Thursday, March 6, 2008

Alternative Pancreatic Cancer Treatments (With Updated FAQs)

There really are people who go into remission from pancreatic cancer. Adenocarcinoma of the pancreas is survivable, and all of the people surviving pancreatic cancer I've observed in recent years have combined alternative pancreatic cancer treatments with conventional therapy. (For a series of updates on this topic posted in late 2010, please also see New Herbal Medicines for Pancreatic Cancer and later postings.)

Cancers of the pancreas are hard to treat because the cells of the pancreas are energetically unique, and that has an enormous influence on how they respond to diet, to electrolytes, and to chemotherapy and radiation. Understanding this principle can help you choose the right foods to eat if you have pancreatic cancer, one of the cancers for which diet makes a huge difference.

Every cell in the human body is surrounded by a membrane that lets oxygen, hormones, nutrients, waste products, and toxins in and out. The membrane admits or ejects these substances with electrostatic charge.

Some cells, like those is the heart, have a particularly potent electrostatic charge (about -90mV in the case of a cardiomyocyte). A pancreatic cell, on the other hand, has a charge of about -4mV.
If a cell "loses its charge," typically because some electrolyte has gone out of balance, it can't release metabolic byproducts and take in oxygen and nutrients. The pancreas is uniquely at risk for various kinds of metabolic imbalances that people with a bent toward complementary therapies call "toxic," and it is also uniquely sensitive to efforts to treat it.

That's why alternative pancreatic cancer treatments that actually work aren't drastic, and don't take the place of surgery, chemo, radiation, or any other medically directed therapy.

So if you're given the dreadful diagnosis of pancreatic cancer, what can you do?

I'll talk about the scientifically explicable options first.

The very simplest thing anyone with pancreatic cancer can do to increase both length of life and quality of life is to cut salty foods out of the diet.

In 2000 and 2001 I observed pancreatic cancer patients treated by the late Dr. Demetrio Sodi-Pallares (1913-2003), a cardiologist who had taught medicine at UCLA, Michigan, and Baylor. Almost by accident he learned that the heart patients he put on sodium-restricted diets sometimes went into spontaneous remission from various forms of cancer.

Dr. Sodi-Pallares developed a more elaborate therapy for pancreatic cancer than you can do on your own: what's called a GIK (glucose-insulin-potassium) infusion and pulsed magnetic therapy in place of radiation therapy as well as severe dietary sodium restriction. Nonetheless, one of his patients, whom I met in 2001, went into remission from stage IV of a non-resectable pancreatic cancer in 1989 and was, last time I inquired in 2004, still alive. She simply strictly avoided salted foods and high-sodium foods (even foods like carrots and celery) for all those years, and, for reasons the doctor could not explain then and I can't explain now, went into remission and stayed into remission.

Dr. Sodi-Pallares developed an elaborate theory of how increasing dietary potassium and decreasing dietary sodium might cause cancer cells to go into apoptosis (die without chemo) or revert to normal, but he never secured funds to do full-scale research. If you were to search the medical literature for studies that confirm Dr. Sodi-Pallares' experience with about 20 pancreatic cancer patients over the last 25 years of his practice, you'd find exactly one--in Japanese. But I would recommend this much for anyone who has been diagnosed with pancreatic cancer:


