institute for cancer research

What is Lung Cancer?

Nearly 170,000 Americans are diagnosed with lung cancer each year. While cigarette smoking is the main cause, anyone can develop lung cancer.

The lungs contain many different types of cells. Most cells in the lung are epithelial cells. These cells line the airways and produce mucus, which lubricates and protects the lung. The lung also contains nerve cells, hormone-producing cells, blood cells, and structural or supporting cells.

There are two major types of lung cancer. Non-small cell lung cancer (the most common) is believed to arise from epithelial cells. Small cell lung cancer is believed to arise from nerve cells or hormone-producing cells. The term “small cell” refers to the size and shape of the cancer cells seen under the microscope.

Lung cancer begins when cells in the lung grow out of control, and form a tumor. A lung tumor can begin anywhere in the lung. Once a lung tumor begins to grow, it may or may not shed cancer cells. These cells can travel through tiny tubes in the lung called lymphatic vessels, which drain into collecting stations called lymph nodes located in the lungs and the center of the chest. Cancer cells can also travel through blood vessels to distant sites in the body, where they can form other tumors. This process is known as metastasis.

Not all lung tumors metastasize. In general, small cell lung cancers are more likely to metastasize than non-small cell lung cancers, so the two types of lung cancer are treated in different ways. Lung cancer is always treatable, no matter the size, location, or if the cancer has spread.

Lung cancer is a malignant tumor that grows in one or both lungs. Lung cancer usually forms from cells that line the airways and nearby glands because these cells are what come in contact with the air we breathe which may contain carcinogens. In lung cancer, the changing of normal cells into cancerous cells usually happens over a period of years.

What causes lung cancer?

There are several factors that can contribute to the development of lung cancer. Smoking is the number one cause of lung cancer. While smoking is an important risk factor in developing lung cancer, there are many people with lung cancer who have never smoked. Other factors that contribute to lung cancer include the following:

Exposure to chemicals in the air such as asbestos and radon

• Lung diseases that can block airflow to the lungs such as chronic obstructive pulmonary disease (COPD) or tuberculosis


• Genetics - people with a relative who had lung cancer are at higher risk for developing lung cancer


• Age - lung cancer occurs more often in people over 65 years of age

Cigarette smoke contains at least 43 different carcinogens (cancer-causing chemicals). It has been associated with various cancers including lung, esophagus, mouth, stomach, pancreas, and liver, to name just a few. Smoking accounts for at least 30% of all cancer-related deaths and 87% of lung cancer deaths. Approximately 50% of new lung cancers are diagnosed in former smokers. The risk of lung cancer increases with an increase in the total number of cigarettes smoked, referred to as pack-years (number of packs smoked per day times the number of years smoked). The use of cigar and pipe tobacco also increases the risk of developing cancer, but the risk is not as high as with cigarettes.

Secondhand smoke also contains carcinogens, and each year in the US between 5,000 and 10,000 people are diagnosed with lung cancer resulting from breathing secondhand smoke.

Quitting smoking decreases the risk of developing lung cancer. Ten years after quitting, the risk decreases by half. Although smoking cessation lowers this risk of developing lung cancer, the risk never decreases to the level of people who have never smoked. Recent findings for smokers who have been diagnosed with lung cancer suggest that those who quit smoking during their lung cancer treatment may live longer than those who continue to smoke during treatment.

It’s never too late to quit smoking! If you currently smoke and would like to quit, talk to your doctor about the different options to help you stop smoking.

LUNG CANCER SYMPTOMS

Some of the symptoms of lung cancer are similar to symptoms of other common illnesses. So, it’s important for your doctor to perform a thorough physical examination and to know your medical history. Your doctor will consider your age, smoking history, and diseases or conditions that you and your family members may have. Your doctor will also need to know if you’ve been exposed to any harmful chemicals. All of these things will help to determine the next steps.

The most common symptom of lung cancer is cough; it occurs in over 50% of people with lung cancer. The tumor causes irritation to the lungs and airway tissue, resulting in cough. Other common symptoms of lung cancer are chest pain, shortness of breath (dyspnea), and wheezing. About 30% of people with lung cancer will cough up blood, called hemoptysis; you should call your doctor immediately if this happens. If the tumor grows larger, it can press on nearby organs and bones. When this happens, symptoms may include bone pain, chest pain, hoarseness, cough, shortness of breath, swelling of the face or arms, and/or a build up of fluid around the outside of the lungs, also called pleural effusion.

Some symptoms are caused by the cancer spreading to other parts of the body (the lung cancer has metastasized). Symptoms from lung cancer metastases depend on where the cancer has spread. If the lung cancer has spread to the brain or spinal cord, you may experience headaches, nausea, vomiting, weakness, tiredness, or seizures. If the lung cancer has spread to the bones, you may feel bone pain. If the cancer has spread to the liver, you may have right-sided abdominal pain and jaundice. There are also some general symptoms of lung cancer like weight loss, fatigue, and loss of appetite. If you have been diagnosed with lung cancer and you develop any of these or other new symptoms, you should let your doctor know.

Healthy Cells vs. Cancer Cells

Healthy cells are like a cat.  They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.

