Use of Low-Dose Naltrexone (LDN) in Treatment of Cancer Patients.

Pathophysiology of Cancer:

Cancer is an ailment in which cells in your body divide at an unlimited rate. Our body's innate defense against this growth is called tumor suppressor genes. But, mutations may occur, resulting in the formation of oncogenes, which promote abnormal cell growth and replication or destruction of tumor suppressor genes. If this happens, the cells will divide uncontrollably, leading to tumors or large lumps formation and causing your body's healthy cells to destroy themselves. These malignant cells will then move to different areas of your body via the blood through metastasis. Cancer may continue to arise in these regions when this occurs, making it very challenging to treat.

How Does LDN Work?

At standard doses of 50-100 mg, low dose naltrexone acts as an opioid antagonist to treat alcohol dependence. However, when given in significantly lower portions, naltrexone serves as an anti-inflammatory agent. When scientists used LDN more, the more they involved it in animal and human investigations and found it helpful in several other conditions like cancer. Although researchers do not understand the entire mechanism of action it performs in cancer patients, below are some suggested ways:

● Intermittent dosing greatly decreased tumor development compared to a constant blockade that stimulated tumor growth.

● LDN may enhance the activity of natural killer cells, IL-2, T-Cell, and TH-2 through the mu receptor, and they attach to receptors on cancer cells to destroy them. These defensive cells play a major role in our body's innate immune system.

● LDN increases the cell death rate in some cancers and likely improves patient response to chemotherapeutic drugs.

● Treating cells with LDN up-regulates BIK1 and BAD genes, and both help in cell death.

● Some patients on intermittent LDN received notable benefits from chemotherapy.

Effectiveness:

The research on naltrexone's potential for cancer treatment began principally by Penn State researchers Ian Zagon and his co-workers. They were the first to study and publish confirmation that a 0.1mg/kg dose in mice decreased neuroblastoma tumor occurrence by 66%, reduced tumor formation by 98%, and improved endurance by 36% in comparison to controls.

More up-to-date publications propose that cells cultured with low-dose naltrexone before chemotherapy always revealed a more significant reduction in cell number and viability than cells treated with LDN following chemotherapy. However, cells that underwent standard NTX therapy did not usually result in considerable cell number or viability declines with any cytotoxic medicines.

The prominent researcher of LDN, Dr.Bernard Bihari, has proclaimed to have treated almost 450 cancer patients using LDN, and he says that over 270 patients experienced notable benefits from LDN therapy. Of those cancer patients, 86 showed objective indications of a reduction in tumor size (at least 75%). Almost 125 cases showed stabilization leading towards remission.

Dose Adjustment:

Initial doses are often between 0.5 mg to 1.5 mg, which are gradually increased up to 4.5 mg, and that is the highest dose for Low Dose Naltrexone. Especially for people with cancer, the daily dose adjustment must be a goal for at least 1st seven days of treatment "on/off cycle."

● On/off cycle - it consists of 3 days with LDN treatment and three days without LDN.

● The three days off need to fall right before chemotherapy treatment. However, LDN has no recognized contraindications with chemotherapy. It is, though, advised to avoid use together till further research confirms it.

In few cancer patients, it is observed that using a CBD product during three days off enhances the anti-tumor influence of LDN.

LDN Side Effects:

Low Dose Naltrexone is well-tolerated in many patients, and the dose is decreased more if a patient is prescribed a start low or go-slow approach. The patient must be given a low amount initially and titrated up gradually. When side effects happen, they usually are mild and involve:

● Sleep disturbances

● Mild agitation

● Mild headache

● GI effects (consider changing to liquid sublingual form to bypass GI tract)

It was discovered that for patients who experienced side effects, the dose was decreased by half for 1st three days and later titration again.

Forms of LDN:

● Oral liquid (1 mg/1 mL per day)

● Tablets (variable dose)

● Sublingual drops - placed beneath the tongue with a dropper

● Creams (0.5 mg/mL) - Beneficial for children who experience difficulty taking the other forms or people allergic to additives in different formulations of LDN.