The following is an excerpt from the book Defeat Cancer: 15 Doctors of Integrative and Naturopathic Medicine Tell You How, by Connie Strasheim. The book is 439 pages and retails for $39.95; it is available from BioMed Publishing Group by calling 530-573-0190, or online at www.CancerBookSource.com. The book was published in May 2011. You may request free informational book flyers on our website.

This excerpt is from Chapter 5, based on our interview with Juergen Winkler, MD, of Oceanside, California. The chapter contains important parts of Dr. Winkler’s integrative cancer treatment protocol (please note: this is not the complete version of Chapter 5, and some areas of Dr. Winkler’s treatment protocol are not included in this excerpt).

Excerpt from Chapter 5 of Defeat Cancer: 15 Doctors of Integrative and Naturopathic Medicine Tell You How

Biography: Juergen Winkler, MD

Juergen Winkler, MD, is board certified in family medicine. He completed his medical training at San Bernardino County Medical Center in 1991, and subsequently spent four years in the Air Force at two different bases. At KI Sawyer Air Force Base, he was chief of the primary care clinic, where he improved patients’ access to, and the delivery of, medical care within the hospital. Additionally, he managed its allergy and immunization clinic and also directed a headache clinic. After leaving the Air Force, Dr. Winkler went into private practice in Carlsbad, California, for two years, after which time he began an eight-year career in home care, where he made over 12,000 house calls to homebound geriatric patients in San Diego County. Since 2005, he has been working with Les Breitman, MD, in private practice at Genesis Health Systems: An Integrative Cancer and Medical Treatment Center (formerly called the Alternative Cancer Treatment Center of Southern California).

Dr. Winkler has maintained an interest in alternative and complementary medicine since medical school, and in 1996 he joined the American College for the Advancement in Medicine. He is also a member of the American College of Osteopathic Pain Management & Sclerotherapy Inc. He has special training in chelation therapy, insulin potentiation therapy (IPT) for cancer treatment, and mesotherapy for pain management. His treatment approach is based on nutrition, heavy metal detoxification, and immune system enhancement. In addition, he treats hormonal conditions associated with menopause, hypothyroidism, and andropause.

Treatment Approach

We focus upon treating patients individually, and addressing the particular characteristics of their cancers, as well as their ability to detoxify. This includes stimulating the immune system to help it recognize cancer, and reducing blood flow to tumors (inhibiting angiogenesis). These, as well as other aspects of our treatment approach, are covered more in depth in the following sections.

IPT – Insulin Potentiation Therapy

Insulin Potentiation Therapy is a simple medical procedure that uses the hormone insulin, followed by chemotherapy and glucose, to make chemotherapy drugs more effective, in smaller doses, with few to no side effects.

There are no double-blind, placebo-controlled, university-based, FDA, or pharmaceutical company-funded studies for IPT, or many of the other treatments that we do at our clinic. IPT was basically developed as a result of several doctors who better understood cancer physiology and how the body works, and who felt they could treat cancer patients with less toxic methods than what’s found in conventional medicine.

A Mexican doctor named Donato Perez Garcia, MD, was the first to notice that insulin, when combined with certain medications and nutrients, was useful for treating various health conditions. For instance, he and his son, also a doctor, found that insulin, when combined with low dosages of chemotherapy, was very effective for treating cancer patients. Their results were impressive and they presented their data to the National Health Institute (NIH) in the early 1960s. The NIH promptly shelved the information and has since made it difficult for physicians to get funding to study the effects of IPT. Since then, a growing international organization has been developed, which teaches IPT to interested physicians.

In order to understand how IPT works, it’s important to first explain cancer cell physiology and compare it to that of normal cells. Cancer cells have six times as many receptors for insulin on the surface of their membranes as normal cells, and ten times as many IGF-1 factors, or Insulin Growth Factor-1 receptors. Insulin stimulates growth and the uptake of glucose into the cells for energy. It also transports amino acids and vitamins into the cell. Cancer has a high metabolism, and must feed itself. It prefers sugar and simple carbohydrates since it doesn’t metabolize fats and proteins very well.

