was not exactly what I had recommended either because I thought that cancer could potentially be curable.

However, the case does demonstrate that in cases where let's say a patient refuses surgery, or if surgery were to be too risky, then LDN could be an option for patients to try, especially if the cancer is non-aggressive.

In addition to using LDN, we almost always recommend vitamin D. The dosing of vitamin D is very controversial, but there's adequate research now that supports using high doses of the vitamin. So, that's what we're doing: we're using typically in the range of 5,000 to 10,000 units per day of vitamin D3, preferably in a liquid form because it's easier to take, and so patient compliance is high. Sometimes we even need upwards of 15,000 units or 20,000 units of vitamin D per day. As an aside, I personally take 15,000 units of vitamin D myself, and I've been taking that for about a year now. I take it from my allergies, and I find it to be highly effective.

So I became acquainted with Naloxone and Naltrexone, the drugs, in my training over 20 years ago in emergency medicine, and early in my career in general medicine began to explore the use of low dose naltrexone for a variety of illnesses, including auto-immunity, pediatric disease and then cancer. As the years of practice went on, we developed more and more cancer patient care where we were using the low dose naltrexone as an integral part of the patient's therapy.

We began adding low dose naltrexone with a variety of cancers, not knowing for sure which ones would be more or less responsive. And back at that time, the data was very sparse, so we were basically asking patients if they were okay with us trying it, So, many would come in with articles they had read, and we would start the therapy with them.

We have had a number of responses that run the gamut from—stabilizing disease, to being very supportive of other therapies that were being done, both natural and standard chemotherapy and radiation in some cases. And then one of the most beneficial uses we have seen is in the patient who has come back from the oncologist, and there is the report there's no more we can do for you. So, we use it in our program for stabilizing those patients where the standard of care has run out. I think the persistence of our using the low dose naltrexone as therapy is owed to the fact that we see positive results frequently enough, that we keep using it with many therapies that are nonstandard. You'll find that they work in a very narrow margin or for only certain types of cancer or certain types of illnesses, and so we'll reserve those for those certain type things. Low dose naltrexone at this point, as they say, eight or more years has impressed me enough that I keep it at the beginning of treatment when I'm working with patients all across the board with cancer.

So, the results are quite varied. We have had some patients, especially elderly patients, where they're very sensitive to medications. They've been told by their oncologist that they are not a candidate for standard therapy, because they're too elderly or frail. We have had a few of those patients where their disease, their cancer, has stabilized with basically the addition of low dose naltrexone on its own.

We don't expect that in everybody, but it's been curious to me to see one agent do that in cancer, which is very unusual. Most people, what we see is, it is a very good synergist with the rest of the care, and sometimes what will happen is, a patient will stop taking it and not tell us, they'll come back and they'll have some regression or some addition of symptoms from their cancer, we'll find out they've gone off low dose naltrexone. They'll go back on, and often those symptoms will go back away. So, we do see it as an integral part of care. I would say the number of patients with cancer that we have prescribed low dose naltrexone for in the last seven or eight years amongst myself and my colleagues at my clinic would probably reach a number between 250 and 350 patients.

As I said, we've seen a wide spectrum of response all the way from it was the only thing that they could tolerate, due to age or frailty, and we saw a stabilization of their disease, meaning it didn't progress, which is a very positive finding, to the person on multiple therapies where it's being used as part of a team approach, and as I mentioned, it being withdrawal caused a reversal of the positive. So, I would say in at least 30% of people, we have some verification, either based on it being the only drug used or it being taken away from their therapy, and them having regression that we could really point to clinical success. The rest of the patients, it's not that it made or broke their therapy, but we definitely left it in their therapy and never withdrew it to see if that was part of the success or not. But we definitely have seen, and as I say with either on standard oncology or natural therapies, I've seen it to be useful and positive in cancer cases, more than most other therapies I've used.

I would say that of all of the integrative and standard therapies that I have seen both in chronic illness, but especially in cancer in the last 20 years, low dose naltrexone has been one of the top treatments that have impressed me as far as outcomes. Improving the quality of life and stabilizing disease.

For patients, it's largely letting them know that it has a very low incidence of side effects and downside., and the most we can do is share case reports with them that match their cancer, and normally we have some positive ones. Of course, you can't guarantee anything in cancer, but to me, it's a low downside, low cost, and high-value therapy.


