Welcome to Moffitt Cancer Center
Department of Cancer Imaging and Metabolism

The Department of Cancer Imaging and Metabolism was initiated in April 2008 with the hiring of Drs. Robert A. Gatenby and Robert J. Gillies as chair and vice-chair of Radiology. 


Research Projects

Buffer Therapy:
(This work is sponsored by Reliable Cancer Therapies http://www.reliablecancertherapies.com)

Cancer cells metabolize sugars at a remarkably high rate. Normally, metabolized sugars combine with oxygen to produce carbon dioxide, which is removed by the lungs. In cancer, however, the rate of sugar (glucose) consumption is much higher than the availability of oxygen, so the excess metabolized glucose is shunted out of the cells as lactic acid. This excess acid must diffuse to the blood in order to be removed. Because the blood supply in tumors is disorganized, a lot of this acid doesn’t make it into the blood right away and diffuses into the surrounding tissue. Thus, tumors are not only acidic, they also export acid into surrounding tissues.

We believe that this export of acid enables tumor cells to invade into surrounding normal tissues as tumors grow. To test this, neutralization of the acid with pH buffers, should inhibit invasion and thus reduce the process of metastasis. We had shown previously that oral doses of sodium bicarbonate could neutralize the acidity of tumors in mice. Thus we tested and observed that chronic ingestion of sodium bicarbonate reduced the incidence of metastases in experimental animals. There were some important observations from this work:

  1. The bicarbonate buffer reduced both spontaneous and experimental metastases. In spontaneous metastases, primary tumors are allowed to grow for a period of time, after which they are surgically removed and then the formation of metastases is followed. In experimental metastases, tumor cells are injected directly into the blood of animals and tumor colonies are allowed to form in metastatic sites, generally the lung or liver. What this means is that the buffer therapy likely inhibits the ability of tumor cells to colonize other organs, which is an essential component of the metastatic paradigm.

  2. Metastases of two types of tumors were not inhibited by bicarbonate. Notably, these two grew very fast and were metabolically much more active than the sensitive tumors. What this likely means is that the buffer therapy, under the conditions used in the study, was not able to completely inhibit all the acid and thus was less effective for faster metabolizing tumors. This does, however, open the possibility that better buffers or higher doses would be effective.

  3. The therapy had no effect on the pH of the blood. This was expected and is a common mis-conception about this therapy. It is not an alkalinizing therapy, it is a buffer therapy. Thus, it is intended to only affect the pH of tissues that are: (a) out of balance and (b) lack an internal homeostatic mechanism, like tumors.

Since this original work, we have continued to work in animal models and have also shown (as yet unpublished that other buffers can work as well, or better, than sodium bicarbonate and thus the effect is not specific to bicarbonate but is a shared property of buffers.

Clinical Trials
. We have also initiated clinical trials in patients with pancreatic cancer. The protocol involves a dose escalation starting from 0.3 grams and moving up to 0.9 grams of sodium bicarbonate per day per kilogram of body weight (0.13 – 0.4 grams per pound per day). Patients are advised to measure their daily dose based on their body weight and dissolve it in 1 liter (1 quart) of water and to drink this throughout the day. Notably, some toxicities, such as nausea and vomiting, have been observed. This may be due to too much being ingested at a single time, as sodium bicarbonate in high doses can act as an emetic. Diarrhea is also a common side effect.

At this time (July, 2011) we are working on two parallel tracks:

  1. To improve the formulation – things we are trying include asking patients to ingest the doses more slowly and steadily throughout the day, going to an intravenous infusion in some patients, and altering the salt to Calcium carbonate, which is just as effective and may be more palatable. This last approach has to be approved by the FDA before we can move forward.

  2. To develop high buffer diet recommendations, that can be used as an adjuvant to the supplemental buffers. This work is being written up for publication and will be deposited here following peer review. Once this is published, we will generate dietary guidelines for adjuvant therapy. In the meantime, stay away from acidic food products, such as soft drinks.

A word about Simoncini. If you Google “bicarbonate therapy and cancer” you will invariably be led to Tulio Simoncini. He is an Italian physician who has been promoting bicarbonate therapy for a number of maladies, including cancer. He has promoted this aggressively on YOUTUBE and multiple websites. He has somewhat obfuscated the issue by claiming that cancer is a fungal disease, for which there is no scientific evidence. He is not a scientist in the modern sense. His claims are not founded in his own empirical or systematic observations, he has not developed and tested hypotheses, and he appears to be somewhat of a self-promoter. However, this does not make him or his ideas wrong. We are empirical scientists and firmly believe that the application of buffers for therapeutic intervention must be grounded in systematic studies to uncover the mechanisms of their effects.  Go back

Gillies/Gatenby References for buffer therapy

Related Links


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11/2012: The Radiomics Workshop report 2012 is available[View]


Abstract accepted for WMIC 2012: Characterization of Multivalent Targeted Molecular Imaging Probes


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