It’s been another fantastic year at the Pine Street Foundation…we’ve published peer-reviewed research, presented papers at conferences, received lots of media coverage in the national press, hosted community health screenings, and made huge strides with all our other ongoing research projects.

Published Research: Complementary & Alternative Medicine For Lung & Colon Cancer
For patients with lung and colon cancer, does adding complementary and alternative medical (CAM) therapy to standard treatment extend survival? We analyzed more than 10 years of follow-up data from the Pine Street Clinic for patients who used CAM therapy and compared their outcomes to a control group. In two papers published this autumn in Integrative Cancer Therapies, one of the most important peer-reviewed journals in this field, we found that patients who took an integrative approach had significantly better longevity than those patients who only had standard treatment. Click here for more.

Continuing Research: Can Dogs Detect Ovarian Cancer?
Is there meaningful information contained within the breath that could lead to the early detection of ovarian cancer? In collaboration with Baylor University and the University of California at San Francisco, we are using dogs to find biomarkers in the exhaled breath of women with ovarian cancer that could lead to earlier detection – and better treatment outcomes – for women diagnosed with this disease.

We’ve made great progress on this study this past year and, in preliminary analysis of our data, have seen that training dogs to detect ovarian cancer is highly feasible and efficient, similar to what was seen in our 2006 paper on patients with lung and breast cancers.

To complete this study, we just need to recruit eight more women who are either newly diagnosed with ovarian cancer but have not yet begun treatment, or have been previously treated and now have a rising CA-125 but have not yet resumed treatment. Click here to see if you or someone you know is eligible to participate.

As The Year Draws To A Close…
Whether you’ve known us since 1989 or have only recently discovered our work, it is important to note that the Pine Street Foundation is one of the most efficient and cost-ef- fective research organizations of its kind in the country. And since the vast majority of all our funding comes from individual donors like you, your financial support truly helps us advance the field of integrative medicine and benefits those in need of better treatments. Click here to make a secure donation now.

As you consider your year-end charitable giving, please keep the Pine Street Foundation in mind. We really appreciate it!

Best wishes,

Pine Street Foundation

2011 PUBLICATIONS (PEER REVIEWED)
1.      McCulloch MF, Broffman M, van der Laan M, Hubbard A, Kushi L, Kramer A, Gao J, Colford JM: Lung Cancer Survival With Herbal Medicine & Vitamins In A Whole-Systems Approach: 10-Year Follow-Up Data Analyzed With Marginal Structural Models and Propensity Score Methods. 2011. [Epub ahead of print, PMID 21964510] Integrative Cancer Therapies.
2.      McCulloch MF, Broffman M, van der Laan M, Hubbard A, Kushi L, Abrams DI, Gao J, Colford JM: Colon Cancer Survival With Herbal Medicine & Vitamins In A Whole-Systems Approach: 10-Year Follow-Up Data Analyzed With Marginal Structural Models And Propensity Score Methods. 2011. Sep 30. [Epub ahead of print, PMID 21964510] Integrative Cancer Therapies.
3.      See, CJ, McCulloch MF, Smikle C, & Gao J. (2011). “Chinese herbal medicine and clomiphene citrate for anovulation: a meta-analysis of randomized controlled trials.” Journal of Alternative and Complementary Medicine 17(5): 397-405.

LECTURES/TEACHING
2011     Novel Statistical Approaches to Evaluating Whole Systems Therapies: The Case of Lung and Colon Cancer Survival
2011     Project-Based Learning: Research in Chinese Medicine, A Course for 3rd year students on how to read, and conduct research. American College of Traditional Chinese Medicine. San Francisco, CA. (Presented in two consecutive semesters)

REVIEWER FOR THE FOLLOWING JOURNALS & COMPETITIONS
European Respiratory Journal: 2011
Integrative Cancer Therapies: 2011

EDUCATION
We held two free health screenings for members of our community in Marin County, California. Click here to learn more about these events.

Click here to read the entire paper.

WHAT WE PLAN TO DO
We will be looking for the impact of Chinese herbal medicine on both immediate results (do people using herbal medicine experience less damage to white blood cells or less drug toxicity?) and long-term results (do people using herbal medicine live longer after treatment and is their quality of life better?), as compared to treatment with chemotherapy alone.