So low dose naltrexone isn't the cure to cancer, unfortunately, and I suppose there's no such thing as a true cure to cancer, but what low dose naltrexone will do, is it will support the actions of other drugs that are out there, which have been shown to have an effect. For instance, chemotherapies are efficacious in lots of patients, but they could be boosted. Irradiation is also effective in lots of cancers, but again, they can also be improved, and these agents that can support the activities of other drugs, these so-called agents, is a class of agent that low dose naltrexone will sit-in, which makes it an incredibly exciting piece of the compound.

So, what we did with all this genetic data, we went on to see if these cancer cells that we brought into lab could be sensitized or could be affected upon by naltrexone. So, we use in vitro experiments, experiments performed in a lab to see if we could kill these cancer cells.

And the disappointment was, that by using naltrexone at low concentrations continuously, we were having no effect on a number of cancer cells. However, the genetic fingerprint told us that it should work. So, by changing the schedule in the way that we gave this, this treatment to the cancer cells, based upon our understanding from the genetic fingerprint, we could actually cause these cancer cells to undergo cell death.

So, to summarize all that, we have a situation where if you were to use low dose naltrexone continuously you'd have no effects or effects will be minimal. However, if you were to use a schedule that involves slightly different aspects, you would end up killing those cancer cells. And that's something that armed with, we can take forward to the clinic and convince clinicians to start using low dose naltrexone, not on its own, possibly in combination with other therapies such as these chemotherapies, as I alluded to, as well as other newer drugs, such as the immunotherapies. So, the results of our studies that have allowed us to understand the action of low dose naltrexone much, much better than we did a while ago. And armed with this knowledge, we can design new treatment regimens, these new, different strategies that can be used in patients. And in that regard, it’s a game-changer. We now know how best to use naltrexone. In the past, we used to think naltrexone should be used continuously, and that would induce some effects in the number of patients. However, the data that we've generated very recently, suggests that we can actually improve on that. And it's these small step changes that will lead to a situation where these patients with cancer will benefit. We've worked on a number of cancers in our lab-based studies, and these cancers have involved cancers of the colon, of the breast and also of the lungs, and in these cell lines, we've shown that the effects of other drugs can be enhanced by using low dose naltrexone. And we are yet to find cancer that doesn't respond in this positive way, but we've only just started very recently and in the three cancer cell types that we've used, we've had a response that's always been positive.

Our results suggest that doctors who prescribe naltrexone need to be very wary of the way it's given. We've shown that depending on how the drug is given, you may get responses that are not optimal. Indeed, our results specifically showed that by giving this drug continuously over four days, would result in effects, although good on its own, was inferior to if you were to use the naltrexone on a different schedule altogether. What our data suggests, is that low dose naltrexone effects can be improved if you were to modify the schedule to involve breaks in treatment.

 My hope for low dose naltrexone is that it's incorporated in treatment regimens, in treatment strategies in patients with cancer. Naltrexone, especially low dose naltrexone, will enhance the actions of a number of chemotherapies in a number of cancers, and my hope is to see it being included in treatment.

Well, in a word, with the findings that we've captured here, gives a complete scientific justification for taking this forward into the clinic and giving evidence to the commissions, and the regulatory authorities and say look this does this, that, and the other, it should be incredibly useful in these conditions, and here you have this enormous amount of anecdotal evidence that it is. So basically, we want to go forward and capture it so it can actually be used and prescribed in the clinic on the NHS.

Our data gives us a better insight into low dose naltrexone, but better understanding, low dose naltrexone, we can better understand the ways that you can treat patients with cancer. So, I suppose the take-home message would be, we need to know how this drug works to maximize its uses in cancer patients. Patients are not interested in how the drug works, they are more interested in whether or not the drug works or not.

What our data suggests is that we have the best understanding. And by understanding the drug better, we can design better treatments that will benefit patients.

Well, the NHS and the government say, and various people say, that they would basically like drugs which are non-toxic cheap.

The current drugs being used to treat cancer are coming in at an average of about 5,000 pounds a month. And when you finish one, there's another one, so these costs are totally unsustainable. Whereas the advantage for a drug like this, that's a cheap, non-toxic can extend life, possibly, we don't know until we try that, but you can see it's a doctorate. It does improve the quality of life in a lot of people; that's an enormous potential that could save I believe you know, millions and all the treatments that we currently use to try and improve the quality of life and extend, et cetera.