  • Avoid pickles, cured meats, luncheon meats, ham, bacon, and sausage.
  • Don't salt your food.
  • And to the extent you can, eat at least 5, preferably 9 or even more servings of fruits and vegetables every day.
That last recommendation is crucial. It's possible that Dr. Sodi-Pallares' patients did not survive pancreatic cancer just because they reduced their sodium, but also because they got more quercetin.
Quercetin is an antioxidant found in highest concentrations in onions, grapefruit, and apples, but also in a variety of fruits and vegetables. There are two things quercetin can do:
  • Kill pancreatic cancer cells under laboratory conditions and
  • Cause the liver to "concentrate" certain medications.
Obviously, if you are going to go out of your way to eat lots of fruits and vegetables and you're getting any kind of chemotherapy, you need to let your oncologist know. But it's possible that when you are not taking chemo, quercetin will kill cancer levels the same way chemo kills cancer cells at a higher level.
There's a great deal written about specific nutrients and pancreatic cancer, specifically folic acid, lycopene, phytoestrogens, soy, and vitamin D, but these studies are concerned with identifying foods associated with lower risk of pancreatic cancer, not curing it.
The one nutrient that is found in everyday food that probably does have an effect on pancreatic cancer once it occurs is gamma linolenic acid (GLA). This is the fatty acid found in:
  • Borage oil,
  • Hempseed oil, and
  • Flaxseed oil
GLA is an omega-6 essential fatty acid. Omega-6's are just as important as the better-known omega-3's in controlling inflamation. Omega-3's, as you probably know, promote circulation. Omega-6's slow circulation down, and scientists speculate that they may stop the growth of blood vessels to tumors and thereby keep them from becoming malignant.
Medical science knows a lot more about GLA than it does about sodium restriction. The English-language medical literature (which is very important to your oncologist) confirms that GLA is non-toxic. At least one British laboratory study found that GLA stops the proliferation of pancreatic cancer cells treated with just a few millionths of a gram of the fatty acid in a test tube. Clinical reports confirm that it seems to increase the benefits and reduce the side effects of gemcitabine (Gemzar) and high-dose 5-Fluorouracil ( also known as Efudex, Adrucil, Fluoroplex).
Another nutrient that may have an effect on pancreatic cancer once it occurs is zinc. Supplemental zinc may reduce the risk of skin reactions after pancreatic surgery.
But even then, not everybody needs to take zinc. It's easy to tell if you do. If you put a zinc supplement in your mouth, and it tastes bad, chances are you don't need it. When you are zinc deficient, you become insensitive to the metallic taste of zinc. Do not take more than 60 mg a day, and let your doctor know you are taking the supplement.
Other widely publicized natural therapies aimed directly at treating the pancreatic cancer are more "iffy," and, frankly, I don't have any personal experience with them. There are personal testimonies for life extension due to coffee enema "detox," but the part that gets left out in the natural health news is that the kind of pancreatic cancer being treated was an islet cell carcinoma, not the deadlier adenocarcinoma.
That's what you can do to attack the cancer directly. But there's still more you can do to live as well as you can as long as you can.
The first thing you need to know about avoiding wasting syndromes in pancreatic cancer is, in nutrition, timing is everything.
To rebuild muscle tissue, organ tissue, and immune cells, the body needs carbohydrates and protein at the same time. You shouldn't eat just crackers or just a protein food, eat small quantities of both at the same time.
Also, to avoid tissue loss, the body needs omega-3 fatty acids like those found in fish oil. These fatty acids don't act as directly on cancer cells as omega-6 fatty acids found in GLA supplements. A clinical study involving pancreatic cancer patients have found that getting just about 1 ounce (28 grams--actually the study used 32.2 grams) of protein a day with 2 EPA from fish oil (what you'd get in two capsules) stopped both muscle wasting and loss of fat under the skin. The amount of supplemental protein and omega-3 fatty acids needed to improve quality of life is really quite small.
Finally, there's a case to be made for curcumin. As I note in Could Curcumin Prevent Cancer?, the antioxidant curcumin found in the curry spice turmeric does seem to activate a "cancer watchdog" gene called p53. It's possible, but not proven, that curcumin (and you'd need a supplement, turmeric or curry won't give you enough curcumin to make a difference) might slow down the proliferation of pancreatic cancer cells.
Interestingly, curcumin may cure cancer the same way sodium restriction cured the patients of Dr. Sodi-Pallares. Scientists at the University of Texas at El Paso have found that curcumin "untangles" DNA that may have been distorted in a precancerous cell. And it restores a normal electrostatic charge that helps a cell stay healthy by bringing in all the nutrients it needs.
So to recap, to enhance medically directed therapies against pancreatic cancer:
  • Avoid sodium.
  • Eat fruit and vegetables every day.
  • Take borage, hempseed, and flaxseed oil.
And to maintain healthy tissue:
  • Consume carbohydrate and protein at the same time.
  • Get at least 1 oz (28 grams) of protein every day.
  • Get at least 2 grams of EPA every day.
Folic acid, perillyl alcohols, green tea, and vitamin D may also help.


Even if you don't go the alternative route, long-term survival may be possible:

A Poster Boy for Surviving Pancreatic Cancer

You may also be interested in:

"Zapping" Pancreatic Cancer with Radiofrequency Ablation
Tofu and the Risk of Pancreatic Cancer
Curcumin and Soy Isoflavones Against Pancreatic Cancer
Belly Fat, Testosterone, and Pancreatic Cancer
Sleep and Pancreatic Cancer
Probiotics and Pancreatic Cancer
Stopping Pancreatic Inflammation to Stop Pancreatic Cancer
Could Curcumin Cure Pancreatic Cancer?
Chinese Herbal Medicine for Pancreatic Cancer

Vitamin D and the Risk of Pancreatic Cancer
Folic Acid and Pancreatic Cancer
Pancreatic Cancer and L-Arginine Supplementation
Does a Red-Meat Diet Increase Risk of Pancreatic Cancer?

