Life Extension Magazine February 2008
Coenzyme Q10 and Cancer
Enhancing Treatment Outcomes and Improving Chemotherapy Tolerability
By Julius Goepp, MD
Frustratingly, and often tragically, compelling data from animal studies is only slowly translated into human clinical trials—arguably at considerable cost in human suffering. This has been the situation with CoQ10 until quite recently. In fact, Life Extension enlisted a ‘call to action’ in early 200624 for increased support of human trials using various doses of CoQ10. Fortunately, that call has been heard, and convincing data from properly conducted human trials are now emerging.
Several small human trials were conducted in the 1990s, but with a regrettable lack of enthusiasm in the medical community.25 For example, the immune-stimulating powers of CoQ10 were explored by the same Austin biochemists who later attained prominence as a result of their fundamental work with the nutrient.26 When they gave CoQ10 and vitamin B6 (pyridoxine) to human subjects and measured levels of immunoglobulin G (an important antibody protein in the human immune system), they noted significant increases. Intriguingly, they also found that blood levels of the “T4-helper” cell line also increased, as did the ratio of T-helper/T-suppressor cells, indicating a significant boost in subjects’ immunologic protection against viruses and the abnormal cell surface markers associated with cancer.
In 1994, partial remission of breast cancer was noted in a group of patients in Denmark following their supplementation with CoQ10 along with other antioxidants and essential fatty acids.27 In this groundbreaking study, 32 women with breast cancer categorized as high risk, because of the spread of their tumor to the lymph nodes, took supplements of vitamins C and E plus selenium, essential fatty acids, and CoQ10 (90 mg/day). The researchers took this “combinatorial” approach using their knowledge that multiple factors act synergistically to initiate and promote cancer growth. Based on this principle the researchers hypothesized that the synergistic effects of multiple components should also be tested to evaluate their anticancer effects together. All patients in this study had already undergone surgery but were known to have residual tumor remaining. Dramatically, there were zero deaths during the study period, despite an expected mortality rate of four patients. No patient showed signs of developing new metastases, and all patients reported an improvement in the quality of life.
Still more remarkably, in that same Danish study, was the finding that six of the 32 women actually showed partial tumor regression (that is, not only did remaining tumors not grow, but they actually became smaller). Encouraged, the researchers increased the daily dose of CoQ10 in one patient to 390 mg—a month later, she had no tumor detectable on physical examination, and by the end of the following month, the tumor was entirely gone on her mammogram. The investigators then raised the dose in a second patient as well—the researchers reported that, “after three months, the patient was in excellent clinical condition and there was no residual tumor tissue.” Concluding this stunning report, the scientists noted that CoQ10’s “bioenergetic activity” (that is, its ability to protect cells from oxidant damage and to make more energy available for healthy function) may be the dominant mechanism causing these dramatic regressions of breast cancer.28
The Indian researchers in Madras also took their knowledge and skills from the laboratory to the bedside with definitive studies of CoQ10 in human cancer patients, publishing their results in 2007.29,30 They began their work with the established observation that it is the tumor metastasis, not the primary cancer, which is the cause of death in breast cancer patients. Find a way to prevent metastasis or at least slow its progression, the researchers reasoned, and one might dramatically improve outcomes for breast cancer sufferers. To test their hypothesis, they conducted two studies among a group of 84 breast cancer patients, randomly assigning them to receive a placebo or daily supplements with 100 mg CoQ10, 10 mg riboflavin, and 50 mg niacin. All patients were treated with tamoxifen as the primary chemotherapy drug as well.
In the first study, the researchers measured tumor markers, the blood proteins that reflect the degree to which a tumor has progressed and potentially spread.29 Once treated with tamoxifen, levels of tumor markers dropped significantly, as was expected. But patients treated with the CoQ10-containing supplement had still larger decreases in their tumor marker levels. From this work, the researchers concluded that the CoQ10-containing supplement “reduces… the risk of cancer recurrence and metastases.”
