Thursday, April 30, 2020

I wish I could hug you.
I just need a bit of support. I really only trust you. You make me feel like things will be okay.
I cry more easily than I did, but my hopes keep me looking forward. I hope you know how amazing you are. I have grieving so long. Wouldn't it be the best to have grief end in happy?

I hate sadness.  It's been such a long stretch. Anything with you would be my delight.
How are you?
I would be so thrilled to be sitting there and see you walk by and smile at me.  I want to just pick back up like normal, but as a friend. It has been such a long time.
Please don't let anything stop us from being friends. I would make you feel happy you did.
I think of you very often. It makes me happy.
I can do haircuts for men. I have become fairly proficient.
"You need to have the courage to follow your heart"

~"Letters to Juilet"
I would do anything to keep the one I love safe. I only know how to do what I am able to do in my position. I also don't know if I might mess things up for anyone. I am just trying to do the right thing.
Watching, "Letters to Juilet." It is a sweet story.
I know I would love Italy.
I think I may have struck paydirt with the med.  I am very excited.
I am getting congested. I will sleep. I was up late.
If I do die and can't say good- bye.....you know. Forever. I am glad I got to experience that beauty. It is something I can take with me into eternity.
Be safe.
I wish I could know if the people in charge were sincere, or if they want to hurt me. This makes no sense.
I have been a lone individual against a well organized group of violent, aggressive bullies, who flout the law and the moral code of decency. Those are not your people. They are scary, indoctrinated terrorists who think that I am terrible for some reason. I am not surprised. It was a well organized group led by desperate professionals who want their agenda advanced, no matter the cost of (my) life.  They are selfish driven, I am kindness driven. I do not hurt people. I do not know entirely their point, but they have focused their hate upon me. I am a victim. My friend is a victim. All I can do is speak the truth. It is all I know. They are the ones who need to keep up with their lies and reason for cruelty. All I care about is wanting my friend to be safe and happy. I have done nothing. I was still attacked after they came up with the breast cancer scare. They seem happy that I took some of the med. I will see how long that lasts. I think they figure I will dry up and blow away. Not going to happen. I knew they would begin attacking around now. I am just minding my business and just living one day at a time. It is all I can do. I have been basically isolated for nearly 5 years. Doing nothing, while others live normal lives. I am not the one in control. I would not be living in mystery, anxiety and stress. I did nothing wrong. No one except the attackers did. They broke laws, they harassed, attacked and had no compassion for anyone else. Their own desires were paramount.....at any cost to anyone else. That is the  definition of narcissism, selfishness and greed. It is ugly, disgusting and dangerous! They have no excuse for using forgery, which steals a person's identity. They are guaranteed criminals. I am not. Yes, I am better than those people. They have no right to hurt people, or steal their identity. Period. I have no respect for criminals.
Life is often lonely and sad.
 I know that in my struggles to grasp this horrible ordeal, I may do wrong things, but they are honest mistakes while trying to survive. I am basically alone and scared or many things, but mostly scared of not seeing you again. I hope you will be understanding and forgiving. I never hurt anyone purposely. That is for others to do. I love and care about people.....especially you.
I am a reasonable, kind, caring, compassionate person. I want your happiness. People can beat the crap out of me....and they have and I will still be devoted to you. Forever.
I spoke about you to to my angels tonight. No matter how things go, I will be there.
I could always be moved to do all the good things for myself with your motivation. I could exercise like mad, eat very little and think poetic thoughts. You owe me nothing, but I was able to stay alive to be able to see you again. I was stunned, shocked and frightened and worried about false accusations and if they were going to harm you. I always had dreams of needing to go out in the middle of the night to rescue you. I felt like a fireman always on the ready. I have not changed the tone of my heart. It is still tuned to you.

Wednesday, April 29, 2020

I loved that part in the program about taking Tupperware to the restaurant and packing up 1/2 the food.
You are so fun. I love you so much.
That is clearly an abusive person. No one should feel obligated to stay with an abusive person.
It makes me feel as if I have been abandoned because I had that diagnosis. My friend is not a fair weather one is he? It never seemed so. I just want to see his face again, please?
I am not someone who seeks revenge against anyone, but the person who instigated this against me was certainly taking a risk by thinking this would never get out in the open. Nothing like risking a career, reputation, and disdain, merely because she was too gutless to fight her own battles. I think her attorney has sought refuge at another firm. Self-centered people as she, don't see, or care to see, what harm they do to others, but feel plenty sorry for themselves. No empathy. Everybody has some tough times in life, but hers could have been avoided with some kindness and understanding and realizing other people in the world exist and matter. She hit me hard without one thought of how much I could have been hurt. Now, I see she still has no remorse, just more severe, life threatening painful attacks against me by her colleagues. That is someone who would never be sorry, or seek redemption. Narcissists feel their own pain, no one else's.  It has been all this time and it could have been ended awhile ago out of remorse, but nothing, just more violent attacks. Don't trust her; she is too set in her hardened ways as a monster. You deserve to be loved and admired for all the lovely things about you. You have served enough and suffered enough. It is time to be happy yourself.
Find out how it feels to be cherished and appreciated. You are loved very much.
I think someone who knows the difference between cancer and lipedema, or Dercum's, etc. I just feel like there could be a mistake in my case.
I was attacked once, why should I trust them now?
I need another opinion. I cannot trust these K people.
My jaw has swollen up and I saw it can be a side effect of the Arimidex, but no one seems to care.  I don't like those people.
Why do people feel the need to use cruel behavior and dirty tricks?
My great Grandfather's book.
You should only be around people who genuinely care about you.
https://www.huffpost.com/entry/medicine-in-the-body-_b_823530
If I could see you, I would be so happy.