One of the issues with LDN being a generic drug is that if it has been proven to be effective as a treatment for a disease like cancer, it could certainly prove to be challenging for the pharmaceutical industry. The reason is that this very cost-effective medication could potentially compete with branded drugs that are out there already.

So, I think that there is going to be a bit of a challenge moving LDN forward as more of mainstream therapy because it would likely be opposed by the pharmaceutical industry. Well, at the current rate of growth of cancer around the world, and looking at the cost of cancer therapies right now, it’s pretty clear that in a short number of years, the treatment of cancer is going to be unsustainable, so we actually desperately need more cost-effective therapies. Now with the current research model, there's really no motivation to conduct large formal scale clinical trials with LDN, because it is not a profitable drug. So, what we really need is a different model for researching LDN. One in which there should probably input from the government, in order to fund large scale trials to finally put to rest the idea that LDN is in fact, a valuable therapy and potentially from the insurance industry there should be funding because they're probably going to benefit greatly from the reduction in the cost of cancer therapies.

Low dose naltrexone increases what's called the OGF and OGF receptor. These are little peptides, basically proteins, that when connected together inside the cell, they give a signal to the nucleus that inhibits the cancer cell production. The amazing thing that they found is this is present in 90% of the human cancers, over 47 different lines of cancer, they've shown that this mechanism is present, and after reading their papers regarding this, I found the science to be good enough to be legitimate to try for people who have cancers that really have no other choice; stage three, four cancers that really are done with their therapy. It also increases what's called the P16 and P21 pathways, that are the key components to inhibiting the cancer cell division, and what they found interesting enough is in the cancer cells, they don't have a lot of OGF and OGF receptors. So, what it does is it boosts the body's own way of inhibiting cancer cells. We don't know that it really destroys tumours., it just inhibits cancer cells from dividing. So, in doing so, I took it upon myself to do research on it before it would use it.

You know, I'm a scientific type of person. I like the science to be there. Dr Zagon published articles regarding ovarian cancer cells specifically with naltrexone and OGF, and since ovarian cancer’s, the fourth leading cause of cancer mortality with women, and it's the leading cause of gynaecological cancer; this is a tough cancer and it’s critical to understand the cancer mechanism. And they found that the OGF receptor mechanism was present there. They showed it reduced cancer cell proliferation, and he's had a number of other articles showing the same thing.

So, I have a patient who is 2004 had initial ovarian cancer, and as Dr Zagon points out in his articles, 65% of the patients with ovarian cancer recur within two years. Well, she went six or seven years, and then she had stage four metastatic ovarian cancer everywhere. Her spleen, liver, colon, she had the surgery, she had some chemo, and then she heard about me through a friend, and so I started her on low dose naltrexone in 2011. And as a matter of fact, I just talked to her two days ago. She's doing very well. Her liver metastases have stabilized, and she's now in a stable state, and this is four years, four and a half years later, which is significant, because I was anticipating that she wouldn't have lasted more than four or five months with metastasis through her whole abdominal wall cavity, and the other areas I mentioned.

I had another patient who at 38 years old had a discovery that he had stage four squamous cell carcinoma of the tonsil. And he was treated with the usual chemotherapy, radiation; he elected not to have a radical neck dissection. He just said I'm not doing that. So about eight months go by, and he's just not doing very well.

He was tired, fatigued, and so I said, well, come to my clinic. I did a bunch of body chemistry tasks; hormone levels and found that the chemo and radiation destroyed all those, which is very common. Once I got those balanced, he was feeling better now, and he's doing great, but I also put him on LDN and Squamous cell carcinoma that tonsil does not do very well when you're stage four. This is four years later now. There are no signs of cancer. His oncologist says we really don't even have to follow the PET scans anymore because there's really no evidence of any recurrence. And he now is doing very well. He's doing worldwide trips, working two jobs, and he takes the 4.5 milligrams every day and hasn't had a problem since. In regards to how well he's done, well, maybe half the people last five years with that diagnosis, he met two other men who had the same diagnosis, same exact diagnosis when he was at MD Anderson, they have now both passed away a couple of years ago, so as long as he lives, it's another telling sign that LDN could be very positive for people, you know, long-term, and maybe preventing the recurrence by inhibiting any other cancer cells that are residing or starting to rise again.

