Saturday, January 15, 2011

Sodium Bicarbonate - Critique and Studies

http://www.cancerdecisions.com/content/view/228/2/lang,english/

There is a doctor in Italy, Tullio Simoncini, MD, who has roiled the waters of oncology by claiming that all cancers are actually outbreaks of fungal disease. He has written a book to this effect, Cancer Is A Fungus, and also produced Web sites and online videos expounding his theories. His work is discussed at almost 50,000 Web sites.


Basically, Simoncini's main claims are as follows:


1) Cancer is actually an opportunistic fungal infection of the common form of yeast, Candida albicans.
2) Tumors are therefore not composed of human cells, but are invasive colonies of Candida albicans.
3) One proof of this is that cancer is invariably white in color, since Candida is also white (the word "albicans" itself means "white body".)
4) Cancer can be successfully treated with sodium bicarbonate (baking soda), one of the least expensive products in the entire pharmacopoeia.
For many people, the Simoncini controversy is in essence a battle between conventional and complementary and alternative medicine (CAM), and they take sides accordingly. Simoncini casts himself as a heroic opponent and victim of Big Pharma. The "quackbusters," who also abound on the Internet, use various weaknesses in Simoncini's argument to make sweeping attacks against what they call "s-CAM." Simoncini lost his medical license in Italy in 2003 and in 2006 was convicted of manslaughter, due to the death of a cancer patient. This of course led to an increase in the acrimony around the whole concept of the bicarbonate treatment of cancer.


My own feeling is that Simoncini is fundamentally wrong in most of his theories. However, as I shall show, there may be some merit, at least potentially, in the use of bicarbonate as a cancer treatment.

As to the theory of cancer's origins, there are major deficiencies. Let us take Simoncini's claim that cancer is always white in appearance. What then about the skin cancer known as malignant melanoma? (See Figure 1).


Figure 1 Malignant Melanoma
Source: Wikimedia Commons
Melanoma


This is anything but white. In fact, the name melanoma means a tumor containing dark pigment. If we follow Simoncini's logic, either melanomas are not cancers, or else all cancers are not white. Yet melanomas are real cancers and can be deadly. They will afflict over 68,000 Americans this year and kill 8,650.

If we look at the more common cancers, many of them are indeed white in their interior portions. But so too are many other parts of the body that are not connected to cancer (bones, nails, some people's skin, etc.) So being white is not proof of being cancerous.


More importantly, one can easily demonstrate that cancers are NOT fungi but are human cells gone awry. The two kinds of cells are dramatically different, not just in their appearance but in their genetic makeup (genome). Candida albicans is a unicellular member of the Saccharomycetaceae family. It is present in a harmless form in 80 percent of human beings, although under certain pathological conditions can become the source of various diseases (such as "thrush").

Starting in October 1996, the genome of C. abicans has been sequenced at the Stanford DNA Sequencing and Technology Center and the Broad Institute of MIT and Harvard University. The entire diploid genome sequence of Candida alibicans was published in the Proceedings of the National Academy of Sciences (PNAS) in 2004 and is available online.


The DNA of a fungus is, of course, radically different from that of a human being. Yet, to my knowledge, every study of the DNA of cancer cells (and there are thousands) points to their human origin. If they were of fungal origin, wouldn't this be immediately evident to every competent pathologist in the world?


Bicarbonate Treatment?



For these, and other reasons I do not believe that Simoncini's basic theory of cancer's origins has merit. However, this faulty theory needs to be sharply delineated from his proposed treatment, which is the application of a solution of sodium bicarbonate (baking soda), particularly to the site of the tumor. After all, it is possible that his Candida theory could be all wrong and yet his proposed treatment could be effective. Or, as E.K. Sander wrote, in reference to a different medical controversy, "Therapy results add notoriously little to resolution of competing theories, since they too are capable of diverse explanations" (Sander 1975).


The theory that cancer is acidic, and can be combated with some sort of antacid solution, is not original to this Italian doctor. It is a very old idea. In 17th century Germany, according to James Ewing, MD in Neoplastic Diseases, "Chemical conceptions [of cancer, ed.] held sway, and cancer was attributed usually to excess of acid, to be treated with alkalai" (Ewing 1942). This, says Ewing, was the theory of J.B. Van Helmont (1579-1644) and Michael Ettmüller (1644-1683).

It is a common observation, and in no way limited to the work of Simoncini, that tumors tend to exist and thrive in an acidic environment. One of the key reasons for this is the so-called "Warburg effect," i.e., the production of lactic acid by cells breaking down glucose through glycolysis. Prof. Ian Tannock and his colleagues at the University of Toronto have written: "Solid tumors have been observed to develop an acidic extracellular environment." This "is believed to occur as a result of lactic acid accumulation produced during aerobic and anaerobic glycolysis." However, these authors also point out that lactic acid production is "not the only mechanism responsible for the development of an acidic environment within solid tumors" (Newell 1993). Another mechanism might be the poor perfusion of blood around tumors (Robey 2009).


For more than a decade there has been very interesting work going on at the University of Arizona, using bicarbonate as a potential treatment for cancer. Robert J. Gillies and his colleagues have demonstrated that pre-treatment of mice with sodium bicarbonate results in the alkalinization of the area around tumors. This "enhances the anti-tumor activity" of two anticancer drugs, doxorubicin and mitoxantrone, in two different mouse tumor models (Raghunand 2003).


In March 2009, the same group reported that bicarbonate increases tumor pH (i.e., make it more alkaline) and also inhibits spontaneous metastases (Robey 2009). An acidic pH has been shown to stimulate tumor cell invasion and metastasis in animal models. The question was whether inhibition of tumor acidity would reduce the incidence of metastases. The authors showed that oral sodium bicarbonate increased the pH of tumors and also reduced the formation of spontaneous metastases in mice with breast cancer. It also reduced the rate of lymph node involvement, yet it did not affect the levels of circulating tumor cells (Robey 2009).


At various Simoncini proponent Web sites, however, this is already being hailed as a confirmation of the Italian doctor's theories. But, as I have shown, Simoncini did not originate the theory that cancer is acidic in nature, nor the very old idea of using alkaline substances in its treatment. So I don't think he can claim this work now, nor does it give sanction for patients to abandon potentially more effective treatments in order to seek sodium bicarbonate injections under what could be dangerous conditions. There is no comparison, for instance, between this poorly documented treatment and the much better founded CAM treatments (such as hyperthermia) given at the best German clinics.

That said, it is striking that in these Arizona experiments, the oral administration of bicarbonate was able to reduce the spontaneous formation of metastases in mice with breast cancer. This is impressive work that needs to go forward. However, it does a disservice to patients to identify these important scientific findings with the unsubstantiated theories of Dr. Simoncini regarding the supposed fungal nature of cancer.


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