Dr. Nagourney's Blog

Life Imitates Art in Treating Glioblastoma: Was Dr. McCoy Right?

By Robert A. Nagourney, MD

Star Trek aficionados will remember Dr. Leonard H. McCoy played by DeForest Kelley who served as the original USS Enterprise ship physician. “Bones” as he was affectionately called by Captain Kirk had a collection of advanced medical devices for diagnosis and treatment.

Among them was a handheld medical scanner, a surgical support frame that assisted during surgery and a medical diagnostics bed. Some of these futuristic instruments have actually come to be, like Dr. McCoy’s hypospray that delivered injections without a needle. Now we may be witness to another of Dr. McCoy’s miracle devices moving into contemporary medical practice.  

In 2015 the FDA approved a technology for the treatment of advanced glioblastoma multiforme (GBM), the most lethal form of brain cancer. To date, surgery, radiation and chemotherapy have had only a modest impact on survival.

An Israeli group then developed a device that delivers alternating electrical fields to the brain with an instrument that is applied directly to the scalp. The combination of tumor treating fields (TTFs) with the widely used chemotherapy drug Temozolomide (Temodar) provided a significant improvement in time to progression and survival for patients with recurrent disease. 

The findings are of interest as electrical field therapy is truly a novel approach to cancer.

These TTFs appear to disrupt cellular division and are selective for actively dividing cells. The effects depend not only on the intensity of the field, but also on the cell’s spatial orientation along the so-called mitotic axis (the line along which the chromosomes are separated). Interestingly the treatments appear virtually nontoxic. 

Several questions arise.

Is the efficacy limited to brain tumors and their dependence on electrochemical signals (neurotransmitters) or could it be generalized to other parts of the body such as an extremity or the breast? Do we truly understand how electromagnetic fields influence cancer cells? And, does this have implications for other forms of electromagnetic exposure? 

While highly focused, intensive electrical fields appear to be quite different from the low levels associated with environmental phenomena, is there a continuum from chronic low level exposures to these higher intensity TTF therapies? 

The findings are also of interest as they reflect on our understanding of human cancer biology at the level of biochemistry and biophysics, well beyond current efforts to interrogate cancers at the genomic (DNA) level. Biology reflects chemistry and chemical reactions occur when electrons are transferred from one molecule to another. 

Many processes in cancer occur when phosphate groups are attached to enzymes causing reactions that act like on/off switches for the cell. Might TTF electrical impulses influence these reactions?

Could these electrical impulses influence the energy center of the cell, the mitochondrion, and disrupt the very process of cellular energy production? 

The fact that electrical fields can induce cell death supports the concept that cancer is an electrochemical phenomenon.

This could open entirely new fields of therapy.

Changing mitochondrial function with electrical impulses may be similar to newer classes of drugs that chemically effect mitochondrial energy production. This serves as the basis of the new field of metabolomics that offers such brilliant opportunities for future therapies. 

I do not recall the Star Trek episode in which Dr. McCoy said “Damn it Jim, I’m a doctor, not an electro physiologist” but in retrospect it seems appropriate.

In 2016, we may be seeing the glimmer of therapeutic interventions that Gene Roddenberry originally predicted for 2265. Perhaps we can close that gap in time with breakthroughs like these. 

As always, I appreciate your thoughts and comments.

 

Dr. Robert Nagourney, has been internationally recognized as a pioneer in cancer research and personalized cancer treatment for over 20 years.  He is a TEDX SPEAKER, author of the book OUTLIVING CANCER, a practicing oncologist and triple board certified in Internal Medicine, Medical Oncology and Hematology helping cancer patients from around the world at his Nagourney Cancer Institute in Long Beach, California.  For more info go to NAGOURNEYCANCERINSTITUTE.COM