Frequently Asked Questions:

Q. What about flaxseed and pancreatic carcinoma?

A. It won't hurt, and it may help.

Flaxseed, that is, the ground flaxseed you can find in bags at the grocery store (but not the whole flaxseeds you get in products like Uncle Sam Cereal), provides lignans that have a number of possible benefits in other forms of cancer. I have to tell you, though, no one has found that flaxseed itself is any way correlated with pancreatic cancer prevention or remission. That doesn't mean it isn't, just that no one has proven the connection.

The alpha-linolenic acid that is in both flaxseeds and flaxseed oil is better investigated. The National Institute of Health Sciences in Japan has found that alpha-linolenic acid may help prevent the breast, prostate, colon, and pancreatic cancers caused by the food carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP). This is a chemical that's formed as a byproduct of cooking red meat, and what it does it essentially to disable the "off" switch that causes cancer cells to go through apoptosis, or "cell suicide" when they detect abnormalities in their DNA.

The Japanese research studied alpha-linolenic acid specifically in perilla oil, not flaxseed oil, although the focus was the alpha-linolenic acid, not its source.

Q. Are there foods that cure pancreatic cancer? Are there healthy foods to eat for pancreatic cancer?

A. There is no single "miracle food" for pancreatic cancer. The important thing seems to be avoiding too much sodium and getting enough potassium. That means strictly staying away from pickles, cured meat, and most canned foods, and getting more fruits and vegetables, fruits preferable. The foods that are highest in potassium while lowest in sodium are:


  • Hazelnuts,
  • Pecans,
  • Navy beans cooked without salt,
  • Longans (fresh, not canned),
  • Fresh cherries,
  • Sweet corn (no salt),
  • Oranges,
  • Summer squash,
  • Fresh plums,
  • Kellogg's Puffed Rice,
  • Grapefruit,
  • Pears, and
  • White rice, cooked without salt.
I'm only aware of one person who went into remission from documented pancreatic cancer after dietary intervention alone (and I met her several years ago). But these foods are relatively "healthy."
Q. Is there any list of what pancreatic patients should not eat?
A. Generally speaking, high-sodium foods, especially:
  • Table salt,
  • Baking soda,
  • Soup mixes,
  • Gravy mixes,
  • Pudding mixes,
  • Salted cod,
  • Fuyu (dried, salted tofu),
  • Canned grape leaves,
  • Beef jerky,
  • Hot sauce,
  • Fried pork skins,
  • Salami,
  • Bacon,
  • Sun-dried tomatoes,
  • Ramen noodles,
  • Hamburger helper,
  • Instant grits,
  • Pickled eggplant,
  • Pepperoni,
  • Parmesan cheese,
  • Pickled olives,
  • Polish sausage,
  • Processed cheese,
  • Velveeta,
  • Low-fat turkey or chicken luncheon meat,
  • Snack crackers with cheese, and
  • Pickled peppers.
These are just the worst. If it's salty, it's not good for the pancreas.
Q. Are there foods you need to avoid specifically after surgery for pancreatic cancer?
A. Generally speaking, anything bitter is likely to be problematic. That's because bitter foods trigger a reflex that increases stomach acid and accelerates digestion. You have a "dump" of digested protein and fat hitting the small intestine quickly, but your pancreas can't produce lipase fast enough to take care of the fat. The result may be diarrhea, flatulence, burping, and acid reflux--and who needs all that after cancer surgery?
Q. What about homeopathy for pancreatic cancer?
A. It might not be a bad idea, but "homeopathy" is not at all the same as the "homepathic" little pills you get in bottles.
A good homeopath works with a patient to identify life issues that manifest themselves as disease. The process of working through the "junk" that leads to the health issues is at least as healing as anything you get in a pill.


Homeopathic "pills," however, may be helpful in recovery from surgery or radiation. You just don't take the homeopathy instead of the surgery or radiation. They are used with surgery or radiation. If you'd like to see the current medical literature on homeopathy and cancer, see Homeopathy for Cancer, in Current Oncology.