Tuesday, April 28, 2020

May I have the honor of being your friend? It would mean more than anything.
I am still not convinced that it is breast cancer. I will trust you to give me the straight scoop.
I know my love will never fade.
I was attacked by people who did not care how I was affected by it, or even if I died. It bothers me not just that I could have been dead, or ill, (as now) or any other responsibility, but that people like that have had control over you. It has left me frantic at times and emboldened enough to ask for your protection. Of course I was given no end of rankor for it by people who think others have ulterior motives simply because that is how their mind works. They never have known love. They think love is a number, not a pair of dark brown eyes, behind a serene, lovely face.




P.O.V.

The essence of your ethereal drama
expresses itself each time my serene
mind wanders into your field of
harmony and companionship

I love the tune you emit from your
generous, wondrous soul
You are the song in my heart and the
lilt in my head

I love with a sustaining flow of
seductive emotion
It is the beauty of the naive
who ask only for minimal reaction
to their ebullient waves of intense
fervor

it's okay

In my eyes you are life,
everything good
elegant
perfection
understated
minimalist

Your name is my mantra
Your eyes, my temptation
Your smile, my indulgence
Your happiness, my devotion


You don't need to be the
center
of
my
attention
but..........you
are.
~Haviva

(c) HVM 2020

Monday, April 27, 2020

I believe we can bring it back, do you?

(Our friendship)
I can have any imperfections corrected, but I think I am interesting and funny and we had a lot of things in common. That was fun. I would never hurt you, or make you sad, but I would comfort you, if you were.
Have I just been a joke? I hope not. I have such trust.
You know that I will only do what you tell me to do.  You were hurt too, not just me. I just need you to protect me. There are things people should not get away with, but I will not hurt anyone you don't want hurt. I will just leave it all up to you, but keep me safe, please? I will always do that for you and comfort you. Love is forever.
I wish you were here. It is a beautiful day.
I guess I will have to find a specially licensed person to give me an Rx for LDN.
I want him on my surgical team. I need him on my surgical team.

"Never Stray"~
I saw the twinkle in your eye
each time you slowly sauntered by
My heart leaped
up and did a dance
It knew it wanted
at least a chance

A day that held your happy
gaze
Could lift my spirits
many ways

I more than need your charms
today
For time and cruelty
chased them away

There's nothing better here on Earth
to make one feel a sense of worth
Then hear a loved one sweetly say
"I'm here beside you, I'll never stray."

~Haviva
(c) HVM 2020



You know I am someone with a lot of decorum, so you may rest assured that whatever emotions are bubbling along on the inside, I am perfectly calm inside. (I may faint first...)my doctor is calling today @ 3.
I am upset about the possibility of cancer, but what has me sad is thinking I could lose your friendship.
I have been a loyal, devoted friend and always sought
and worried for your safety first. I guess if that is not good enough, then okay.
They had a professional hired to attack me, to "get rid" of me and mentally torment me to try and get me to kill myself, because I gave my kind doctor few gifts of thanks. That is called, hiring a "hit man", that is illegal.

I asked a surgeon (that same doctor I gave the gifts) I knew who had been my doctor, to observe my surgery. Afterward,
I called a number given to me by manager of patient relations to say thank you to the surgeon. About a week later I was served a TRO.

So far, who did anything wrong? Me? Or the person who hired the "hit man?"

I had no control over much of anything. I was basically a rag doll. I was screamed at. I was demeaned. I was taunted and humiliated. I was accused of false things. I was set up. I was taken from my health care. I moved far away  became a recluse. I was harassed by the new HOA. My things were broken. My older cars were towed away. I could not afford to get them out, or find a place to put them.

I was reamed out by an insane acting judge who called me names during the trial. An attorney was twice shoved on me, yelled at me, claimed to
be my attorney from a program for which I did not qualify, and the program said I was not in. The attorney was obviously bought to babysit me. He did not defend me. He basically served me up on a platter for the judge to abuse and then jail.

All that abuse was heaped on me and I could do nothing. I had no voice. All I could do was save up and find a handwriting expert, or two. They said my doctor's signature was forged. That left me worried for my doctor.

