21 October 2020
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Cancer. How close are we to winning the war?

Dr Ross Walker
16 October 2020

When I started my medical degree in the 1970s, a diagnosis of cancer was typically a death sentence. Occasionally, if cancer was detected early, there was some hope for surgical resection. The radiotherapy and chemotherapy used back in those days was rather primitive and certainly often extremely toxic to the body. 

Now in the year 2020, despite significant emphasis being appropriately placed on improved therapies and vaccines for COVID-19, the medical world is closing in on a cure for cancer. Over the past decade, the widespread use of immunotherapy and the somewhat newer CAR-T therapies & their spinoffs have revolutionised the treatments of many cancers including haematologic cancers, such as leukaemia and lymphoma but also the common solid tumours such as breast, prostate, colon, lung and melanoma, to name a few.

One of the issues with cancers is that they form a shield around individual tumour cells making them almost invisible to the immune system. Many of the newer immunotherapies help break down the shield, allowing the body’s own immune system to attack the tumour cells.

One of the best group of tumour killing cells in the immune system are T cells known as Tumour Infiltrating Lymphocytes (TILs). Although these are probably the best soldiers of the immune system, once they enter the battlefield of the tumour micro-environment they are disabled by many of the stressors present in this situation. All cells, whether they be our own naturally occurring cells or those of tumours that have formed in our body, require a supply of nutrients and oxygen to function correctly. 

Thus, when a TIL enters a tumour to do its work, it is competing with the tumour for local nutrients and oxygen. The tumour being extremely greedy steals these nutrients leading to a reduction in the function of a component of all cells known as the mitochondria. Mitochondria are the fuel supply of the cell creating energy for the cell, allowing it to do its work and exist. If we deprive the mitochondria of nutrients, the mitochondria are converted into a sluggish state known as terminal exhaustion. Also, when the T cell’s mitochondria are starting to age, there is a natural process that breaks down the cells and replaces them with younger, healthier T cells to continue the job of trying to destroy any tumours that are present.

The function of any living cell, including T cells and tumour cells, is to survive. Cancer cells create particular antigens which stimulate a protein known as PD-1, which suppresses the T-cell response. Thus, when you have  cancer, there is this constant battle being waged inside your body between your own immune system and the tumour.

Now for the good news. Scientists from the US have discovered that a commonly used supplement for anti-ageing known as NAD-riboside enhances mitochondrial function in these failing T cells and allows them to recharge themselves to enhance their attack against tumours. When NAD-riboside was added to specific immunotherapy drugs, this significantly inhibited the growth of a variety of tumours in mice.

Professor David Sinclair from Harvard University has pioneered the use of NAD-riboside for anti-ageing demonstrating that this is a safe and effective  supplement, prolonging the life of laboratory animals by 20%. Prof Sinclair has also demonstrated the same anti-ageing markers in human beings. There now appears to be another feather in the cap for this safe and seemingly effective supplement, which may become standard care to be added to all new cancer therapies.

A word of caution in that this has not been trialled in humans as additional therapy but, many people, including myself, already take NAD-riboside or a related supplement e.g. NMN; NAD plus, as a potential anti-ageing therapy. I have been saying for a number of years that vitamin B3 and its variety of analogues such as NAD-riboside are a vital part of good health. This is yet more evidence to support these claims. Although we have not achieved a cure for cancer in 2020, we are certainly edging closer.

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