DCA Source

Has anyone contacted TCI America as a source of DCA?  This is the source one of the studies Steven has posted used.  I have also heard that Medicore purchases their DCA through them.  I have no direct communication with Medicor regrading the truth regarding their source, but the information has been floating around.  Their 99%+ pure DCA is more expensive than pharma-dca (about 45 percent more), but the source might be more reliable.  Anyway, anyone have any experience with them?  Maybe they only sell to labs and research facilities. 

Grade 2....post your cocktails!

Wanted to see what other grade 2's are taking for their cocktails? Just starting this journey and wanted too see what other people are taking for supplements and diets!!

Thank you
Jennifer

IDH Wild-Type GBM

I''ve copied over the addendum path report for my husbands tumor.  I haven't been able to find any promising treatment throughout my research for his tumor type and feeling quite desperate!  Any suggestions based on the additional information we have...I'm not liking what I've read so far and the outcome doesn't look good....

Comment This case was subjected to IDH1/2 mutation analysis performed at Moffitt. It was also sent for MGMT promoter methylation testing, for FISH testing of chromosomes 1 and 19, and of chromosome 10  (PTEN locus), as well as for EGFR vIII assessment. No IDH1 or IDH2 hotspot mutation was found by sequenom. MGMT testing was negative for methylation of the gene promoter. FISH testing was  negative for codeletion of chromosomes 1p/19q, but positive for monosomy of C10 at the PTEN locus.  The EGFR vIII deletion was negative. In addition oncogene testing by Next Generation Sequencing was  performed at Moffitt and reported separately; in summary, no mutation was found in the assessed  genetic 'hotspots'. The findings are characteristic of IDH-wildtype glioblastoma. The histopathologic  diagnosis and interpretation are unchangedAddendum Pathology Report
	RIGHT TEMPORAL TUMOR Addendum IDH1 AND IDH2 MUTATIONAL STATUS: - NEGATIVE FOR IDH1 AND IDH2 MUTATIONS BY SEQUENOM 1p/19q STATUS: - NEGATIVE FOR 1p/19q CODELETION BY FISH MGMT PROMOTER METHYLATION STATUS: - NEGATIVE FOR MGMT PROMOTER METHYLATION PTEN/CHROMOSOME 10 STATUS: - POSITIVE FOR PTEN/C10 LOSS BY FISH EGFR vIII STATUS: - NEGATIVE FOR EGFR vIII NGS TRUSIGHT HOTSPOT MUTATION ANALYSIS: - NEGATIVE FOR ACTIONABLE MUTATIONS Any help would be much appreciated!

Dosing DCA ,Disulfiram together

Please correct me if I am wrong.

So both Disulfiram and DCA cause neuropathy. I am trying to dose both.

DCA can cause memory problems and hand tremors and possible Korsakoffs syndrome which could be very serious and what  I am worried the most about. Of all the patients treated by Medicore they did not mention that side effect of DCA but in theory it is possible.

So this Korsakoffs is caused by not enough vit B1. 

Neuropathy caused by Disulfiram is caused by other mechanism  I assume and not by vit B1 depletion. CUSP 9 doctors are not supplementing with B1. 

In that case Disulfiram would never cause Krsakoffs or memory problems because it does not deplete vit B1. So dosing Disulfiram even if taken with DCA I wouldn't have to worry about heart failure, or memory problems. So even If vit b1 is low and I stopped DCA I can still give Disulfiram. Is that correct?

Cancer compass review - PD-1 inhibitors

The following is what was said on the Cancer Compass cocktail thread about PD-1 inhibitors:

page 128:
A: "He mentioned Nivolumab, a PD-1 inhibitor, and essentially said that it would be possible to pay for it out of pocket. My girlfriend doesn't weigh much at this point, and he said paying for 3 administrations of the drug would probably be about $12,000 total. He said that, if he were choosing between Rindopepimut and Nivolumab, he would go for the Nivolumab."


A: "The Nivolumab idea has the potential to be a pretty effective addition at a rather reasonable cost (at least I consider 12k to be reasonable after getting quotes of 150k from the likes of DCVax and such). I'm going to be looking into it a lot now.

