From The Cancer Chronicles #12
© Autumn 1992 by Ralph W. Moss, Ph.D.


Cancers of the liver or the lung, whether a primary growth or metastases, are among the most ominous types of malignancy. There are very few good treatment options, and patients often lose hope when they learn they have this condition. There is however a new and innovative Japanese treatment which is offering hope to some people with these conditions.

The treatment is a new form of chemotherapy with the rather inelegant name of SMANCS-Lipiodol. Let's break this down. First of all, NCS stands for "neocarzinostatin," an antitumor antibiotic derived from the 'strep' microbe and discovered in Japan in 1965. Its nature was characterized by H. Maeda in 1966, currently chairman of the Microbiology Department at the University of Kumamoto. Over 500 scientific papers have been written about NCS, one of a class of anticancer compounds known as Enediynes (Science 5/22/92).

The SMA in SMANCS stands for a mixture of two other chemicals that increase the activity of the primary drug. (Drugs other than SMANCS are also being tried in this approach.) Lipiodol is thick, viscous stuff produced by mixing iodine, about 40 percent by volume, with vegetable oil. It is routinely used as a contrast medium for X rays. In other words, when x-ray pictures are taken, lipiodol makes internal organs show up better. It also turns out--and this is the real innovation--that this oily contrast agent enhances the activity of chemotherapy, including SMANCS, in key internal organs. The oil is sticky and particularly so in cancer. It exploits the helter-skelter blood vessels the tumor has patched together for its own growth and survival. At the same time, doctors temporarily raise the patient's blood pressure to drive the oily mixture deep into the tumor.

In 1986, Dr. T. Nonno wrote in a Japanese medical journal: "We discovered that when the lipid contrast medium, Lipiodol, was

administered arterially, it remained selectively in the solid tumor for a long time. Using this characteristic nature of lipiodol... remarkable anticancer effects against various malignant solid tumors were observed...."

The word "chemotherapy" usually conjures up serious side effect damage to the immune system. For example, a standard treatment for liver cancer, 5-fluorouracil (5-FU), can be extremely toxic. SMANCS/Lipiodol, while certainly chemotherapy, appears remarkably non-toxic . However, there is a big "but," that must modify this statement. For if it is administered incorrectly, it can also be highly toxic, even fatal. In the Maki Hospital in Kumamoto, Japan, Dr. S. Maki infuses a solution of SMANCS-Lipiodol into the affected organ (generally, the liver or lung) by means of a catheter. This is introduced into a major blood vessel that runs past the groin, the femoral artery. This catheter is carefully threaded up the blood stream toward the target organ. Needless to say, this has to be done by a very skilled surgeon, such as Dr. Maki.

If by chance the drug is fed into the wrong artery, it could do heavy damage. In the case of the liver, it can accidentally infuse the sensitive tissues of the stomach or gastrointestinal tract and result in instant ulcers. In the case of the lung, mistakenly introducing SMANCS/Lipiodol into the arterial feed of the spinal column could result in instant paralysis.

Nevertheless, some brave doctors and very much braver patients have started to employ this therapy in Japan. A smattering of Occidentals are also going to Japan to receive it. A man named Harlan Smith has posted the fascinating account of his and his wife, Betty's, Japanese odyssey to the "Cancer Forum" of Compuserve. At this writing, the Smiths are on their second trip to the Maki Hospital in Kumamoto, an island in Western Japan. Harlan is a 61 year old electrical engineer and Betty , 59, a retired S&L branch manager. They have five children and five grandchildren.

In August 1990, Betty had surgery for colon cancer. A year later the cancer had spread and Dallas surgeons removed half her liver to stop metastases. However, Betty's cancer progressed to both liver and lung. The Smiths rejected the conventional therapy for this condition (5-FU/leukovorin) because they were "not very impressed with its performance." They instead decided to explore all options they could discover. The Smiths eventually uncovered this new treatment, SMANCS-Lipiodol.

From Harlan's account, one can draw the following conclusions:

  • The treatment seems helpful, if not a miracle cure. After several weeks of treatment, Betty's liver tumors have stabilized, if they have not yet completely disappeared.
  • The Japanese people have been extremely friendly, which makes up for some of the formidable language and dietary differences.
  • The doctors and staff at the Maki Hospital, including Dr. Maki himself, seem skillful and compassionate, although there are communications difficulties.
  • The cost of the treatment is around $15,000. This is no higher than many treatments in the US. The main problem is that third party insurance companies balk at paying for anything experimental.
  • In general, Harlan has found the FDA, which has not approved the therapy, to be uncooperative in helping him get SMANCS for Betty in the United States, whereas NCI officials have been somewhat more helpful.

SMANCS is clearly not for everyone. But for those who have sufficient time, energy and money, it is definitely something to know about in the treatment of cancers that are not easily benefited by any approach. In addition to the Maki Hospital, other doctors using similar methods include N. Nakoa, Department of Radiology, Hyogo College of Medicine, Nishinomiya,who has increased 5-year survival of advanced liver cancer from 18 to 27 percent, and T. Kanematsu, Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, who calls this is "an effective treatment for [liver] carcinoma" when the tumor cannot be surgically removed.


IN CANCER CHRONICLES #13 (December, 1992)


In the last issue, we discussed a relatively new form of chemotherapy, SMANCS/Lipiodol, used experimentally in Japan. Harlan Smith, who investigated this method first hand, now feels his description may have been too optimistic. When U.S. doctors examined his wife Betty's MRI scans they concluded that no real progress had been made in regressing her tumors. Betty is now undergoing the Burzynski treatment in Houston.... Harlan also wants it known that not just NCI, but also FDA, co-operated with him in obtaining the Japanese chemotherapy for his wife in the U.S.

articles on war on cancer

Ralph W. Moss, Ph.D. is director of the The Moss Reports for cancer patients. Dr. Moss is the author of eleven books and three documentaries on cancer-related topics. He is or has been an advisor on alternative cancer treatments to the National Institutes of Health, the National Cancer Institute, the American Urological Association, Columbia University, the University of Texas, the Susan G. Komen Foundation and the German Society of Oncology. He wrote the first article on alternative medicine for the Encyclopedia Britannica yearbook. He is listed in Marquis Who's Who in America, Who's Who in the World, Who's Who in the East, and Who's Who in Entertainment (as a film documentarian). This Web site does not advocate any particular treatment for cancer. We urge you to always seek competent medical advice for all health problems, especially cancer. Before consulting our site please read our full Disclaimer statement.

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