There is a fascinating and exceedingly important area of medicine that most of us have not been exposed to at any level of medical care.

We have been working with an integrative oncologist in Illinois who does chrono modulated chemo therapy. This is how I first learned about its benefits. It is much easier for a cancer patient to tolerate. And in most cases, beneficial.

Chronomodulatedchemotherapy has been researched since the early 1970’s. Yet it hasn’t been approved by the FDA. And hasn’t had enough clinical trials to have it approved. Alternative care specialists are using it. Dr. Block, the integrative oncologist we are consulting with does do this therapy. https://blockmed.com.

Also known as chronobiology, it is the study of how time-related events shape our daily biological responses and apply to any aspect of medicine as well as other health conditions, not just cancers.

For example, normally occurring circadian (daily cycles, approximately 24 hours) events such as cortisol levels, occur in the body around 10 pm and 4 am and elevate histamine and other mediator levels that occur between midnight and 4 am, play a major role in the worsening of asthma during the night. In fact, this nocturnal exacerbation occurs in the majority of asthmatic patients.

Biologic rhythms are ingrained, and although they can be changed over time by changing the wake-sleep cycle, these alterations occur over days. However, sleep itself can adversely affects the pathophysiology of disease. The non-light/dark influence of biologic rhythms was first described in 1729 by French astronomer Jean-Jacques de Mairan, it was presumed that the small red flowers of the plant Kalanchoe bloss feldiuna opened in the day because of the sunlight and closed at night because of the darkness. When de Mairan placed the plant in total darkness, the opening and closing of the flowers still occurred on its intrinsic circadian basis.

I see this in many flowers. Even on rainy or foggy days. They don’t want to open until the sun is out! I’m sure we all sometimes feel like this!

It is intriguing to think about how the time of day governs the pathophysiology of disease. On awakening in the morning, heart rate and blood pressure briskly increase, as do platelet aggregability and other clotting factors. This can be linked to the peak event of the heart attacks.

Biologic responses to many agents such as medications, chemical substances are not constant over a 24-hour period nor are the responses random variations. These responses do not apply only to the human body. The response of antibiotics to bacteria and of cancer cells to chemotherapeutic agents or radiotherapy are but two examples of the way that circadian changes after therapeutic response.

In studies done on leukemia in mice, it was shown that giving Ara-C on a chemotherapeutic basis produced superior results compared with the same total dosage but equally divided. There was twice the survival and no drug toxicity death with the chronotherapeutic approach compared with the equal-dosing regimen. Applying this concept to human beings, researcher Rivard and coworkers studied children with acute lymphoblastic leukemia that were in remission. The children had remission chemotherapy either before 10 am or after 5 pm.

The dose and drugs used were identical for both groups; only the dosing time was different. After 1 year, the children who received morning chemotherapy had a relapse rate that was 4.6 times that of the children who received evening chemotherapy. In these children, the results held up for an additional 6 years, with the relative risk for relapse remaining at 2.56 times greater for the morning regimen.

Chronotherapy won’t work for all drugs however. Medicines that break down very slowly in the body, such as the Alzheimer drug Donepezil, can’t be made more effective by dosing at a set time because they tend to provide a stable concentration over a 24-hour period. That is why most chronotherapy efforts focus on drugs with a half-life of less than 15 hours. Donepezil has a half-life of 70 hours.

Chronotherapy (also known as chronomedicine) dates back to the 1970s when researchers noticed how mice with cancer responded better to treatment given in decreased doses over a 24-hour cycle. 

It is unfortunate that this field of medicine isn’t widely used at this time. There is plenty of research on it. If you are interested in learning more, visit Dr. Keith Block’s website. https://blockmd.com.  Also go to Google Scholars to find further articles and research on this most effective therapy.