 

LUNG CANCER STAGING

Once lung cancer has been diagnosed, your doctor will want to determine the stage or extent of the disease. This involves finding out how large the tumor is and whether the cancer is limited to the lungs or if it has spread to other parts of the body (the presence of metastasis). The tests your doctor performed to diagnose lung cancer, such as a CAT scan and MRI, help determine the stage of disease.

Why is it important for your doctor to determine the stage of your lung cancer?
When you and your doctor know how the cancer is growing and where it is located, you can together choose the best treatment option. The most common system used to describe stages of lung cancer is the TNM staging system, which stands for Tumor, Node, Metastasis. Your doctor will determine the T, N, and M status of the tumor. The first step is assigning a T or tumor stage.

LUNG CANCER DIAGNOSIS

Early diagnosis of lung cancer is difficult because symptoms do not usually occur until the disease is more advanced. You may have felt well and your diagnosis came as a surprise to you and your doctor. Or, you may have had signs or symptoms of lung cancer during a routine physical examination, and your doctor ordered tests that found lung cancer. Certain tests need to be performed for a doctor to be able to diagnose lung cancer. Below is a description of some of the more common tests doctors use.

Chest X-Ray

A chest x-ray is the most common test used when lung cancer is suspected. It uses small amounts of radiation to take a picture of the inside of the chest, including the lungs. Tumors in your lungs can be seen on a chest x-ray. Your doctor may compare old chest x-rays with recent ones to see if the tumor is growing or shrinking.

Computed Tomography (CT) Scan

Computed tomography, also known as a CAT or CT scan, is another test used to help diagnose lung cancer. It’s similar to a chest x-ray but it gives a more detailed picture of the lungs. A CAT scan can detect extremely small tumors that may not be seen on a chest x-ray. Also, it may help your doctor determine whether or not the tumor has spread into the surrounding lymph nodes.

Magnetic Resonance Imaging (MRI), or MRI, is similar to a CAT scan, but it uses magnetic fields instead of radiation to create a picture. An MRI produces clear images of your internal body parts, including tissues, muscles, nerves, and bones. Your doctor can use these images to detect the presence of tumors.

Positron Emission Tomography (PET) Scan, or PET scan, determines the way the cells in the body act in the presence of sugar. Normal cells take in sugar and use it to make energy. Cancer cells usually take in more sugar than normal cells. If you are going to have a PET scan, your doctor will give you a special type of sugar before the test. The PET scan will detect the presence of tumors by detecting “hot spots,” which are bright colored areas on the picture where the sugar has been taken in by cells. The more sugar the tumor takes in, the more likely it is a cancer.

A special type of PET scan is available, which involves the use of a special sugar called fluoro-deoxyglucose (FDG). This PET scan is useful in evaluating the extent of your cancer. More FDG taken up by your lung tissues can mean a more advanced stage of cancer. A PET scan using FDG is more accurate in determining the stage of your cancer compared to a CAT scan.

Sputum Cytology

In this test, your sputum (or mucous that is coughed up) is collected and examined under the microscope to look for cancer cells. The most accurate way to do this test is to collect and analyze early morning mucus for three days.

Biopsy

The techniques that allow the doctor to view the inside of your body do not test the tumor for the presence of cancer cells. So, these tests do not provide absolute proof that you have cancer. To confirm the presence of cancer, a sample of tissue from the tumor is necessary. A biopsy is the removal and examination of a tissue sample from the tumor to determine if it is cancerous (malignant) or non-cancerous (benign). Biopsies can be obtained in several different ways depending on the location and the size of a tumor. Below are different ways a biopsy can be taken.

LUNG CANCER TREATMENTS

Surgery

Depending on the stage of cancer and your health, lung surgery, which is also known as a thoracotomy, may be used alone or in combination with radiation or chemotherapy. Surgery is usually used to treat cancer that is diagnosed early, such as Stage I or II. If your cancer is located only in the lungs and has not spread to the lymph nodes or outside the chest cavity, your doctor may perform surgery to remove the tumor. If your cancer has spread to other parts of your body, surgery is not generally an option.

Other factors that may play a role in deciding whether or not surgery is the best option are the size and location of the tumor and your general health. If your cancer is near your vital organs such as the heart, windpipe, or major blood vessels, your doctor may recommend other treatment options, because surgery too close to these organs may be complicated. Also, if you have other serious health conditions such as a heart condition or other lung problems, you may not be able to have surgery. Your doctor will know whether or not lung surgery is the right option to treat your lung cancer. A thoracotomy involves opening one side of your chest between your ribs to avoid damaging organs such as the heart or the windpipe. Your ribs are spread apart and a small piece of your ribs may even be removed, so that the surgeon can see into your chest to remove the tumor.

Depending on the location, size, and type of tumor, there are several different types of surgeries that can be performed. A small part of your lung may be removed, a lobe of your lung may be removed, or a whole lung may be removed. Below is a description of these procedures.

Wedge resection or segmentectomy

There are two operations to remove a small section of the lung: a wedge resection and a segmentectomy. A wedge resection involves removal of a smaller part of your lung compared to a segmentectomy. Your doctor may use these types of surgery if you have been diagnosed with an early stage and the cancer is very small.

Lobectomy

You may recall from your earlier reading that the right lung has three lobes and the left lung has two lobes. Your doctor may decide to remove an entire lobe of your lung if he or she believes that the cancer is just in one part of the lung. This process is known as lobectomy.