I'm a stickler for facts. I want facts. I want proof. I want black and white. I want to know this is how it works. It increases the endorphins in the body, we know this. We know what endorphins do to the tumour cells; they block those tumour cells, and they block the receptors on the tumour cells. They cut down the inflammation around these tumours because this inflammation around the tumours helps it to grow, helps it to get blood vessels to grow out of those tumours so you can get more metasticies et cetera. So low dose naltrexone plays a role directly there at the tumour surface at the tumour cell.

However, it has another mechanism. This is what's also fascinating. And that was, as I said before, it down-regulates some of the T suppressor cells; the ones that are the most important in suppressing the immune system, it blocks those. So, the immune system can go up, and you can get the immune system up by down-regulating these T suppressor cells it's called foxp3, for those who are in biochemistry or studying this area. The foxp3 cells are blocked by low dose naltrexone, and so you're raising your immune system, you're working directly against the inflammation at the tumour cells, and you're helping the patients to be able to reverse their own tumours,  but not as one drug alone, but in combination with other things. If any of my cancer patients have cancer, they should all be on low dose naltrexone, because of the fact that it is helpful for them in every area of cancer therapy…period. If I had it myself, I would be on low dose naltrexone, and I'm a physician and a pharmacologist and a former FDA official, and I would recommend it to any and every one of my patients. It's imperative, as far as I'm concerned as a support measure, and we need to realize this. We need to realize this is not a cure. We need to realize that this is something that is an agent that will help tremendously, and that when patients are in remission, it will help to keep them in remission. The fact that low dose naltrexone cannot do any harm, and we've been showing efficacies in autoimmune diseases as well as cancer, it's something that I think the FDA is going to have to recognize this as a support measure for many of these illnesses.

A very diligent radiographer went back through all my medical notes and said, perhaps we should look at the pathology of the spots you had removed from your leg seven years ago. And sure enough, it showed that there were some suspicious cells there that hadn't been removed. So, it was then decided that it was probably melanoma, and I had my lymph glands down my right leg removed. And then I was having a few spasms in my right arm and my right hand. My GP, my same GP, suggested that I was just anxious about my golf swing and that I shouldn't be too worried at my age. So, off I went on holiday and while I was walking on holiday, I had the most amazing spasms in my right leg, and I knew something was wrong. Thinking I'd got a trapped nerve, I went straight back to the doctor when I returned home. By the afternoon, I was seeing a neurosurgeon. He sent me for an MRI, and the result came back that yes, I had I think five-centimetre tumour in my left side of my brain. So, I had a pet scan, and it revealed I had a tumour on my adrenal gland and tumours in my lungs.

My name is Annette Manabi, and I'm a physician in Illinois. My background is in osteopathic medicine, and I have two board certifications, family practice, and neuromusculoskeletal medicine. I was diagnosed in December of 2014 with cancer, and at that point, it was a stage one endometrial cancer and the initial treatment plan is always surgery, which I asked to defer in an attempt to hopefully avoid surgery. And so they were willing to work with me. I said, you know, there are a lot of options that they do with women who are still trying to have children, and once you're menopausal, they just want to go straight to surgery. So, I said give me a chance to try some of these things. I, unfortunately, wasn't able to find a practitioner in my area who was versed in using LDN in cancer patients, and so I was having to navigate a lot of that on my own, but I worked up to the four and a half milligram dose, and over the course of six months incorporated a lot of integrative holistic treatments as well into my cancer treatment regimen. During that time, my tumour markers continued to rise. So ultimately, I did have surgery in June of last year. However, at the time of the surgery, what was of note to me, and I feel assigned that the LDN and the supportive treatments I did were helpful is the tumour itself did not invade systemically. So at the time of the surgery, it was still only a half-centimetre into the wall of the uterus. It didn't go into the lymph nodes. It didn't go into the circulation or metastasize anywhere. It did grow into the uterus. So, the tumour itself increased in size, but not into my own tissues, and so I feel had I got it sooner and had I caught cancer when it was much smaller, I may have had success in actually avoiding the surgery, and I'm continuing on the LDN at this point to prevent any recurrence or continue to boost my immune system because we don't really understand all the mechanisms of why cancer occurs and there's still a risk for recurrence or metastasis, and so I'm trying to boost my chances, and there's so much promising research coming out, showing it is effective in fighting cancers of all types and all stages. And so, I have no qualms in continuing to use it to support my own immune function.