I figured that he was the actual target. He was being punished for helping me, but I think it morphed into their stealing his identity and his belongings and not leaving a witness. I had to stay strong and keep fighting for him and exposing the bad people. I had to warn him. Instead, I was jailed and kept away.

The people who made the plan are twisted and cruel. They harm without regret. They are supposed to be better than that, trustworthy. But they are not. To this day they attack me physically and mentally by telling me I have breast cancer and scream at me and treat me roughly. I knew they would escalate. They are desperate opportunists.

They want money. I want my doctor's safety and happiness. I want my health, but I think I was injected with something, I don't know. No one seems to care about what happens to me. It's been 5 years of near isolation. Waiting to be my doctor's friend, but I don't know.

So, I am thought of as the "bad guy?" On what planet?

I would please like a chance to be your friend.
You and I are people of humanity and compassion. We have both had cruelty and self-absorption pushing us around, that must end. They pretend they are better, but they are not.
I adore you. If you give me a chance, you will find it so.
Since taking ALA and Vit C many improvements have happened with my lipedema. I truly do think there is a mistake with the cancer idea. If the thought of cancer bothers you, don't let it. I cannot say for certain, but it may be that it is an incorrect diagnosis. The hormone blocker may be helpful for the lipedema, however. I would try the natural form.
Are you well? I hope so very much. Time is near to say hi. That will be lovely. Big hugs.
I ask forgiveness for anything I may have said, or done to offend during
this nearly five year ordeal of torment and trial, humbling and demeaning while fighting for my own honor and dignity as well as your safety. I am not cruel, I love and nurture. My only source of soothing
was knowing I would once again see your sweet face smiling at me. It was my dearest wish and is still to this day. Always with love.
I wish I could know that you were there. It warms my heart knowing you are well and perhaps thinking kindly of me. You bless me.

Fire Lookout



Author Jack Kerouac spends 63 days as a fire lookout on Desolation Peak in the summer of 1956.

  • By David Wilma
  •  
  • Posted 12/18/2006
  •  
  • HistoryLink.org Essay 8034
During the summer of 1956, author Jack Kerouac (1922-1969) spends 63 days as a U.S. Forest Service fire lookout on Desolation Peak in the Mount Baker National Forest in Whatcom County. Kerouac hopes to use the solitude to write, but he will be disappointed. His experiences in the Northwest and his journal entries will provide material for two novels: The Dharma Bums (1958) and Desolation Angels (1960).
Jean-Louis Lebris de Kerouac is best known as Jack Kerouac and for his On The Road (1957), which in 1956 had yet to be published. Inspired by a mountain-climbing trip in the Sierras with friends, Kerouac thought that a summer as a fire lookout away from people, drugs, and alcohol might help his writing. He managed a seasonal appointment as a fire lookout at the Mount Baker National Forest in Whatcom County for $230 a month. He hitchhiked from the San Francisco Bay Area through Seattle to the ranger station in Marblemount.
In The Dharma Bums he describes the journey this way:
"And suddenly I saw the Northwest was a great deal more than the little vision I had of it of Japhy in my mind. It was miles and miles of unbelievable mountains grooking on all horizons in the wild broken clouds, Mount Olympus and Mount Baker, a giant orange sash in the gloom over the Pacific-ward skies that led I knew toward the Hokkaido Siberian desolations of the world. I huddled against the bridgehouse hearing the Mark Twain talk of the skipper and the wheelman inside. In the deepened dusk fog ahead the big red neons saying: PORT OF SEATTLE. And suddenly everything Japhy had ever told me about Seattle began to seep into me like cold rain, I could feel it and see it now, and not just think it. It was exactly like he'd said: wet, immense, timbered, mountainous, cold, exhilarating, challenging. The ferry nosed in at the pier on Alaskan Way and immediately I saw the totem poles in old stores and the ancient 1880-style switch goat with sleepy firemen chug chugging up and down the waterfront spur like a scene from my old dreams, the old Casey Jones locomotive of American, the only one I ever saw that old outside of Western movies, but actually working and hauling boxcars in the smoky gloom of the magic city.
"Now I was beginning to see the Cascades on the northeast horizon, unbelievable jags and twisted rock and snow-covered immensities, enough to make you gulp. The road ran right through the dreamy fertile valleys of the Stilaquamish [Stillaguamish] and the Skagit, rich butterfat valleys with farms and cows browsing under that tremendous background of snow-pure heaps. The further north I hitched the bigger the mountains got till I finally began to feel afraid. I got a ride from a fellow who looked like a bespectacled careful lawyer in a conservative car, but turned out that he was the famous Bat Lindstrom the hardtop racing champion and his conservative automobile had in it a souped-up motor that could make it go a hundred and seventy miles an hour ...
"The fellows who picked me up were loggers, uranium prospectors, farmers, they drove me through the final big town of Skagit Valley, Sedro Woolley, a farming market town, and then out as the road got narrower and more curved among cliffs and the Skagit River, which we'd crossed on 99 as a dreaming belly river with meadows on both sides, was now a pure torrent of melted snow pouring narrow and fast between muddy snag shores. Cliffs began to appear on both sides. The snow-covered mountains themselves had disappeared, receded from my view, I couldn't see them any more but now I was beginning to feel them more" (The Dharma Bums, 222-223).
At Marblemout Kerouac received a week's training in fighting fires in June and started up the Skagit River with $45 worth of groceries (purchased on credit), to Diablo Dam, up the Seattle City Light incline lift, across Diablo Lake by boat, up to Ross Dam and Ross Lake, across Ross Lake by boat again, then by horseback with a ranger and a packer six miles up to Desolation Peak. His only contact with the outside world be through a two-way radio to the ranger station.
Kerouac found the reality of stunning panoramas, solitude, abstinence something less than the fantasy. Years later, a ranger who remembered Kerouac, complained that the writer would turn off the radio in order to write. But Kerouac apparently penned only one letter to his mother, some haiku poetry, and journal entries.
In September, Kerouac received a radio message that he was being recalled. He left the lookout the way he came up, hitchhiked to Seattle. He later wrote in Desolation Angels in his runon sentence style:
"The Seattle of ships — ramps — docks — totem poles — old locomotives switching on the waterfront — steam, smoke — Skid Row, bars — Indians — the Seattle of my boyhood vision I see there in the rusted old junkyard with old non color fence leaning in a general maze.
"I tell the busdriver to let me off downtown, I jump off and go klomping past City Halls and pigeons down to the general direction of the water where I know I'll find a good clean Skid Row room with bed and hot bath down the hall —
"I go all the way down to First Avenue and turn left, leaving the shoppers and the Seattleites behind, and lo! Here's all humanity hep and weird wandering on the evening sidewalk amazing me outta my eyeballs — Indian girls in slacks, with Indian boys with Tony Curtis haircuts — twisted — arm in arm — families of old Okie fame just parked their car in the lot, going down to the market for bread and meat — Drunks — The doors of bars I fly by incredible with crowded and waiting humanity, fingering drinks and looking up at the Johnny Saxton-Carmen Basilion fight on TV ...
"Hotel Stevens is an old clean hotel, you look in the big windows and see a clean tile floor and spittoons and old leather chairs and a clock talking and a silver-rimmed clerk in the cage — $1.75 for one night, steep for Skid Row, but no bed bugs, that's important — I buy my room and go up in the elevator with the gent, second floor, and get my room — Throw my pack in the rocking chair, lay on the bed — soft bed, clean sheets, reprieve and retreat till 1 p.m. checkout time tomorrow —
"A drinking and eating place is still showing the fight but also what attracts me (on the rosy blue neon-coming-on street) is a fellow in a vest carefully chalking out the day's baseball scores on a huge scoreboard, like old days — I stand there watching" (Desolation Angels, 101-103).