Pneumonectomy

Is the removal of an entire lung and is used when your doctor believes that cancer is present in only one lung but it may be anywhere in that lung. Although removing a lung can reduce the function of your lungs, you can breathe normally with only one lung. However, if you had breathing problems before, you may continue having those after your surgery.

Video-assisted thoracic surgery

Video-assisted thoracic surgery (VATS) is a recently developed technique, which may be used for several procedures. It can be used to confirm a diagnosis of lung cancer, and to remove cancer in patients who cannot tolerate open-chest surgery or have a small tumor confined to the lungs. VATS is usually done before a thoracotomy. The surgeon makes small incisions on your chest, which allows him or her to look inside and remove tumors close to the outside edge of the lung. The doctor does not have to open your entire chest to see and remove a tumor. However, it can only be used to treat cancer if it has not spread throughout the lungs or other parts of the body.

What should I expect with surgery?

As with any major surgery, lung cancer surgery is associated with risks such as bleeding, infection, pain, and damage to the heart, lungs and other organs. You will be admitted to the hospital and you may have to stay several days after the surgery. Your remaining lung function, overall health, the type of surgery done, and the amount of pain you are experiencing are some of the factors that will determine how long you will stay in the hospital. Chest tubes may be placed in your chest to help drain fluid, blood, or air present around the lungs after your surgery. These tubes are removed once all the fluid has drained out of your chest. You will be instructed on how to do breathing exercises that will help you recover from the surgery and prevent complications.

Radiation

Radiation or radiotherapy uses high-energy rays to kill lung cancer cells, shrink tumors, and prevent cancer cells from dividing and spreading. Radiation is directed to the area where the tumor is located and injures or destroys the cells by damaging the cells’ genetic material. This kills the cells or makes it impossible for them to grow. More than half of all patients with cancer are treated with some type of radiation.

In lung cancer, radiation therapy is most often administered to patients with early stage disease, such as Stage I, who may not be well enough to undergo surgery. It may also be given before or after surgery in early disease (Stage I or II) or in combination with chemotherapy in later stages of the disease (Stage III). Some patients will also receive radiation therapy to relieve some of the symptoms of lung cancer or to treat an area of metastases in Stage IV disease. For example, if the lung cancer has spread to the bones and is causing pain, radiation to the bone may decrease the tumor size and lessen the bone pain.

It is nearly impossible to direct the radiation rays only at the cancer cells. As a result, both cancer cells and nearby healthy cells may be damaged. However, normal cells, unlike cancer cells, may recover from the effects of radiation. In addition, your doctor will try to limit the effect of radiation on normal cells by aiming the radiation toward the tumor, limiting the dose of radiation, and spreading out the treatment over time.

How is radiation given?

There are two ways in which radiation can be given: external beam radiation and a type of internal radiation called brachytherapy. External beam radiation is the most common type of radiation used for the treatment of lung cancer. With external beam radiation, you’re positioned under a machine that sends high-energy rays toward the tumor. The radiation only lasts for a few minutes at each session, and is usually given once daily for 5 days a week for up to 6 to 8 weeks. You will probably not receive radiation on the weekend, which allows the normal cells time to recover. Another type of external beam radiation is called hyperfractionated radiation. During hyper-fractionated radiation, the daily dose of radiation is given as smaller doses but more than once a day. You may receive radiation several times a day separated by 4 to 6 hours.

Internal radiation is also called brachytherapy. During this treatment, your doctor will place the source of radiation inside of your body, near the tumor. The source of radiation is some type of seed or small implant that is placed into the lung. This is done by inserting a tube into the nose, down the trachea, and into the lung. The radioactive seeds are then placed down the tube and positioned near the tumor. The seeds may stay in the lung for a few minutes or permanently, depending on the dose of radiation needed. Your doctor will determine the dose of radiation and how long the seeds need to stay in your lung. Brachytherapy allows a high dose of radiation to be given to a small area of the body, but it’s not often used in lung cancer.

What are the side effects of radiation?

Side effects will be different for every patient and they may continue for several months after radiation treatment is over. Most people who undergo radiation experience fatigue. You may feel tired for months after therapy, so you may want to get more rest during this time. Other side effects you may experience include mild skin problems at the radiation site, nausea, and vomiting. If you get radiation to your chest area, you may experience shortness of breath, and cough. Since your esophagus may be exposed to radiation, difficulty with swallowing may occur. Most of these side effects will usually lessen after treatment is completed.

If you have Stage IV disease and the cancer has spread to your brain, you may get radiation to your brain to relieve some of the symptoms that you are experiencing. Radiation to the brain may cause hair loss, memory loss, headache, or difficulty thinking.

Make sure you tell your doctor if you experience any of these side effects.

Chemotherapy

Is the use of powerful drugs to attack cancer cells. The drugs circulate throughout the body in the bloodstream and may kill any rapidly growing cells, including cancer cells and some healthy cells. Chemotherapy drugs are carefully controlled in both dosage and frequency so that cancer cells are destroyed while minimizing the risk to healthy cells.

How is chemotherapy given?