One reason we know that cancer cells have a higher than normal metabolism is because of PET scans, which reveal areas of increased metabolic activity in the body. These scans essentially involve injecting labeled sugar molecules into the body, which are then detected by scanners once they are inside the body. The sugar molecules go to areas of increased metabolic activity, which happen to be where the cancer is. To further understand how this works, consider the following example: Let’s say you have a cage with a bunch of hamsters that are sleeping or crawling around, with the exception of one, which is very active, running on a wheel and burning a lot of calories. The active hamster represents a metabolically active tumor in a body of normal cells (which are the sleeping and crawling hamsters). Thus, tumor cells are more sensitive to sugar because they need more glucose for producing energy. So they pick up sugar by means of insulin, a lot faster and more aggressively than normal cells do.

When doctors drop their patients’ blood sugar levels by giving them insulin, it creates a state in the body, called a therapeutic moment, in which the body elicits the release of adrenaline (epinephrine). This causes patients to feel hot, sweaty, and drowsy. When adrenaline and insulin are mixed together in a low blood sugar state, cancer cells and other inflamed cells become much more receptive to whatever substances are introduced to them through an IV, including chemotherapy. This means that doctors can give much lower doses of chemotherapy to their patients, and their effects will be greatly enhanced, or potentiated, by the insulin. Only one-tenth of the full chemotherapy dose is needed to obtain effective results, and it can be administered in a much shorter period of time than regular chemotherapy. In order for IPT to be effective, the patient’s blood sugar levels must be dropped to 30-40 mg/dL (the normal range is 65-99 mg/dL). Despite this, the procedure is thoroughly safe. People do get a bit groggy, but after a while they get used to it, and after the procedure doctors can quickly restore their low blood sugar back to normal by giving them an infusion of glucose.

Chemotherapy Sensitivity Testing

Two patients with the same type of cancer can be sensitive to a whole different array of chemotherapeutic agents, so instead of grouping all of our patients together and giving them all the same agents, we do chemotherapy sensitivity tests. These determine the specific chemotherapy agents that their tumor cells may best respond to. There are two labs that we use for this purpose; one is in Greece, the other is in Germany. The lab in Greece is called Research Genetics Cancer Center (RGCC). Here, they extract circulating tumor cells from patients’ blood samples, culture them out, and then expose them to different chemotherapeutic agents. Results are then calculated according to the percentage of cancer cells that are killed by the agents, which may be 50 or 80 percent of a culture – or none. Then they choose the agents that the cancer cells have the highest response rate to and recommend that these be used for treatment. The labs can also provide comprehensive information on the genetic makeup of people’s cancers, which helps us determine appropriate therapies for our patients. Once we have this information, ideally, we will put together two different treatment regimens for each of them, with each regimen consisting of three different medications, which we alternate. The purpose of doing this is to reduce the cancer cells’ resistance to the drugs. It takes ten days for the results of the Greek test to come back. Another advantage of this test is that only a blood sample is required to do it, rather than tissue from the tumor itself, so unlike some types of chemotherapy sensitivity testing, it’s safe to use in those with metastatic disease.

Most doctors in the United States won’t even look at this type of testing, though. But those that do, find it helpful, and are discovering that drugs that most doctors ordinarily wouldn’t even think of using to treat certain types of cancer are effective for those cancers. For example, many conventional doctors use a drug called Gemcitabine to treat pancreatic cancer, but the RGCC test demonstrates various breast cancers to also be sensitive to this agent, and recent breast cancer studies confirm this. We use agents that aren’t commonly prescribed to treat certain cancers and yet we find that they work.

So not only have we been able to figure out how to best treat our patients through chemotherapy sensitivity testing and the IPT process, but we have also figured out strategies to make treatments more tolerable for them.

Additionally, we use a bioresonance device called the ASYRA on our patients, which detects areas of stress in the body, even before those areas of stress manifest as symptoms. We have found a strong correlation between the chemotherapy agents that patients test positive for with the Asyra, and the ones that they test positive for on the RGCC test. So the results that the ASYRA provides help us to determine useful chemotherapy agent combinations for our patients. The medical community needs to learn more about devices such as the Asyra, but they thus far appear to be quite useful.