He essentially said that he was at a meeting where they were discussing very preliminary results of a study testing a PD-1 inhibitor vs. avastin in recurrent tumors. They were talking about how they were able to radiographically see increased inflammation from an immune response after the administration of a PD-1 inhibitor in a subset of the patients. This included some stable tumors and one that showed some regression."

SW: "I came across an interesting study showing that response to PD-1 inhibitors is correlated with mutational load. The study shows a graph which correlates response rate in various types of cancers to the median frequency of somatic mutations in those types of cancers. For example, melanoma has the highest response rate to PD-1 inhibitors, and also has the highest median number of somatic mutations.

Hypermutated tumors may have a better chance of response to these drugs, at least as single agents. Recurrent tumors previously treated with single agent TMZ are more likely to be hypermutated upon recurrence, but the only way to know if a tumor is hypermutated is with comprehensive genetic testing like FoundationOne. If there are a large number of mutations, plus a mutation in a DNA mismatch repair gene like MSH6, that would suggest a hypermutated tumor.

This is not to say that only hypermutated tumors would benefit from PD-1 inhibitors or CTLA-4 inhibitors, just that they might especially benefit.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937193/

In most cases newly diagnosed tumors won't be hypermutated. Mutations in mismatch repair genes (like MSH6) can be a resistance mechanism following single agent TMZ."

page 134:

A: "I've been doing some research, and some of the upcoming trials are combining Nivolumab with Ipilimumab (Opdivo and Yervoy). This is a PD-1 inhibitor combined with a CTLA-4 inhibitor. The toxicity seems rather large, with something like 50% of patients experiencing grades 3 and 4 adverse events. In melanoma, however, this combination has been very effective.

In mouse studies with glioblastoma, the results of combination PD-1 and CTLA-4 inhibition seems very promising.

What are your thoughts on this combination following 6 adjuvant chemo cycles? In theory, residual tumor burden would be low, and the cells that survived initial treatment might already be expressing a larger number of mutations.

Our NO is the one that initially suggested Nivolumab, which has a lower toxicity profile than Ipilimumab, so I'm not sure that he would even go for the combination. I've priced out 4 doses of the combination, which would be about $44,000. 4 doses of Nivolumab alone would be $16,000."

DS: "Dr. Conrad at MD Anderson (though he recently left MDA) told us that the Nivolumab with Ipilimumab trial had dropped the ipilimumab because it was too toxic and he signed my son up for the Nivolumab alone -- all the ipilimumab portions of the trial documentation were stricken through. We opted not to do the trial as it turned out."

A: "Thank you for that information! I'm surprised they dropped it, as they are combining the two for the treatment of advanced melanoma, and showing a lot of success.

They do note that the toxicity profile is high, but I wonder why they are OK with treating melanoma patients with that protocol and not GBM patients. I now see that the trial is being offered at UVA, so I'm guessing that is how our NO was able to hear preliminary information about some responses."

M: "from what i could determine about the nivo/ipi trial for gbm versus melanoma is this; the mechanism of action causes swelling. greater tumor burden correlates to greater swelling. there is no room for swelling in the brain as opposed to other organs of the body. melanoma patients may tolerate swelling whereas gbm patients would have to go on massive doses of steroids (which might not even help) and that would negate the workings of the immunotherapy."



Download the poster from the 2015 ASCO conference showing the first preliminary results of GBM patients treated with nivolumab alone or nivolumab plus ipilimumab (Yervoy).  Download here.

Citicoline and THC/CBD oils

Hey all,

I know many of you follow Cheryl Broyle's plan for taking THC/CBD concentrates.  On her website, she discusses how she takes Citicoline prior to taking the oils, as it helps alleviate the "stoned" feeling.  She made a post on facebook yesterday warning about taking Citicoline:


"CITICOLINE with Medical Marijuana

I just got this Citicoline information (see below) from a fellow brain tumor friend. WOW it's scary that I've been on the Citicoline for about 2 years now! I'm never taking Citicoline again! Just wanted to let others know too that may be on it.

CITICOLINE
We have been suggesting citicoline, but new research has shown that caution may be advised for cancer patients. Dr. Joe D. Goldstrich has written the following :

A word of caution concerning citicoline. While citicoline has been shown to be beneficial in ameliorating the adverse effects of acute ischemic stroke,http://www.ncbi.nlm.nih.gov/pubmed/24739589 , it may not be the best agent for supporting cognition while using cannabis to combat cancer, especially glioblastomas and other tumors treated with bevacizumab (Avastin).

