Low immunity is the most common problem in cancer patients, and it is also a headache.
The consumption of the disease itself, coupled with the further damage to the immune system caused by conventional tumor therapy (surgery or radiotherapy, chemotherapy), make the patient’s immunity suffer a heavy blow. If there is no timely intervention, the patient will not be able to tolerate subsequent treatment, the condition will worsen, and in severe cases, death will be accelerated!
How to improve the immunity of cancer patients? Patients and their families will think of “supplementary nutrition”. But in fact, for the vast majority of patients, due to the lack of correct nutritional treatment guidance and scientific methods to rebuild immunity, they often fail to make up for it, which is counterproductive.
So, how should cancer patients supplement nutrition scientifically? Which methods are the most effective to reshape the immunity of tumor patients and prolong their survival? What new treatments are there now?
With these questions, MED24 conducted an exclusive interview with Professor Jiang Hua.
Professor Jiang Hua explained “How to reshape the immunity of tumor patients” ↑↑
The worse the immunity of tumor patients
The worse the treatment
MED24: Are Immunocompromised People More Likely to Get Cancer?
Jiang Hua: People with low immunity are more likely to get tumors. In Chinese medicine, the occurrence of tumors is an imbalance between good and evil, lack of good qi, and the invasion of evil qi. The righteousness is immunity.
But this is the strength of immunity in a broad sense. From a scientific point of view, immunity is a very complex issue. Today, whether we are scientists engaged in basic research or clinical physicians, we still do not have a 100% understanding of the body’s immune system.
While the body’s immune system is critical for cancer prevention, it’s not the whole story. There are often such examples in life. Some people insist on exercising every day, do not smoke or drink, and have a good physique, but they still have tumors. Maybe there is no problem with his systemic immunity, but there is a problem with his local immunity.
What is a local immunity problem? In the microenvironment around the tumor tissue, positive immune cells, or immunoregulatory factors, are reduced and cannot remove cancer cells in the body, so the cancer cells grow in large numbers and form tumors.
Therefore, immunity is the basis for defeating tumors, and improving immunity can help patients fight cancer and recover.
MED24: Why does the immunity of tumor patients experience a cliff-like decline?
Jiang Hua: The reason why tumor patients suffer from decreased immunity is firstly due to the side effects of tumor treatment methods, and secondly, due to the after-diagnosis of the tumor, accompanied by The patient’s psychological changes, immunity will also change.
Each patient goes through four periods of psychological reaction after a tumor diagnosis. The first stage is denial, the test result must be wrong. The second stage is anger, why is this disease in me? The third stage is depression. The fourth stage is to accept the reality and then cooperate with the treatment.
The first three stages will have a blow to the body’s immunity. We need to help the patient go through the psychological reaction period as soon as possible and stimulate the vitality of the immune system.
MED24: The harm of decreased immunity in cancer patients?
Jiang Hua: If tumor patients do not have enough immunity, the therapeutic effect will definitely be affected. When tumor treatment enters the era of immunotherapy, there are certain requirements for the immunity of patients. If the patient’s own immunity is very low, no matter how immunotherapy is done, the effect will not be good.
Our team started immunotherapy in 2018. At first we used it for all patients. After a year of use, we found that the more patients who used it in the back line, the effect was not as good as the earlier use. In the final analysis, it is actually the result of changes in the body’s immunity. The later the immune system is lower, the less effective the treatment will be.
When the patient’s immune function is damaged due to treatment or other factors, we need to find a way to restore the patient’s immune function, which is what we need to pay attention to.
Immunonutrition + Rehabilitation
Two “weapons” for boosting immunity
MED24: Why did you think of oncology nutrition therapy for cancer patients?
Jiang Hua: We have been paying attention to tumor nutrition, but it was probably in 2017 that we really started to build a team to do tumor nutrition. Why have this idea? The oncologist rounds the ward every day, and some patients will ask “Can the rooster be eaten?”, “Can the fish be eaten?”, “What should I eat to enhance nutrition?”… But the doctors and nurses of the oncology department don’t know how to The answer will cause the patient to eat indiscriminately.
There are also supplements, and while some supplements are good, there are more messes. During the 30 years of my career, I have seen some so-called health products at every stage, misleading patients to buy them through advertising and other forms.
