Vitamin D, Hydroxychloroquine and Pancreatic Cancer: What You Need to Know

Pancreatic cancer, which affects about 60,000 Americans every year, is one of the deadliest forms of cancer. After diagnosis, fewer than 10 percent of patients survive for five years.

While some chemotherapies are initially effective, pancreatic tumors often become resistant to them. The disease has also proven difficult to treat with newer approaches such as immunotherapy.

Dr Steve Bigelsen 

Steve Bigelsen, MD is a physician specializing in Allergy and Asthma, who in July 2016 was diagnosed with pancreatic adenocarcinoma. He had tumors in the head and the tail with scattered peritoneal metastases and a CA19-9 of 11,575 U/ml. Working with physicians from Weill-Cornell and Johns Hopkins, he began treatment with gemcitabine and capecitabine, plus IV paricalcitol (an analog of Vitamin D) and hydroxychloroquine (an old malaria drug). Both of these are in clinical trials separately, however, no one had ever combined them. Both are relatively safe, inexpensive, and may be prescribed by any oncologist as they are already on the market for other conditions. He has now enjoyed a complete response with his latest CA19-9 of just 18 U/ml and no evidence of active disease for the past 2 years.

As a physician who does not practice alternative or complementary treatments, he is aware of the hurdles and arguments against recommending non-FDA approved treatments and has several concerns himself. He believes that if these concerns are adequately addressed, we can fill a void that is sorely lacking between patients looking for something experimental to improve their odds of survival (many of whom turn to inappropriate, futile alternative treatments) and the legitimate scientific community who has real hope to offer.

Pancreatic Cancer and CA19-9 Tumor Marker Levels

The graph below displays the test results of a Stage 4 Pancreatic Cancer patient's tumor marker levels over time.

The lower the CA19-9, in general, the lower the cancer activity. Within days of adding a repurposed drug cocktail to standard treatment, this patient’s CA19-9 level dropped like a stone, faster than any of his Oncologists had seen with this type of cancer. The repurposed drugs he added were Hydroxychloroquine and Paricalcitol - a form of injectable Vitamin D.

A normal CA19-9 level in someone without cancer is below 35. This patient with terminal Pancreatic cancer saw his levels drop from 11,500 to below 35 in about three months. However, he was not an average patient; he was himself a physician. 

Dr. Stephen Bigelsen has taught at Rutgers University Medical School as a professor in Allergy and Immunology. He is a scientist and goes by the book. He researched his cancer and spoke to others who did more specific research, and he did not accept the consensus standard of care. Instead, he innovated, and he remains alive, some five years later, fully recovered from Pancreatic Cancer. Like Ivermectin, Hydroxychloroquine and Paricalcitol are repurposed drugs. They are deemed safe and effective by the FDA for another disease, yet used in cancer after showing scientific promise. 

Like Ivermectin, the FDA and regulators hate the idea of repurposed drugs because they are being used without their permission or approval. Regardless, it is legal for physicians to prescribe them if they believe, based upon their knowledge and experience, it may help or even save a life. In the case of Dr. Bigelsen, it was his own life that was saved.


#1. Suppose no one survives Stage 4 Pancreatic Cancer using standard treatment - the standard treatment of chemo/radiation/surgery received by Alex Trebek, Patrick Swayze, and Michael Landon. Why don't we INFORM ALL cancer patients that repurposed drugs are an option? Must you be a physician like Dr. Stephen Bigelsen to get the repurposed cocktail? Most of us would never know even to ask.

Must a patient stumble on a book that explains this?

Very few people stumble upon repurposed drugs for cancer. As a result, 99.999% never get the type of treatment that Dr. Bigelsen did. And he tells his story that getting into a clinical trial is not all that helpful if you get only one drug, or only get the placebo, or if you wait until the late stages when cancer has returned in a resistant state.

Getting into a clinical trial after all else fails in cancer care is too little, too late. It may help the study, but it usually does little for the patient. Dr. Bigelsen got all the drugs started by writing a prescription for himself, something most of us cannot do.

The repurposed drug cocktails MUST BE STARTED EARLY.

It is the same with COVID-19. The earlier one starts the Ivermectin, the better. In India, entire households would begin the Ivermectin the moment one family member got sick. This strategy proved remarkably effective, and it did not produce deaths, strokes, or blood clots.

What is the point of all this? 1.9 million Americans contract cancer each year, and 600,000 die from the disease. These numbers, in my opinion, can be reduced by 1/3 by the widespread adoption of repurposed drug cocktails. Unfortunately, the standard of care for most cancers remains Chemo/Radiation/Surgery. I write a lot about the SAM cocktail, a combination of Statin/Aspirin/Metformin. Dr. Bigelsen writes about this as well.


Does hydroxychloroquine kill cancer?