We will also be looking carefully at the quality of the published studies. Most of the studies we have located in our systematic search of the medical literature were published in China and one of our goals with this meta-analysis is to better understand the level of scientific quality of these studies; many researchers in the Western scientific community have criticized Chinese studies for their low quality of design and reporting.

WHY THIS WORK IS IMPORTANT
By analyzing these studies, we’ll determine what study quality problems are most significant and where improvement is needed. Pine Street has three primary aims in conducting this meta-analysis. First, we are using the results of this study as a basis for designing a double-blinded, randomized trial for patients with colon cancer. Second, by pointing out where improvements in study methodology are needed, we hope to contribute to the improvement in quality of clinical studies in China. Third, we want to educate readers outside of China on the vast quantity of research being conducted there, research that highlights the potential clinical benefits of integrative medical care.

HOW YOUR CAN HELP
We are asking for your support to conduct this research. Specifically, we need help to cover:

Database fees: $5,250
Researcher & Support Staff Salaries: $42,550
Publication Costs: $3,500

Click here to make a gift (of any amount) to help support this important project.

We seek to compare vitamin D blood test results of two different labs: Quest and LabCorp. We are willing to pay your costs, up to $100, once we get copies of both tests results,  drawn on the same day,  and your receipts. To participate,  you need to find a doctor or clinic in your area that uses Quest and call your doctor and arrange for a 25-hydroxy-vitamin D blood test done by Quest. This will cost anywhere from $50 to $150 dollars. In the meantime,  you will need to arrange to have your blood tested by LabCorp the same day. Thus, you will be having your blood drawn twice on the same day,  one sample sent to Quest and the other sample sent to LabCorp. The easiest and cheapest way to arrange for the LabCorp test is through Life Extension Foundation: call 1-800-544-4440 and let the operator know you are ordering this test in conjunction with the Vitamin D Council study. The price will be $35.25 for the LabCorp 25(OH)D test through Life Extension.
John Cannell,  MD, 1241 Johnson Ave.,  #134, San Luis Obispo,  CA 93401
vitamindcouncil@vitamindcouncil.org

Vitamin D3: A Review of the Evidence for its Role in Human Health

Download the Spring/Summer 2010 issue (0.7 MB): [PDF]

We are doing this with sophisticated chemical analysis at Dr. Solouki’s University of Maine laboratory and with a team of trained dogs at the Pine Street Foundation’s offices in California. We also hope the results of our research will help to predict whether a woman’s ovarian cancer will recur after treatment or become resistant to treatment.

Recruitment Update
So far, over 200 women have contacted us seeking to become enrolled in the study. Of those, 94 are currently eligible and include 13 women with ovarian cancer, 54 healthy controls, and 7 controls with endometriosis or polycystic ovarian syndrome. Study enrollment is still open for non-smoking women who have ovarian, fallopian tube or primary peritoneal cancer (newly diagnosed or recurrent), endometriosis, or polycystic ovarian syndrome. Click here to find out how you can donate a sample of your breath.

Canine Update
At the Pine Street Foundation’s training location, we have been training a team of five dogs, all of whom have reached the most advanced level of our training program. We will soon begin the post-training testing phase of the program, where we’ll be gathering the data that will be reported in scientific publications.

Laboratory Update
Dr. Solouki and his team at the University of Maine have worked diligently to continue to push the sensitivity of the analytical equipment, further increasing our ability to detect meaningful ovarian cancer biomarkers at ever lower concentrations. Dr. Solouki recently joined Michael McCulloch, the Pine Street Foundation’s Director of Research, at a conference sponsored by the Canary Foundation to present a poster session on our exhaled breath analysis study.

How You Can Become Involved
This study is open for enrollment until December 31, 2009. You can also become involved in the study by volunteering to donate a sample of your breath as either a patient or control, work with the dogs, or by making a donating to our research program.