The above factors will lead to malnutrition in patients, which will not only lead to decreased treatment tolerance and reduced treatment opportunities, but also may lead to increased complications and shortened survival.
In 2018, Changzhou Second People’s Hospital Cancer Center was rated as the first batch of “Tumor Nutrition Treatment Demonstration Wards” in China
MED24: Do cancer patients need to avoid diets? How to strengthen nutrition scientifically?
Jiang Hua: There is no need to avoid food. Cancer patients have a bad appetite. If they are not allowed to eat, what else can they eat? The regular basic diet only needs to have a balanced and moderate combination of meat and vegetables.
On this basis, if you want to increase immune nutrients according to the patient’s immune problems, you must first eat enough, and second, you must eat properly. What kind of patients need to strengthen nutrition, and what kind of patients only need simple diet adjustment, there is actually a strict medical evaluation here. The patient is malnourished to several degrees, and there are very professional opinions on what kind of countermeasures we should take.
Patient undergoing nutritional assessment
MED24: Why should cancer patients attach importance to functional exercise during rehabilitation?
Jiang Hua: Improving immunity, nutrition is one aspect, and recovery is another. There are differences in concept between East and West in this area. Take eating as an example, Western rehabilitation practitioners will encourage patients to use their own functional exercises, even if they leak or tremble, they should try to eat by themselves, and we mostly feed patients.
We should treat the patient as a normal person and let the patient do it himself. Excessive protection is very bad for the patient’s psychology.
Patient wears wearable for rehabilitation training
Fecal transplant
A new attempt to reshape the immunity of cancer patients
MED24: What is a fecal transplant?
Jiang Hua: The so-called fecal microbiota transplantation is simply to extract functional flora from the feces of healthy people, and then transplant them into the patient’s intestine. Intestinal flora, so as to achieve the purpose of treatment of diseases inside and outside the intestine. In fact, the earliest record of fecal bacteria transplantation was in AD 300-400. Ge Hong recorded in related medical books during the Eastern Han Dynasty that the use of human fecal supernatant to treat food poisoning and severe diarrhea has achieved relatively good results. Effect.
Eastern Jin Taoist theorist, famous alchemist and medical scientist Ge Hong
So why would I use it on cancer patients? Immunotherapy lacks an endogenous material basis because the micro-ecosystem in the intestinal tract is disturbed after repeated chemotherapy, radiotherapy and immunotherapy. The intestinal microecology is reconstructed through fecal bacteria transplantation, and the immune microenvironment is normalized, so that the patient’s immunity becomes better, and the follow-up combined immunotherapy improves the patient’s therapeutic effect.
Fecal transplant process
MED24: Can fecal transplants help prolong survival in patients with advanced cancer?
Jiang Hua: We probably started doing fecal bacterial transplantation in March 2019. The first five patients tried fecal transplantation after all treatments were used up. Bacteria transplanted. Two patients lived very long, and one of them is still alive for more than 4 years. Another patient lived for 28.5 months, and after the fecal bacteria transplant, his mental state, appetite and other aspects changed significantly. The patient then volunteered to do it again.
We believe that after the patient is supplemented with fresh bacterial fluid, the diversity of intestinal bacteria gradually recovers, thereby indirectly improving the body’s immune function. On the other hand, due to the enhancement of the body’s immunity, the speed of tumor development is indirectly inhibited.
After summarizing the treatment of these five patients, in 2020 we re-registered a clinical study to improve patient nutrition. Ten patients received routine nutritional therapy, and the other ten patients received fecal bacteria transplantation on the basis of routine nutritional therapy to check the improvement of patients’ nutritional status.
At that time, a 75-year-old patient with esophageal cancer was almost in a coma due to nutritional problems. We placed a nasoenteric tube on the basis of nutritional therapy, and then performed a bacterial flora transplant on him. About a month later, the patient’s condition began to improve and he could eat something. Originally, this patient had no chance of tumor treatment. After nutritional improvement and follow-up tumor treatment, the patient lived for nearly two years. This September, the study received a lot of attention at the European Oncology Congress in Paris.
Because of the good results, we now have another study using immunotherapy plus microbiota transplantation in patients with early stage tumors. Start with patients who have no treatment and work their way up. As I said earlier, the effect of immunotherapy must be the sooner the better, so the effect of immunotherapy plus flora transplantation may also improve with time.
Editor | Yin Le
Reviewer | Zhu Wen