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Featuring Demian Dressler, DVM and Sue Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

Chemosensitizers

Updated: October 4th, 2018

We need longer life expectancies in dogs with cancer.

When guardians hear the statistics about dog cancer survival, they are often shocked at how grim things sound.  And to be honest, they are grim. For this reason, we need to start looking “outside the box” of existing conventional cancer care.

This was one of the main reasons The Dog Cancer Survival Guide was written.

A very new strategy is to focus on non-chemo approaches to make chemo better.

There are a few ways to do this.  One of the most promising is to use tactics to make the cancer cells more sensitive to the chemo drugs we use. There are a couple of major advantages to this approach.

First, if the cancer cells are more sensitive to chemo, we may be able to use lower chemo doses to get the same effect.  This makes a lot of sense when we want to lessen side effects. Less side effects, better life quality, and life quality is critical when treating cancer.

Secondly, we may be able to use the same doses of chemo and end up with a higher kill rate of cancer cells. This means more life extension with chemo, and life quantity is also critical in treating cancer.

There has been a bit of research in this area.

First, a drug called sumarin was used in a phase 1 trial for dogs with cancer. This drug was originally developed to treat parasitic infections in humans.

Low-dose suramin has been shown to help dogs being treated with doxorubicin.

We don’t know the best ways to use this drug to chemosensitize cancers in dogs yet.  But, one problem is that there are some side effects, at least in humans receiving standard doses.  A large number of humans develop a rash, as well as injury to the adrenal gland.  There are also occasional cases of kidney damage.

However, there are other ways to sensitize cancer cells using natural compounds found in plants.

These have not yet been formally evaluated in dogs with cancer, but they have been shown to sensitize cancers in lab animals and also in vitro (in test tubes and petri dishes using cancer cells).

Here are some of the most promising. Each of these is included in the formula for Apocaps, which I use in my patients.  The chemo drug and cancer is included for each chemosensitizer.  I believe we will see more and more cancers that respond to these substances as research continues.

Luteolin

Apigenin

Curcumin

 

Silymarin

The great thing about these compounds is that they have a much higher safety margin than sumarin, and can be given by mouth by guardians at home.

For more information about Apocaps, click here.

Best,

Dr D

Discover the Full Spectrum Approach to Dog Cancer

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  1. Denise on March 17, 2013 at 8:36 am

    Update: We met with the director of the University of Illinois Small Animal Hospital to express our concerns about Dr. Portela’s treatment of our dog. She denied everything, and her immediate supervisor supported her in her denials–even though we have much of our conversation with Dr. Portela on a cell phone recording. Both even went so far as to claim that oncologists never give half-doses of chemotherapy drugs–despite the fact that this is a standard protocol for dogs with the MDR gene variant, and the fact that one of their own oncologists gave our dog a half dose of mitoxantrone for his first round of chemotherapy.

    Our bills totaled nearly $3,000. We requested two things from the director. First, an apology from Dr. Portela, and second a credit for the round of chemotherapy that we did not consent to. That was over a week ago, and we have received no reply as yet.

    My husband and I would also appreciate an acknowledgement of these posts from either Dr. Dressler or Dr. Ettinger. This was quite a trauma to have gone through, and it indirectly involved Apocaps. A kind word or two would be much appreciated.

    • Dr. Demian Dressler on March 19, 2013 at 5:00 pm

      Dear Denise,
      I am so sorry you have gone through all this with your dog. I can’t imagine what this all must have been like, and all I can say is that I am very sorry for you and for your loved dog. It sounds like a complete horror. I am so sorry.
      Dr D

    • Dr. Susan Ettinger on April 5, 2013 at 9:31 am

      Denise,
      I thought I replied on a different earlier post from you. I am so sorry for all you went through. Your dog was lucky to have such a dedicated family caring for him. I wish I could take away your pain, but try to focus on all the good moments shared through the years.
      With sympathy, Dr Sue

  2. Denise on February 24, 2013 at 1:35 pm

    Dr. Dressler,

    I posted this on Dr. Ettinger’s site as well because I think it is important for others who may run into similar problems with their oncologists when trying to incorporate Apocaps into a recommended chemo regimen.