Following a stroke, citicoline helps promotes new blood vessel formation (angiogenesis) via induction and upregulation of vascular endothelial growth factor (VEGF). Induction of VEGF helps promote new blood vessels to the area of the brain undergoing healing and regeneration. This is a good thing.http://examine.com/supplements/CDP-choline/,http://www.ncbi.nlm.nih.gov/pubmed/?term=citicoline+vegf

Avastin is a monoclonal antibody that blocks angiogenesis by inhibiting VEGF. New blood vessels support the growth of primary tumors and their metastases. Avastin has been used to treat metastatic colon cancer, certain lung cancers, renal cancers, ovarian cancers, and several eye diseases that are characterized by excessive vascularization (e.g. diabetic retinopathy).https://en.wikipedia.org/wiki/Bevacizumab

Avastin and citicoline appear to have opposite effects on new blood vessel formation. While new blood vessels may be an important aspect of recovery from an acute ischemic stroke, shutting down blood flow to primary and metastatic tumors is a way of destroying these cancers.

Citicoline is also beneficial in acute ischemic stroke and retinal neurodegeneration by helping injured brain and retina cells stay alive. It has an anti-apoptotic action. THC is thought to help kill cancer cells by inducing apoptosis (programmed cell death). http://examine.com/supplements/CDP-choline/ , http://www.ncbi.nlm.nih.gov/pubmed/24736780

As you can see, citicoline appears to promote (at least in acute ischemic stroke) VEGA and anti-apoptosis. For these reasons it seems prudent to not use citicoline as a cognition booster and psycho activity inhibitor in conjunction THC treatments for cancer.

Another nootropic nutraceutical, Bacopa monnieri, appears to have pro-apoptotic actions http://www.ncbi.nlm.nih.gov/pubmed/22467255 and may thus be a better nutritional supplement for countering THC induced psycho activity"

Wishing everybody the best,

Kendall

Stephen's edit: the article above (in red) was reposted on facebook from the original source at the Aunt Zelda's website.  See the original article here: http://azcannaoil.com/a-word-of-caution-concerning-citicoline-cancer-and-cannabis/

Cocktail for other cancers?

I hope that people here will not get angry at me. So we have a cocktail for glioblastoma. I know some people with other cancer types. Are any of the drugs or supplements in our cocktails safe to advise for people with other cancer types? Nobody of us has much time to do a lot of research but maybe I can pick some of our drugs and make a sort of cancer cocktail blueprint which I can pass to few of the people with cancer that I know and who have all kinds of cancer?

Magnesium and Potassium supplements

I have read that our cocktails can deplete magnesium and Potassium among other things.  Does anyone specifically supplement with these?  What kind?  Source?  Thanks.
Aunt Jo

CLA

I want to find out if anyone is using a CLA supplement?  Life Extention has several and I'm thinking about trying one but don't know which one or how much.  Does anyone have knowledge on this?  Thanks.
Aunt Jo

Thalidomide

I am wanting to know how those of you using this drug were able to convince your NO to prescribe, what you are using in combination and your rationale.  Also any effects you have seen or experienced with using thalidomide.

Aunt Jo

Tamoxifen

How does one get this drug?  I've repeatedly asked our NO about this and he basically just doesn't answer me.  I'd like to hear from people using this and how they are using in combination with what, etc.  Thanks.
Joan

Accutane

My son is on Accutane for the anti-cancer benefits - but Ben Williams stated IL-2 works well with Accutane.  I am wondering if anyone has additional information on this or if anyone is using this combination? We are using only 40 mg metronomically. Has anyone used this method with good results?  Rich thinks this is a good way to dose Accutane.
Aunt Jo

Verapamil

Has anyone had trouble with taking Verapamil?  My son's bp has not been under good control since starting verapamil, but we've wanted to stay on it for the anti-cancer benefits of disrupting the BBB.

TCA (imipramine) and the anti-coagulant (ticlopidine)for GBM treatment.

