Jane McLelland, a Medical Sherlock Holmes or Cubism Painter of Cancer Metabolism Pathway

 Jane McLelland is a physiotherapist, and  a long time cancer survivor. She was diagnosed with stage IV cervical cancer 20 years ago and she beamed her cancer with her wisdom and science. She has mapped the landscape of cancer metabolism  in a new way that everyone can understand. She discovered that ketogenic diet and fasting, diet, nutritional supplements and off label old  low-toxicity drugs, when taken together, as Metabolic Cocktail, acted synergistically, to kill even the toughest cancer. She is regarded as “A modern-day Cancer Sherlock Holmes”. Her most famous contribution is the MetroMap of cancer metabolism. This reminds me of Cubism and Picasso, rather than Holmes. The Cubism revealed in the work of Picasso shows  the breaking down, or analysis, of  complex forms by eliminating the details. She painted the  complicated cancer metabolism pathways in cubism style with simplicity and poetic beauty. 

As a medical oncologist and researcher in cancer stem cells and drug repurposing(or off label), I bought and read her book  How to Starve Cancers, I have to say it is one of best books I ever read and I believe it will change the public opinion on how we should treat cancer in 2020. 

Off Label DRUGS:

“Off-label” means the medication is being used in a manner not specified in the FDA’s approved packaging label, or insert. Off-label of drugs use is the use of FDA-approved pharmaceutical drugs for an unapproved indication. As many as 200 non-cancer drugs have shown  evidence of anti-tumor effects. The most studied drugs are disulfiram, metformin, itraconazole, mebendazole, hydroxychloroquine. cimetidine, nitroglycerin, diclofenac, clarithromycin, and the humble daily aspirin.  Therefore, the use of those medicines to treat cancer will constitute off-label use. Off-label use is generally legal and ethical in the medical community. Physicians are not required to limit prescriptions or recommendations to the indications approved by FDA. In fact the standard of care for many conditions involves off-label uses, either as first-line therapy or as a subsequent line. For example, methotrexate is commonly used off-label because its immunomodulatory effects relieve various disorders. Off-label use is very common. Up to one-fifth of all drugs are prescribed off-label. A 1991 study by the U.S. General Accounting Office found that one-third of all drug administrations to cancer patients were off-label, and more than half of cancer patients received at least one drug for an off-label indication. A 1997 survey of 200 cancer physicians by the American Enterprise Institute and the American Cancer Society found that 60% of them prescribed drugs off-label. Frequently, the standard of care for a particular type or stage of cancer involves the off-label use of one or more drugs.  In her book, How To Starve Cancer, Jane McLelland told us her story of overcoming her terminal cancer by block tumor cell metabolic pathways with off-label drugs and supplements. 

THE GLUCOSE PATHWAYS

Glucose Transporter 1 GLUT1

  • Statins – atorvastatin (Lipitor) 20mg to 80mg QHS
  • Quercetin: 500 mg BID

Insulin

  • Low Glycemic Index Diet or Ketogenic diet
  • Metformin 500 mg BID or TID
  • Berberine, from Chinese medicine; 500mg TID(max 1.5 g /day)
  • Chromium picolinate (CrPic) high 1000 mcg( 1mg) QD or moderate 600 mcg, QD
  • Pentpose Phosphate Pathway (P P Pathway)
  • DHEA (supplement) – Dehydroepiandrosterone 100 mg oral daily. Max 400mg QD

Oxidative Phosphorylation (OXPHOS)

  • Berberine 500mg TID(max 1.5 g /day)
  • Doxycycline 100mg PO QD or BID
  • Metformin 500 mg BID or TID
  • Niclosamide 2 g on Day 1 then 1 g once daily for 6 days. Treatment may be repeated in seven to fourteen days if needed. ALT dosing: 2000 mg daily for 1–7 days. Safe at 500mg TID; Poor tolerance beyond 1000mg TID

Aerobic Glycolysis

  • High Dose IV Vitamin C Salt. Doses vary. 50-100 g IV weekly
  • Dichloroacetate  (DCA ) Recommended DCA daily dose is 20 mg/kg daily per DCA Guide. 5 days on, 2 days off.
  • 2-Deoxyglucose (2-DG ) safe; 63 mg/kg was selected as the clinically tolerable dose from a phase I trial. 
  • 3-Bromopyruvate  (3BP ) N/A dosing

THE GLUTAMINE/AMINO ACID PATHWAYS

Insulin like growth factor-1 (IGF-1)

  • Metformin 500 mg BID or TID
  • Tamoxifen 20mg PO QD

Glutamine oxidative phosphorylation

  • Berberine 500mg TID(max 1.5 g /day)
  • Doxycycline 100 mg PO QD or BID
  • Metformin 500 mg BID or TID
  • Niclosamide 2 g on Day 1 then 1 g once daily for 6 days. Treatment may be repeated in seven to fourteen days if needed. ALT dosing: 2000 mg daily for 1–7 days. Safe at 500mg TID; Poor tolerance beyond 1000mg TID

mTOR (mammalian target of rapamycin or mechanistic target of rapamycin)

  • Metformin 500 mg BID or TID
  • Berberine 500mg TID(max 1.5 g /day)

Macropinocytosis

  • Chloroquine Hydroxychloroquine 200 mg QD or BID
  • Loratadine Claritin 10 mg QD is usual dose; Loratadine 40 mg once daily up to 14 days was effective and safe in clinical trials.

Nucleoside Salvage

  • Dipyridamole (Persantine) 50-100 mg TID; The recommended dose is 75-100 mg four times daily as an adjunct to the usual warfarin therapy. In another trial, aspirin (30-325 mg daily) with dipyridamole 200 mg twice daily for 6 months are safe. Dipyridamole 75 mg TID during the FU administration.

Glutaminolysis

  • EGCG 200 mg TID
  • Ursolic Acid 150 mg QD, BID or TID
  • Curcumin, BCM95 
  • Resveratrol 20-5000 mg daily; Most clinical trials use 500mg or 1000mg QD
  • Asparaginase L-asparaginase; This is a chemo by IV
  • Bis-2-(5-phenylacetamido-1,2,4-thiadiazol-2-yl)ethyl sulfide (Doctor?) – aka BPTES

THE FAT PATHWAYS

Acetate + SREBP-1

  • Berberine 500mg TID(max 1.5 g /day)

ATP Citrate Lyase (ACLY)

Hydroxycitrate 500-1000 mg TID 

Fatty Acid Synthesis (FAS)

  • Metformin  + Aspirin 

Fatty Acid Oxidation (FAO)

  • Doxycycline 100 mg PO QD or BID
  • Mildronate 

Mevalonate + SREBP-2

  • Statins + Dipyridamole