Pre-Chemotherapy Nutritional Protocol

In addition to IPT, we give our patients pre-chemotherapy nutritional IVs, comprised of nine nutritional supplements, which we administer prior to IPT. These substances make the chemotherapy more effective by keeping the drug(s) in the cells longer. They also prevent the cancer from repairing itself after it has been damaged by chemotherapy, and reduce its resistance to the chemotherapy. Also, while the pre-IPT nutritional IV is intended to have its greatest effects at the site of the cancer, it has the additional benefit of boosting the immune system at the same time.

One of the substances that we use in the pre-cancer nutritional IV is glutamine. We give patients this amino acid both orally and intravenously before they start treatments. Other substances that we include in the IV are L-arginine, L-proline, resveratrol, quercetin, niacinamide, acetyl-L-carnitine, and L-theanine. We also give a green tea extract known as EGCG. Each one of these substances has a different effect upon the cancer and patients’ symptoms. For instance, acetyl-L-carnitine reduces brain fog and glutamine boosts neutrophil, macrophage and other immune cell counts and is a source of food for them. Glutamine has additional anti-cancer properties, and protects the GI tract against the side effects of chemotherapy.

A lot of oncologists struggle to overcome the MDR-1(multi-drug resistance-1) gene in cancer. This gene codes for a pump in the cancer cell called the Pgp pump, which removes chemotherapy drugs from the cell. Nutrition can inhibit that pump and thereby reduce the cancer’s resistance to chemotherapy.

We used to have patients who would become resistant to their chemo drugs somewhere between their eighth and tenth treatments, and we found that if we switched their drugs from time to time and did pre-chemo nutritional IVs, we got better results. So now we rotate their drug regimens, and use three different chemotherapy drugs at a time, so that their cancers don’t have a chance to develop resistance to them. Since we have employed these strategies, it now takes 16–25 treatments before patients might become resistant to their treatments. Drug resistance is something that all IPT practitioners, as well as traditional oncologists, must address.

Tailoring Treatments to the Individual Patient

Whether or not we recommend IPT depends upon the patient that we’re treating and the type of cancer that they have. For instance, we may recommend that a twenty-year-old with lymphoma see a conventional oncologist, because conventional medicine tends to have good results with lymphomas, leukemia, and testicular cancers. Lymphoid tissue replicates quickly and responds well to full-dose chemotherapy, so doctors can get away with using higher dosages of medication for this type of cancer. For an 80-year-old with ovarian cancer, which isn’t a very metabolically active cancer, we may recommend IPT treatments once per week, or even less frequently, since older patients aren’t as metabolically active and therefore, their cancers don’t replicate as quickly.

As another example, recently, we had a patient come to our clinic who had just been released from the hospital. She had lost forty pounds over the course of six weeks. We wouldn’t immediately give this kind of person chemotherapy until we figured out what her nutritional status was. We know that patients who have a weakened antioxidant and nutritional status are set up for failure in their treatments. If we were to give this woman low-dose chemotherapy through IPT, she would wind up in the hospital for a blood transfusion, because she would be too weak to tolerate the chemotherapy, even at lower dosages. Considering patients’ unique situations helps us to determine appropriate treatment protocols for them.

Determining whether IPT treatments are effective for our patients is also very important, so we do a PET/CT scan on them after they have done six weeks of therapy. We also measure their tumor markers on a weekly basis, and observe the trend in the markers, which helps us to discern their response to treatment.

Conventional Chemotherapy versus IPT

When patients’ cancers respond well to conventional medicine, as in cases of leukemia, lymphoma, or testicular cancer, we refer them to a conventional oncologist. We will continue to see them to give them nutritional support, which helps them to get through their conventional treatments and also reduces the side effects of those treatments. We can do IPT for these cancers too, but the IPT organization of doctors as a whole supports conventional treatment for certain types of cancer. IPT does work on most types of cancer, though, so we will use it on patients with the above-mentioned cancers if they prefer to not receive conventional care.