Interesting study using TCA (imipramine) and the anti-coagulant (ticlopidine)for GBM treatment.

http://m.medicalxpress.com/news/2015-09-antidepressants-blood-thinners-brain-cancer.html 

Dosage of Pterostilbene

Dear all,
we are supplementing with Pterostilbene instead of Resveratrol.. I just want to make sure about the dosage please..

new trial Durvalumab checkpoint inhibitor now recruiting

This trial is currently recruiting in Aus and seven facilities around the US. Just scroll to the last page to see what US state  is participating


https://www.clinicaltrials.gov/ct2/show/NCT02336165?term=MEDI4736&rank=20

Chance's latest (this month) MRI showed edema

At Chance's MRI on 9/11, edema was found. Chance had been getting increasingly dizzy. Within the last couple of weeks he left his job on short term disability because he had several times he referred to as his brain not working. He could not put words together to explain he was having a problem comprehending or communicating. His position was in high stress software sales, so it was probably the last thing he should have been doing, but of course he wanted to keep working as long as he could.

His NO suggested he increase the Decadron to 4mg a day (he was finally down to 1 mg a day).

A worrisome MRI happened once before, last spring, so we prayed we could wait 30 days and have him retested, but his case went to the UCSF tumor board on 9/17 and it was agreed edema was caused by progression and that his tumor was now inoperable because of it's location - near language and memory.

The board suggested Avastin and CCNU.

Based on what I've learned these last few months, I had no problem saying NO!

Stephen gave me some trials to consider, two at UCSF and two at Duke. All but one required some sort of surgery, so we went with the least invasive: Toca 511 at UCSF. Chance will be the first participant in Cohort 7, which means they will use an infusion in hand or arm, rather than placing the virus directly into the tumor. They say it has been proven that the virus gets to the brain regardless of where it is given. He will have the virus infusion over three days starting next Monday. A month later they start a dosing with an anti-fungal that becomes a powerful chemotherapy agent to kill dividing cells. He will take the anti-fungal pills every six weeks for four cycles. The beauty of this particular trial is that it has a continuation arm.

For those unfamiliar with Toca 511, there is a lot on YouTube you can find by searching "Toca 511". It is being offered at nine locations in the U.S.

We are consulting Duke for a second opinion and treatment options just to get a foot in the door in case we want to pursue in the future.

I wanted to update Chance's status and include a huge shout-out for Stephen, Ben, Rich and Cheryl and so many others for everything they have done and are doing for their GBM sisters and brothers. I am grateful beyond measure.

Help on Accutane/PCV interaction

Hi All,
This is my first post so far, thanks to all for the knowledge shared especially to Stephen for the time he spends on this.

My wife was diagnosed 2 months ago with a GBM (mutated IDH1 / no MGNT) , It evolved from 2 full resection (201203-AAG3 / 201504-AAG3). Due to the internal capsule in compromised, there is a high risk of hemiplegia, so NO decided to apply PCV protocol in order to produce some regression that may help the work of the NS in a future surgery, decreasing the chance of collateral damage. Her tumour growth was fast in the last 3 months, but after the first PCV it has been stabilized. At that time we found Ben Williams story, Astrocytoma Options web, so we decided to follow cocktail aproach to create sinergy. She is now in the 2nd PCV cycle and we added Tamoxifen, Verapamil, Celebrex, Metformin and a bunch of suplements like Curcumine, Boswellia, Resveratrol, Fish Oil and a couple more. So now we want to add Accutane but we want to be aware of any possible interactions with PCV and avoid them.

PCV Protocol:

• Day 1 - Lomustine.
• Day 8 till 21 Procarbazine.
• Day 8 and 29 Vincristine.
• 2 weeks off.

Any advice on when she should take Accutane?

Thanks in advance.
Francisco.

Alan's Cocktail

Dx March 2014 with 3 tumours in  frontal lobe GBM4, unmethylated and IDH1 negative

 23rd April 2014 - 95% resection followed by 6 weeks chemoradiation.
 Tumour grew through chemo radiation but was first thought to be pseudo progression.
 Started on 100mg procarbazine plus 100mg TMZ 7 day schedule for almost 3 months but hubby was declining there was massive swelling and progression as per photo. Swelling was causing psychotic behaviour. Improved on 16mg dex daily, but still confusion.
Consulted for another operation but would most probably result in no short term memory. Started Avastin biweekly 8.5mg/kilo . First 2 MRI's showed reduction and all MRI's have been stable since.