The drugs used for chemotherapy come in many different forms. While some are given directly into a vein (intravenous) or a muscle (intramuscular), others may be taken by mouth. Some of the drugs must be given in the doctor’s office or clinic and others can be taken at home. Certain types of chemotherapy need to be given in the hospital because they require special monitoring of both the treatment and its possible side effects. There are many different chemotherapy drugs, each with its own strengths and weaknesses.

Chemotherapy may sometimes be used in combination with surgery or radiation for Stage II disease. It is more commonly used alone or with radiation to treat Stage III and IV disease. When chemotherapy is used before surgery or radiation in earlier stage disease it is called neo-adjuvant therapy. Neo-adjuvant chemotherapy may reduce the size of the tumor so it’s easier to remove during surgery or easier to treat with radiation. When it is used immediately after surgery or radiation in earlier stage disease it’s called adjuvant therapy. Adjuvant therapy may kill any cancer cells that may remain in the body after surgery or radiation. The term minimal residual disease (MRD) is used to describe these cancer cells that may remain in the body despite successful surgery or radiation. MRD does not mean that you have metastatic disease. However, the remaining tumor cells may go undetected for years, and they can develop into metastatic disease if they are not treated.

Most often chemotherapy is used to treat advanced stages of lung cancer (Stages IIIb and IV). Usually different chemotherapy drugs are given together to treat advanced lung cancer. Some combinations of chemotherapy can prolong survival, improve the quality of life, and reduce lung cancer symptoms in people with advanced stages of lung cancer. When chemotherapy is used to ease the symptoms of lung cancer but not used to prolong survival, it is called palliative therapy.

Chemotherapy is considered the standard therapy for advanced lung cancer. The first chemotherapy regimen that a person receives to treat the cancer is referred to as first line. Therapies that are used first-line are considered the best way to treat the cancer. If first-line chemotherapy doesn’t work or if the disease re-occurs following first-line therapy, second line therapy may be given. Some people with lung cancer go on to receive more than 4 or 5 different chemotherapy regimens. Your doctor will determine what drug or combinations of drugs is the most appropriate for you by considering your type and stage of lung cancer, other illnesses you may have, and the possible side effects of the therapy.

What should I expect with chemotherapy?

Chemotherapy is administered in “cycles.” A cycle is usually made up of 21 days in a row and you may not receive chemotherapy on every day of a cycle. For example, you may receive one chemotherapy drug on day 1 of a cycle, while you may get a second chemotherapy drug in combination with the first drug on day 1 and by itself day 8. Chemotherapy regimens for lung cancer can last for up to 6 cycles with each cycle being about 21 days long. Sometimes, after you finish your chemotherapy cycles your doctor may recommend you continue some therapy for a longer period of time in order to keep the cancer from coming back. This type of therapy is called maintenance therapy.

Sometimes chemotherapy is given at a clinic or hospital over a period of several hours, so you will need to make arrangements to get to your scheduled appointments. Depending on the type of chemotherapy that you receive, you may be given “premedications” (medications given before the chemotherapy) in order to prevent certain side effects. You may also have to receive intravenous fluids before or after the chemotherapy.

What are the side effects of chemotherapy?

Chemotherapy drugs circulate throughout the whole body and they can affect both healthy and cancer cells. When healthy cells are affected you may experience side effects. The specific side effects depend upon which drugs and regimens are used. The most common side effects include hair loss, nausea, vomiting, diarrhea, lowered blood counts, reduced ability of the blood to clot, a tingling or numbing sensation of the hands and feet, and an increased risk of infection. Other side effects may include blisters or sores in the mouth and throat and a feeling of tiredness. Some of these side effects occur only temporarily or are more noticeable when treatment is first started. Many of the side effects disappear when the drugs are stopped. For instance, hair will grow back once chemotherapy is stopped. You should talk to your doctor about what side effects to expect for your therapy and how to manage them if they occur.

Treatment of Non-small Cell Lung Cancer

In general, early-stage non-small cell lung cancer (stage 0-II) is treated with surgery. Surgeons cure many patients with early-stage lung cancer with a single operation. Radiation therapy can also be used to treat and cure early-stage lung tumors in people who cannot tolerate surgery. Stage III non-small cell lung cancer has spread so much that surgery or radiation alone is either impossible, or not enough to treat the disease. Patients with stage III disease have a high risk of the cancer returning, either in the same place, or at a distant location, even if surgery or radiation has completely removed the cancer. For this reason, doctors generally do not recommend immediate surgery, and may recommend immediate chemotherapy for patients with stage III disease.Chemotherapy can shrink a stage IIIA tumor, and make it easier for the surgeon to remove, or easier for the radiation oncologist to irradiate. In theory, since chemotherapy travels throughout the body it can kill cancer cells that have traveled to distant sites.Because of the highrisk of distant and local recurrence, stage IIIB tumors are usually not removed surgically, no matter how effective chemotherapy might be. For these patients, chemotherapy delivered at the same time as radiation has been shown to improve the ability of radiation to shrink the cancer. With these concepts in mind, patients with stage III disease are generally treated with some combination of chemotherapy followed by surgery, or chemotherapy followed by radiation. Some patients, especially those with stage IIIB disease, are treated with chemotherapy at the same time as radiation. Treatment of stage III non-small cell lung cancer with combination therapy has resulted in prolonged survival for many patients. Delivering chemotherapy and radiation at the same time may cause greater side effects.

