Cancer and Alzheimer’s (Alz) are both fatal if untreated; each makes the top ten list of US deaths. But many can survive cancer with life-saving treatments. For Alz, we don’t even have the “first survivor,” according to a TV commercial on the Alz Assn website.
Yet there are rare reports of Alz responses, some dramatic. And just this month Dr. Dale Bredesen’s group published a case series. More on those reports (and skepticism) later.
The National Cancer Institute (NCI) survivors website (2022) says that there are now 18.1 million cancer survivors in the US; about 12 million of those are at least five years after diagnosis and treatment. Oncologists are reluctant to say they are “cured,” but the relapse rate after five years is usually low.
The National Institute of Aging (NIA) Alz Basics website (2022) states that Alz disease is “an irreversible, progressive brain disorder that slowly destroys memory and thinking skills…” Another Alz Assn webpage states: “Alzheimer’s has no cure…” but it mentions there are some treatments that may help.
The NIA made their FY 2024 Budget available, asking for $3.87B. Not much text is given to new concrete therapeutic efforts [unless one counts aspirations for CAR-T/M], any new strategies or learning from past failures. They do make this statement: “…none of these therapies have yet demonstrated clear clinical benefits, such as slowing of cognitive decline, though several trials of monoclonal antibodies are ongoing.” [page 16 of full PDF].
But what about Alz’s First Survivor?
A hematologist treating myeloma in a 64 y/o man reported that chemotherapy improved the patient’s dementia, but only temporarily, 1997. Neuropsychological testing was well documented, but the patient died of myeloma. The post-mortem brain had the hallmarks of Alz, confirmed at Duke. When personally contacted, the author (sadly now deceased) said that he was surprised by how little attention the report generated.
A physician in PA reported that a 71 y/o woman who had memory issues seemed to clear her dementia with plasma exchange [PE], done mainly for high cholesterol, 2016. (PE is a hematology / blood bank technique for removing a fluid portion of a patient’s circulating blood, usually replacing it with human donor plasma or albumin).
An academic group in Spain has been trying a similar technique for several years, reporting results of an international sham-procedure-controlled trial, 2020. The sidebar conclusion: “This trial suggests that PE [plasma exchange] with albumin replacement could slow cognitive and functional decline in AD, although further studies are warranted.”
Two authors described a 77 y/o man with Alz who seemed to respond dramatically to oral DNAse1, 2016. This agent was FDA approved in 1993 for cystic fibrosis ,with the trade name Pulmozyme ™ as an inhaled aerosol. These authors haven’t published any specific followup since then that is easily found.
Phil Gutis, a reporter, was part of the aducanumab trial for dementia about five years ago, and he states that he is much better. although some memory issues remain. Is he one of the First Survivors? That would be fantastic! AlzGadfly sincerely hopes it worked for him.
A British reporter wrote up his story then asked several UK academics about him; they were a bit skeptical. The aducanumab studies that caused so much controversy were published together earlier this year. One wonders why there aren’t more positive reports of cases like Mr. Gutis, or even follow up reports on negative cases.
Dr. Dale Bredesen is a neurologist who has done neuroscience research, and he clinically developed “The Bredesen Protocol” about ten years ago for Alz. This program relies of diet, sleep hygiene, lifestyle and other personalized things, reviewed on a website. The protocol also had its skeptics, but the WHO and the Lancet Commission reviewers recommend lifestyle improvements, more for prevention than treatment.
Last year, his latest book was published: The First Survivors of Alzheimer’s. The book contains testimonials from his patients. It was reviewed by two researchers in the field this year. They state: “In conclusion, we argue that Dr. Bredesen has not yet sufficiently demonstrated that his therapeutic protocol is effective for regular use, and therefore is not yet a generalizable solution for AD…”
The Bredesen group published a case series of 25 patients available online Aug 16,2022. They call this a “proof-of-concept” pilot study, so it is not a randomized or controlled trial. They compare each patient on the protocol to their own baseline performance.
Remarkably 11 of the 25 were college graduates, and another 11 of the 25 had post-graduate studies. The three others were at least HS grads. One of their main tools was the Montreal Cognitive Assessment (MoCA) test, which includes drawing, serial subtractions, and delayed word recall. It may be best for subjective memory issues or mild cognitive impairment. From their paper:
Toups, K et al, Open Access CC BY-NC 4.0 Journal of Alzheimer’s Disease, vol. 88, no. 4, pp. 1411-1421, 2022
If interested, the reader should follow the links above to draw your own conclusions….
This is Part 2 of a 3-Part posting, trying to compare therapeutic research in cancer vs Alzheimer’s. The previous post was about a remarkable 100% response in a recent rectal cancer trial vs more recent Alz failed trials. This one is about responses and survivors, so stay on the watch for Part 3!
p.s. the medical literature can be uneven in quality, and many feel that single case reports don’t make much impact. Still, some of us do indulge, so this link is “Survival with Persistent Metastatic Alveolar Rhabdomyosarcoma.” It may be of uncertain value, and it avoids claims of specific efficacy, but AlzGadfly was invited to the subject’s wedding about 15 years after initial diagnosis.