When chemotherapy is given in smaller, gentler and more frequent doses we have observed that patients respond well with fewer side effects than if they had done full-dose chemotherapy. Some patients that have stopped conventional care due to its side effects have re-grown their hair while undergoing IPT. We, along with other IPT doctors, have also observed that patients have less deterioration in their quality of life than if they had done conventional treatments.

The kinds of people who walk through our door are generally very educated and don’t want conventional care, anyway. Many others have already been through conventional care. Either the side effects of their conventional treatments were intolerable or they didn’t respond to the treatments. They are the type of people who make their own decisions regarding treatment (rather than allowing someone else to dictate what they should do), so we don’t usually have to discuss whether IPT or conventional medicine is best for them. We don’t participate in any insurance plans, so patients don’t get assigned to us for treatment. They are here because they want to be here. We are a cash-based practice and most doctors who do the type of treatment that we do are also cash-based, because IPT is generally outside of the health insurance system. People look for us; we don’t look for them. They call us because they don’t want conventional treatment. At times, I may suggest that they see an oncologist to see if they can offer them an effective treatment option that we might be unaware of or unable to provide, and I have no qualms about making such referrals. I have no animosity towards mainstream medicine. I just prefer to do things “outside of the box.” Fortunately, I believe that IPT may become a mainstream type of treatment as more and more people become aware of its benefits.

Treating Hormone Imbalances

It’s important for us to treat our patients’ hormone imbalances, especially if they have hormonally-driven cancers, such as of the breast, prostate, ovaries, and uterus. To determine hormonal status, we do 24-hour urine tests, which provide us with a comprehensive breakdown of the body’s hormone levels, and clues about what we need to do to treat them. If women have hormonally-driven cancers, it’s important that we get their estradiol (and some of their other hormones) into a less proliferative state. Estradiol is one of three types of estrogen that the body produces which contributes to cancer growth. Estriol, or E-3, is a less proliferative hormone than estradiol, E-2. E-2 is a great hormone for females to have at age thirteen when they are becoming women, but women in their 50s and 60s need more estriol, not estradiol.

Unfortunately, we live in a society where all of the chemicals and toxins that we are exposed to, such as phthalates and Styrofoam (polystyrene), are mimicking and creating more estradiol in our bodies. As a result, men are becoming more feminine, gaining weight, developing insulin resistance, and getting bigger chests. The chemicals which are stored in their fat are estrogen-aggravating, which perpetuates the problem. Women face similar problems as a result of excess estrogen. Also, estrogens interfere with thyroid function, so the thyroid becomes more sluggish, and in turn makes the rest of the body more sluggish. Then the liver can’t process all the estrogen and the result is a condition of estrogen dominance in the body, which worsens insulin resistance and creates a tendency for people to put on weight. This then creates even more problems in the body. For example, when women become overweight, their bodies produce more testosterone, which leads to polycystic ovarian and masculine-type problems, such as facial hair and acne.

Doris Rapp, MD, an environmental doctor who has written several books and who is still practicing in Arizona, said at a recent conference that there is such a pollution problem in some of the lakes in England that some of the male fish are now carrying eggs! The male fish are no longer male fish.

Excess estrogen not only has an effect upon cancer, but upon the immune and nervous systems, as well. We have a model that we use in our practice; a triangle diagram, which illustrates the integration and interrelationship between the nervous, hormonal, and immune systems. The nervous system sits on the top of the triangle, the immune system sits off to the right, and the hormonal system is on the left. We address and treat imbalances in each one of these systems so that they work together better as a whole.