Advanced Non-small Cell Lung Cancer Patients with stage IV non-small cell lung cancer or stage IIIB disease due to cancer cells in fluid around the lung (called "advanced" disease) are typically not treated with surgery or radiation. Rarely, a single brain or adrenal metastasis can be removed surgically or radiation can treat a single site of disease. However, patients with advanced disease are at very high risk for their cancer growing in a different location, so most patients with advanced non-small cell lung cancer are treated with chemotherapy alone.

The goal of chemotherapy is to shrink the cancer, relieve discomfort caused by the cancer, and slow the spread of the disease. Rarely, chemotherapy can cause metastatic lung cancer to disappear completely, but these patients are still at very high risk of cancer returning. Therefore, patients with advanced disease are never considered "cured" of their cancer no matter how well the chemotherapy works. These patients must be followed closely by their doctors, and require chronic or intermittent chemotherapy to control their disease.
In these patients, highly toxic treatment approaches should be avoided in favor of treatments designed to improve both quantity, and quality of life. Chemotherapy has been proven to improve both quantity and quality of life for patients with advanced non-small cell lung cancer.

Treatment of Small Cell Lung Cancer

Small cell lung cancer spreads quickly and rarely responds well to surgery or radiation therapy alone. Patients with limited-stage small cell lung cancer are usually treated with chemotherapy plus radiation to the site of disease. Radiation therapy is given during the first or second month of chemotherapy, with chemotherapy continuing for 3 to 6 months.

Patients with extensive-stage disease are usually treated with chemotherapy only. In patients whose tumors have disappeared after chemotherapy, radiation may help prevent cancer from later attacking the brain. This is called prophylactic cranial irradiation (PCI).

INTEGRATIVE THERAPY

THE SCIENTIFICALLY FORMULATED AMINO ACID THERAPY

(Keep in mind, CAAT is much more than just a “diet”; it is an amino acid, carbohydrate, & glucose REDUCTION protocol which strategically uses the chemical reactions of amino acids, foods, and nutritional supplements to impair the development of cancer cells, thus starving them to death.) Clinical trials have already been done with humans using amino acid depravation formulas, and with much success. (Journal American Medical Association. 1967; 200:211)

CAAT is a course of therapy to control a patient’s amino acid intake. This is achieved by taking certain foods out of a persons’ daily food plan for a short time and by replacing them with a scientifically supported formula of amino acids. It is also important to emphasize that the food plan that accompanies the amino acid formula needs to be followed so not to offset any of the benefits we are creating by depriving the cancer cells the nutrients they need to grow. Also, it is important to realize that the patient does not need to abandon their conventional cancer treatment, (surgery, chemotherapy, radiation, hormone treatments) nor is it recommended that they do so unless it has already failed them. CAAT works synergistically with chemotherapy and/or radiation to enhance their benefits (see study by Dr. Marco Rabinowitz of the National Cancer Institute). His report on amino acid deprivation, such as with Controlled Amino Acid Therapy (CAAT), proven to inhibit phosphofructokinase which shuts down the energy supply to cancer cells, simultaneously enhancing the benefits of chemotherapy while lessening their toxic side effects. CAAT has also proven to work successfully alone.

Phase 1: CAAT Formulation

The most important component of CAAT is the scientifically formulated amino acids. Based on the specific formula for each cancer, it consists of separate amino acids, citric acid, and small amounts of sodium benzoate. Each formula replaces most of the regular daily proteins found in meats, dairy, fish, beans and nuts, which cancer cells can derive their energy from. The CAAT formula taken two times per day will nourish the healthy cells while causing the cancer cells to starve to death. Of course each individual has specific needs concerning their diet, and this is explained in the second phase of the protocol as well as with a specialist at the Institute when beginning the CAAT therapy.

Phase 2: Daily Food Intake

DISCLAIMER: The following food program SHOULD NOT be consumed without the amino acid formula and without consent from your doctor and our Institute.

Breakfast:
*1/2 Grapefruit or 1-orange or 6-ounces of fresh orange juice.
Whey Enhanced Protein (Vanilla Flavor – Vitamin Shoppe Brand) approximately
10 – 12 grams of protein – read label carefully, based on 150 lb. person ].
A serving of Grits (Butter, cinnamon and other spices are okay).
1 cup of green or black tea (Fructose is sweetener of choice).
* Do Not have ½ grapefruit if taking Chemotherapy

Explanation: ½ Grapefruit or 1 orange or 6 ounces of fresh orange juice are rich in the natural nutrients called Limonene and Citric Acid. Limonene helps shut down the Ras cancer gene which is over active in 90 percent of all cancers. Citric Acid helps shut down glycolosis which in turn helps starve cancer cells to death.

Whey Enhanced Protein (Vanilla Flavor – Vitamin Shoppe Brand) Phosphorus is a nutrient that cancer cells must utilize in order to grow and reproduce. This brand of whey protein is very low in phosphorous and contains no additional vitamins, so when using approximately 10 – 12 grams of protein per 150 lb. person, it helps to protect normal cells, maintain a normal appetite, and also helps to fight edema. (Edema is the swelling or water build up in the legs or other sites in the body)
Whey protein is included in the daily menu of all advanced or metastatic cancer patients. When treating cancers that are stable or have regressed in size, patients then have the option of including other protein foods at their breakfast meals such as cottage cheese, yogurt, or soy foods. Eggs are allowed in the diets of patients with lymphoma and brain cancers.