20 comments:

  1. Can you please comment on the amounts of flaxseed oil one would take daily if diagnosed with pancreatic cancer?

    ReplyDelete
  2. Thank you for your question.

    The first thing I'd repeat is, anyone who has been diagnosed with pancreatic cancer should rely on medical treatment and use dietary intervention to jump the hurdles to remission. And the second thing I'd repeat is, flaxseed (the actual seeds ground up, but not the whole seeds, because the whole seeds are even less digestible), not the oil, has been investigated in preventing, not treating, pancreatic cancer. So there is no "should" regarding flaxseed oil and pancreatic cancer treatment. There is no recommendation for it.

    As to whether is a "should not," flaxseed oil may be as tolerated as any other fat after Whipple or during chemo, etc., maybe a little is better. If you're having trouble keeping food down, orm, more likely, just plain not feeling like eating, flaxseed oil would not be high on my list of foods during recovery. You need energy, you need complete protein, you need fluid, and if you're avoiding the sodium, too, you've got a lot to keep up with. I have been cooked wonderful meals (two, to be precise) by people who had pancreatic cancer they watched me eat. I just wouldn't say, don't eat, have a flaxseed oil capsule instead.


    Not a single person I know who has had pancreatic cancer has used it, however, and I do not recommend it. I don't know anyone who's used ground flaxseed after diagnosis, either, and, at any rate, the benefits seem to focus on counteracting the harmful effects of grilled meat. That's likely much more important in prevention than in treatment simply because of there are a lot of years leading up to the disease.

    If you or someone close to you has been diagnosed, you have my deepest sympathies. And if there is some other reliable information out there about using ALA (alpha-linolenic acid) or any of the ALA-rich oils, after diagnosis, I'll be sure to link it here.

    ReplyDelete
  3. This is such a well informed and balanced site. Thank you.

    You do not consider Nigella Sativa in your discussion. How do you rate that and its healing properties?

    ReplyDelete
  4. Regarding the dietary guidelines mentioned here for pancreatic cancer remission, does the tumor actually decrease in size and retreat? My husband was diagnosed a week ago and they say they will not operate because the tumor is growing around the major arteries. This would be a miracle indeed if he could survive this, and it sounds like it is possible....This posting was from 2008, are there more recent developments?

    ReplyDelete
  5. L, my deepest sympathies to you and your husband.

    In Dr. Sodi's experience, tumors did decrease in size. The best results occurred when his patients followed a low-sodium diet and received an infusion of glucose, insulin, and potassium. In the medical literature, this is discussed in the context of cardiac care, but it's nothing esoteric: KCl, dextrose, insulin to "cover" the dextrose.

    I got an email this morning from the son of a woman who had stage III pancreatic cancer I've been following since 2007. She's had a lot of rough periods, but she's very much still here, availing herself of the heavy arterillery chemos, diet, prayer, meditation, everything she could.

    I suggest that you contact the late Dr. Sodi-Pallares associate, Dr. Ines Aguilar at 55444131 in Mexico City. The website is in Spanish, www.sodipallares.com.mx. She should be able to give you further direction and tell you a great deal more about how patients are doing on the therapies recently. And if there is some difficulty making the connection, please let me know, and I'll make a request for information myself.

    Robert

    ReplyDelete
  6. Are you suggesting that the proteins and fish oil must be consumed at different times to aid digestion? My father has advanced pancreatic cancer and we are following a dietary approach for treating it. Recently we have been facing hurdles due to frequent diarrhea.

    ReplyDelete
  7. Are you suggesting the proteins and fish oil must be consumed at difference times to aid digestion? My father has pancreatic Ca and frequently has stomach upsets, which is a hurdle in our dietary treatment.

    ReplyDelete
  8. First of all my deepest sympathies to you.

    When stomach upset and diarrhea occur after taking fish oil, the problem most commonly is the "marine liquids" that are included in the oil. This usually is something on the lines of "fish juice" that can be (1) allergenic or (2) microbially contaminated.

    The solution to the problem is to switch brands. Since the makers of fish oil aren't going to tell you "oh, by the way, our product is contaminated," the thing to look for is at least 600 mg of DHA + EPA in the capsule, for instance 360 mg of DHA and 240 mg of EPA, adding up to at least 600 mg. It can be any combination of milligrams. There won't be enough room for "junk" if there is that much DHA + EPA inside.