Within 16 hours of having his first avastin infusion Alan was a different person, no confusion and could recall conversations from the day before etc.
The only deficits Alan has is some tiredness and the  occasional word finding difficulties, he is the one who remembers where I put my sunglasses etc.

COCKTAIL LIST
Metformin 500mg x3 daily ( update 11th Oct 750mg morn & night, 500mg midday) total 2000
Celebrex 200mg x2 daily
Chloroquine 250mg x1 every 2nd day update 14/10/15 taking daily again
Tagamet 200mg x 2 daily
DCA 20mg per kilo (started mid June 2015) update 18/10/15 reduced to 10mg per k
Clexaine inj 40mg daily (prophylactically, had PE during radiation and now having Avastin)
Keppra 750mg x2
Melatonin 20mg daily
Curcumin 2g x3daily
pteropure50mg x 6 daily
selenium 200mcg daily
zinc 50mg daily
5-lox inhibitor 200mg x 3 daily
Boswellia 1800mg x 3 daily
green tea extract 1500mg x 2 daily
ultra soy 5g daily
ultra thistle 360mg x 3 daily
benfotiamine 250mg x 1 daily
vitamin b1 500mg x 1 daily
vitamin d3 10,000 daily
lycopene 15mg daily
boron 3 mg dily
psk 1.5g x 2 daily
maitake 600mg x 2 daily
broccoli sprout powder x 3 scoops daily
Fresh aloe vera
Paw paw leaf extract
Echinacea added 18/10/2015

Immunotherapy

June 2015 started immunotherapy, had 3 vaccines made from very small amount of tumour and have had first t cell vaccine targeting CMV virus.

Imiquimod 250mg sachets used for 5 days surrounding vaccine (2 days before, day of vaccine and 2 days after

Tetanus vaccine used once with tumour pulsed vaccine and once with Tcell targeting cmv vaccine.

Reactions

Drug related nutrient depletion-reason to take folate

Interesting article. Another reason to take folate
http://nutritionreview.org/2013/04/practical-guide-avoiding-drug-induced-nutrient-depletion/

Chloroquine and Celebrex.. interactions?

Our NO had his pharmacist review the cocktail we're doing and had this to say about Chloroquine and Celebrex.  I assume others are taking both - has anyone had problems?  The drug interaction online says "moderate":  http://www.drugs.com/drug-interactions/celebrex-with-chloroquine-560-284-593-0.html

MEDICATION DRUGS Interaction/Potential toxicity Celebrex No clinical evidence for cancer prevention in gliomas. Risk outweighs benefit: increased cardiovascular risk considering patient had recent stroke [annie: this is not accurate - Dad has not had a stroke]. Also increased risk for gastrointestinal bleeding. Also, drug interaction with chloroquine in which clearance of celebrex may be affected. Thus, potentially higher drug levels of celebrex and increased toxicity.

Thiamine influencing cancer growth.

Here is some article about thiamine, that it influences cancer growth both ways depending on the dose. Since we are supplementing dca with it I am wondering what dosages should we use and if it should be thiamine or benfotiamine.

http://www.ncbi.nlm.nih.gov/pubmed/23893925

DCA

Have been reading the DCA posts of negative effects of even small dosages of DCA.  I was starting DCA today at a higher dose as recommended by one of the group but now as rethinking as I read of these ill effects.  Does anyone know if these effects are reversible?

Also I am still trying to figure out the best way to administer the DCA - now that I've learned how to measure it.  Should it be in water, juice, with food, how?

How about mistletoe?

Here is some article about mistletoe. What do you people think about it?
http://www.ncbi.nlm.nih.gov/pubmed/10928154

Disulfiram and copper

Steven

Do you know what dose of copper would be used with disulfiram?  Being copper seems to be involved in cancer growth if not initation, it seems that the lowest dose of copper should be used.

Also, I am of the belief that it is the copper that is beneficial, not the gluconate component (the study specified CU gluconate)  Typically we see various chelated forms of minerals have different bioavailabitly, but it is the mineral with the therapeutic effect.  In the disulfiram/copper combination I suspect this is the case as well.  Do you know if there is something special about this particular copper preparation that gives it synergy with disulfiram?