Grits or Cream of Wheat or 1 slice of white toast or ½ plain bagel or ½ English muffin (Butter is okay)
Grits or white rice is the preferred carbohydrate food at each meal. The other choices are options once the patient’s cancer is stable or reduced in size. Unrefined carbohydrates are included in the CAAT menu instead of whole grains to deprive cancer cells of a certain B-complex vitamin called Pyridoxine (Vitamin B-6). Cancer cells require this vitamin to manufacture certain amino acids that we keep away from through CAAT’s amino acid reduction formula and diet.
Grits is the preferred carbohydrate food at all meals instead of rice, corn, or pasta because it helps deplete Tryptophan in the body, which is essential for the growth and spreading of cancer cells.

1 cup of green or black tea, using fructose as the sweetener of choice. These teas are rich sources of several compounds that help shut down glycolosis and cut off the energy supply to cancer cells. Also, green or regular tea helps to prevent certain hormones and tumor growth factors from stimulating cancer cells to grow and metastasize to other parts of the body. Brassica teas can also be taken because they contain sulphorane, a nutrient that inhibits cancer growth, and also shuts down the cancer genes.
* Why we use fructose as the sweetener of choice will be explained in detail at the end of this phase of the CAAT protocol.

Lunch:

Amino acid formula (4 level plastic scoops) mixed with any of the following: Water & Fructose; Sugar free Kool-Aid; Diet ginger ale; Fresh lemonade & Fructose; Chicken or Beef broth; V8 juice.
Generous amounts of One cooked vegetable or a combination of the following: asparagus, broccoli, cabbage, brussell sprouts, spinach, squash, string beans.
One serving (1/2 cup)of fresh fruit. Choice of: pear, orange, blueberries, raspberries, strawberries.
1 serving (moderate) of grits or corn or rice or pasta (Add tomato sauce or butter)
1 tablespoon of coconut oil
8 to 10 black or green olives
2 tablespoons of vinegar (minimum of 5% acidity) add to vegetables or food
1 cup of green or black tea (Fructose as desired)

Explanation:

This Amino Acid Reduction Formula (4 level plastic scoops may vary) combined with the special diet, allows the CAAT Protocol to reduce certain amino acids in the daily diet of the cancer patient, and is designed to replace most of the animal protein in the diet. Cancer cells require the amino acids glycine, serine, glutamic acid, and aspartic acid to synthesize DNA, build new blood vessels or duplicate its entire contents of proteins. Also, cancer cells require these and certain other amino acids in order to synthesize other proteins that act as growth promoting hormones or tumor growth factors. CAAT impairs the synthesis of a protein called elastin, which is absolutely essential to the manufacture of new blood vessels. The Amino Acid Reduction Formula, diet, certain phytochemicals and herbs work efficaciously to attack cancer cells at each and every biological front.

The generous amounts of one cooked vegetable or a combination of such helps keep normal cells healthy. They are low in carbohydrates and proteins, and high in phytochemicals, compounds which help fight cancer. Patients are allowed to eat these vegetables and salads whenever desired.

The 8 to 10 olives are rich in squalene and oleic acid, nutrients that have been reported to inhibit certain cancer growth factors. The calories in olives also help control body weight and increases ketones in the blood. Ketones help fight cancer by impairing glycolosis – a process in which cancer cells depend almost exclusively upon for their daily supply of energy. Vinegar (and fructose) are two natural products that increase the production of both ACETIC ACID and CITRIC ACID in the body.

Acetic acid and citric acid also help fight cancer by shutting down the process of glycolosis.
Normal cells derive most of their daily energy supply from acetic acid and citric acid, where as cancer cells derive most of their daily energy from glycolosis.

Dinner:

Amino acid formula (4 plastic level scoops) mixed with any of the following: Water & fructose; Sugar free Kool–Ade; Diet Ginger Ale; Fresh lemonade & Fructose; Chicken or Beef broth; V8 Juice.
Generous amounts of One cooked vegetable or a combination of the following: asparagus, broccoli, cabbage, brussel sprouts, spinach, squash, string beans.
One serving (1/2 cup) of stewed plums with fresh cream & fructose; use 4-ounces of orange juice if plums are not in season.
Avacado salad with lettuce, tomatoes, celery, onions, with lemon juice and coconut oil or olive oil.
2 tablespoons of vinegar (minimum of 5% acidity) add to vegetables or food.
1 serving of grits or corn or pasta or rice (Add garlic and butter or tomato sauce)
1 cup of green or black tea (Fructose as desired)

Mid Evening Snack: Ketogenic Cocktail – 2 ounces of fresh cream, ½ ounce each of both coconut & olive oil, 1 tablespoon of Fructose.
Sugar free Jell-O with whipped cream & Fructose or 1 plum or 4 ounces of orange juice.

Explanation: The sugar free jell-o helps to appease the appetite. Plums contain quinlic acid, which is converted into benzoic acid in the body and which in turn helps to deplete the availability of the amino acid Glycine (Glycine is essential to the synthesis of DNA for cancer cells) and the proteins that cancer cells require to build new blood vessels and their tumor growth factors. If underweight take two ounces of light cream and one ounce of olive oil/coconut oil as needed to maintain weight.