Sources:
Ellis Amburn, Subterranean Kerouac: The Hidden Life of Jack Kerouac (New York: St. Martin's Press, 1995), 239, 246-253; Michael J. Dittman, Jack Kerouac: A Biography, (Westport, CT: Greenwood Press, 2004), 69; Ann Charter, Kerouac: A Biography, (New York: St. Martin's Press, 1973), 266-278; Jack Kerouac, The Dharma Bums (New York: The Viking Press, [1958] 1973), 216-244; Jack Kerouac, Desolation Angels (New York: Perigree Books, 1960), 101-103.

Sunday, April 26, 2020

I don't know what is going on with you, but I miss you so very much. I am still in love with you, but I am happy just to know you. I want what makes you happy. I still want to share what I have with you.
As I have said, we had such a nice relationship before, there is no reason to think it would not be nice again. At least giving it a shot, would be respectful to all the time and energy and grief and anxiety and fear put into it. I truly want to know you and be there for you. It  is a thought that kept me alive at times. I was pretty low.

Lipedema and cancer.....?

I hope you can put yourself in my place. I have had people making false accusations against me from the very beginning. Saying ugly things about me to a variety of people. My name was smeared like paint on a wall. MP was trying to get me to kill myself. It was the most complete and strange attack one could imagine. Plus they said every odd thing about you imaginable. I knew them to be lies, or I just didn't care, or it wasn't my business. What I did know was you did not deserve what was said and the personal information that was being disseminated. It was also very weird how they seemed to be pulling your strings like a puppet.
I may not deal with everything in a perfect manner, but I also do not think they thought I would live this long and I was given a shitload with which I had to deal anyway. I was always researching, saving to get expert opinions for handwriting, talking to people then dealing with the behind my back crap they did to me by hacking my various accounts, like my mail, my FB page, etc.  I used so much paper and in, it was astounding. That awful attorney was such an invasive person, so cruel and callous, I was afraid for your life. None of them were nice. They were astoundingly cruel. I worried so much about you, I could barely sleep. It was awful. I tried to get the police to make extra patrols, and I was told they would, but that awful attorney made them stop and then said I was a stalker by doing it. How? Iwas sincerely worried. I have taken each odd thing by faith in you. There was never going to be a time when I was going to blame you. That idiot attorney must have never cared about anyone sincerely before in his life. I even went to the local PD there and spoke with a short, stocky, dark haired police officer who wore a red baseball cap. I don't remember his name, but he was pretty nice. I didn't have to know the address, because they seemed to know everyone and where they lived. I never drove there.
That attorney has a very twisted way of thinking. He thinks everyone is a weirdo like himself. If that woman is a real psychiatrist, then she must have gone to the sadist's school of psychiatry.  I took everything they said about you with a bushel of salt. Never had I ever witnessed two more prolific liars and desperate characters. Smarmy and sadistic.....they could be a vegas act.

