Tuesday, June 30, 2009

June Interview: Howard Cohen on Fighting Cancer with Mothers' Milk

This is not an interview on secrets, but I want to start with the observation that at any given moment, you don't really know what the people around you - even some of your closest friends and perhaps family - have gone through. Sometimes you find out by accident or if the person who holds the secret is willing to share, and I find this phenomenon particularly true in the case of one's health.

It's not surprising, really. For ages, social stigmas have been created around certain diseases - leprosy, STDs, schizophrenia to name a few. That's why I find it incredibly respectable when people who have gone through life-threatening and often life-changing experiences are willing to tell their stories. This month, Jelly Theory features Dr. Howard Cohen, a biotech entrepreneur who was diagnosed with prostate cancer about ten years ago and fought it with an alternative form of treatment - mothers' milk.

As Howard reminded me after our interview, his story may feel far removed for those of us in our 20s and 30s. Prostate cancer affects older men, and the advantages of breastfeeding are too early to think about now, but "the world is filled with new things." Oh, and by the way, there's no second "r" in the world "prostate" - a commonly made mistake.

Howard, how did you find out you had cancer, and if you don't mind sharing: what was going through your head?

I had always been very healthy and never had any health issues in my life. Ten years ago, I went in for a routine physical and requested a PSA (Prostate-Specific Antigen) blood test because a friend of mine had recently been diagnosed with prostate cancer. The results showed that my PSA level was high and the rate of increase in my PSA level was high too - a sign that the cancer could be rapidly growing. I setup a biopsy, and after a couple ambiguous results, I was diagnosed with prostate cancer. Just like anyone who is diagnosed with cancer, I felt like a deer in the headlights: you don't hear anything else and go through this existential fear, wondering what you're going to do. The news was image shattering. I had planned to live a long healthy life.

PSA level over time (taken from Howard's site)

Thanks for sharing that process with us. How did you transition from your initial shock to fighting the cancer?
I gave myself a week to wallow in my emotions and then started researching the disease, what my options were, and how quickly I had to move. I started looking at the Web, read books that offered different viewpoints and could provide me with a basis to understand my medical options. Meanwhile, my wife was pursuing her own intuition. She had nursed all of our children, and it's a well-known fact that children who are nursed with mothers' milk are less susceptible to childhood and adult cancers, infections, and allergies, as well as build a better immune system. In the early 1990s, a research team in Sweden led by Catharina Svanborg at Lund University discovered that when mothers' milk was added to cell cultures of cancer cells, the cancer cells died, but left healthy cells unharmed. The team added mothers' milk extracts to all 40 lines of cancer cells that they had access to and found that the cancer cells were committing suicide, or in scientific terms, going through apoptosis or programmed cell death. In 1999, the American Cancer Society started funding their research and continues to do so.

That sounds too good to be true! What's going on biochemically?
When mothers' milk gets in an acid environment, such as one's stomach, the alpha-lactalbumin molecules react with the acid and unfold. They then combine with oleic acid, more common in human breast milk than other mammals, and take on a new shape. This new conformation, called HAMLET (Human Alpha-lactalbumin Made Lethal to Tumors), causes cancer cells to go through programmed cell death, while not affecting normal healthy cells. To this day, it's still not understood why this new shape does this. There are fundamental questions left unanswered: If you drink mothers' milk, how much of it is converted to HAMLET? How much is absorbed by cancer cells? How is it transported through the body? Where does it end up? How is it that it selectively targets cancer cells? What's the appropriate dosage? None of these answers are known.

HAMLET (click image for photo source)

What convinced you to try mothers' milk as an alternative form of treatment and mostly importantly how did you purchase it since it's not available on the market yet?
I thought, What the hell? While I was figuring out my surgery and radiation options and improving my diet and exercise, mothers' milk was an interesting prospect that I began to seriously consider. My wife called the milk bank in San Jose and was told by the director that the milk was only available for premature babies, which was frustrating. Later, at a BBQ, we met a woman who was a cancer survivor and nursing a six-month old baby and agreed to pump extra milk for me. She would freeze the milk for me, and I'd pick it up once a week and incorporate two ounces a day into my diet.

How did you monitor results?
Two months after my biopsy, I went in for another PSA test and my PSA level was in the middle of the normal range. At this point, I had only taken mothers' milk for about a month and thought it may have been a fluke, but I continued to do blood work on a monthly basis, as opposed to every three to four months, which the doctors recommended, so that I could get enough data to pull signal out of noise. I was totally blown away and amazed. Though I had previously decided on surgery and found the best surgeon in the Bay Area, I decided to postpone the procedure and see what would happen. The surgeon told me that I would be back to see him. It's been 10 years, and I haven't been back to him to schedule surgery.