    Our 10 year neutered Australian Shepherd was diagnosed with metastatic prostate cancer in 1/22/13. It had metastasized to the local lymph nodes and pelvis. He was negative for the MDR-1 gene variant. After discussing our options with the University of Illinois Veterinary Teaching Hospital, we opted for chemotherapy in the hope that it would slow down progression of the disease. We understood that, unlike chemo for lymphoma, chemo for metastatic prostate cancer has a very low success rate. So we began researching ways of improving his chances of benefiting from the chemo.

    My husband and I read your book, and decided to include Apocaps and K-9 in his treatment protocol in order to make the chemo more effective. We printed out the section from your book on Apocaps and gave it to the oncologists who were assigned to our dog. We asked that they go to the veterinary portal on the Apocaps site to familiarize themselves with these products and to talk directly to an Apocaps representative or to you for information about how to safely include these products in his protocol. They declined to do so.

    Our dog became septic after receiving a half-dose of mitoxantrone; his neutrophil count plummeted. He was treated with clavamox. He developed a rash, and the vet advised us to take him off all meds for 5 days and reintroduce each one in order to determine which one was causing the problem. We started with adding back Apocaps at half dosage, then K-9, then gabapentin. He reacted to gabapentin, so we were given tramadol for his pain instead.

    Over the next week, our dog improved on the Apocaps and K-9. His neutrophil count bounced back (which we understand may have done anyway), and he became active and more like his old self.

    A new oncologist, Dr. Portela, was assigned to our dog’s case. We expressed reluctance to continue chemo given how badly our dog reacted to a half dose of mitoxantrone. She recommended switching to carboplatin for his next dose. We said we would be willing to try again if she go the the veterinary portal for information about how Apocaps and K-9 might impact his reaction to chemo. She declined to do so. As a compromise, we said we would agree to carboplatin if he received half or a quarter dose. We explained that these nutraceuticals were chemo sensitizing, so our concern was that a full dose might be more than he could handle given his reaction to a half dose of mitoxantrone and the fact that he was on nutraceuticals that have chemosensitizing effects.

    She ignored our request and gave him nearly a full dose (240 mg/m2) on 2/14/13. He declined rapidly over the course of the following eight days. We repeatedly asked that she check his CBC to see if he was experiencing a more severe or earlier nadir than would be expected, but she declined to do so, saying that 10-14 days would be fine.

    On day 8, we finally took him to the ER. His platelet levels were below 6,000. Dr. Portela chastised us for using Apocaps, which she blamed for our dog’s poor response to chemo. She said it was the cause of his poor response, and that she would make sure it was never used for any animal in her care. Her attitude was one of smug triumph that she had been proved right–that the nutraceutical was harming him, not helping him. I can’t tell how much it devastated us to hear that our oncologist was blaming us for our dog’s suffering.

    She refused any other treatment other than pain killers and fluids. The ER veterinarian offered to try immunosuppression therapy to stop the destruction of his platelets. We were very grateful that she was willing to help, and gave our permission.

    His counts did not improve, and we allowed them to euthanize him yesterday. The ER doctors were very supportive, telling us that we did not harm our dog. They said it was plain how much he meant to us, and that they could see how much we were trying to make the best decision for him regarding treatment.

    While it is possible that our dog simply responded idiosyncratically to chemo, we were wondering whether the Apocaps did indeed improve the efficacy of the carboplatin such that giving him that large a dose actually constituted an overdose for him.

    If we had it to do over again, we would not do the chemo for this kind of cancer. We would just use the Apocaps and K-9, and have him regularly checked for improvement or decline.

    For the record, we have found integrative/holistic approaches to our pets’ health to be efficacious. One of our cats lived to be 20 (after having been diagnosed with a nasal tumor when she was 18) with holistic treatment, another of our cats was diagnosed with stage 3/4 renal failure 2 years ago and is still going strong (on Azodyl), one of our dogs survived valley fever with holistic care (contracted at age 8; she died of natural causes at age 15), and my horse lived to be 30 years old while still looking and acting like a 10 year old. So your book made a lot of sense to us. We just wish the oncology department at UIUC had been more willing to adopt a cooperative integrative approach to our dog’s treatment rather than an adversarial one.

    Thanks for listening.

  3. Linda pike on January 15, 2013 at 1:15 pm

    Hello Dr. Dresslars,
    Your book is wonderful and a great help for my dog Allie and I. Can Apocaps be taken with Artemisinin and Piroxicam. I read that with the Artemisinin they just need to be cycled and taken while off the Arte?
    Thank you

  4. Heather on September 9, 2011 at 4:42 am

    Dr. Dressler, I have the same question as Ellen. Can/should our dog be given Apocaps while on Carboplatin. She is going for her second round of chemo next week and is not on any supplements yet. Thanks!