I figure this breast cancer thing is just a last ditch effort. I have to take it as real, but I cannot help but think that it is more lipedema than cancer, but then, how was it compared microscopically to cancer? I had been saying they needed an expert in lipedema to look into it.

All I ever knew was that being around you was a joy. Even looking up information about various diseases/syndromes was exciting, because you always took what I offered seriously. I was trying various supplements to see what might help. I have noticed that large doses of ALA has softened even "candlewax" hard flesh and reduced the size and intensity of the orange peel skin. One thing leads to another and it sometimes leads to very interesting findings.

That and so many other things were so much fun to speak with you about. I really look forward to speaking with you again, if that is acceptable to you. I cannot think of anyone who makes life more enjoyable.
Please don't ever be mad at me w/o talking to me first. Communication is key.

(Only I see numbers.)
COVID-19 is an emerging, rapidly evolving situation.
Get the latest public health information from CDC: https://www.coronavirus.gov .
Get the latest research from NIH: https://www.nih.gov/coronavirus.
Logo of ictLink to Publisher's site
. 2018 Sep; 17(3): 986–993.
Published online 2017 Dec 19. doi: 10.1177/1534735417747984
PMCID: PMC6142095
PMID: 29258346

The Long-Term Survival of a Patient With Stage IV Renal Cell Carcinoma Following an Integrative Treatment Approach Including the Intravenous α-Lipoic Acid/Low-Dose Naltrexone Protocol