Optional Meal:

3 to 4 ounces of Veal, Fish of choice, Beef, Chicken breast, and 1-slice of white bread.

Consume this meal with a minimum of 3 hours before or after taking the amino acids.

Explanation: If the patient is 10 or more pounds underweight or if their albumin levels are below normal is when the optional meal is allowed. This meal should be eaten a minimum of 3 hours before or after taking the amino acids. CAAT provides sufficient protein to maintain the health of normal cells and adequate amounts of calories to maintain desired body weight. Any proteins taken in excess of amounts recommended in the diet will counter act the benefits of the CAAT protocol.

Special Diets: A special diet will be created for any cancer patient whose ability to consume food and liquids has placed them in a critical situation. When a patient is using a feeding apparatus, or they have become too weak or lethargic to eat and drink the daily minimum amount for survival, we will break up the total breakfast, lunch, and dinner over a period of every 2 hours during the entire day until the patient is capable of returning to a daily diet as outlined above.

Carbohydrate and glucose reduction in this diet: CAAT’S dietary menu provides approximately 20 percent of its calories in the form of carbohydrates. Calories need not be a focal point or counted daily. It is recommended that all patients combat their cancers by keeping their body weight at normal or slightly below normal levels. A patient’s desired body weight is regulated by their rate of metabolism, which in turn is regulated by their blood levels of thyroxine, cortisone, insulin, and the amounts of fats and oils in the diet. Studies with human cancer patients and laboratory animals show that reducing the calories of carbohydrates (glucose) in their daily diet by only 10 percent reduced the size of cancerous tumors. When carbohydrate (glucose) calories were reduced 40 percent, the cancers disappeared. It is recommended that those patients who are obese gradually and systematically lose their excess weight to increase the efficiency of the CAAT protocol. Those patients who are underweight shoudn’t gain weight unless they are more than 10 pounds below normal levels. When a patient is underweight due to anorexia or cachexia, such illnesses must be addressed before the CAAT protocol can begin.

Why we use Fructose and Vinegar to treat cancer:

Nobel Prize winner Dr. Otto Warburg discovered more than 50 years ago that all cancer cells produce inordinate amount of lactic acid but he couldn’t explain why.

In 2001 our Institute published the first study to show that cancer cells produce excess amounts of lactic acid because they could not access the oxygen in compartments in the cells called the mitochondria. This provided evidence that cancer cells depend almost exclusively upon glycolosis or the metabolism of glucose as their major source of energy.

Dr. Spitz and Dr. Lee with other cancer researchers published studies showing that when cancer cells are deprived glucose, their energy supply is cut off which causes these cancer cells to commit suicide.

Therefore shutting down glycolosis would be one means of destroying cancer cells because energy can only be derived from glucose through the metabolic process called glycolosis.

Recently our Cancer Institute discovered that both acetic acid and citric acid could inhibit the activity of a key enzyme in glycolosis called phosphofructokinase, which in turn shuts down the process of glycolosis. Our cancer Institute is the first to introduce both fructose and vinegar as treatments for cancer because they either contain or produce acetic acid.

In conclusion, fructose and vinegar are added as supplements to the CAAT protocol because of their acetic acid properties that help shut down glycolosis, shutting off cancer cells energy supply and causing them to die off.

Phase 3: Nutritional Supplements

Nutritional supplements are based on each unique situation. For example, slow-growing cancers produce low levels of toxic free radicals. Tumor cells that grow aggressively produce large amounts of toxic free radicals. The patient will be instructed whether or not to take anti-oxidants (in a nutritional supplement), and at what dosage, according to the levels of toxic free radicals produced in the cancerous cells.

An example of how nutritional supplements can help manipulate cancer cells involves vitamin B-6 (pyroxidine) There are four amino acids essential to the synthesis of DNA. However, those amino acids cannot be synthesized without a certain enzyme, which includes vitamin B-6 among other components. Any supplement containing vitamin B-6 SHOULD NOT be taken during the first 2 months of the CAAT protocol.

The patient will be instructed as to which nutritional supplements or phytochemicals should be purchased and at what dosage strength. Keep in mind that each supplement only complements the CAAT protocol. However, when they are combined they augment the therapeutic benefits of the aminoacid, carbohydrate, and glucose reduction diet.

Parsley: Contains ingredients that can help shut down certain enzymes called Epithelial Growth Factors, which stimulate the growth and spread of cancer. ( CAAT’S amino acid reduction diet works in the same manner )

Vitamin D: Helps activate in many kinds of cancers enzymes called Phosphotases, which literally shut down the activities of other enzymes called Kinases, which are essential to the growth and reproduction of cancer cells.

Green Tea Extract: Phytochemicals in tea help shut down glycolosis (cancer cell’s main supplier of energy) and thereby help to starve cancer cells to death. These effects help complement the effects of CAAT’S carbohydrate reduction.

Anti-Oxidants: The controversy as to whether or not to treat cancer with anti-oxidants is slowly resolving with the current understanding of how they affect the activity of genes and enzymes in cancer cells. The prevailing data shows that the benefits or lack of benefits depend upon the oxidative state the cancer cells are in. Anti-oxidants taken when the cells are in a very high oxidative state may prevent cancer cells from entering apoptosis ( apoptosis is when a cancer cell commits suicide) When oxidative stress in cancer cells is only slightly above normal, anti-oxidants are then expected to stop their growth and reproduction.

