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HOUSTON CHRONICLE (Texas) 23 January 08 Cancer fight turns to toxic toad venom - Local experts study Chinese remedy (Todd Ackerman)
Photo: Bufo gargarizans, the Asiatic toad, sickens attackers with its toxic venom. (Wikimedia Commons)
A Houston hospital known for seeking the most advanced cancer therapies that modern science can develop is turning its attention to a centuries-old Chinese treatment: toad venom.
Scientists from the University of Texas M.D. Anderson Cancer Center are investigating whether the stuff that some types of toads use to sicken their natural predators can also be a healer, as doctors of traditional Chinese medicine have long believed.
"Without hesitation, toad venom was the No. 1 drug (Chinese) doctors mentioned when we asked them to suggest the best natural cancer medicines to test," Lorenzo Cohen, director of M.D. Anderson's integrative medicine program, said from China. "It may sound wild to Americans, but it's accepted as a standard of care here."
It also appears to hold promise. In clinical trials Cohen is leading in Shanghai, the venom secreted by the Asiatic toad has shown some benefit and no apparent side effects in patients with advanced liver, pancreatic and lung cancer — which are not easy cancers to fight.
Cohen said he hopes to bring the drug to Houston to test on M.D. Anderson patients in a couple of years. It already has been tested successfully in laboratory and mouse studies at the cancer center.
The research, funded by the National Cancer Institute, is part of an M.D. Anderson program to determine whether alternative therapies can be integrated with accepted Western practices. In his work in the program, Cohen makes frequent trips to China.
One expert said he was impressed that M.D. Anderson would take up the research of toad venom, or ChanSu, as it's known in China.
"In terms of clinical research, we're in the infancy of testing herbs, much less animal products," said Ted Kaptchuk, a Harvard professor of medicine and author of The Web That Has No Weaver: Understanding Chinese Medicine.
"Animal products tend to make scientists queasy," he said, "to be seen as possibly culturally influenced, as if they're hocus-pocus."
Kaptchuk said it makes sense to investigate toad venom because it's much-discussed in cancer alternative treatment circles. He was hard-pressed to think of other animal products used in traditional Asian medicine that have been exposed to clinical trials.
The remedy is thought to date at least to the Song dynasty (960-1279) and has been used to treat many ailments, including cancer and heart problems. Although it now is injected in patients in China in conjunction with chemotherapy or other treatment, it also is still given in some parts of the country as a broth of dried toad skin, herbs or other animal products.
Cohen hopes to come up with a pill form of the venom to use in the U.S. In China, the injections are given daily for 14 consecutive days, or five days a week for three weeks. That would be too costly at U.S. hospitals.
M.D. Anderson researchers believe the toad venom works because of a compound called cardiac glycosides. The substance can be toxic in overdoses, but from other sources is already used in the treatment of congestive heart failure.
''It appears to inhibit proteins promoting cancer cell growth, and then cause cancer cell death," said Peiying Yang, an assistant professor of experimental therapeutics at M.D. Anderson.
''A lot of people think it's unwise to use," said Yang, "but in Chinese medicine, one philosophy is: To cure a toxic disease, you may have to use a toxic substance. The dose just needs to be low enough to not cause side effects."
Yang said that, in the mouse studies, pancreatic tumors shrank in as many as 60 percent of the subjects. That result is slightly better than the performance of the standard chemotherapy drug gemcitabine.
In the clinical trial at Fudan University Cancer Hospital in Shanghai, the extract stopped tumor growth in six of 14 patients with advanced lung, liver or pancreatic cancer, Cohen said.
Of course, in some respects, the success of natural remedies comes as no surprise. Cohen and Kaptchuk note that more than 60 percent of cancer drugs are derived from plants.
But Cohen said he isn't yet looking down the road at commercialization.
"Right now, I'm just looking for evidence for further exploration," he said. "But it's not that easy to isolate a single biologically active ingredient from Chinese medicine remedies."
Cancer fight turns to toxic toad venom

“Cohen hopes to come up with a pill form of the venom to use in the U.S. In China, the injections are given daily for 14 consecutive days, or five days a week for three weeks. That would be too costly at U.S. hospitals.”

Wow, you are talking fourteen or fifteen shots to see benefits in advanced liver, pancreatic and lung cancer but somehow that’s too expensive for U.S. hospitals?
That part of the toad story really jumped out at me…

the high cost is in relation to hospital time and the qualified staff to deliver the drug...and the likelyhood of insurance companies to actually pay it.

I could actually see it being much more likely to be used here in a pill form. Or at least I could see it making its way in faster if it had a pill form. Even as homeopathic that is relatively inexpensive and a person does not have to pay hospital costs out of pocket to obtain.

Cohen hopes to come up with a pill form of the venom to use in the U.S. In China, the injections are given daily for 14 consecutive days, or five days a week for three weeks. That would be too costly at U.S. hospitals.”

"Wow, you are talking fourteen or fifteen shots to see benefits in advanced liver, pancreatic and lung cancer but somehow that’s too expensive for U.S. hospitals?
That part of the toad story really jumped out at me…"

The US has more stringent approvals for drugs. It takes millions just to get the drug to clinical trials, and millions more to finally get it approved. If it's not approved by the FDA, then it's a no-go unless they do it on an experimental level, in which there is nothing to be made, and insurance will not cover experimental drugs.
The money that needs to be recovered from start to end of drugs is staggering, that's why most new drugs are expensive.
Just an example, but one small bag of chemotherapy is roughly $9000. If by some chance it's not being used, then the hospital bought it, and wasted money most don't have, or insurance didn't cover and they get stuck with the bills.

The drug company needs their cut, and the hospital ups the price to offset the fact that most are in the negatives. Regardless of what people may think, many, if not most hospitals, don't make money and are constantly in debt.

It's a continuing cycle that many other countries don't have to worry about. But they also don't have the level of assurance without the regulations the FDA have.