Late-Stage Metastatic Cancer Treatment

Advanced Treatment Options Beyond Standardized Protocols for Late-Stage Metastatic Cancer Patients


Cancer treatment continues to advance at a fast pace around the world, however treating advanced refractory and resistant metastasized cancer remains extremely difficult when approached with standardized cancer treatment protocols. Patient’s often turn to naturopathic, integrative, or adjunctive medicine models when their conventional protocol fails but these options can be just as ineffective when not properly targeted. Fortunately, at Envita Medical Center, we have taken healthcare to an entirely new level by specializing in targeted cancer care for complex and metastasized cases while using an integrative molecular oncology approach that brings next level precision medicine and treatment options to our cancer patients.

Envita Medical Centers doesn't make any guarantee of outcomes. Results are not typical and will vary from person to person and should not be expected.

Conventional cancer care relies on static NCCN guidelines to treat cancer based on tissue type and staging. If a genetic test is recommended by NCCN guidelines, they will typically suggest an antiquated genomic test that may not provide real-time therapeutic targets or enough targeting data for next level planning. What these genetic tests lack is the precision to illuminate the most effective cancer treatment based on the patient’s cancer markers. Furthermore, as tumors continue to mutate and metastasize, the standard one-size-fits-all approach becomes less and less effective. It is typically at this point when patients realize they need to look beyond standardized cancer care and testing in order to find a more precise approach. This is where Envita steps in.

Envita is a truly personalized integrative oncology facility that brings a holistic approach to cancer care by providing its patients with the latest conventional medicine technology in combination with clinically proven and research-based intravenous natural medicine options. We deploy the latest in next-level extensive genomic testing methods to build personalized precision protocols designed for each patient’s unique needs. This advanced approach to care is the result of our 20 years of helping the most complex and difficult cancer cases where patients were told there were no options left. We are constantly evaluating and reevaluating our processes to improve our testing and treatment methods so we can always stay on the cutting-edge of cancer care advancements to help our patients outperform.

Graphical depiction of cancer cells metastasis

Having access to both advanced conventional therapies and research-based IV natural medicine gives Envita a greater “tool-box” to pull from to provide our patients with what they need based on their comprehensive genomic findings. By going beyond the basic NCCN treatment guidelines, we have the freedom to take a personalized approach that relies on highly detailed genomic factors like advanced molecular tumor markers , immunoreactivity, tumor mutational burden and important epigenetic miRNA factors like oncogenes and tumor suppressor genes to drive treatment to the next level in personalized medicine.

Through our clinical experience we have discovered that many of these unique genomic factors do not have established conventional treatment options. To overcome this limitation Envita has established its own custom compounding pharmacy to create patient specific treatment options to address these unique genomic targets and give our patients a more comprehensive and precise treatment plan. Furthermore, we offer our patients customized comprehensive cancer solutions that not only aim to address the tumors and metastatic cancer cells; but also work to remove the potential drivers linked to metastatic and microsatellite instability (mutations) that can cause uncontrolled cancer growth and spread.

Understanding Basic Metastasis and Tumor Angiogenesis

Metastasis is the spread of cancer cells from the tumor of origin to other parts of the body. Cancer cells start by spreading out and take root in nearby tissue, then growing into separate tumors. From there, cancer cells can also spread to nearby lymph nodes and organs, as well as distant or hard to reach areas of the body.

Stages of Cancer chart: Stages 1 - 4

The body delivers oxygen and nutrients via blood vessels. Without a constant source of oxygen and nutrients, it can become difficult for a tumor to grow beyond about 2mm [1]. As part of its survival mechanism, a malignant tumor will release chemical signals that produce Vascular Endothelial Growth Factor A (VEGFA) to stimulate angiogenesis and have the host body provide blood vessels for continued growth [2]. These newly formed blood vessels are significant because they become the conduits through which circulating tumor cells (CTCs) migrate. With access to the bloodstream, cancerous cells from the malignant tumor can enter the newly created blood vessel and travel around the body via the bloodstream. From there, cells from the original localized tumor can move to lymph nodes and take root in different organs or distant tissue where they become tumors themselves. However, the process of metastasis involves a series of complex signaling and factors going beyond VEGFA and angiogenesis to include various key drivers.

Because stopping and preventing metastasis is vitally important for long-term outcomes, Envita has developed unique treatment options and it all begins with circulating tumor cell diagnostics.

Graphical depiction of angiogenesis

The Importance of Circulating Tumor Cells Diagnostics

Treatment of cancer becomes more complicated once the tumor has gone through metastasis and is actively releasing circulating tumor cells (CTCs) into the blood stream. Fortunately, Envita has developed methods to harvest these CTCs to discover actionable treatment targets for metastatic cancer patients. Because these CTCs represent the latest mutations with real time information related to the cancerous tumors, we can study them and direct treatment to attack the cancer at where it is going as opposed to where it has been. The information collected from CTCs yields useful data that typically cannot be collected from a traditional tumor biopsy. Cancer is a disease of mutations and these mutations can change rapidly in difficult cancers which is why accurate real time data is crucial.

