DCA: Cancer Breakthrough or Urban Legend?

There is the medical equivalent of a tsunami wave building out there, only we don't know where this one is going to land.

It is called DCA, and we at the American Cancer Society are suddenly receiving requests for information about something few if any of us had heard about as a cancer treatment until this past week.

I suspect some of this rapid explosion is fueled in part by the Internet and the rapid exchange of information, and some by advocates who believe in the long-held conspiracy theory that someone is holding back the single simple answer to curing all cancer.

We even received an urgent plea from one media outlet Thursday asking us to help them out with understanding DCA, since its Web site was being inundated with Internet traffic that was overwhelming its servers.

Before we replace rational discourse with irrational exuberance, it is my personal opinion that a bit of caution is in order. The basic reason for my conservative view is "been there, done that."

Origin of DCA Hopes Unclear

I don't know the details of how this phenomenon got started, but I can take a stab at an answer.

An article written by a researcher at the University of Alberta in Canada appeared in the January 2007 issue of the journal Cancer Cell. I do not know the researcher, but the institution is one that is a recognized, established university.

The basic gist of the research report is that cancer cells rely on certain energy pathways that are different from normal cells, similar to the situation that occurs in what we medically call lactic acidosis.

Lactic acidosis, in very simple terms, occurs in our bodies when we are very ill or may be suddenly severely traumatized. Our cells basically become starved for energy and switch into other energy pathways that rely less on oxygen, resulting in the production of lactic acid.

As a result, large quantities of lactic acid circulate in our system, which can contribute to a significantly increased risk of death.

What the Alberta researcher hypothesized was that cancer cells work through similar metabolic pathways. If you could revert them to normal, then the cells would switch back to the typical energy pathway, and either die or convert to normal cells.

Where DCA, or dichloroacetic acid, fits into this theory is that it can apparently convert the bad metabolic pathways into good ones.

As noted in the conclusions of the study, it can do so selectively -- affecting cancer cells and not harming normal cells.

According to the authors of the report, DCA is nontoxic and is currently used in children who have a rare genetic condition where they produce too much lactic acid.

They go on to point out that DCA is used in these children to reverse the condition with minimal or no side effects.

No Simple Answer

Let me assure you that this is a gross oversimplification of a very complicated discussion. Trying to explain this study in plain words is not an easy task.

But the concepts are basic, and the theories of differential cancer cell metabolism have been around for a long time. The paper itself cites something called the Warburg theory, espoused in the 1930s as an example of support for this principle.

In fact, for years we have been studying the possibility that improving the microenvironment surrounding cancer cells by increasing oxygen levels of tumors through various means will lead to improved responses to treatments.

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