    • DemianDressler on September 13, 2011 at 9:02 pm

      Dear Heather,
      the concern with treatments like supplements with chemo is that there may be an antioxidant effect which could theoretically interfere with the chemo:
      https://www.dogcancerblog.com/blog/anti-oxidants-versus-pro-oxidants/
      Here are the treatments where anti oxidants could interfere (Carbo is on the list):
      Alkylating Agents: Busulfan, Carmustine, Lomustine, Chlorambucil, Cyclophosphamide,
      Cisplatin, Carboplatin, Ifosamide, Mechlorethamine, Melphalan, Thiotepa, Dacarbazine,
      Procarbazine
      Antitumor Antibiotics: Bleomycin, Dactinomycin, Daunorubicin, Doxorubicin, Idarubicin,
      Mitomycin, Mitoxantrone, Plicamycin.
      Topoisomerase II inhibitor: Etoposide, Teniposide
      Radiation Therapy

      Apocaps are designed to deliver a net pro-oxidant effect. I use Carbo with Apocaps (discuss with your vet). Apocaps also have magnesium, shown to help lessen kidney toxicity with platinum compounds (more cisplatin than carbo, but nonetheless).
      I hope this helps
      D

  5. Philip Caldwell on December 20, 2010 at 8:33 am

    Regarding this subject, it might be added to that resveratrol, a natural plant compound, has been shown as a “sensitizer” to chemo and radiation.

    Subsequent to his research findings regarding this, Paul Okunieff, MD, chief of radiation oncology at the University of Rochester Medical Center, states “Resveratrol seems to have a therapeutic gain by making tumor cells more sensitive to radation and making normal tissue less sensitive. The study was published in the journal, Advances in Experimental Medicine and Biology and delt specifically on pancreatic cancer cells.

    The results showed that resveratrol had a variety of potentially anti-cancer effects, including:
    – Making the cancer cells more sensitive to chemotherapy by hamperinjg proteins that resist treatment
    -Triggering cancer death
    – Injuring the cancer cell’s energy source and decreasing its potential to function

    Here’s a link where you can read about this:
    http://www.webmd.com/cancer/news/20080326/red-wine-antioxidant-fights-cancer

    Although this research was not performed on dogs as is the case with the research you’ve cited in your article, it does serve to illustrate the therapeutic potential of these “sensitizers” such as resveratrol for dogs for the treatment of cancer in conjunction with chemo and/or radiation.

  6. Ellen on December 17, 2010 at 10:18 am

    Hi Dr. Dressler,
    I have a question about Apocaps. Our 2.5 year old chocolate lab, Charley (neutered male, 65#), was dx with OSA (proximal humerus) on 10-19-10. He had his L front leg & scapula amputated on 10-28-10 and he has has 2 of 5 rounds of Carboplatin (11-10-10, 12-1-10). His next Carboplatin chemo is 12-22-10. Can he take Apocaps while receiving Carboplatin chemo?
    I am on pg 200 of your book and have learned a lot (Thanks!), although there is so much to absorb. Charley is not on any supplements currently since he is not finished with chemo and I can’t find a clear cut answer on what I can give him (so I haven’t given him anything yet).
    I look forward to your answer!
    Sincerely,
    Ellen & Charley

  7. Elizabeth RIchards on December 16, 2010 at 8:08 am

    It would be great to have more information on protocols for dogs with the MDR-1 mutation. I have rough collies (one with lymphoma) and he is not able to take the usual chemo drugs. Since approx. 70% of collies have this mutation and a number of other herding breeds also are affected it would be helpful to know what research is being done for alternative treatments for them. Thank you.

  8. abby lim on December 15, 2010 at 5:03 am

    Hi Dr D.

    I just received ur book. Been going thru it again and again.
    i live in singapore and there is no onco canine doctors here. only those neighbourhood vet that doesnt recommend anything even diets.
    they say my dog randy can eat anything even after dianosed with bladder cancer.
    the tumour is 0.33cm at the neck of the bladder. surgery is done 2weeks ago.
    our vet gives Piroxicam for randy and nothing else.

    i would need ur help. what are the other drugs to help randy that can goes along with Piroxicam ?
    i have ordered Onco Support and Essiac tea. they are on the way to singapore. Please help. Im so far away from help in singapore.

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