Blood Chemistry: Blood tests are usually taken every 6 to 8 weeks, depending upon the results of each test. Not only is it important to monitor the tumor markers but equally important to keep abreast of the overall health of normal tissues and organs. For example, it is important to learn of the health of the kidneys and liver, whether the body is producing sufficient red and white blood cells, etc. Low albumin levels most often indicate insufficient intake of proteins in the diet and this problem would have to be addressed. CAAT is designed to attack cancer but keep the normal cells and tissues functioning harmoniously.

Whey Protein: This protein food is recommended at the breakfast meal to help meet the daily needs of amino acids for the normal cells of the body, and to help keep albumin levels normal and to help prevent edema. We recommend Whey protein purchased from the Vitamin Shoppe because it is the only brand that we have seen with no phosphorous or additional vitamins added to it.

Grits: Grits are also recommended at the breakfast meal in place of whole grains because it is low in vitamin B-6. Cancer cells require B-6 to manufacture the amino acid Glycine, which is required for DNA synthesis. Grits, instead of whole grains, therefore helps prevent cancer cells from manufacturing DNA and building new blood vessels.

Calcium D-Glucurate: This phytochemical helps the body to retain a compound called Glucuronic acid. This is necessary to eliminate both estrogen and testosterone from the body. This is why Calcium D-Glucurate is added to the regiments of patients with breast & prostate cancers. Calcium D-Glucurate is not to be confused with calcium carbonate, which is nothing more than a calcium supplement.

D-Limonene: This phytochemical found mostly in citrus fruits blocks the process called Isoprenylation, which is necessary for tumor growth factors such as the RAS gene, Epithelial Growth factor, Tyrosine Kinase, and Insulin-Like-Growth-factor, to send their signals into the nucleus of a cancer cell and directs them to grow and divide into more cancer cells.

Tocotrienols: This member of the Vitamin E family also helps shut down Isoprenylation and assists D-Limonene in blocking the actions of the various tumor growth factors. More specifically, tocotrienols shut down an enzyme called HMG-2, which is essential to the synthesis of the building blocks that form the Isoprenylation process.

Niacin: This B-Complex vitamin works with D-limonene and the Tocotrienols to shut down the process of Isoprenylation, which as mentioned above prevents the cancer promoting RAS genes from sending signals into the nucleus of the cell. Niacin also helps deplete thee amino acid Glycine, which cancer cells need to synthesize DNA. And by reducing cholesterole in the body, Niacin helps lower the production of estrogen and testosterone.

Choline: This B-complex vitamin is included in our supplement list to help the liver metabolize Niacin and other compounds and to help fight fatigue that accompanies most forms of cancer.

Selenium: Numerous studies show that this mineral can interfere with the activity of certain genes that promote the growth of cancer and to induce cancer cells to commit suicide (apoptosis)

Perilla Oil: This oil is rich in Alpha Linolenic Acid which can inhibit the growth of cancer cells in several ways. One way is to inhibit the synthesis in the body of a tumor growth promotin hormone called Prostaglandin-2, also, Alpha Linolenic Acid inhibits the actions of certain genes that promote the growth of cancer cells. Linolenic acid is not to be confused with linoleic acid, which is a bad fat that stimulates the growth of cancer cells. This bad fat, linoleic acid, is found in all vegetable oils and nuts (With the exception of coconut oil). Olive oil has the least amount of this bad fat.

Super Miraforte: This herb impairs the synthesis of estrogen from testosterone in the body and is included in the regiments of women with breast cancer.
Licorice Root Extract & Pantothenic Acid: This herb and vitamin are added to the regiment when it is desirable to produce steroid like actions in the body. Also used to help patient’s gain weight and to inhibit the growth of lymphomas and leukemia’s.

Resveratrol: This phytochemical blocks the actions of a number of a number of cancer promoting genes thereby causing cancer cells to enter into apoptosis (cell death) and is included in the treatment of all cancers.

Indole-3 Carbinol & D.I.M.: These two phytochemicals block the actions of both estrogen and testosterone and are included in the regiments of both breast and prostate gland cancer.

Melatonin: Numerous studies show that this hormone blocks the synthesis of the cancer promoting chemicals in the body called Leukotrienes, and is included in the treatment of all cancers.

Artho Pro System: This combination of herbs and phytochemicals inhibits the synthesis of the cancer promoting hormone called Prostaglandin-2 and the Leukotriens and replaces the drug celebrex when liver problems are present. The Prostaglandin hormone is over active in most cancers and stimulates cancer growth. The body manufactures the Prostaglandin hormone from the bad fat, Linoleic acid, mentioned above.

Licorice Root Extract & Pantothenic Acid: This HERB and VITAMIN are added to the regiment when it is desirable to produce steroid like actions in the body. Used also to help patients gain weight and ti inhibit the growth of Lymphomas and Leukemias.

CAAT is designed to attack cancer, while keeping normal cells and tissues functioning harmoniously.

* When considering any type of complementary cancer treatment or alternative cancer treatment, always consult with your physician first, as possible interactions could reduce your regimen’s efficacy.

If this information has generated any questions you would like answered.