Are these effects of DCA?

I started my coctail on the 2nd of July, then added DCA on the 12th of August at .8 mg/kg, so i have been doing .5 mg once daily.
Starting September, 3, I began experiencing shaking in hands and head. My balance is way off, I cannot drive anymore. Occasionally, when I play with my daughter, I fall on the couch or something else just because I lose balance  when moving among things. I have to hold onto walls when I walk, especially at night.
  Also, what surprised me, is that I talk and make movements with my hands before falling asleep. Right at the point of being between here and there, I may dream of something (like sewing a button or petting my cat) and start making these movements or/and saying separate words. This has never happened to me before.
My last MRI on the 11th showed almost no signs of tumor and no new growth in other parts of the brain. I have nothing but meds to blame, particularly DCA. Or do you think I am steadily declining due to everythng else - tumor, surgery, radiation, chemo? I thought I was recovering pretty good, but now I am at the point when I quickly started making some arrangements and finish things I haven't yet finished because I thought I had at least a month or two to go. 

Withholding temozolomide in glioblastoma patients with unmethylated MGMT promoter

http://neuro-oncology.oxfordjournals.org/content/early/2015/09/14/neuonc.nov198.extract

Will add to the brain tumor Library.

Quote from Hegi and Stupp:

"Together, the data allow the conclusion that alkylating agent chemotherapy is of marginal benefit, if any, for patients with MGMT unmethylated GBM. By continuing to treat the majority of MGMT unmethylated patients with TMZ, we are missing an opportunity to do better."

Keep in mind that this was written by the lead investigators of the 2005 trial that led to TMZ becoming standard of care for newly diagnosed GBM.  The writing is on the wall.  Soon there will be two standards of care for ndGBM based on MGMT status.  It make take a few years, but patients with unmethylated MGMT status deserve something better.

However, this editorial did not consider the potential to sensitize these tumors to TMZ using agents that inhibit MGMT, or the potential of metronomic schedule TMZ in cases with EGFR overexpression. I wouldn't suggest abandoning TMZ altogether for these patients, but the current protocol does need to be tweaked for these patients (obviously).

DCA dosing

What are the dosing for DCA for most with GBM?  How are the doses dispersed throughout the day? When using the powder form is the powder put into capsules? Is the DCA taken with food or on empty stomach?  Any advice on this drug use will be appreciated.  I understand about the PN.  My son's GBM is extremely aggressive with very poor prognosis.  Thanks for your input.

could not take any meds for a week.

hello, My husband, Corneliu was hospitalized because a severe enterocolitis and he didn't took any pill for a week. He was on third day of tmz. also, remained 2 days whitout treatment. I am very concerned about this situation, analyzes of hospital show the erythrocyte sedimentation rate is high 30. He started yesterday the cocktail pills again, hope he will be all right. I don't know what to do with the remaining TMZ pills, i think i could give him every day , during 8 days?! Melinda.

Sertraline vs Fluoxetine

Steven and others…

I have been considering switching from Sertraline to Prozac.  I would appreciate your thoughts:   

Heres what I know based on what Steven has written on his web site.

·           

• When sertraline was added to doxorubicin it resulted in increased chemosensitive over fluoxetine and doxorubicin.  This is apparently due to sertraline’s ability to impact efflux pumps better than fluoxetine.  I do not know if TMZ and doxorubicin are comparable with regards to benefits brought about by inhibiting efflux pumps.

•    Prozac inhibits MGMT activity, sertraline does not

•     Disulfiram inhibits MGMT activity

Then from CUSP9*:

•  Sertraline blocks multiple survival pathways.  No mention of this is made with fluoxetine

So here are my questions:

• If sertraline inhibits efflux pumps as does disulfiram, how important are PPI’s likely to be if both sertraline and disulfiram are already being utilized?

• Since disulfiram already inhibits MGMT activity, in theory fluoxetine would not need to be used for this (ignoring the possibility of synergy for now).  And since both sertraline and fluoxetine inhibit efflux pumps, it seems sertraline might be better combined with disulfiram rather than fluoxetine and disulfiram because sertraline has the added benefit of blocking multiple survival pathways.  Do you agree with my thinking on this?