So, I went away and I followed a very strict diet, then I was very conscious that I needed to rebuild my immune system and really fight cancer through my immune system. So, I followed that for the whole of that year. In July of that year, there were some more slight spots on my brain. So, the gamma knifed it again, and then I had seven sections of my small intestine removed.

So it wasn't until mid-2007 when I collapsed and was taken into hospital, ended up in Hammersmith Hospital. And I had a ruptured tumour on the outside of my liver, which caused me to bleed internally. And I was very seriously ill. You know they basically resected my the liver at that stage and shut everything down and that was the start.

So, Professor Dalgleish said, well, I wanted you to have LDN anyway because I think it's going to be good to build your immune system. He also advised me at that point to take vitamin D3, 25 UGS, high dosage every day. I was having B12 injections because I had so much that my intestine removed and I was trying to drink a lot of green tea.

So, he put me on green tea extract at that point, which was much easier.

So, it was about that time that I have an old school friend and his wife plays tennis with Professor Angus Dalgleish, and she said, why don't you go and talk to him? He's a top oncologist. And so I did, ‘cause I really didn't know what I should be doing at that stage.

So, I thought, well, I've got nothing to lose. And I went and spoke to him; had a consultancy session, and what he did tell me, he said, look, you know, it's just not quite my field, but he said, I can tell you, he said, I can't recommend it, but I can tell you that I have a dozen or so patients who are self-prescribing low dose naltrexone for malignant melanoma, and remarkably they've been symptom-free for 18 months, and he said, that's very interesting.

So here I am, just over seven years with, I hate to say it, but at the moment…good scans. And that’s really about where I am now. I suppose I love it, that's all I can say. My lungs are completely clear and that's only happened since I took the LDN. Up until that time, it was still growing. So, from my point of view, that's very positive. It's had no impact on my life whatsoever.

When I initially started taking the low dose naltrexone, I started at one and a half milligrams worked up to four and a half. I'm currently still on four and a half milligrams of the low dose naltrexone.

Initially, I did notice an improvement in my energy and an overall sense of feeling better. And aside from the initial disruption of sleep, which took place, my quality of sleep improved dramatically on the low dose naltrexone. And that persist, like if I miss a night or during the surgery, when I had to stop because of the pain medications, I could see a difference when I was off the low dose naltrexone than when it was back on the low dose naltrexone. So, I find overall, it's helping my overall wellness and state of health.

So, following on from that, I got more information from him and I didn't do anything about it immediately. I don't know why. I think it was because I'd been around the alternative market, and I was talking to all sorts of odd people. One of them selling mistletoe therapy.

I consider the impact of low dose naltrexone on myself and potential negative side effects. I did experience initially some of the sleep disruption that is commonly reported, where I was a little bit more awake at night, or I woke up a little more frequently.

And after about two weeks that passed and the quality of my sleep actually improved. Other than that, I've not had any other types of side effects from it that I'm aware of, and in general, I am feeling much better in how I feel my sleep energy and I haven't noticed any other specific side effects.

And so I was a bit sceptical about following Professor Dalgleish’s advice at that time, so I didn't do anything about it for 18 months. Anyway, within that timescale, I had two further recurrences of. HCC, which is hepatocellular carcinoma. It's a tumour in the liver. It doesn't spread in the body, but all the same, it destroys your liver.

When I came out, I did a bit more research, following up on what Angus Dalgleish had told me, and I researched  Dr Buhari in New York, and I thought, well, this is very interesting. And it kind of supported what Professor Dalgleish had said to me. And I also got to know about Dr Berk Berkson’s books and who's in Las Cruces, New Mexico, who was doing very interesting work as well with LDN and also using antioxidants, in particular, alpha-lipoic acid and some other things, and so, based on my research, I thought, well, I mean, I've got nothing to lose so I'll give this a whirl.