The real time laboratory data collected from circulating tumor cells provides us with precision information on cancer growth and mutation, this information allows for more frequent updates on the state of the disease. By looking at the latest CTC data as opposed to of old biopsy data, Envita can react to cancer mutations dynamically and create personalized treatment protocols that proactively treat the genetic markers of the most recent mutations. Finally, CTCs are a better indicator of successful treatment when considered with other progression markers and imaging. Even when all tumors are gone, circulating cancer cells can remain, increasing the chances of tumor recurrence. By deploying specialty treatment options that are aimed at the eradication of CTCs as well as the solid tumors, Envita is able to stack the odds in our patients favor and potentially lead to longer lasting results. Not all CTC testing is equal which is why Envita uses next level genetic sequencing (NGS) to reveal precise targets so we can build the treatment from the ground up.

How Genes Affect Cancer Spread

Standard treatment relies heavily on chemotherapy and radiation to treat most stages of cancer. These are considered to be the best and most well-researched treatment modalities. However, these treatments alone often fail cancer patients when not targeted, and the question becomes, “Why is my cancer able to become metastatic/resistant and continue to spread if the treatment options delivered by my oncologist were supposed to work?” We see clinically that the answer is partly linked to miRNA and in particular tumor suppressor genes and tumor oncogenes. Loss of tumor suppressor and oncogene regulation has been highly correlated with metastasis and tumor growth [3]. The normal balance of tumor suppression and oncogene expression is disrupted in cancerous cells [4]. This balance is how the body normally regulates cell division and death; when this balance is disrupted the cancerous cell can mutate and spread with impunity [4]. These cells will work to gain a blood supply through the angiogenesis process and begin spreading throughout the body if the miRNA is not addressed in treatment as soon as possible.

MiRNA is responsible for regulating the expression of tumor suppression genes, oncogenes, and other growth factors in the cell. Early-stage tumors may be able to proliferate in the presence of standardized cancer treatment options because these genetic factors are not being accounted for. Early intervention with miRNA therapy works to upregulate tumor suppressor genes and downregulate oncogenes. This process can initiate the body's natural defense against cancerous cells, possibly halting the growth and spread of the disease. Furthermore, miRNA is also responsible for regulating angiogenesis through VEGFA expression [5]. MiRNA therapy can be used to influence this growth factor and block the tumors’ ability to develop a blood supply through angiogenesis [5]. Without a blood supply, the tumor cannot grow and, most importantly, cannot facilitate metastasis throughout the body.

In our clinical opinion, early intervention with miRNA and customized immunotherapy is the key to halting cancer progression, and it is immensely important in all stages of cancer. The biggest hurdle with miRNA is that there are very few conventional treatment options that are designed to work on the miRNA signaling pathways; this is where Envita’s custom pharmacy shines. In our pharmacy we are able to research and develop specialty treatments that are designed to affect these pathways by down regulating tumor oncogenes and upregulating tumor suppressor genes. By turning these pathways on and off, we aim to effectively shut down the tumor’s ability to metastasize, leading to a more complete treatment protocol. MiRNA therapy provides an important modality for fighting cancer, and it is vital in the treatment of both early-stage and late-stage cancer to combat angiogenesis and metastasis. Envita uses miRNA therapies with immunotherapies, in conjunction with many other tailored treatments, to push the patient’s condition towards shutting down cancer spread and growth.

Metastasis Treatment

Treating metastasis is the most important goal of all cancer treatment. The majority of cancer-related deaths are a result of metastasis coupled with a lack of a harmonious treatment plan. That’s why at Envita Medical Center, metastasis is one of our primary areas of expertise. Using nearly 20 years of clinical experience and research, Envita has developed cancer treatment methods and protocols to help fight metastasis from multiple angles to help our patients outperform the statistics. Another key to Envita’s cancer treatment approach is the combination of immunotherapy and genetically targeted fractionated chemotherapy.

Genetically Targeted Fractionated Chemotherapy

Genetically Targeted Fractionated Chemotherapy (GTFC) is Envita’s proprietary method for providing personalized cancer treatment for our patients [6]. The current standard approach to oncology prescribes chemotherapies based on tissue stage and location derived from the NCCN guidelines [7]. The NCCN (National Comprehensive Cancer Network) is defined as an alliance of 28 cancer centers aiming to use a multidisciplinary team approach to patient care in order to help select the best treatment options for a specific type and stage of cancer [7]. However, NCCN cancer regimens are designed based on data taken from large clinical trials that try to find the best treatment for the largest percentage of the population with the same type and stage of cancer [7]. By definition, this approach will exclude some percentage of the population for which the recommended treatment will not be optimal or perhaps even effective at all. For the subset of people who the NCCN guidelines were not designed for, personalized medicine is the best shot at remission and recovery.