The body’s hormonal system is based primarily on the thyroid, adrenal gland, and sex hormones. It’s important to make sure that all of these hormones are functioning properly, because they affect cancer growth and patients’ overall health. We have many patients who have low thyroid and adrenal function, and their sex hormones are also in disarray. So, for example, we may look at their thyroid function and treat them for hypo- or hyperthyroidism based on their body’s basal temperature and symptoms, not just their test results. If patients have a body temperature of 96.8, are freezing cold, and have a pulse of 50 bpm, but their thyroid tests are normal – sorry, I don’t think that their thyroid function is normal! If I give them thyroid hormone and they perk up, then it means that they had a thyroid problem, regardless of what their blood tests showed. It’s because blood tests can be inaccurate that we prefer to diagnose based on the body’s temperature and functioning.

When we do use thyroid tests to support a clinical diagnosis, we don’t just look at T4 values, but also free T3, free T4, and reverse T3. It’s important to properly balance all of these levels. We don’t give thyroid hormone to people who have depleted adrenal glands, though, because then their livers will metabolize cortisol that’s produced by the adrenals too fast, and they will get tired. So we first support their adrenal glands with adrenal glandular extracts, homotoxicology formulas, and products such as AdreCor, by NeuroScience, which contains various vitamins, amino acids, and the adrenal-balancing herb Rhodiola rosea. One liquid glandular formula that we use is called CF Support, by Xtra-Cell, which contains proteins and peptides, as well as other growth factors and signaling molecules from porcine adrenal and mesenchyme tissue (the latter is a type of loose, connective embryonic tissue). We use a lot of other agents for adrenal and thyroid support, as well.

Treating Immune System Imbalances and Infections

We don’t just do tests to determine the status of our patients’ cancers and hormones; we also look for any other problems that might be impacting their health. Through additional testing, we often find that we need to detoxify them and clean up their immune systems. For instance, in the early stages of treatment, we measure their inflammatory mediators, such as cytokines, to determine what’s causing the inflammation in their bodies. We check the status of their immune cells, to see what, for example, the T-cells and natural killer (NK) cells are doing. We want their immune systems to be active and balanced, and will prescribe remedies to accomplish that. Many patients have chronic infections that weaken their immune systems and impair their ability to effectively fight cancer.

The immune system is comprised of cells that are divided into two types; Th-1 and Th-2, the ratios of which should be balanced in the body. Basically, the body starts off with a Th-0 cell, which eventually differentiates to become a Th-1 cell or a Th-2 cell. These further differentiate to make lymphocytes, B cells, and T cells, among others. Understanding immune cell differentiation is complicated, but basically, there should be balanced numbers of all the immune cells in the body. We can determine what might be affecting the immune system based on the body’s balance of Th-1 and Th-2 cells. We then use a whole array of supplements to balance and activate the immune system, including homeopathy and homotoxicology remedies from GUNA and Heel, which are very helpful for this purpose. If necessary, we complement our cancer treatments with these agents.

Another remedy that we use a lot of is AVE (also known as Avemar), which is fermented wheat germ, to boost NK activity, because NK numbers tend to be low in people with cancer. AVE also keeps cancer from taking up sugar, and thereby prevents its growth. It has a lot of other beneficial properties, as well.

Intravenous germanium is another substance that we sometimes give our patients. This is an immune balancer that stimulates Interferon gamma (a cytokine that’s critical for innate and adaptive immunity against viral and intracellular bacterial infections and for tumor control), reduces cancer pain, and stimulates oxygen delivery to tissues. We also use herbal supports, such as ginkgo biloba, green tea extract, marshmallow, and slippery elm. These herbs support the gut, and thereby, immune function.

In addition to supporting the immune system with nutrients, we also look for other chronic diseases that our patients might have in addition to cancer, because these weigh down the immune system. For instance, some people have chronic mycoplasma and get fevers every night. Others have Lyme disease and we have to treat them with antibiotics, or natural remedies that include homotoxicolgy formulas, which we can also do as part of their IPT treatments. By using IPT to treat infections, we are able to kill two birds with one stone, because IPT makes treatments for Lyme and other chronic infections more effective, too.