Burton M. Berkson, MD, MS, PhD1,2 and Francisco Calvo Riera, MD3

Case History

Kidney cancer is among the 10 most common cancers in both men and women. The lifetime risk for developing kidney cancer, which is higher in men than in women, is about 1 in 63 (1.6%), a rate that has been rising since the 1990s. According to the American Cancer Society, the 5-year survival rate for stage IV renal cancer is just 8%.
The patient subject of this report is a 64-year-old man with a history of fatigue, atherosclerotic vascular disease, prostatitis, joint pains, and myalgias. He was diagnosed with renal cell carcinoma (RCC) with metastases to the lung in early June 2008 after he started to feel vague flank discomfort followed soon afterwards by gross hematuria. He immediately presented to the local emergency room. A computed tomography (CT) scan was performed, which revealed a large hyperdense mass occupying the mid to lower pole of the left kidney (Figure 1) and a 1-cm noncalcified nodule within the upper lobe of the left lung (Figure 2).
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June 2008, CT scan showing a large hyperdense mass (arrow) occupying the mid to lower pole of the left kidney.
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June 2008, CT scan showing a 1-cm noncalcified nodule within the upper lobe of the left lung (see arrow).
After a left nephrectomy, his hematuria resolved, and the patient was started on bevacizumab by his local oncologist for 4 months with no positive results. He was then prescribed sunitinib and sorafenib at a large Texas University cancer center.
Unfortunately, the patient’s condition continued to worsen. He became anemic, leukopenic, and thrombocytopenic and was unresponsive to the antiangiogenic agents. The size of the solitary lung metastasis increased from 1 cm to 8-9 cm on a CT scan.
He was advised that he had exhausted his therapeutic options and that he should consider palliative hospice care given his poor prognosis and lack of response to conventional care.
The patient decided to seek another opinion and traveled to the Integrative Medical Center of New Mexico (IMCNM) in August 2010 where he was seen in consult by one of the authors (BB). At the time of presentation, his review of systems was positive for shortness of breath, seasonal allergic symptoms, heartburn, tinnitus, a decrease in force of urinary stream, insomnia, severe weight loss, flank pain, profound emotional stress, and anxiety. He appeared very thin and frail and weighed 176 pounds, having lost about 30 pounds.
A full medical workup was conducted including a positron emission tomography (PET)/CT scan that showed a large pleural based mass in his left upper lung (Figure 3).
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August 2010, a PET/CT scan showed a large pleural based mass in his left upper lung (see arrow).
Since the patient had very few treatment options beyond clinical trials, an integrative medical program was developed and prescribed for him. The purpose of the program was nutritional support, comfort, immune stimulation, and metabolic alteration of the malignant process. The hope was that his disease progression could be slowed and that his life could be prolonged. It was strongly recommended that the patient continue with a board-certified oncologist but he refused because he had been told by his oncologist that he failed conventional treatment regimens.
The key therapeutic agents initially prescribed by BB were intravenous (IV) vitamin C 25 to 50 g every morning and IV racemic α-lipoic acid (ALA) 300 to 600 mg every afternoon after a meal (to prevent hypoglycemia). These therapies were administered at the clinic on an outpatient basis. The oral protocol included low-dose naltrexone (LDN) 4.5 mg at bedtime, the oral Triple Antioxidant Therapy protocol, with (1) racemic ALA 300 mg twice daily, (2) selenomethionine 200 µg twice daily, and (3) silymarin 900 mg twice a day along with 3 professional-strength B-50 complex capsules a day. Oral hydroxycitrate (HCA) 500 mg 3 times daily was added to the protocol in September 2013, based on the work of Dr Laurent Schwartz et al.,
It was also suggested that the patient followed the IMCNM lifestyle program including a strict diet with 4 servings of fresh vegetables a day, very low simple carbohydrate intake, and no processed food, especially preserved animal products. Some organic animal protein was allowed. In addition, an exercise and a stress reducing program were prescribed.
This program had been used frequently at the IMCNM with many patients and was previously reported in the scientific literature in 4 cases of pancreatic cancer and one case of B cell lymphoma.,,
After 1week of receiving IV ALA and IV vitamin C, he began to subjectively look and feel better. He reported “increased energy and a new sense of well-being.”
After this 1 week of initial treatment in the author’s clinic, the patient went home and adhered to the programmed lifestyle and supplements, and a local integrative doctor in Fort Worth, Texas, continued the IV ALA infusions twice a week and IV vitamin C twice a week.
The patient continued to visit the IMCNM every 3 months for a week or two of intensive daily IV vitamin C and IV ALA therapy. In January of 2011, he stated that he was beginning to feel healthy again. At that time, he weighed 184 pounds, an 8-pound increase since beginning treatment. The patient continued to go to work throughout the course of his treatment. In January 2011, a repeat PET/CT scan was performed (Figure 4). Again, the mass in the left lung was demonstrated, with no apparent change in size.
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January 2011, a repeat CT scan was performed, and again the mass in the left lung was demonstrated, with no apparent change in size.
In June 2011, another PET/CT scan showed that the upper lung mass was much smaller in size (7.2-4.4 cm; figure not shown).
A repeat PET/CT scan in March 2012 showed complete resolution of the upper lung mass (Figure 5).
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A repeat PET/CT scan in March 2012 showed complete resolution of the upper lung metastasis.
Subsequent PET/CT scans in September 2013, January 2014, and August 2014 continued to demonstrate absence of the left lung mass (Figures 6,7,7, and and8,8, respectively). The right kidney contrast in all PET/CT scans was considered by the radiologist to be normal physiologic contrast elimination (left nephrectomy was performed in 2008).
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PET/CT scan, September 2013.
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PET/CT scan, January 2014.
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PET/CT scan, August 2014.
A CT scan of June 2015 (Figure 9) shows no mass in the left lung. As of September 2017, the patient continues on his integrative protocol without changes to his regimen and is alive and in good health. He now weighs 206 pounds, 30 pounds more than when he presented to our clinic.
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June 2015, CT scan, showing absence of the left pulmonary metastatic mass.

