Supplements play an important role in improving quality of life.
By RICK SHALVOY, with narrative contributed by STEPHEN SINATRA, M.D., F.A.C.C.
I used to think that a conventional doctor was a doctor who attends a lot of conventions. By the time I finally understood the difference between a conventional practitioner and an “alternative” practitioner, the next phase in the evolution of language tinkering had already begun to appear on the horizon.
Enter CAM, the now widely used acronym for “Complementary and Alternative Medicine.” I am not a big fan of hybridized labeling when it comes to medical practices, human or veterinary, but there is so much evidence to support the use of certain modalities to complement conventional protocols that many of the most ardent proponents of conventional medicine have now joined the complementary movement in the practice of medicine. If nutritional support or other supplements with a proven track record of safety can be shown to improve outcomes and quality of life for those who are undergoing cancer therapy, those therapies should clearly be recommended for the kinds of cancer patients that have been shown to benefit from taking these supplements.
Before addressing the use of specific supplements or treatments designed to enhance quality of life and examining what benefits they might have for veterinary or human cancer patients, it should be noted that every effort has been made to check opinions at the door and stick to the facts. During the nearly twenty-five years that have passed since my last day working as an animal health technician, I have tried to prevent any opinions I may have formed regarding medical practices and procedures from influencing the content of my writing. In a world where medical practices are defined by words like “mainstream,” “alternative,” “holistic” and “integrative,” there is only one kind of medicine that any of us should be paying attention to; evidence-based medicine. According to the Center for Evidence-Based Medicine, “Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”
The studies that must be completed before one can point to a solid body of evidence supporting any modality require careful planning, impeccable execution, fastidious attention to detail, a significant allocation of resources and the dedication of top-level professionals who are committed to the quality of the research. Corporate and other organizational entities that are planning to sponsor a study in the field of human oncology have a number of distinguished cancer centers to approach when seeking potential collaborators for clinical trials. In the field of veterinary oncology, however, California Veterinary Specialists’ Angel Care Cancer Center and its allied research foundation, The Special Care Foundation for Companion Animals, shine so brightly among the stars in this universe that they are literally overloaded with inquiries from prospective study sponsors and others who want Angel Care Cancer Center personnel to evaluate new developments that are designed to improve or enhance the practice of veterinary oncology.
Careful screening of these inquiries has allowed veterinary oncologists Drs. Gregory K. Ogilvie and David Proulx to focus on only those projects that hold the highest promise for leading to a significant advancement in the diagnosis, treatment or management of veterinary cancer patients. Regardless, their goal is to develop only those therapeutics and diagnostics that will enhance quality of life and win the fight against cancer in pets and people with this horrible disease. The diagnostic and therapeutic capabilities at Angel Care Cancer Center’s main hospital in Carlsbad, California are comparable to, and in many ways superior to, those that are available at the finest human cancer centers in the world. Form a technological standpoint, the term “cutting edge” only begins to describe the advanced level of care that has become a 24-hour-a-day, 365-day-a-year reality at this hospital. With Dr. Ogilvie serving as my tour guide, I have seen what it is like to have preeminent technology, unsurpassed expertise and extraordinarily compassionate care seamlessly melded together under one roof. (You have to see this place to believe it — to catch a glimpse, click on the video link at the bottom of the home page at www.cvsangelcare.com.)
Dr. Ogilvie’s full curriculum vitae (a biographical summary of one’s education, special training, achievements, awards, publications and other professional credentials) contains enough pages to fill one of those big binders I used to hate carrying to school. When it comes to veterinary cancer care, he wrote the book. In fact, Dr. Ogilvie has coauthored three outstanding reference books with Dr. Antony S. Moore — Managing the Veterinary Cancer Patient: A Practice Manual, Feline Oncology: A Comprehensive Guide for Compassionate Careand Canine Oncology: A Comprehensive Guide for Compassionate Care.
