Dichloroacetate (DCA) as a cure for cancer

Question

A while ago I read about a cheap and safe drug that kills most cancers. It was the already known compound dichloroacetate (DCA) and the discovery was widely reported in the media. The results at that time were only preliminary, but people still used it "off-label" despite not being approved as a cancer drug.

The compound itself has been known for a while and is therefore not patentable itself. Some people then claimed that "big pharma" would have no interest in such a cure they could not earn a lot of money from and that such a drug would never be approved.

Where the initial claims validated, does DCA show effectiveness against some cancers? Is it a viable drug or just the result of an overhyped early experiment?

Answer 1

The single most important thing I need to stress is that "cancer" is not one specific disease with one specific treatment. and there are no treatments without side effects.

Here's what I can sum up for you about DCA. I'm going to try to be as general as I can, but this is NOT a simple, cut and dry topic. However every link below should connect to an actual published, peer-reviewed study or at least an abstract (not some wikipedia link) to guide your own research.

DCA is a pyruvate mimetic compound that stimulates mitochondrial function by inhibiting the family of regulatory pyruvate dehydrogenase kinases (PDK1-4). The stimulation of mitochondrial function, at the expense of glycolysis, reverses the Warburg effect and is thought to block the growth advantage of highly glycolytic tumors. (Basically, cancer cells eat more and grow more, DCA is thought to alter that tumor's metabolism). It has been used for about 30 years or so to treat mitochondrial disorders, and is currently under investigation as a possible cancer therapy.

However, research has run into a problem evaluating DCA for cancer. The weird thing seems to be that there is a marked difference in the way DCA appears to act in a dish, the way it appears to act in animals, and the way it appears to act in humans.

This peculiarity alone may take years of research and tons of money to understand, mostly because in vitro (dish) analysis is usually the first step in evaluating potential new compounds, and it may suggest that there are things about tumor growth and metabolism which have yet to be understood properly enough to evaluate the effectiveness of DCA.

From what I have read, DCA does have toxic effects, which seem to be mainly neuropathies and adverse effects on the liver.

Another problem is that DCA has a long history of being studied as a pollutant, cause of tumors in mice,and possible disease in humans particularly in association with other toxic hydrocarbons in superfund sites.

Simply take into consideration the idea of how carefully you would want to study something that was previously investigated as a toxin and pollutant, and you're not sure yet how it exactly works. You'd probably want to be as thorough as possible before handing it out like candy in oncology wards across the world, regardless of how much money is involved.

On the whole, DCA seems to show promise in some forms of cancer, mainly by acting on the tumor's metabolic pathways in a manner not yet clearly understood. A DCA treatment protocol will still take man hours, years, dollars, and whatever comes of it, beneficial or not, it will certainly not be a miracle cure.

Now comes the problem with dealing with profit for "BIG PHARMA". A lot of this seems to stem from the article here, and is of course debatable and could easily devolve into heated, off-topic debates.

Most people need to understand that what they think of as the "BIG PHARMA" is actually thousands of independent international interests including pharmaceutical companies, hospitals, clinics, regulatory agencies at local, state, federal levels, research firms, laboratories, universities, philanthropic organizations who provide grant funding, insurance providers, government and military agencies, oversight comittees, educational institutions, marketing firms, legal firms, advertising agencies, all the way down to individual medical personnel and the guy who empties the bedpans. The interaction between the way these entities compete and cooperate with each other is complex, to say the least and there is indeed much room for critique of the system as it currently stands, but to lump the whole thing under some "BIG PHARMA" cabal run by Satan and Darth Vader from atop a gigantic pile of money is a bit naive. If there is real promise in DCA, someone will find it, someone will fund it and despite any bureaucratic or economic hiccups, it will get to market, because there is no one out there profit-driven or not, who wouldn't want to sell their products with the label "From The Company Who Cured Cancer".

Here are a few more studies done

DCA in colorectal cancer DCAin endometrial cancer DCA and tumor metabolism DCA and glioblastoma (type of brain tumor) DCA and Non-Hodgkin's Lymphoma DCA and neurological side effects DCA to that of standard chemotherapies

Answer 2

There's an article on cancer.org that sums up the current state of the DCA research pretty well.

Clinical trials take a long time, and this is perhaps more true for medicine than it is for any other field. It is not surprising that preliminary indications reported in 2007, have not yet reached the market.

From what I've been able to gather, research on the topic progresses as you'd expect (it does not seem inhibited by a lack of interest from the medical establishment), and it even seems promising. The article linked to above references a 2010 study, which I do not have access to, but see the discussion in the cancer.org article for more on that study.