Not content with examining just one measure (tumor markers) of the effects of supplementation, the research group proceeded to examine the ways in which supplementation affected the various immune and tumor regulation system components that can contribute to the spread of cancer.30 Focusing on cytokines, the potent inter- and intracellular chemicals that signal inflammation and promote or allow the spread of cancer, the researchers obtained blood samples from the same 84 patients in the previous study. They also measured levels of vascular endothelial growth factor (VEGF), a tumor-promoting protein that cancer cells use to grow blood vessels. Lowering levels of all of these tumor-enhancing chemicals is a crucial step in slowing or preventing tumor spread. Again, the results were unambiguous—supplemented [CoQ10, riboflavin, and niacin] patients had significantly reduced levels of all the cytokines and VEGF, compared with those treated with tamoxifen only. Powerfully, the scientists concluded that, “such a decrease in serum cytokine levels after [CoQ10, riboflavin, and niacin] supplementation in breast cancer patients may suggest good prognosis and efficacy of the treatment, and might even offer protection from metastases and recurrence of cancer.”
These dramatic findings all point to CoQ10’s versatile immune-enhancing and tumor-reducing powers in breast cancer. But what about other, even more resistant cancers? Given the vital role of the immune system in keeping patients cancer-free after treatment of all kinds of tumors, researchers in Rome studied immune-boosting treatments for patients with one of the most deadly and treatment-resistant cancers, malignant melanoma.31 Early and aggressive surgery has been the mainstay of treatment for this deadly form of skin cancer.32 The addition of treatment with immune-boosting cytokines such as interferon-alpha and interleukin-2 has slightly improved survival but at the cost of significant side effects.33 The Rome researchers had noted that melanoma patients have low levels of CoQ10, and reasoned that the addition of the nutrient to interferon therapy might enhance its success while reducing side effects. They conducted a three-year trial of uninterrupted treatment with low-dose interferon-alpha only, or with the addition of 400 mg/day of CoQ10 in patients with early melanoma following surgical removal of the tumors. They followed the patients all the way out to 5 years following treatment. Remarkably for such a lengthy study, no patient withdrew from the trial as a result of side effects. Most importantly, the disease progressed much more slowly in the interferon plus CoQ10-treated patients, who also had a significantly reduced rate of recurrence of the tumors than the unsupplemented group.31
One of the reasons that cytokine levels are elevated in cancer patients is the powerful inflammatory response produced in normal tissues by the tumor—and, as we’ve seen, the inflammatory response is itself involved in the growth and spread of new tumor tissues. Unfortunately, many cancer chemotherapy agents produce inflammation, often as a result of the intentional oxidant damage they inflict on tumor cells and their components. Despite its beneficial effects in the treatment of breast cancer, tamoxifen is notorious for imposing oxidative stress and increasing markers of inflammation. It also disrupts patients’ lipid profiles, elevating low-density lipoprotein (LDL), triglycerides, and total cholesterol, while lowering the protective high-density lipoprotein (HDL). The Madras research group therefore set out to determine how CoQ10 affects antioxidant status and lipid profiles, reasoning that some of its benefit might be the result of restoring balance to these fundamental parameters.34,35
Not surprisingly, untreated breast cancer patients were found to have increased lipid levels and elevated levels of inflammatory oxidized fats. Treatment with tamoxifen had only a limited impact on oxidative stress, and also induced a severe elevation of triglycerides (fat molecules) in the patients’ serum. When the researchers added CoQ10, riboflavin, and niacin supplementation, however, levels of oxidized fats fell dramatically, with a concomitant increase in antioxidant levels.34
Remarkably, the tamoxifen-induced disruptions in the lipid profiles also responded to CoQ10 combination therapy. All of the lipid profile abnormalities reverted to near-normal levels after 90 days of treatment with the combination (tamoxifen plus CoQ10 and other nutrients) therapy.35
Perhaps even more feared than the diagnosis of cancer itself are the horrendous side effects associated with chemotherapy. New discoveries show that coenzyme Q10 not only helps prevent healthy cells from undergoing malignant changes, but also protects against chemotherapy side effects and inflammatory damage inflicted on the body by cancer cells.
Coenzyme Q10 celebrated the 50th anniversary of its discovery in 2007. For most of its “lifetime” in human biology, it has been seen only as a nutrient related to cellular energy metabolism and has therefore been best known for its beneficial effects on heart muscle and brain tissue.36,37 In recent years, CoQ10 has found vast new roles in maintaining health and prolonging life. •
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