Q&A With Dr Burt Berkson - Low Dose Naltrexone and Alpha Lipoic Acid

A couple of years ago I found an extraordinary paper in the journal Integrative Cancer Therapies which described a number of cases in which patients with advanced pancreatic cancers had responded to therapy with low dose naltrexone and alpha lipoic acid. It was a paper that positively demanded following up with a clinical trial, but although I checked up periodically no trial was forthcoming. However, the recent LDN Aware DVD included an interview with the man behind that paper, Dr Burt Berkson.

I am pleased to say that Dr Berkson agreed to answer a few questions for Anticancer.org.uk, the first part of which appears below.


PP: Background - how did the LDN/ALA protocol arise?

BB: Alpha Lipoic Acid (ALA)

While working as an internal medical resident at one of the Case Western Reserve teaching hospitals in 1977, I was told by the chief to follow two patients with severe and acute liver damage that resulted from eating hepatotoxic mushrooms. This condition is often fatal and I was told that these patients would surely die.

As a medical doctor it was necessary to follow the orders of the chief; however, as a PhD, I sought new ways of doing things. I called Dr. Fred Bartter (former chief of endocrinology) at the National Institutes of Health and asked him if he knew of anything that would help regenerate damaged organs. He answered that he was working with thioctic acid (alpha lipoic acid, ALA) as a possible treatment for diabetic complications and when given to people with diabetes, it seemed to help heal damaged livers and other organs.

Dr. Bartter sent me a case of ALA for intravenous administration. I picked it up at the Cleveland airport about seven hours after I initially called him. I rushed back to the hospital and injected the ALA into the two patients. I administered this treatment every six hours for 14 days. The patients started to recover and felt much better by the second day and were able to leave the hospital within two weeks with normal liver function. They are still alive and free of liver disease today, 34 years later.

It is interesting to note that some of the chiefs at the hospitals where I practiced medicine seemed to discourage my use of ALA. I was told that with an M.D., and a Ph.D. in cell biology/microbiology, and internal medicine training, I should concern myself with doing infectious disease research and stay out of liver disease.

Dr. Bartter, however, thought our work was very important and told me that some day we might win a Nobel Prize for our human work with ALA. He suggested that I leave Cleveland and come to work with him at NIH. But I was very discouraged by the response that I experienced from the medical community in Ohio. I left the region and moved my family to a rural community not too far from Lubbock, TX.

I became a country doctor, driving from one hospital to another each day, and even delivered babies in people’s houses on isolated ranches. When my children were high school age we moved back to a relatively large city. About fifteen years ago, I opened an integrative medical practice in Las Cruces where I use antioxidants and certain innovative prescription drugs to treat diabetes, chronic hepatitis, rheumatoid disease, lupus and other disorders with exceptionally good results. I also try to support and improve the immune system of people with cancer.

Melatonin and cancer treatments

Melatonin is a compound that is produced in the body by the pineal gland, and is associated with regulation day/night rhythms (also known as the circadian rhythm). Often described as a hormone, melatonin is also known as a powerful antioxidant and has immune stimulating properties, additionally has been shown to have a range of anti-cancer activities in a wide variety of cancer types. It also has a range of medical uses, including as a treatment for insomnia and seasonal affective disorder. Most importantly, it has very, very low levels of toxicity, and does not appear to have negative interactions with a wide range of drugs. This last point is an important one when considering the use of melatonin by cancer patients.

This is interesting in light of a publication of a major review of clinical studies involving melatonin and cancer treatments. The paper, Melatonin as Adjuvant Cancer Care With and Without Chemotherapy: A Systematic Review and Meta-analysis of Randomized Trials, published in the October 2011 edition of the journal Integrative Cancer Therapies, concludes:

MLT may benefit cancer patients who are also receiving chemotherapy, radiotherapy, supportive therapy, or palliative therapy by improving survival and ameliorating the side effects of chemotherapy.

What the authors of this paper have done is gone back and collected all of the data from a range of clinical trials that compared cancer treatments with and without melatonin use. They systematically excluded trials that did not have direct comparisons between treatments that included melatonin and those that didn’t, that did not randomise patients (i.e. trials that gave each patient an equal chance of being on the melatonin arm or the non-melatonin arm – in this way avoiding biasing the results), and they excluded those trials that did not satisfy a range of other quality criteria. At the end of this process there were 21 clinical trials included, all of them looking at patients with solid tumours. The treatments included standard chemotherapy, radiotherapy and palliative care.