Johanna Altgelt, Kirk Turner, Michael McCulloch, Kathy O’Brien, and Jett Gulbronsen pose with Tessy and Captain Jennings at the Pine Street Foundation in San Anselmo, California

Tessy, a three-year-old yellow Labrador retriever, sniffs at boxes containing breath samples from women with ovarian cancer and from healthy controls and determines which is which

Tessy closes in on which breath sample was given by a woman with ovarian cancer

A breath sample cartridge inside a weighted training box

Published in “People Magazine” August 17, 2009

At first glance, cancer researcher Michael McCulloch’s lab at the Pine Street Foundation in San Rafael, Calif., looks predictably humdrum — a computer, a few beakers and some vials. And yet, if you look a little closer, there’s something downright peculiar about the place. Most notably, the water bowls, leashes and the roll of paper towels used for sopping up slobber.

For the past 10 years, McCulloch, an acupuncturist by training, has been exploring whether the sensitive nose of his furry, four-legged research subjects can detect cancer. And after hearing accounts of canines that reportedly saved the lives of their human owners by sniffing, pawing and barking at their tumors (long before being diagnosed by a physician), he has been grappling with a thought-provoking theory: If a dog can do that spontaneously, that suggests they can be trained to do it.

The idea isn’t as far-fetched as it sounds, insists Dr. J. Leonard Lichtenfeld, the American Cancer Society’s deputy chief medical officer. “An enormous amount of research is being done to find those proteins present in small quantities in the bloodstream that may signal cancer,” Lichtenfeld tells PEOPLE. “That a dog could smell these is definitely within the realm of possibility.”

McCulloch first became aware of the concept that certain diseases can be detected in a person’s breath from an ancient medical text in the early 1980s while studying acupuncture in Taiwan and mainland China. In 2003, he and his colleagues at the Pine Street Foundation began collecting breath samples from nearly a hundred lung and breast cancer patients. Next, they went to work developing a technique to train a group of dogs to sniff out the samples in much the same way law-enforcement personnel teach canines to use their noses to find narcotics and explosives.

What they learned was truly explosive. It turned out his canine research subjects and their sensitive noses could detect lung cancer 99 percent of the time and had an 88-percent accuracy rate for breast cancer. What McCulloch thinks the dogs are detecting is metabolic waste “from the tumor cells, which is chemically different from normal cells. The waste travels through the bloodstream and is exhaled out through the lungs.”

McCulloch recently began working on a follow-up study funded by the federal government and private donations. Last year, they began collecting breath samples from women recently diagnosed with ovarian cancer, known as a particularly aggressive, fast-growing type of cancer cell rarely detected in its early stages. Once again, McCulloch and his team set out to determine if the dogs could be trained to accurately locate the samples — held in fist-sized plastic tubes — when hidden amongst four other similar tubes containing breath samples from healthy adults.

Although the full results of the study won’t be known until December, so far the canines have displayed uncanny accuracy. Which leads McCulloch to wonder if perhaps some day a woman’s breath sample might prove to be a more accurate and earlier way to detect ovarian cancer than the commonly used blood test or ultrasound.

“What does all this mean?” asks McCulloch. “I think part of the answer is that whenever you see dogs greeting each other out on the street, sniffing each other out, they’re probably asking a very simple question: ‘How’s your health today?’ “

Volunteer Position 1
Light cleaning, set-up, and break-down on Mondays from Noon until 1pm (1 hour). Mopping floors after dogs leave, vacuuming, moving lightweight but bulky dog crates from one room to another, setting up room for breath sample subjects. You will be working with 1 to 2 other experienced volunteers.

Volunteer Position 2
Can you post fliers for us around Marin county for our cancer research study? Fliers are ready now and can be picked up in downtown San Anselmo or mailed to you.

WOMEN NEEDED: Click here for study eligibility.

INTRODUCTION
Is there meaningful information contained within a person’s breath? Could this information lead to early detection of ovarian cancer? In partnership with Touradj Solouki, associate professor of chemistry at the University of Maine, the Pine Street Foundation seeks to answer these questions by using two of the most sensitive and sophisticated scent detection devices on the planet: a type of mass spectrometer and a dog’s nose.

We are thrilled to announce that this project has recently been awarded a federal research grant by the Congressionally Directed Medical Research Program and we’ll be launching this next phase of our groundbreaking canine scent detection work soon.

We will focus specifically on detecting ovarian cancer through analysis of exhaled breath, leading the way towards a truly noninvasive way to diagnose ovarian cancer. A major step forward in this study is that breath analysis will be conducted both with trained dogs here at the Pine Street Foundation as well as with sophisticated analytical chemistry at the laboratories of Dr. Solouki in Maine.