A 2017 review — which reviewed more than 190 studies investigating how chloroquine (CQ) and hydroxychloroquine (HCQ) affect cancer cells — describes how the malaria drugs may increase tumor sensitivity to existing cancer treatments.

Based on their findings, first study author Ciska Verbaanderd, from the University of Leuven in Belgium, and her colleagues say that the drugs “deserve further clinical investigations in several cancer types.”

The reviewTrusted Source was published in the journal ecancermedicalscience.

While the United States has seen a fall in cancer death rates in recent years, the disease remains a significant burden on public health. Last year, there were more than 1.6 millionTrusted Source new cancer cases diagnosed in the U.S. and more than 595,000 cancer deaths.

Given that cancer is increasingly becoming resistant to existing therapies, there is a desperate need to uncover new ways to fight the disease.

Verbaanderd and colleagues believe that the drugs CQ and HCQ could help in this fight.

CQ and HCQ as cancer therapies

CQ and HCQ are medications used to prevent and treat malaria. They may also be used in the treatment of lupus and rheumatoid arthritis. A wealth of researchTrusted Source, however, has suggested that these drugs may also have anti-cancer properties.

For their review, Verbaanderd and colleagues analyzed the results of more than 190 animal and human studies that assessed the effects of CQ and HCQ on different types of cancer.

According to the researchers, the aim of their review was “to inform further research and trials on repurposing CQ and HCQ as anti-cancer agents.”

The team uncovered evidence to suggest that CQ and HCQ could be effective for the treatment of a number of cancers, including glioblastoma — which is a deadly brain cancer — lung cancer, and pancreatic cancer.

“CQ and HCQ have been studied in multiple preclinical cancer models,” write the authors, “and have demonstrated activity on several cancer-supporting pathways and in combination with a broad range of other therapies.”

“[…] The majority of these studies have reported an improved therapeutic efficacy as compared with monotherapy with existing anti-cancer drugs,” they add.

The review also indicates that both drugs are “safe and tolerable” as an anti-cancer therapy, though current evidence suggests that HCQ might pose fewer side effects.

How can CQ and HCQ fight cancer?

According to the team, their review highlights a number of mechanisms by which CQ and HCQ could help to treat cancer.

Firstly, there is evidence to suggest that the drugs can inhibit autophagy, which is the process whereby cells devour their own damaged or unnecessary components.

“Autophagic properties such as nutrient recycling can support cancer cell survival,” the authors note. “Moreover, key regulators of cell growth can be degraded and the DNA damage response can be suppressed through increased autophagy.”

“Therefore, inhibition of autophagy can be an interesting anti-cancer strategy when cancer cells start depending on autophagy for survival.”

The review also revealed that CQ and HCQ can block the CXCL12/CXCR4 signaling pathway, which previous research has associated with cancer progression.

Additionally, there is evidence that CQ can stabilize a protein called p53, which is a known tumor suppressor, and it may also help to normalize blood vessel dysfunction in tumors.

“The benefits of vessel normalization include a decrease in tumor hypoxia, reduced cancer cell intravasation and metastasis, and an increase in chemotherapeutic drug delivery and response,” the authors explain.

Drugs could offer ‘significant clinical benefit’

Overall, Verbaanderd and colleagues believe that their study has highlighted the potential benefits of CQ and HCQ as a cancer treatment, as well as the mechanisms behind their anti-cancer properties.

The team notes that there are 30 clinical trials currently investigating the effects of CQ and HCQ against various cancer types.

Based on their review, the researchers conclude that these trials should focus on the efficacy of these medications, as well as the best doses and methods of administration.


Case report: stage 4 pancreatic cancer to remission using paricalcitol and hydroxychloroquine in addition to traditional chemotherapy by Stephen Bigelsen: I am a physician specializing in Allergy and Asthma, who in July 2016, had tumors in the head and the tail of the pancreas with scattered peritoneal metastases and a CA19-9 of 11,575 U/mL. Working with physicians from Weill-Cornell and Johns Hopkins, I began treatment with gemcitabine and capecitabine, plus IV Paricalcitol (25 mcg 3x’s/week) and hydroxychloroquine (600 mg BID). These are both safe and inexpensive treatment options that have shown success in pre-clinical models, phase 2 human trials, and are readily available. I have now enjoyed a complete response with my latest CA19-9 of just 15 U/mL and no evidence of active disease on my most recent CT scan.

Hydroxychloroquine in Previously Treated Patients With Metastatic Pancreatic Cancer Hydroxychloroquine is approved for the treatment of non-cancerous illnesses such as rheumatoid arthritis and systemic lupus erythematous. Researchers in the laboratory have tested tumors from patients with pancreatic cancer and have discovered that they have certain pathways inside the cells that promote growth and survival of the tumor. Hydroxychloroquine may inactivate these pathways and results in the death of pancreatic cancer cells.

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