Compounds in Cancer Therapy: Promising Nontoxic Antitumor Agents from Plants & Other Natural Sources, by John Boik. 2001, 521 pp., softcover with tables, figures. ISBN 0-9648280-1-4. $32. ABC Catalog #B494.
John Boik's first book, Cancer and Natural Medicine published in 1996, caught the attention of many in the natural medicine and cancer treatment fields. The premise of his second book on natural compounds oncology is that the synergistic combination of 15—18 natural compounds administered in non-toxic biologically active oral doses is capable of halting cancer growth. This may be the first science-based guide to complementary and alternative medical (CAM) oncology. The book clearly explains seven strategies to induce programmed natural cell death (apoptosis) in cancer cells:
1. Reduce genetic instability
2. Inhibit abnormal expression of genes
3. Inhibit abnormal signal transduction
4. Encourage normal cell-to-cell communication
5. Inhibit tumor angiogenesis
6. Inhibit invasion and metastasis
7. Increase immune response against cancer cells
Boik then proceeds to describe the biochemical pathways by which natural compounds, mostly phytochemicals, alter genetic instability, gene expression, signal transduction, angiogenesis, and metastasis. The book focuses on the 36 most promising natural compounds, from anthocyanidins to vitamin E succinate, then shows – using mostly in vitro data – how each of these 36 compounds is biochemically capable of generating more "die and do not proliferate" signals to tumor cells. The 36 compounds were selected based on mostly in vitro data showing apoptotic effects in vitro and in animal studies. The list seems comprehensive. Nearly all the main science-based natural medicines now in current use by cancer patients in Europe and America are included, with the curious absence of European mistletoe (Viscum album L., Viscaceae), for which there is a growing body of in vitro, animal, and human clinical data.
A chapter is devoted to each of the main chemical families of active constituents, including the trace minerals, antioxidants, polysaccharides, lipids, amino acids, flavonoids, phenolics, terpenes, and lipid-soluble vitamins. Boik provides carefully estimated human oral doses for the oncology patient, calculated and hypothesized to achieve results that have been observed in in vitro studies. And indeed, this seems not only possible to me as a naturopathic physician, but likely.
Boik has produced his second important book on CAM oncology and the first systematic, rational approach to combination natural medicine protocols for cancer patients. Dose estimations from both in vitro and animal data for each of the compounds is helpful. The figures and tables are helpful and well placed in the flow of the text. The appendices provide useful information, including molecular diagrams for the natural compounds discussed in the book and pharmacokinetic data and dose estimation techniques. The Growth Factors and Signal Transduction chapter, and its accompanying appendix, explain the role of protein tyrosine kinase and protein kinase C and the ways that many natural compounds alter their activity. This well-written chapter explains clearly the complex genetic and cell signaling pathways that make a cancer cell different from a healthy cell including p53, fos, myc, jun, ras, Bcl-2, epigenetic gene instability, redox modulation, protein tyrosine kinase and protein kinase C, and topoisomerase. The chapter on the interaction of natural compounds with radiation and chemotherapy is very useful. Mr. Boik has responsibly and respectfully cited credits for data and figures, and the references are thorough. This will (or should) be a core text in oncology medical programs at leading edge universities.
Boik's method was to search MEDLINE up to the year 2000. Already the book is out of date. The most recent papers cited were done in 1999 [the author updates the research online at <www.ompress.com/research-updates.htm>]. Let's hope that the CAM oncology medical and scientific community has made additional progress in the last three years. However, research on combination botanical medicine is just beginning. Federally funded research into combination natural medicine protocols is in its infancy. We need more data on synergism from in vitro and human studies.
John Boik has written a brave, even brazen, book. The author himself acknowledges the absence of human clinical data. There is even a paucity of in vitro data on combinations. Nevertheless, this book points the way to a rational research agenda in CAM oncology. A cancer research doctoral student at M.D. Anderson Cancer Center, Boik has a clinical master's degree in Chinese medicine and an undergraduate degree in civil engineering. His mastery of chemistry and cell biology evident in the book is a marvel. One must wonder if such clarity of thought and his innovative, systematic, rational approach could only have been born outside of our major universities.
Boik advises readers that this book should not be used by cancer patients for self-treatment. He does not suggest that clinicians use the book to develop treatment plans for their patients. However, this is exactly how the book will be used by some CAM clinicians. I would guess that most of Mr. Boik's readers will be doctors like myself who offer adjunct natural medicine treatment to cancer patients. The synergistic combination model of therapy is central to naturopathic medicine.
Physicians who attempt to use this book to generate rational CAM therapeutics for their cancer patients will be frustrated. The book is not organized by cancer type, so the clinician will need to use the index to find relevant information scattered throughout the book. While it would be useful if the book was in a format to design potentially effective, low toxicity protocols for patients with breast, colon, lung, prostate, and ovarian cancer, as well as the leukemias and lymphomas, more easily, the current version already pushes the envelope of what can be recommended at this time from such an immature research base.
John Boik's purpose is to offer a rational approach to experimental cancer therapeutics and this book should inspire a whole program of research. I hope the National Institutes of Health and major university cancer centers are paying attention to the ideas emerging from botanical medicine that are so well described in this serious and innovative book on oncology.
– Leanna J. Standish, N.D., Ph.D., L.Ac. Senior Research Scientist Bastyr University