PUBLIC ABSTRACT:
Early Detection of Epithelial Ovarian Cancer Using Exhaled Breath Markers:
GC/FT-ICR Mass Spectrometry and Canine Olfaction

BACKGROUND WORK
Epithelial ovarian cancer is the fifth leading cause of cancer death in women. Early diagnosis is the most important step toward reducing morbidity and mortality from epithelial ovarian cancer (e.g., from less than 10% in late stage cancer to greater than 90% survival rate for early detection). Although some women with early stage ovarian cancer experience symptoms, research has shown that early signs may be misleading. Furthermore, the best current method to test for ovarian cancer, a combination of a blood test called CA-125 and ultrasound of the lower abdomen, is also not an accurate indicator of early-stage disease.

Our preliminary results suggest that human exhaled breath condensate (EBC) may provide an important source of biomarkers for early detection of ovarian cancer. We have explored exhaled breath condensate analysis using a biological method (trained dogs in California labs). In careful double-blinded conditions, we have tested the ability of trained dogs to distinguish ovarian cancer cases from controls using samples of exhaled breath condensate with accuracy of over 97%. In addition, we have acquired preliminary data from chemical methods involving Gas Chromatography/Fourier transform Ion Cyclotron Resonance Mass Spectrometry (GC/FT-ICR MS analyses in Maine labs). Preliminary results strongly suggest that there is a tangible prospect to identify potentially unique biomarkers from exhaled breath condensate for early detection of ovarian cancer. Currently, we hold the GC/MS world record for mass resolving power; this unique ability to distinguish very similar molecules from each other, coupled with the unrivaled capability of FT-ICR MS for accurate mass measurement and identification of minor components in a complex mixture, allows sample “fingerprinting” at the highest level of confidence currently achievable. We believe that these two biological and chemical sensing methods, examined in combination, will allow us to develop a new “breathalyzer” type test for early detection of ovarian cancer from

WHAT WE HOPE TO FIND
We believe that, using our approach, patients with epithelial ovarian cancer can be distinguished from both healthy women and women who have other abdominal disorders, endometriosis or polycystic ovarian syndrome controls. It is anticipated that exhaled breath condensate analysis can predict whether a woman’s ovarian cancer will recur after treatment or become resistant to treatment.

HOW WE PROPOSE TO DO THIS
Our primary aim is to identify exhaled breath condensate biomarker(s) that can be used to distinguish ovarian cancer patients from healthy controls at the molecular level. To accomplish this aim, we will first obtain exhaled breath condensate from both epithelial ovarian cancer cases (between biopsy and initiation of therapy) and healthy controls. We will then analyze the collected samples using sophisticated FT-ICR technology (equipped with electron impact [EI], chemical ionization [CI], and electrospray [ESI] ionization sources), followed by statistical data analysis. Our secondary aim is to train five dogs to discriminate between the exhaled breath condensate of epithelial ovarian cancer patients and healthy controls, using our previously established and published methods. We will use samples of exhaled breath condensate from the same cases and controls, described in the primary aim. Dogs will be trained to indicate the cancer patient samples by sitting directly in front of the cancer sample only, and sniffing but ignoring the samples from healthy controls. Having trained the dogs on a “training set” of epithelial ovarian cancer cases and healthy controls, we will then test this approach with a new set of cases and controls, using a controlled double-blind testing design.

We will apply both of the above methods, chemical analysis and canine scent detection, to distinguish epithelial ovarian cancer patients from controls with polycystic ovarian syndrome and endometriosis.
Finally, in order to test the prognostic capability of these exhaled breath condensate analyses, we will continue to follow epithelial ovarian cancer cases until recurrence, death, or end of the proposed studies.

DESIGN
The proposed project will incorporate a case-control design in which we will compare cases and controls. In order to control for potential confounding by inflammation, which can be associated both with epithelial cancer and other non-malignant diseases such as polycystic ovarian syndrome and endometriosis, we will also collect data on CA-125, level of physical activity, body mass index, and concurrent chronic obstructive pulmonary disease, periodontal disease, rheumatoid arthritis, asthma, rhinitis, diabetes, renal disease, and cardiovascular disease.