That's truly good news to hear. Have you continued the treatment?
A year passed. My donor weaned her baby, and I didn't have a supply of mothers' milk anymore, so I tried to concoct my own version, and my PSA level went up. My wife called the milk bank again, and it agreed to sell us mothers' milk if I got a prescription from the doctor. One urologist that I approached wouldn't put his reputation on the line, but three other doctors agreed to do it. A week later, my PSA level was back down and that experience further convinced me that mothers' milk was really effective, since nothing else I was doing had changed. I continued taking it on a regular basis - two 3.5 ounce bottles a week - and the cancer eventually became undetectable. About a month after seeing these good results, I gave a talk at a support group about my initial results and what I had discovered about mothers' milk. People started requesting copies of my talk, and so in March 2000, I began creating my website, SOME GOOD NEWS - Improvements Without Knives or Rays, which documents my story. I hope to turn it into a book someday.

What other stories can you share with us on cancer patients who have also tried mothers' milk treatment?

In November 2007, I was contacted by a woman whose husband had stage four colon cancer that had metastasized to his liver. She was nursing an infant and started supplying her husband with her milk. In June 2008, I heard from the couple again. The man had gone into surgery, and his doctors told him that the tumors, which had metastasized to his liver, were dead and that the chemotherapy must have been really good. A colonoscopy found no tumors in his rectum or colon. This man's story is much more amazing than mine. He was probably six months away from his deathbed.

There was also an interesting bladder cancer study done in Sweden. To quote the abstract of the study, "Nine bladder cancer patients received 5 daily instillations of HAMLET during the week before surgery. HAMLET stimulated a rapid increase in the shedding of tumor cells into the urine, daily. Most of the shed cells were dead and 6 of 9 patients showed an apoptotic response. At surgery 8 of 9 patients showed a reduction in tumor size or change of tumor character. Adjacent healthy tissue showed no negative changes."

But it's been almost 20 years since the discovery of mothers' milk. Why has research innovation been so slow?
Research in pharmaceutical companies is motivated by money, and you can't patent a natural substance. There's also a difference between academic researchers who are trying to get papers out and researchers who are trying to bring something into the clinic and save lives. In my humble opinion, this research is Nobel Prize worthy once its full implications are discovered and implemented.

What does mothers' milk taste like?
Each batch tastes a bit different because the composition changes with the mothers' diet and health, and her baby's needs. It's often more watery than cow's milk and has an oily taste because of the oleic acid. I usually drink it in smoothies - mixing it in with other foods makes it more palatable. People can take it however they want.

What is the screening process that milk banks have to undergo?
A woman who wants to be a donor has to go through some blood work to make sure she doesn't have any STDs, Tuberculosis, AIDS, etc. Every batch that comes in is screened, mixed together, pasteurized, frozen, and then shipped out. With the pasteurization process, the heat treatment denatures some of the the alpha-lactalbumin, so it may not be as effective. Banks will keep a supply of mothers' milk in raw form that's low in bacteria count for patients like myself who request it.

What are the social implications associated with mothers' milk treatment?
There are lots of positive things to be said for mothers who breastfeed their children. The American Academy of Pediatrics recommends exclusive feeding on breastmilk for the first six months of a child's life, then continued breast feeding at least for the first year and longer if possible. These infants grow up to be healthier children, which has enormous implications for public health and medical expenditures. In addition, nursing children helps women recover from childbirth and leads to greater mother-child bonding. It's an emotional investment that's almost chemical and helps build healthier families. The child has a stronger sense of belonging and feels more wanted, so s/he is likely to achieve greater success in life.

What my wife and I are pressing for now is that, like in Europe, women get subsidized by the state to stay home for a year to nurse their children; the quid-pro-quo would be that they pump and supply additional milk for premature children and people with poor immune systems and cancer. This would decrease the cost of oncology treatments and increase the effectiveness of chemotherapy. We wrote a letter to the president, as well as key senators and representatives in Congress. This is long-term and potentially short-term cost effective.

I imagine you've been met with some resistance over the years?
Americans are weird about the human body, sexuality, and nutrition. I've gotten reactions from complete disgust to the wink, wink, nod, nod dirty old man approach, so there are definitely cultural barriers that need to be crossed in order for the treatment to become more acceptable to the general public. That said, this was more true in British press coverage than in U.S. newspapers.

What advice would you offer people who, like yourself many years ago, have recently been diagnosed with cancer?
Don't let anyone bully you into doing something that's irreversible. Some cancers move quickly, so understand your time constraints. Go through the emotions and find a support group of people who you can connect with, who have been through what you are starting to cope with, and whose collective experience you can learn from. Educate yourself, and don't completely believe in doctors. Treat them as consultants who are people you're hiring to help you come to the best decision. Get help from your family and friends. It's your life, and no one is as big of an advocate as you are.

Please define what an entrepreneur means to you.
An entrepreneur is a person who can take an idea and turn it into a going economic enterprise, can motivate and coordinate people around him/her, and combine creativity, people and business skills. In this Valley, s/he usually has technical skills as well. Success often requires luck and timing, as well as passion and hard work.

Thank you very much, Howard, for telling your story on Jelly Theory. Here's to the future of medical discovery and living life well.

(click image for photo credit)