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The preparation is commonly found on sale. Dose levels must be adjusted to patient's weight, blood calcium response and stage of disease.
The drug is not available for sale like other chemical medications but has to be prepared by a pharmacist. As a galenical preparation it requires special equipment and scientific expertise. Non-polar, hence water insoluble molecules like beta-carotene, retinol, retinoic acid and vitamin E require the use of an organic solvent that must be eliminated at the end of the preparation. The whole process must occur in the presence of nitrogen to avoid oxidation of active ingredients. (read the "Trials" chapter in the "Di Bella Method" section). Complete removal of the organic solvent, e.g. acetone or alcohol, is essential to avoid toxic effects and denaturation of active ingredients. Notably acetone has to be removed totally because of its proven carcinogenic effects triggered by manifold mechanisms, including the induction of cytochrome P450 2E1 (CYP2E1), very active in biologically inducing pro-carcinogenic substances. Other acetone-induced effects include a rise in free radicals and a drop in cellular ATP, which is key to cell apoptosis. The retinoid solution may be properly prepared following Prof. Di Bella's indications (again read the "Trials" chapter under the "Di Bella Method" section). During the 1998 MBD trials traces of acetone were found in all retinoid solutions prepared by the Italian Health Institute, with concentrations in some cases up to 850 mg per liter. These concentrations not only have carcinogenic effects but are also toxic, as much is evidenced by attached reports.
Cabergoline - included in the fixed therapy module - is employed in the place of bromocriptine when the latter is not tolerated, at dose levels of 0.5 mg. per week, which can be increased in special cases of tumor progression and metastatic dissemination, especially in prolactin-dependent and hormone-dependent tumors. It is recommended in treating all types of cancer because it is a strong inhibitor of growth factors and interacts synergically with somatostatine, its synthetic analogues, and melatonin. It is especially effective in tumors mostly influenced by prolactin as a growth factor.
Bromocriptine - included in the fixed therapy module - is employed at dose levels of 2.5 mg administered 2-3 times a day during meals. It is recommended in treating all types of cancer because it is a strong inhibitor of growth factors and interacts synergically with somatostatine, its synthetic analogues and melatonin. It is especially effective in tumors mostly influenced by prolactin as a growth factor. Side effects include nausea, which mainly occurs with a single and fasting administration per day. Such side effects may be avoided by fractioning drug administration during meals.
In order to obtain maximum bioavailability melatonin is prepared galenically in capsules with adenosine and glycine. Natural melatonin is "connected" to adenosine by hydrogen. Average dose levels are about ten 2 mg capsules daily, to be ingested during the day with a greater concentration in the evening. The antioxidant, anti-free radicals, anti-proliferation, anti-metastatic and pro-apoptotic effects of this molecule have been extensively described in world medical literature thus confirming the rationale of melatonin in the context of a multi-therapeutic approach to treat cancer.
The biological product somatostatine-14 (tetradecapeptide) may be administered subcutaneously by means of a syringe pump over ten hours' time, during the night. Intravenous administration, always by means of a syringe pump, is also possible and definitely more effective in some cases, though more laborious. Average dosage in adults is approximately 3 mg per day.
Somatostatine is available for sale as a chemical preparation and thanks to initiatives promoted by patients treated with MDB, the average price dropped from 516,000 lire (approx. 260.00 euros) per vial in 1998, to the current 18.00 euros (with daily administration). The 8 amino acid synthetic analogue of somatostatine, namely octreotide, is also commonly available as a chemical preparation. Octreotide is employed with the same criteria of somatostatine-14, but at dose levels of 1 mg per day. Because the half-life (period during which the drug exerts its action) of somatostatine-14 is only a couple of minutes, continuous intravenous infusion is needed to keep drug concentrations effective for at least 8-10 hours.
While the half-life of octreotide well exceeds one hour, this nonetheless administration by means of a rate controlled infusion device is essential to avoid, or considerably limit gastro-intestinal symptoms like nausea, abdominal pain, etc. typically caused by rapid administration.
During MDB trials, as much was stated by officials of the Italian Health Institute (see the "Trials" chapter under the "Di Bella Method" section), only very few patients were granted the use of a syringe pump. Yet, their gastro-intestinal symptoms were disgracefully attributed to the substance rather than to its mistaken administration, no to speak of the impaired effectiveness of the drug.
Up until relatively recent times slow-release somatostatine analogues were produced in 10 mg, 20 mg, 30 mg packages and entailed a very high cost of about 1,700 euros per month. A single intramuscular injection of these analogues allows to cover 10, 20 and 30 days respectively. Because the drug remains dormant until it reaches effective concentrations, shorter intervals between injections are advisable (e.g. 27 days rather than 30 days for 30 mg injections).
More and more published reports on somatostatine, its receptors, radio diagnosis and immune-histochemical methods and RT-PCR techniques to identify such receptors, have been helpful to better clarify the mechanisms of action of both somatostatine and its analogues. There are also numerous scientific reports describing receptor properties and characteristics of the various cancer types. Since octreotide is definitely more effective on receptors 2 and 5 than somatostatine-14 and considering the latter's receptor affinity, an ever greater definition of receptors for every cancer type would be desirable to devise more targeted and effective treatment.
Vitamin C may be administered both as a galenical product (much cheaper) or a chemical medication at dose levels of at least 2 g or more per day.