Discussion

According to the American Cancer Society, the 5-year survival rate for stage IV RCC is only 8%.
Since the patient had very few treatment options beyond clinical trials, he chose to follow an integrative medical program that included: IV racemic ALA, IV vitamin C, oral LDN, and the oral Triple Antioxidant Therapy protocol,, with oral lipoic acid, selenomethionine, silymarin, and B complex capsules. The patient was also prescribed the IMCNM lifestyle program including a strict diet, exercise, and a stress-reduction program.
This program had been used frequently at IMCNM and was previously reported in the scientific literature in 4 cases of pancreatic cancer and 1 case of B cell lymphoma.,, HCA was added to the protocol in September 2013 based on the work of Dr Laurent Schwartz et al.,
The first key component in the patient’s treatment protocol was lipoic acid (ALA). IV ALA can reach much higher plasma levels than the oral form, with the oral capsules maintaining levels in between IV infusions. ALA has multiple activities; for instance, it is a powerful antioxidant and heavy metal chelator. It appears that 3 of its actions are relevant in this case: its anti-inflammatory activity, the effect on mitochondrial metabolism, and its epigenetic activity.
First, ALA may discourage the growth of cancer cells by its action involving the pro-inflammatory transcription factor, nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB).
Unmitigated NF-κB activation can produce proliferation, angiogenesis, mutagenesis, metastasis, and chemo-radio resistance in malignant cells and leave them resistant to apoptosis. Patients with advanced cancer exhibit greatly elevated markers of oxidative stress and an unrelenting inflammatory process in part due to NF-κB activation. ALA inhibits NF-κB, blunting these deleterious effects and discouraging the unbridled growth of cancer cells.
Another significant interaction of ALA is with the pyruvate dehydrogenase enzyme complex (PDHC) and its regulatory enzyme pyruvate dehydrogenase kinase (PDK). PDHC consists of 3 mitochondrial enzymes that sit in the intersection of cytoplasm and mitochondria, glycolysis and the Krebs cycle, and anaerobic and aerobic energy metabolism. PDHC converts cytoplasm-generated pyruvate into acetyl CoA, which then enters the Krebs cycle. ALA is the necessary cofactor for PDHC, and without ALA there is no energy produced in the mitochondria.
PDK phosphorylates and inhibits PDHC, regulating its activity. ALA inhibits PDK, and by doing so it further increases PDHC activity.,
These enzymes are involved in a metabolic peculiarity of cancer cells, the so-called Warburg effect, also called “aerobic glycolysis,” a phenotype rather common to malignancies: cancer cells preferentially metabolize glucose and pyruvate into lactic acid, even in the presence of oxygen. This increase in glycolysis might favor the formation of amino acid and nucleotide precursors, important for a rapidly proliferating cell, whose importance might offset the disadvantage of a reduced ATP production.,
McFate et al have shown that inhibition of PDHC activity contributes to the Warburg metabolic and malignant phenotype in human head and neck squamous cell carcinoma. This inhibition occurred by an enhanced expression of pyruvate dehydrogenase kinase (PDHK). Knockdown of PDHK restored pyruvate dehydrogenase (PDH) activity, reverted the Warburg metabolic phenotype, decreased invasiveness, and inhibited xenograft tumor growth in nude mice.
Clear cell RCC is characterized by the constitutive upregulation of the hypoxia inducible factor-1. Hypoxia inducible factor-1 has been shown to promote the Warburg effect in several cancers, including clear cell RCC, in part due to the activation of PDHK (one of its target genes), and subsequent inhibition of PDH. Recently, Lim et al demonstrated that in this type of cancer, most of the 10 tumor samples studied had an elevated PDHK enzyme level, and a decreased PDHC activity, when compared with patient-matched normal tissue.
Schell et al furthered this idea by implying that the inhibition of the Warburg effect in colon cancer cells was associated with decreased cancer cell xenograft growth in nude mice.
Studying a related issue concerning these enzymes, Kaplon et al demonstrated that PDH is a crucial mediator of malignant cell senescence induced by BRAFV600E, a protein kinase and oncogene that is often mutated in melanoma and other cancers. This BRAFV600E-induced senescence was accompanied by simultaneous inhibition of PDHK. Enforced normalization of PDHK inhibited PDH and abolished oncogene-induced senescence, thereby allowing BRAFV600E-driven melanoma growth.
Since ALA inhibits PDHK and activates PDHC, the metabolic peculiarity of cancer cells described by Warburg may be mitigated, and it is likely that the overall cancer growth program may be altered. It is also possible, according to Kaplon’s work, that tumor cell senescence may also be promoted by ALA’s action on these enzymes.
Another potential antineoplastic action of ALA concerns its epigenetic activity. ALA can inhibit histone deacetylase (HDAC) activity in human tumor cells., Histone acetylation and deacetylation are important components in gene regulation.
An active avenue of cancer research involves inhibitors of HDACs, with drugs such as vorinostat.
Recently, it has been found that PDH, thought to be an exclusive mitochondrial enzyme, is also present and functional in the nucleus, probably translocated from the mitochondrion. Inhibition of nuclear PDH in isolated nuclei decreased the acetylation of histone lysine residues. This nuclear PDH has also lipoic acid as cofactor, so ALA provides a source for nuclear acetyl-CoA synthesis required for histone acetylation and epigenetic regulation.
These epigenetic modifications give ALA the capacity of influencing, at a genetic level, tumor behavior and growth. In other words, cancer is not only a genetic disease but is also a metabolic disease. ALA seems to address both of these components.
IV vitamin C was also part of the patient’s treatment protocol. Integrative medical doctors have administered this agent for many years with some positive case history reports. Some of these results include reversal of pulmonary metastases from RCC and from hepatocellular carcinoma.,
HCA is an extract from the citrus fruit, Garcinia cambogia. Not only it inhibits pancreatic α-amylase and intestinal α-glucosidase, but also inhibits ATP-citrate lyase, a cytoplasmic enzyme that catalyzes the generation of acetyl-CoA from mitochondrial-generated citrate. Acetyl-CoA is a vital building block for the endogenous biosynthesis of fatty acids, cholesterol, and isoprenoids.
Studies with C-14 glucose have shown that in cancer cells most fatty acids come from a high rate of de novo synthesis, necessary for a very active membrane biogenesis, and inhibition of ATP-citrate lyase produced inhibition of tumor proliferation in vitro and reduced in vivo xenograft tumor growth.
The authors added HCA to their regime in 2013 at the suggestion of Dr Laurent Schwartz, who showed that HCA was synergistic with ALA to reduce tumor growth in vitro and in vivo.,
ATP-citrate lyase increases histone acetylation in response to growth factor stimulation and during differentiation. As is the case with ALA,- HCA also has an action on cellular metabolism and promotes epigenetic changes. These epigenetic changes could be relevant to the action of these 2 molecules, and it is a fertile ground for further future research.
LDN was yet another key ingredient in this treatment program. Naltrexone is an opioid antagonist that was originally FDA (Food and Drug Administration) approved in 1984 for heroin addiction.
Zagon and McLaughlin, documented the presence of the opioid growth factor receptor (OGFr) axis in a number of human cancers including neuroblastoma, pancreatic, colon, breast, renal, squamous cell carcinoma of the head and neck, and hepatocellular adenoma. In vitro and in vivo studies revealed that opioid growth factor (OGF; also called met-enkephalin), while requiring the presence of OGFr, inhibited cell proliferation in culture and when transplanted into nude mice.,
They also demonstrated that opioid antagonists, like naltrexone, block the endogenous ligand-receptor interaction. Studies using naltrexone to block the receptor showed that high-dose naltrexone blocked the OGFr for a longer duration than LDN did. The duration of time that the receptor was blocked yielded 2 totally different results. Low dosages of the opioid antagonist administered once daily blocked the receptor for short bursts of time and resulted in suppressed cancer cell proliferation and decreased growth of malignant cells in culture and of tumors in mice. These cancer-bearing mice lived longer than controls. Conversely, higher dosages of naltrexone that blocked the receptor for an entire 24-hour period resulted in enhanced growth of the malignant cells and decreased survival of cancer-afflicted mice. This apparent contradiction was solved when it was determined that short-term opioid receptor blockade paradoxically upregulated enkephalin peptide production. The increased levels of circulating enkephalins subsequently bound to OGFr and inhibited cancer cell proliferation.
Administration of low dosages of naltrexone several times daily in order to continuously block the opioid receptor resulted in increased growth of malignant cells. This confirmed that it was the duration of the OGFr blockade, and not the dosage of the naltrexone, that blocked accelerated cancer cell growth.,
In humans, nocturnally administered LDN blocks endogenous opiate receptors for a short period of only a few hours. Due to this receptor blockade, the body perceives a deficiency of endogenous opioids. As a result, endogenous opioid production is dramatically increased (including the production of OGF), OGFr production is upregulated, and the affinity between OGF and OGFr is increased. These endogenous opiates act on 2 sites: on the tumor cells directly, inhibiting their growth, and on the immune system, upregulating it.
Dr Bernard Bihari first used LDN to treat patients with AIDS in the 1980s after discovering the preclinical research of Zagon et al. Given his promising results and based on Zagon’s work, he later used LDN in the treatment of cancer patients. At the IMCNM, we have used LDN in most patients with malignancies.,,