Free of NCCN guidelines, Envita uses genetic data, cancer biomarkers, and molecular targets to determine the most effective chemotherapies for a patient’s unique cancer [6]. This process identifies far more biomarkers than standard genetic testing, and through advanced delivery methods, treats cancer with multiple chemotherapies and chemo adjunctive agents at a fractionated dose [6]. Normal intravenous chemotherapy may only infuse an estimated 4-5% of the chemo agents into the cancerous cells. At Envita, we use superior delivery methods to help increase the absorption of our genetically targeted therapies. Increased absorption allows our doctors to pursue far more genetic targets, bombarding a patient’s cancer at its weakest points [6]. Also, increased absorption allows Envita to use fractionated doses of chemotherapy that, in conjunction with other therapies, can potentially reduce negative side-effects and prevent the collapse of the patient’s immune system which is typically damaged by traditional chemotherapy [6]. By increasing the effectiveness of chemotherapy and protecting the immune system, GTFC works in conjunction with the body to fight cancer. The immune system is integral in fighting cancer and reducing the damage chemotherapy can have on a patient’s immune system can be an extremely effective way to bolster the patient's response to therapy.

GTFC is uniquely designed for each individual patient and created in our in-house pharmacy, ensuring that each treatment is personalized and customized to the patient’s genetic targets. Traditional chemotherapy, when not properly targeted, can be a taxing and destructive treatment that can be as harmful to patients as the condition it is meant to treat. At Envita, we take a more advanced approach. By combining GTFC with natural, research-based therapies, immunotherapies, and many other world-class treatments, we can provide a multifaceted personalized approach to treating cancer that is truly unique to our clinic.

Graphical depiction of DNA

Immunity is Critical for Treating Metastasis

The immune system is recognized as being integral in the fight against cancer, especially since a robust and healthy immune system has the capability to adapt dynamically [8]. As cancer cells mutate, a properly regulated immune system can actively re-evaluate and respond to those mutations [8]. Studies have found that some metastatic cancer patients who have not responded well to treatment, have found success with immunotherapy [9]. The key is finding the immunoreactivity for each cancer and that is what Envita does.

The immune system ultimately serves as both the first and last lines of defense against cancer. We are proud to offer the most advanced genetically targeted immunotherapy and immunotherapy adjunctive options from around the world, customized to help patients fight metastasis and their unique form of cancer. Immunotherapy has been shown to have positive and lasting effects against an extensive list of metastatic cancers, including [10]:

Our medical team recognizes that focused immunotherapy can often greatly increase the effectiveness of other treatments. A plan largely focused on immunotherapy is vital when treating metastasis and micro-metastasis involved in cancer. Envita has gathered therapies from both conventional and natural medicine to provide the latest research-based immunotherapy options for our patients. Our custom pharmacy compounds personalized immuno-adjunctive agents on a level other facilities simply cannot. Furthermore, we provide immunotherapy treatments that are not traditionally available at other cancer centers. By going above and beyond the standard level of care, we hope to help our patients achieve success against their metastasized cancer.

If you have any questions about metastasis or your specific cancer treatment, please contact our Patient Care Coordinators at 866-830-4576 and learn more about Envita’s approach to cancer.


References

[1] Quest, C. Angiogenesis. 2017 [cited 2020 2/14]; Available from: https://www.cancerquest.org/cancer-biology/angiogenesis.

[2] Nishida, N., et al., Angiogenesis in cancer. Vascular health and risk management, 2006. 2(3): p. 213-219.

[3] Levine, A.J. and A.M. Puzio-Kuter, The Control of the Metabolic Switch in Cancers by Oncogenes and Tumor Suppressor Genes. 2010. 330(6009): p. 1340-1344.

[4] Lodish H, B.A., Zipursky SL, Proto-Oncogenes and Tumor-Suppressor Genes. Molecular Cell Biology. Vol. 4th edition. 2000, New York: W. H. Freeman.

[5] Kawagishi, H., et al., ARF Suppresses Tumor Angiogenesis through Translational Control of VEGFA mRNA. 2010. 70(11): p. 4749-4758.

[6] Smith, A.J., J. Oertle, and D. Prato, Genetically Targeted Fractionated Chemotherapy %J Journal of Cancer Therapy. 2015. Vol.06No.02: p. 17.

[7] Network, N.C.C. NCCN Guidelines. 2020 [cited 2020; Available from: https://www.nccn.org/professionals/physician_gls/default.aspx.

[8] Balogh, E., Policy issues in the clinical development and use of immunotherapy for cancer treatment : proceedings of a workshop / Erin Balogh, Kimberly Maxfield, Margie Patlak, and Sharyl J. Nass, rapporteurs
National Cancer Policy Forum, Board on Health Care Services, Health and Medicine Division
the National Academies of Sciences, Engineering, Medicine, ed. K. Maxfield, et al. 2016: Washington, DC : National Academies Press.

[9] Institute, C.R. Immunotherapy By Cancer Type. [cited 2020; Available from: https://www.cancerresearch.org/immunotherapy/cancer-types.

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