A new cancer blog

My neice, Penny, has previously blogged on this site about her campaigning work as an Ambassador for Cancer Research UK. She has just started a new blog, Penny's Pieces, where she writes about cancer, campaigns and more personal stuff. Please take a look. Amd,, while you're at it, she is still looking for volunteers for her fund-raising day in Woodford Green.

Dealing With Stress

Coping with cancer is obviously stressful. Not just for the patient, but for friends and family too. And it’s not just during treatment, the stress can be there even after a patient is declared to be in remission. A new paper, from Duke University Medical Center in the US, reports that post-traumatic stress is prevalent in cancer patients even in long-term remission.

An added factor in this stress is the well known fact that it can have negative effects on the immune system, cause depression and generally make things worse. There is also the worry that stress can make the disease worse, or can make it recur in patients in remission.

So, for all of these very obvious reasons, it’s important to look at what can be done to tackle this issue that can severely impact the quality of life for all of us. The good news is that there are some active steps that can be taken and which don’t involve taking more drugs.

Diet is one factor that may play a part in the ability to handle stress and deal with depression. There is plenty of evidence to show that diets having higher levels of omega 3 fatty acids helps the body deal with stress – it has been shown to reduce the levels of stress hormones and can improve mood and the ability to cope. In fact higher levels of omega 3 – obtained from supplements rather than diet – have also been used to treat depression. And, as a bonus, higher omega 3 than omega 6, helps reduce the inflammatory factors that are shown to be associated with cancer. As a bonus there is emerging evidence that omega 3s are helpful in coping with cancer treatments, and are being investigated for use against cancer cachexia in advanced disease.

Guest Post - Mark Vernon

Guest Post by Mark Vernon, whose daughter Sarah recently died of bowel cancer. It is published here because it makes some extremely important points about the state of cancer treatment in this country.

I wish I had the experience, knowledge and opportunity to write a book on the politics of cancer. All in all, it is the medical establishment that ought to be in the dock now.  Not that I feel inclined to pursue any specific complaint.  Sarah's GP was slow to refer her to a specialist.  She was too young to have cancer:  her problem was off the beaten track, confounding the inadequate diagnostic skills of the GP.  I think of this as a problem with the GP system, by the way, tempting as it is to make accusations of negligence, but a more able GP might have taken the possibility of cancer more seriously, and sooner.  Sarah then had to wait for the referral, though my wife Jane and I were in the dark at this point.  Whether the wait was outside of government targets or normal practice, I don't know.

Then came the diagnosis, followed quite soon by surgery - a hemicolonectomy. There is a saying I have come across about surgery:  the operation was a complete success;  the patient died.  In Sarah's case, this took nearly a year to happen.  But the surgery must be judged to have failed, since the tumour rapidly recurred.  And this happened in the middle of adjuvant chemotherapy, which therefore also completely failed, and was abandoned.  Then came a revised chemo regime, incorporating the expensive monoclonal antibody cetuximab (trade name Erbitux).  This had no effect whatsoever, and was abandoned.  Treatment from this point on was strictly palliative, and the medical establishment officially gave up.

Beta blockers and cancer

There was a recent flurry of headlines about possible new uses of beta blockers - normally prescribed for high blood pressure - and that they might have anticancer properties. For example the BBC headlined the story as Beta blockers 'may stop breast cancer spreading'. The trigger for the story was the announcement an analysis of 800 patient records showed that those cancer patients who had also been treated with beta blockers had lower rates of metastatic disease - in other words there are indications that beta blockers stop or slow breast cancer from spreading to other parts of the body. The real headline is from the abstract of the paper that reported the results:

In addition, there was a 57% reduced risk of metastasis, and a 71% reduction in breast cancer mortality after 10 years. This proof-of-principle study showed beta-blocker therapy significantly reduces distant metastases, cancer recurrence, and cancer-specific mortality in breast cancer patients suggesting a novel role for beta-blocker therapy

This is not the first report on beta blockers and cancer - for example there was also a very recent study looking at beta blockers and malignant melanoma. That study concluded:

Increased survival time of patients with melanoma receiving beta-blockers suggests that use of this drug may hold promise in treatment strategy for these patients.Impact: The observations described here suggest that catecholamines may retard melanoma progression and that beta-blockers may have unrecognized potential as a therapeutic intervention for melanoma.