To determine which infections might be playing a role in our patients’ diseases, we do tests that expose their cells to different fungi, bacterial or viral antigens, to see how they respond, which then gives us clues about what else might be triggering an immune system response. From the results of this testing, we may order more tests; a Lyme disease or stool test, for example, to see specifically why the immune system is reacting in an unbalanced manner. We find that many patients have Epstein-Barr, herpes, and cytolomegaloviruses, as well as other chronic viruses. In addition, some may have Lyme and mycoplasma infections, which are sometimes re-activated in the body by chemotherapy. If they have active viruses, then they usually also have heavy metal toxicity, which further weakens the immune system. Treatment at this point can become complicated, because if they have infections and heavy metal toxicity, then they also tend to have methylation and other detoxification problems. All of these issues must be addressed if they are to fully heal.

Balancing Brain Chemistry

The brain, like the immune system, has its own balancing mechanisms, which can be categorized as excitatory and inhibitory. The inhibitory mechanisms put the body to sleep; the excitatory mechanisms keep it awake and functioning during the day. It’s not good to have too many excitatory mechanisms without enough inhibitory ones and vice versa, because otherwise, people would be manic or in a coma! Most of our patients are running – to quote a colleague, Denise Marks, MD – “an SUV life on a mini coupe gas tank!” They run on “empty,” which means that they have no inhibitory-supporting neurotransmitters such as serotonin, so their mood is down, and neither do they have enough excitatory neurotransmitters, so they have no energy. From urine tests, we can obtain information on our patients’ brain chemistry, and then determine which amino acids will correct their neurotransmitter deficiencies. Green tea with L-theanine, for example, keeps people calm and has anti-cancer effects. Supporting the body’s serotonin levels, with a combination of mainly 5-hydroxy tryptophan, zinc, B6, and other vitamins, helps patients to maintain a positive mood and good quality of sleep. Serotonin also helps to activate the rest of the brain; it’s the gateway to the entire functioning of the brain and its chemistry. Balancing the hormones also has a positive effect upon brain chemistry.

Other Tests and Treatments to Heal and Support the Body

One test panel that we do is based upon a recent lecture that I attended, entitled “Cancer Is a Chronic Disease,” which was given by a nutritionist at the Institute of Functional Medicine. This nutritionist stressed the importance of checking hemoglobin A1-C levels to monitor patients’ glycemic control on their diets, as well as checking fibrinogen, C-reactive protein, and free copper and zinc levels. Testing copper to zinc ratios is important, as well. Most people with cancer have an excess of copper, and not enough zinc, and excess copper stimulates tumor blood vessel growth. So we prescribe different supplements to deal with each of these imbalances: Nattokinase for elevated fibrinogen levels, for example. To reduce inflammation, we treat infections and also use a hops derivative known as Kaprex, by Metagenics.

We also do high dose Vitamin C and K-3 IVs, and detoxification therapy using phenyl-butyrate. Vitamin C appears to a cancer cell as a sugar molecule and is quickly taken up by the cancer. Once the Vitamin C connects with an iron molecule in the cell, peroxide is released, which injures the cells internally. Cancer cells have a difficult time repairing from such damage. Vitamin K-3 augments the effects of Vitamin C and helps to inhibit cancer growth.

Phenyl-butyrate is a derivative of the short-chain fatty acid butyrate, and is thought to have anti-neoplastic activity as well as the ability to assist with cancer cell destruction. It can be given intravenously as part of IPT treatments or a detoxification protocol.

Finally, many of our patients have low Vitamin D levels, so we often prescribe 10,000–15,000 units of Vitamin D per day, along with ox bile and other enzymes to help digest fat, if they have trouble digesting these fats (since Vitamin D is fat-soluble). Some patients have a poor antioxidant status, as a result of not being able to digest fats and proteins (and hence their nutrients), so we add enzymes to their regimens which aid in protein and fat digestion. We also give them antioxidant support in the form of supplements. We have to literally restore everything in their bodies while they are being treated for cancer, and this can’t usually be accomplished in a short amount of time. Thus, we must prepare them for the possibility of doing treatments with us for an extended period of time, perhaps many months.

In summary, we look at different parameters in our patients, and if we can improve those, then it makes their bodies into a more hostile environment for cancer. We have a regimen of supplements that we prescribe, which depend upon their test results and symptoms.