Dr. Ogilvie has been exploring the therapeutic potential of nutrients to treat veterinary cancer patients since 1984 and has published over 100 scientific articles on the subject. A client education booklet published by Angel Care Cancer Center notes that there is much evidence to support supplementation with omega-3 (n-3 series) fatty acids, specifically, docosahexaenoic acid (DHA), a long chain fatty acid that has been shown to have a number of benefits for the veterinary cancer patient. Three key points stated in the booklet are important for pet owners — owners of pets living with cancer — to be aware of:
1.) Dietary n-3 fatty acids, especially DHA, can inhibit tumor growth and development.
2.) N-3 fatty acids appear to be important to reduce radiation and chemotherapy induced
toxicity while increasing the efficacy of these therapies.
3.) DHA from algae may be preferred, as fish sources may be contaminated with heavy
metals and organophosphates (chemicals used in pesticides).
Algae-based DHA is available in gel caps for ease of administration. Small dogs and cats should receive 200 mg once daily; medium sized dogs should receive 200 mg twice daily; large breed dogs should receive 200 mg three times daily; and giant breeds should receive 200 mg four times daily.
Poly-MVA, a liquid dietary supplement with unique properties, has also been used and studied as an adjunct to therapy at Angel Care Cancer Center. Dr. Frank Antonawich, a scientist at Garnett McKeen Laboratory, describes this novel supplement as “a patented Lipoic Acid Palladium complex invented by Dr. Merrill Garnett. While Dr. Garnett’s proprietary formulation is designed to increase cellular energy and enhance a pet’s quality of life during this difficult period of cancer treatment, it also takes advantage of cancer cell dysfunction to facilitate the pet’s recovery.”
Dr. Garnett developed the nontoxic Lipoic Acid Mineral Palladium complexes as metallo-vitamins in 1991. Poly-MVA (MVA = a proprietary mixture of minerals, vitamins and amino acids), introduced in 1994, is very similar to the original formulation but was developed specifically for use as a nutritional supplement.
The safety of the product was already well established when the Poly-MVA study began at Angel Care Cancer Center in 2004. That record of safety remains unblemished as the only Poly-MVA-associated concern reported in the Angel Care study have been related to the B-Vitamin like taste. The taste concern is usually solved quite easily by mixing the liquid supplement into the patient’s food or by pouring the supplement over a small amount of yogurt or ice cream.
Quality of life (QOL), the centerpiece gem of any study designed to evaluate the effectiveness of any adjunctive modality for cancer patients, can be measured with a set of QOL parameters (appetite, energy, behavior patterns, etc.) that are recorded and documented over time. A significant number of pet owners were happy to cooperate with this aspect of the Poly-MVA study by completing QOL surveys and returning them to Angel Care Cancer Center. Although many of the survey responses are admittedly based on the clients’ subjective impressions, an impressive 86% of respondents felt that the supplement improved their pet’s quality of life. The patients that were most likely to be benefited by Poly-MVA included the dogs or cats that had a diminished quality of life prior to treatment.
The patients receiving Poly-MVA along with standard treatments for their cancers tended toward improvement with respect to the objective parameters (weight, anemia, liver function, kidney function, etc.) that have been monitored by the professional staff at Angel Care. Dr. Ogilvie, a scientific purist of the highest caliber, cautions that there will always be some patients responding much better than others in any study, but even he seems to be impressed by the overall trend that has been observed so far.
Among the nearly 800 patients that have been enrolled in the Poly-MVA study during the past three years, the ones with the most delighted pet owners are the ones who enjoy a good quality of life with stable disease (cancer that does not progress). While virtually all of these animals have been receiving DHA in addition to the Poly-MVA, and where appropriate, specific therapy for the cancer including surgery, chemotherapy and radiation, there appears to be a subjective difference among some of those who have had Poly-MVA added to their supplementation regimen compared to those who did not. Randomized, placebo controlled clinical trials have been proposed to confirm these observations.
