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The Dove Clinic for Integrated Medicine

Photodynamic Therapy

Next Generation Photodynamic Therapy (PDT) and Sonodynamic Therapy (SDT)

Role of Treatment in Cancer

Photodynamic therapy is the use of light sensitive substances, which accumulate selectively in cancer cells and when exposed to light of an appropriate wavelength causes an excited state, that is able to transfer its energy to oxygen. This transfer of energy causes the electrons in oxygen to rearrange and assume a different electronic configuration, where all electrons in the oxygen molecule have paired up, resulting in a particular electron spin configuration. This is highly reactive and initiates a series of events that leads to the release of Cytochrome C from the mitochondria (these are the engines of the cell and are present in large numbers in all cells) and this initiates tumour cell death. Tumours tend to be hypoxic (lacking in oxygen), so in treatment protocols in some cases, we use ozone autohaemotherapy, which is a method of increasing oxygen at the tumour site.

Sonodynamic Therapy is the use of low-level ultrasound and this produces tumour destruction from the non-thermal effects of ultra sound, especially cavitations in malignant cells. Ultrasonic cavitations generate free radicals from the breakdown of water molecules. The Photodynamic agent we use is also sensitive to ultrasound frequencies. This approach allows deeper penetration into the body. Sonodynamic therapy is carried out using a simple therapeutic ultrasound machine with an especially designed treatment head known as a maniple, which is applied over the affected area with some ultrasound gel placed on the skin. This is done after the light bed exposure; (see ‘A review of research into the uses of low level ultra sound in cancer therapy’, Uyu Wang & Mason in Ultra Sonics Sonochemistry, Vol 11, issue 2, April 2004, pages 95 — 130).

We are combining Photodynamic therapy with Sonodynamic therapy. This uses low-level ultrasound, which kills cancer cells using a non-thermal effect, especially cavitation. The agent we use is sensitive to the ultrasound frequency we use, which is 3 Mhz. Following the light bed exposure (Photodynamic Therapy), the patient sits in a comfortable chair and the ultrasonic probe, covered with ultra sound gel, is moved over the skin on the area nearest to the main tumour mass. The use of ultrasound enables us to penetrate significantly deeper into the body than we would otherwise be able to do. (see a review of research into the uses of low level ultra sound in cancer therapy, Uyu, Wang & Mason in Ultra Sonics Sonochermistry, Vol 11, issue 2, April 2004, pages 95 — 130).

Most photosensitizers come from a class of naturally occurring compounds called porphorins. Natural porphorins are breakdown products from recycled haemoglobin and are inherently light sensitive. These accumulate in tumours and cause cancer cells to auto-fluoresce. The first generation of photosensitizer approved for use in cancer treatment - photofrin, - is derived from haemoglobin, whilst some of the more advanced agents are Chlorophyll derivatives.

PDT has several advantages over surgery and radiotherapy; it is comparatively non-invasive, it can be targeted accurately and repeated doses can be given without the total dose limitations associated with radiotherapy, and the healing process results in little or no scarring. PDT can always be done on an out-patient or day case setting, and it has no significant side effects.

The next generation of Photodynamic Therapy is a significant advance on previous PDT. This uses a specific agent which does not have to be given intravenously and can be given orally. It accumulates selectively in tumour sites and it does not persist in the skin, so no photosensitivity occurs.  It is also a whole body treatment, and does not require the use of lasers.  The agent is sensitised by a specialized light bed consisting of several tens of thousands of light emitting diodes, emitting in the red light region and the infra-red region of the spectrum. Because the breakdown wave lengths of the oral agent also occur in the infra-red region, this allows deeper prenetration into the body, enabling tumours to be treated from the surface.  Therefore, this is a non-invasive, whole body treatment. The treatment programme can be repeated as often as is necessary, and for advanced tumours it is best to treat slowly so as to avoid too rapid a tumour break down in too short a time.

Method of Treatment Using Next Generation Photodynamic Therapy

The patient is assessed clinically. Then the agent is taken orally, with the drops being absorbed under the tongue.  48-72 hours then elapse whilst the agent clears from the skin and accumulates selectively in tumour sites. Following this the patient is exposed on the light bed to appropriate light frequencies from light emitting diodes. The time of exposure is important, and can vary from up to 20 minutes for patients with less advanced tumours, to only a few minutes with patients with more advanced tumours (the more advanced the tumour, the slower the treatment programme). Exposure on the light bed initially occurs consecutively on three days following the 48-72 hours after administration of the oral agent.

Further light bed exposure is then calculated on an on-going clinical basis. The patient is given enough oral agent to cover one treatment cycle.

Anecdotally there has been the best success using next generation PDT with breast cancer and prostate cancer. There have been encouraging results with several types of brain tumour including glioblastoma multiforme, and many brain tumours significantly regressed during photodynamic therapy. One case of glioblastoma multiforma showed a total disappearance of tumour.

We often combine ozone autohaemotherapy with PDT. PDT relies on the production of singlet oxygen (O). This is derived from oxygen (O2). Tumours are characteristically hypoxic (showing low oxygen levels). Ozone autohaemotherapy is an effective way of increasing oxygenation just before light bed exposure, therefore increasing the effectiveness of the PDT.

The complete Next Generation Photodynamic Therapy (PDT) and Sonodynamic Therapy (SDT) document in PDF format.

 

Scientific information regarding Next Generation Photodynamic Therapy;

Although not available at The Dove Clinic, it is possible to use a fluorescent camera in order to image the patient’s tumour. This is often as good as, if not better than the latest scans known as PET scans (Positron Emission Tomography).