• Fluoxetine does inhibit MGMT as does disulfiram and I suspect the synergy between the two could be beneficial, but since we are dealing with an IDH1 mutation, presumably most of the cells are MGMT methylated.  There would of course be other cells that are not methylated that could benefit from MGMT inhibition, but with disulfiram in the mix already, do I need to prioritize fluoxetine over sertraline because of this?  Or would the added benefit of blocking survival pathways be of more importance?  I realize there is no known answer to this and I am asking you to offer input lacking any data, but I am wondering if based on what you have read, this makes sense.

• Jeremy is not willing to add a PDE5 inhibitor to his cocktail.  I think he has had his fill of drugs and supplements.  Does sertraline seem to improve BBB penetration? 

Thanks for the input!

24 Questions to Ask Your Doctor

Which probiotics to choose

Does anybody use any probiotics containing casei? If so what brands products?

Potassium Channel Blockers

http://www.oncotherapynetwork.com/central-nervous-system-cancer-targets/potassium-channel-blockers-show-promise-treatment-brain-tumors?GUID=027DE295-0400-4A2D-85EA-A43E10BF48F7&rememberme=1&ts=15092015

Not specific to GBM's but of interest

SurVaxM

Just a heads up on this vaccine.  http://www.oncotherapynetwork.com/central-nervous-system-cancer-targets/experimental-vaccine-therapy-glioblastoma-continues-show-promise?GUID=027DE295-0400-4A2D-85EA-A43E10BF48F7&rememberme=1&ts=15092015

Aspirin (or Celebrex) synergize with anti-PD-1 therapy in melanoma mouse model

Cyclooxygenase-Dependent Tumor Growth through Evasion of Immunity

(This study is also open access and can be dowloaded as a free PDF from the link above)

In this study, immunocompetent mice bearing melanoma syngrafts were treated with either aspirin (in the drinking water), or an anti-PD-1 antibody (similar to nivolumab or pembrolizumab), or both drugs combined.  Aspirin alone had no significant effect on tumor growth, the PD-1 antibody had a modestly significant effect, while the combination of both agents was highly effective, with over 50% of mice rejecting the tumors.  When a larger number of melanoma cells was injected into a new set of mice, neither drug alone had any effect on tumor growth, while the combination of both aspirin and PD-1 antibody led to tumor regression at day 30.

Similar experiments were repeated with celecoxib/Celebrex (injected intraperitoneally), with similar results, though slightly less effective than aspirin in the melanoma model.

A similar experiment was then carried out using aspirin and the PD-1 antibody, but this time using colorectal cancer cells.  Again, aspirin alone was ineffective, the PD-1 antibody was modestly effective, while the combination was highly effective, with about 30% of the animals rejecting the tumors.

13-cis retinoic acid (Accutane) and thalidomide combination in GBM mouse model

Inhibition of 13-cis retinoic acid-induced gene expression of reactive-resistance genes by thalidomide in glioblastoma tumours in vivo

In this study, nude mice bearing subcutaneous U251 GBM xenografts were treated orally with either 13-cis retinoic acid (Accutane), or thalidomide, or both.  While neither of the drugs alone influenced tumor growth rates, the combination of both drugs significantly slowed tumor growth up to day 18.

I'm not adding this to the library as it is available as a free download from Oncotarget (click on link above).

Toxicities

I've just added a new page (see top panel) called toxicities, to list the experiences of drug-related toxicites that can be definitely or probably attributed to a specific agent.  I'm relying on all of you to report your stories so that this page will be a reflection of your personal experiences, rather than simply a review of the literature.

Memory problems anybody? Cocktail side effect?

My brother has memory problems. He forgets if he ate or not. They gave him one extra week of radiation because the tumor kept growing during the radiation. Also he is on the cocktail now and I am wondering if any of the cocktail ingredients could be causing it. I red something about omeprazole and Alzheimer link. Also people get high by taking omeprazole with some other agents. I am wondering if combining omeprazole with other agents could be causing it. Any suggestions. I am wondering what to take out from the cocktail. The good news is that the last Pet scan with choline looks better than the ct scan from June. The doctor who does not know about the drugs is very surprised. I am worried about the memory though I don't want to make it worse. Is it someting to be expected after radiation or maybe the extra things he is taking like ashwaganda or hepatometer combined with omeprazole? Please give your opinion :)

Thyroid hormones

The thyroid hormone strategy is something that should be more well known.  How many people here have tried this approach?  How long did it take for blood levels of T4 to drop into the therapeutic range as per Hercbergs?