One dog in particular, Scout Flores, experienced a complete disappearance of what appeared to be metastatic disease after the dose of Poly-MVA was doubled. A 12-year-old mixed breed dog with an osteosarcoma (cancer that originates in the bone) of the front leg, Scout was treated with surgery and followed up with chemotherapy. Scout did remarkably well while being maintained on Poly-MVA, DHA and piroxicam, a non-steroidal anti-inflammatory drug that has been shown to have an anti-tumor effect. When chest x-rays showed what appeared to be lung metastases, the dosage of Poly-MVA was doubled and the apparent metastases disappeared for several months. Scout did subsequently pass away due to progressive disease, however the quality of her life during her treatment period was superb.
Although Dr. Ogilvie does not believe that every patient with every tumor will experience an observable benefit with Poly-MVA (lymphoma cases generally do not seem to improve when Poly-MVA is added to their regimen), “we see our best results among those patients that are treated long term with osteocarcoma, anal sac adenocarcinoma (cancer that originates in the anal sacs below the tail), hemangiosarcoma (a cancer of blood vessels) and many others.”
When asked if he would recommend the use of Poly-MVA for veterinary cancer patients, Dr. Ogilvie, who is clearly one of the most ethical and honest human beings I have ever had the privilege of meeting, prefaced his answer with his own declaration of independence and offered the following response:
“Since starting studies with Poly-MVA, I have not personally benefited in any way financially in its use. In fact, we calculate a significant loss as we spend our time rechecking patients and collecting and cataloging data. I am, however, substantially rewarded daily by the many stories of enhanced health and wellness of my patients and of the lengthened time the animals have had with their families…and the richness that this incredible relationship brings to their lives. I would not be involved in Poly-MVA research if I did not believe it would help the majority of my patients experience an improved quality of life. As for any benefits related to longer survival times, more formalized studies are needed before any definitive statements can be made regarding a statistically significant difference in survival.”
Dr. Ogilvie’s work with Poly-MVA has been strictly limited to its potential use as a supportive modality for veterinary cancer patients. Using the supplement for general health and wellness, as many pet owners do, is an entirely separate matter that is not related to the Angel Care Cancer Center study.
According to the dosage recommendations posted on the Poly-MVA web site (www.polymva.store), when the supplement is used for routine wellness purposes, the recommended dose is one-fifth of one milliliter (ml) per five pounds of body weight, twice daily. (If a dosing dropper is requested when the product is ordered, it will be included at no charge.) For pets with compromised immune systems, such as those undergoing certain forms of chemotherapy or radiation treatments, the recommended dose according to the Poly-MVA web page reference would be one ml per five pounds of body weight, twice daily. Higher doses may be appropriate in certain circumstances. Pet owners with questions pertaining to dosage can call 1-619-401-0715 to be referred to a veterinarian who is familiar with Poly-MVA.
One cancer case that is not related to Dr. Ogilvie’s work at Angel Care Cancer Center came to my attention while I was attending a (human) medical conference in December, 2005. I happened to overhear Dr. Stephen Sinatra, a leading speaker and panelist at the conference, telling someone that his dog had recently been diagnosed with malignant melanoma.
Dr. Sinatra is a board-certified cardiologist, certified nutrition specialist (American College of Nutrition), author of several books and writer/editor of a monthly newsletter entitled Heart, Health and Nutrition: A Cardiologist’s Guide to Total Wellness. The former Chief of Cardiology at Manchester Memorial Hospital (Manchester, Connecticut), who recently appeared on Good Morning America to discuss his latest book, The Fast Food Diet: Lose Weight and Feel Great Even If You’re Too Busy to Eat Right, founded the New England Heart and Longevity Center where he continues to care for his patients while his beloved Chow Chows, Chewie and Kuma, keep Dr. Sinatra and his staff company with their special brand of affection.
As a national speaker with an extensive following that includes readers, subscribers and other physicians, Dr. Sinatra’s travel schedule is so demanding that I did not know whether or not he would be able to accommodate my request for an interview. When the request came to his attention, Dr. Sinatra not only granted my request for an interview, he kindly offered to provide a written narrative. His account of Chewie’s life with cancer is so well written that I have decided to conclude this article with Dr. Sinatra’s narrative and ask for his permission to include him as a coauthor, which he has agreed to.