RELEVANCE AND INNOVATION
Our team will be the first to use analysis of ECB (both by chemical and biological means), for early detection of epithelial ovarian cancer. The proposed approach is a truly non-invasive diagnostic method. There is a strong short-term potential to extend the proposed procedures to identify biomarkers for early detection of other types of cancers and human diseases. A long-term objective is to exploit our research findings to develop portable devices for early detection of ovarian cancer.

WE WILL NEED YOUR HELP
Although we will receive funds to begin this important research project, your donations towards the following will greatly help:

Research Assistant Salaries: $12,000
Recruitment Coordinator Salaries: $12,000
Research Supplies: $575
Research Equipment: $11,984
Hospital Center Data Coordinators: $30,000
Training Site Costs: $16,800
Ethical Review Board Fees: $5,400
TOTAL: $88,759

Your tax-deductible gift, regardless of size, will really make a difference! Learn more about the ways you can give online by clicking here.

Sniffing Out Cancer
by Amanda Robb

This article is from the June 2009 of O, The Oprah Magazine. Click here to read the entire article.

Everyone knows that dogs have great noses. We’ve put them to work detecting explosives, drugs, and missing people. Next assignment: sniffing out cancer.

Tessy, a yellow Labrador retriever, was destined to be a guide dog—she was born at the Guide Dogs for the Blind in San Rafael, California, after all. But when an infection left her blind in one eye, Tessy had to leave the family business. Thankfully, she still had the asset dogs are famous for—her nose. And with it, she’s found a second career: sniffing out ovarian cancer in women.

The first medical journal to report on a dog behaving differently around an owner before the owner received a cancer diagnosis was The Lancet, which in 1989 described a woman whose border collie–Doberman mix wouldn’t stop sniffing her mole. Because of the animal’s persistence, she went to see a doctor, who identified the mole as a malignant melanoma. (The possibility isn’t as crazy as it sounds: Scientists have long known that tumors release tiny amounts of chemicals different than those of healthy tissue.) In the early 2000s, British researchers set out to test dogs’ sniffers. Using a method some police use to train bomb-detecting canines, they taught six dogs to identify the smell of bladder cancer in samples of patients’ urine. The dogs’ success rate wasn’t stellar—41 percent—but it was enough to support additional research.

Within the past decade, researchers at Pine Street Foundation, a nonprofit cancer education and research group in San Anselmo, California, have taught dogs to identify the smell of breast and lung cancer on patients’ breath. Their hope was that the biomarkers for cancer would be easier for the dogs to smell in the breath than in urine. The dogs were trained on breath samples that came from cancer patients; the sniffers earned a treat when they sat in front of the positive sample. “We think dogs are like people and perform best when they get positive feedback,” says Michael McColloch, PhD, director of research at the Pine Street Foundation. The results of the study, published in 2006 in Integrative Cancer Therapies, were remarkable: The dogs achieved a success rate of 88 to 99 percent.

When you consider how sensitive dogs’ noses are, the results aren’t surprising—the average canine can detect scents 10,000 to 100,000 times better than the average human. They can pick up the smells at about one part per trillion, the equivalent of, say, being able to sniff out a single drop of chlorine in an Olympic-size swimming pool.

The next step is training a new set of dogs—Tessy included—to detect ovarian cancer, an often elusive disease that when found early has much higher survival rates. So far, the Pine Street Foundation dogs have done 25,000 scent trials for ovarian cancer. The researchers are collaborating with scientists at the University of Maine, who are trying to mimic the dogs’ cancer-sniffing abilities with laboratory machines.

Nicholas Broffman, executive director of the Pine Street Foundation, foresees a time when women going in for annual physicals will give a Breathalyzer-like sample as routinely as they get their blood pressure taken or have a Pap smear. Whether the test tube that holds their breath samples will be sent away to a conventional lab or one that looks more like a dog run remains to be seen.

For now, the Pine Street canines work four hours a day, one day a week. “It’s a mix of serious work, playtime, and hanging out with people,” says McColloch. “These are all the things that get dog endorphins going.”

And Tessy’s schedule is much lighter than it would have been had she followed her original career path, says her owner, Paolo Pompanin, a master instructor at Guide Dogs for the Blind. It leaves her plenty of time for her other love—charging through powder on ski trips. “She jumps and jumps and jumps and jumps. She lets go completely.”