I'll be uploading the most relevant studies to the Brain Tumor Library (in the "Therapies - human studies" folder).  The most recent study is this one:

Medically induced euthyroid hypothyroxinemia may extend survival in compassionate need cancer patients: an observational study

My wifes Cocktail (brain stem, low grade astrocytoma)

Dear All,

Finally I got the time to summarize my wife’s cocktail. I'm a follower of Stephens Astrocytoma option Site from day one.

Before I list the medication that we use right now here is a timeline for her case:

Sep. 2012 -> double vision when she looks to the very far right

Dec. 2012 -> MRI scan -> non-enhancing mass in the brain stem

Feb. 2013 -> light left side weakness, start with strict Ketogenic diet (less than 15g carbs per day)

March 2013 -> open/ extended biopsy -> low grade astrocytoma, IDH1 positive, 3% K67, stronger left side weakness as a consequence of the surgery 

May - July 2013 -> radiotherapy with 54 Gy 

October 2013 -> relaxing or the Ketogenic diet (less than 30-40g carbs per day)

Feb 2014 -> symptoms on with left side weakness for 14 days, MRI shows an enhancement within the old tumor mass -> doctors not sure if progression or necrosis, symptoms gone after 14 days without any treatment. We started a week before the symptoms appeared Longvita Curcumin, and stopped it then.

March 2014 -> Start of Temodar at 5 days on 2 days off non-standard dose dense (Tegwondo Regime, 100mg/m²).

March 2014- September 2014 -> stable scans, no significant changes, enhancing part slightly less intense 

September 2014 -> start of cannabis, vitamin D 

February 2015 -> MRI scan, small but significant reduction of enhancing and non-enhancing part of the tumor. First time that the non-enhancing part is changing in size after radiotherapy

March 2015 -> end of Temodar treatment

March 2015 -> change from Ketogenic to more Logi oriented diet (still less than 40g carbs per day) 

July 2015 -> another great MRI scan, enhancing part is gone, non-enhancing part again a bit smaller

August 2015 -> change from T4 to T3 as my wife has hypothyroidism. No problems with the change, blood counts are already in the therapeutical range as per Hercbergs articles.

November 2015 -> New MRI Scan. No changes in the size, stable scan. No enhancing part anymore. Not sure if the enhancing part was completly gone already in July or with the latest scan. I was not able to see it also in July.

March 2016 -> MRI Scan stable. No contrast enhancing. We are very happy with the result.

October 2016 -> Another stable scan. Forgot to enter the update from July. Still on the same cocktail. T4 supression now over a year without any side effect.

Here is the list of our supplements and medications:

Supplement	Product	Dosis per Day	Start of treatment
Maitake	Nutrisan Maitake D-Fraktion Forte	6	mid. 2014
Probiotic	Nutrisan Probiotische Caps Forte	2	mid. 2014
Pterostilbene	LifeExtension pTeroPure	2	end. 2014
Brokolli	Nutrisan NutriSGS	2	mid. 2014
Metformin	Metformin	2	mid. 2015
Berberine	GlycoX 500	2	end. 2014
Sensoril	Nutrisan Sensoril	2	end. 2014
Vitamine D3	Dekristol 25000	1	end. 2014
Boswellia serrata	H15 Gufic	6	start 2013
ECGC Green Tee	LifeExtension Mega Green Tea Extrakt	2	mid. 2014
Melatonin	MELATONIN 10mg	1	start 2014
Zink	Zink	2	mid. 2014
Canabis Oil	CBD:8%;THC:0,27%	40 µl CBD; 1,35 µl THC	end. 2014
T3	Trijodthyronin	0,025 mg	August 2015

We are considering to start also LDN. Perillyl alcohol looks also promissing, but we don't know where to get it in Europe. Suggestions what we should consider in addition are welcome.

She recovered from all symtoms of the suregery and the tumor very well and can live a normal live. We hope that the positiv trend of the last MRIs will continue and that something from our cocktail list is effective.