I hope you enjoy reading Dr. Sinatra’s contribution to this article as much as I did…
Like most pet owners, I really love our three dogs. They are very important members of our family. And just as it is with our children, we get upset when they – the pets – have an upset with one another. Such was the case one day in September of 2005; my two beloved Chow Chows had a vicious run-in with one another over a Milk Bone. The older Chow, Chewie, took the brunt of it. Her mouth was bleeding, and it was the next day before she calmed down enough for me to be able to get a good look at her injury. I felt so badly when I saw that one of her back molars was hanging loose in its socket.
I took Chewie to her veterinarian, who agreed that the tooth would have to come out. As poor Chewie was prepped for surgery that morning, the vet asked if I wanted to be called should there be any unforeseen issues. “Just treat her as you would if she were your dog,” I replied. What could go wrong? Then I headed out for my own office to see my own patients.
When it came time to pick Chewie up on my way home, the vet had bad news for me. Something unforeseen had indeed happened. While Chewie’s mouth was relaxed and open, they had noticed a lesion on her tongue. You see, Chewie’s very ladylike about panting, so we’d never noticed anything. Later, when we scrutinized an old photo of Chewie for a few minutes, we did see that the small round change in color had been there.
Because I had given him permission to use his own best judgment that day, the vet scraped the suspicious lesion on Chewie’s tongue to get a tissue sample ( a surgical biopsy), and awaited my permission to send it out to the lab. Our precious Chewie was in sorry shape that night. Her mouth must have been very sore, because she didn’t eat for days, no matter how we coaxed and coddled her with pureed versions of her favorite foods.
The biopsy of the suspicious lesion was indeed positive for melanoma. The vet explained that because Chows have purple-pigmented tongues, melanomas in that area are not uncommon for the breed. He then suggested a surgical resection that would include an area around the tumor. That would mean literally cutting off a very large portion of Chewie’s tongue. My heart sank. Dogs do so much more than lap up food and water with their tongues; they also express their joy, love and affection with them!
Had I been given the option, I would not have even approved disturbing the lesion for the biopsy. I would have just assumed the worst, and treated my sweet pet conservatively. After all, who knows how long that lesion had been there, how aggressively it was progressing or whether it was progressing at all? Why rip it open and put her through the agony?
There was no big decision to be made. We already knew what we wanted for our dog…
We decided against putting Chewie through more pain for a procedure that might ultimately make her unable to enjoy the time we had left with her. I started her on Poly-MVA right away, along with other nutrients to help her immune system keep her melanoma at bay. That was over a year and a half ago.
Our Japanese friend Chizuko takes good care of our dogs when we work and travel, and she follows Chewie’s anti-cancer regimen, too. I get a kick out of how she refers to the Poly-MVA as the “soy sauce for the Chew Chew”. She can’t remember (or pronounce) the name of the liquid dietary supplement that’s been helping Chewie, so the nickname helps us communicate about it with a chuckle and a smile.
We sneak the “soy sauce” in Chewie’s food twice a day. And let me tell you, feeding a Chow is just like feeding a cat; they’re very fickle and very fussy. Just a half teaspoon at each meal has been enough for our 46-pound-runt-of-the-litter. (The first month, I gave her a “loading dose” by giving her four small meals a day, each with ½ teaspoon of “Poly” for a grand total of 2 teaspoonfuls a day in order to get her blood level of Poly-MVA up.)
Chewie was ten years old when her melanoma was diagnosed. A veterinarian friend across the state informs me that he’s yet to see a Chow Chow live longer than twelve years. Our soon to be twelve-year-old Chewie, whose tongue lesion does not appear to have changed since the day it was discovered, is still full of life and still bringing joy into our lives!
As Dr. Sinatra’s — or Chewie’s — narrative indicates, significant possibilities exist for living and living well with cancer. There is an overall trend toward improved quality of life as research pertaining to finding the best treatments and the best complementary modalities continues. Quality of life for our companion pets means quality of life for us, too.