Conclusion

In this case report, we describe the treatment of a 64-year-old patient who was diagnosed with metastatic RCC in June of 2008. Following a left nephrectomy and the standard oncological protocols consisting of bevacizumab, sunitinib, and sorafenib, the patient became leukopenic and thrombocytopenic and could not tolerate any further conventional treatment.
Furthermore, with the standard protocols, his cancer progressed and he was informed that given his diagnosis and poor response to conventional therapy, any further treatment would, at best, be palliative.
The patient arrived at the IMCNM in August of 2010 as a last resort. He was weak, cachectic, physically and emotionally exhausted, and was experiencing almost constant shortness of breath, flank and abdominal pain, and nausea. An integrative program developed by one of the authors (BB),, using IV α-lipoic acid, IV vitamin C, low-dose naltrexone, and HCA, and a healthy life style program was initiated.
Lipoic acid potentially has a central role as it addresses 2 main cancer aspects: metabolic (by its action on the PDHC and the Warburg effect) and epigenetic (by its action on HDAC activity).
From August 2010 to the present (November 2017), the patient’s RCC with metastasis to the left lung has been followed closely using CT and PET/CT imaging. After only a few treatments of IV ALA and IV vitamin C, his symptoms began to improve, and the patient actually regained his original baseline weight, his energy and outlook improved, his dyspnea resolved, and even returned to work. His most recent PET/CT scan demonstrated normal glucose uptake in his left lung (Figure 9). The patient had stable disease with an elimination of the signs and symptoms of stage IV RCC, a full 9 years following diagnosis, with a gentle integrative program, which was essentially free of side effects in his case.
However, from the authors’ experience, when the treatment protocol is halted, in many cases, the cancer growth resumes. Thus, the ALA/N (α-lipoic acid/low-dose naltrexone) protocol appears to induce tumor reduction/dormancy rather than cure the disease process. Further multicenter studies are warranted to assess the success of this treatment regimen and long-term results on a wider population.

Footnotes

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

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