I have in terms of ways to take the low dose naltrexone, I am taking the capsule form that I obtain from a local compounding pharmacist. In terms of the future of LDN in the US I think in the ideal world, I would wish that all the major cancer centres would incorporate it into their treatment regimens immediately. Unfortunately, change in medicine is very slow, and it's challenging, and because it's already a patented medicine, there's not a lot of profit to be made. It's inexpensive, and so that becomes a barrier I think, in realistic means, the integrative medicine and holistic medicine community will be embracing it as the word gets out, as conferences are held, they will be the ones to hold the torch and get it available, as the patients also demand access, it'll be, I think, through that population of physicians who offer it to their patients. I would like to see it as a frontline for anyone who's got a suspicious diagnosis that's potential cancer. They should be started immediately.

So, I started without any expectation. I started taking the LDN and hey presto, miraculously I went into remission for three and a half years. Three and a half years. And that in itself was remarkable. And I was being treated then by someone at Hammersmith Hospital who was a bit dismissive about LDN. He'd never had great faith in it. And what he said to me was he said, look, your liver is recovering,

I don't think your recovery and your remission has anything to do with this low dose naltrexone you're taking. So, he was so dismissive I discontinued it, and I rue the day I listened to him basically. So, I discontinued it, and then within nine months, I'd had another recurrence of another tumour in my liver. But after I’d had this news, I decided I'd go to America to see Dr Berk Berkson, because I'd heard about him. And I thought, well, I'll go and talk to the guy. So I went out there and started on the LDN again with him, and I came back to the UK again with no expectations, and when I got back to the UK, I'd only been on the liver register for six weeks I think it was, and I  just sitting at home one day and I had a phone call saying we've got a liver for you. And I almost fell off my chair and we had to make a sort of an instantaneous decision about where to go. So, I said, yes. Interestingly, when they removed my liver and replaced it with a new one when they sectioned the old one, they said, oh, that's interesting, all your liver cancer has disappeared. Your tumour has completely necrosed. So, I don't know how to explain that, but since that day, that was over three years ago now. So well, I shouldn't really judge, but I suppose in my mind, I know that what did LDN do for me? Well, it gave me three and a half years of remission from the time when the doctors were actually saying, he's going to have another recurrence in three months time and it doesn't look very good, to basically getting me through that period. It's gone very well indeed, and I have no recurrence of any sort. So, do I believe in LDN? Yes, I do. I know, I know it worked for me.

So, more commonly we are getting many inquiries from patients who have been diagnosed with various types of cancer for low dose naltrexone. And it's quite important that if you are going to look at using low dose naltrexone for your cancer therapy that you talk to your individual GP and your oncologist first, because you may be on certain types of pain medication, which are contraindicated initially unless they're very carefully handled. A lot of people have come to us because they've gone onto the internet, and they’ve found something that they can buy. A lot of those are not real, or they are fake medications, which are dangerous, and you should not randomly decide to treat yourself for cancer by buying naltrexone tablets on the internet. I know it sounds very simple, but we find out the great number of people who do that.

So, looking at the possible side effects you can have from taking LDN along with cancer chemotherapy, that's extremely individual, dependent upon the type of cancer chemotherapy that you have. So, for example, there is a growth in biologics and vaccines, versus original chemotherapy drugs, like the platinum and things like gemcitabine, which has a slightly different mechanism of action. So, if you are taking, or you’re being prescribed many different types of cancer chemotherapy drugs, and each individual cancer is specific; cancer is not one disease, it uses multiple different types of treatments for different types of cancer, and the guidelines are always changing.

So, there are biological drugs that are chemically drugs called the plantains, and there are also drugs which can change your immune system, like vaccines. So, it's going to be very individual when and where you're able to take LDN in your treatment cycle or your treatment pathway. Now, there has been some information that we are aware of, which has not yet been released.  And I think over the next year we're probably going to hear more about that along with vitamin D. So, I’d certainly say, if you have been diagnosed with cancer and you're looking at using LDN, the first thing you should do is start taking vitamin D, and the dose for that, you can decide with your practitioner, but really it would be aiming for between five and ten thousand units per day, and LDN seems to work much better when it's being used with that, but LDN itself should not be taken when you're on any strong painkillers without direct medical supervision. So to speak to your doctor or pharmacist, and before embarking upon this journey and make sure that you get someone who is very qualified, who is capable of reading the most recent research and keeping you up to date and make sure that your treatment pathway works as well as possible.

Linda Elsegood: Thank you for listening to this presentation. All past conference presentations can be found on our website, https://ldnresearchtrust.org/