Sunday, March 8, 2009

Sonodynamic Therapy (SDT)

The photodynamic agent we use is also sensitive to ultrasound frequencies. This approach allows deeper penetration into the body. Sonodynamic therpay is carried out using a simple therapeutic ultrasound machine with especially designed treatment head known as maniple, which is applied over the affected area with some ultrasound gel placed on the skin. This is done after the light bed exposure.

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 1 Mhz. Following the light bed exposure (Photodynamic Therapy), 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 occuring 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 dosages 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 side serious effects.

The next generation of Photodynamic Therapy is a significant advance on previous PDT. This uses a specific extract of Chlorophyll A (trade name Ausclorin) 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. Photofrin does persist, so long term photosensitivity can develop lasting as long as 90 days. With the new preparation, the agent is cleared from the skin within 24 to 48 hours, so no photosensitivity occurs. Ausclorin and previous photosensitizers can use the laser, or a specialised light consisting of light emitting diodes, emitting in the red light region and the infra-red region of the spectrum or with light beds using fluorescent tubes in the red light region for whole body treatment.. Because the breakdown wave lengths of Ausclorin also occur in the infra-red region, this means that with the infra-red lights, penetration can occur as deep as twelve inches into the body, so deep tumours can be treated from the surface. This therefore makes it 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 period of time.


The patient is assessed clinically. Then a dose of Ausclorin is calculated based on the patient's weight and stage of the tumour. This is taken orally each morning before breakfast whilst the Ausclorin clears from the skin and accumulates selectively in tumour sites. Following this the patient is exposed to the appropriate lights. The time of exposure is important, and can vary from up to 60 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).

Further light bed exposure is then calculated on an on-going clinical basis. The patient is given enough Ausclorin for treatment at the clinic and three months treatment at home.

Anecdotally there has been success using 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 dissappearance 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 lavels). Ozone autohaemotherapy is an effective way of increasing oxygenation just before light bed exposure, therefore increasing the effectiveness of PDT.


The fluorescent camera can display tumours near the surface of the body. This is often as good as, if not better than the latest scans known as PET scans (position emission tomography).


1. Stage III breast cancer. Primary breast tumour plus metastases in the axillary lymph node, the other breast and the liver. After PDT and lumpectomy: no evidence of cancer in all four sites.

2. Stage IV breast cancer with rampant body metastases. Very low energy, not enough to work in the garden. In bed by 7:30pm. After PDT (ongoing) weight increased 3kg and now normal. Normal sleeping time and energy levels. Resumed gardening. Scan shows that the tumours have stopped spreading.

3. Metastatic melanoma grade IV. ABout 80 metastases visible. Oncologist predicted 2 more months of life. After PDT (ongoing), Alive and well 4 months after prediction. Metastases down to about 20. Energy, appetite and weight improved. Physician estimates that about 80% of the cancer is gone. Further treatment needed.

4. Prostate cancer (large tumolur mass), grade IV, urinary infections, bowel infections, Inability to urinate without catheter, impotent. After SDT/PDT (ongoing) Prostate shrinking and softening, urination better, impotence easing. Needs further treatment but improving.

5. Ovarian cancer Grade IV. Had hysterectomy and other surgery. No symptoms other than elevated cancer marker. After pDT cancer marker now normal. No evidence of cancer.

6. Squamous cell carcinoma grade 1. Lump on upperlip removed surgically. PDD showed 6 metastases on upper lip. After SDT all metastases have disappeared..

7. Prostate grade IV. Hard prostate with 2 nodules, metastasized outside the gland. After SDT (ongoing) Prostate shrunk, softened, one nodule disappeared. Better urination. Clear or almost clear of cancer.

8. Mesothelioma lung cancer. Symptoms include coughing at night, disturbed sleep. Painful breathing, not allowing deep inhalations. Photodynamic diagnosis showed over 12 metastases in the thorax. No noticable benefits from chemotherapy. After SDT (ongoing): Coughing at night has stopped, giving much better sleep. Breathing not as painful, allowing deeper inhilation. "I have an amazing increase in energy". Visible metastases have dropped from 12 or more to one.

9. Breast cancer grade IV. Lumpectomy. PDD showed metastases in the breast and the axillary lymph nodes. After SDT (ongoing) Cleared metastases from the breast. Those in the lymph glands remain. Next treatment will be PDT/SDT.

10. Breast cancer grade IV with extensive liver metastases. PDT failed to hault the progress of the illness. SDT was not available at the time and she has chosen other treatment.