    Also, it's best to get a "triglyceride" form of fish oil rather than an "ester" form of fish oil. The esterified fish oils (the cheap ones) have to be broken down with pancreatic enzymes to enter circulation, and what isn't broken down can cause floating stools and gas.

    I hope this helps. I don't sell fish oil, by the way, but Carlsson, Nordic Naturals, and Xtend Life are good products at reasonable prices. Higher-priced products don't offer more, and lower-priced products, well, you already know. Best wishes, Robert

    ReplyDelete
  9. Thanks Robert for your prompt and detailed reply.

    I actually was asking about this - 'You have a "dump" of digested protein and fat hitting the small intestine quickly, but your pancreas can't produce lipase fast enough to take care of the fat.'

    Does this imply as a general rule that fats and proteins must be consumed at different times?

    ReplyDelete
  10. Sorry I misunderstood your question. I'll answer it on two levels:

    "Triglyceride" fish oils don't require the action of lipase, "esterified" fish oils do.

    But as for mixing proteins and fats, here's the thing. The bile salt dependent lipase secreted by the pancreas doesn't act on proteins, so there is no issue with the fact that the two types of macronutrients are consumed at the same time. However, if one consumes so much protein that the fats in food can't emulsify, then the bile sale dependent lipases can't break down long-chain fats into short-chain fats.

    One way to deal with that is to divide meals into smaller portions and more feedings, eating what otherwise is palatable and nutritious. I realize there are reasons this is hard to accomplish. But if you haven't seen it already, The Cancer Fighting Kitchen by Rebecca Katz and Mat Edelson has some great ideas for the kitchen side of doing this.

    Another way of doing this is to focus on shorter-chain fats that don't require as extensive action by the lipase. This means avoiding anything that's been industrially processed (for example, corn oil that's been sent into a distillation tower for super-heating in the presence of a nickel catalyst) or "esterified." These fats take more of the lipases to be digested. They cause more stomach upset.

    This isn't medical advice. It's which-kind-of-fat-to-look-for-on-the-grocery-store-shelf advice. And I'd be happy to communicate with you further if it's helpful.

    ReplyDelete
  11. Hi, thanks for sharing such a valuable information.

    My dear father was diagnosed with pancreatic adenocarcinoma in July 2010, he had whipple's procedure in august 2010, pathalogy report showed T2N1Mx tumor with 5 out of 12 lymph nodes involvement. So he went through 2 cycles of gemzar(gemcitabine) followed by 28 radiation doses followed by 2 more gemzar cycles. He tolerated well, it all completed in April 2011.
    He was doing quite well until a month ago, but lately his CA19-9 level raised up to 50 which was followed by an obstructive jaundice. His initial CT and PET scan reports showed no recurrence, but our gastroenterologist followed the other symptoms (CA19 and Jaundice, and also he had a septic shock around 10 days ago, he's now out of sepsis but jaundice is there), so he called an imaging review meeting with our oncologist and radiologist which resulted in consensus that there is something going on which isn't a good new.
    so on Monday they are going to remove the obstruction trough endoscopy or open surgery.

    After having gone through your article i concluded that we should do following:
    - Keep sodium free low sugar diet
    - Add curcumin to daily food
    - Take fruits and vegies only

    - Start Flax Seed Oil or Fish Oil
    - Start Quercetin
    - Take Carbohyderate, Protien and Vitamin D enrich food

    Questions:
    1. Did i summarized right?
    2. Should we chose either of Flax and Fish Oil, or should we take both?
    3. Is Fish Oil better of Cod Liver Oil, as Cod Liver Oil has high Vitamin D?

    Thanks in anticipation for your help, I am committed to not give in this battle, and by the help of God we are going to win

    ReplyDelete
  12. Hi, thanks for sharing such a valuable information.

    My dear father was diagnosed with pancreatic adenocarcinoma in July 2010, he had whipple's procedure in august 2010, pathalogy report showed T2N1Mx tumor with 5 out of 12 lymph nodes involvement. So he went through 2 cycles of gemzar(gemcitabine) followed by 28 radiation doses followed by 2 more gemzar cycles. He tolerated well, it all completed in April 2011.
    He was doing quite well until a month ago, but lately his CA19-9 level raised up to 50 which was followed by an obstructive jaundice. His initial CT and PET scan reports showed no recurrence, but our gastroenterologist followed the other symptoms (CA19 and Jaundice, and also he had a septic shock around 10 days ago, he's now out of sepsis but jaundice is there), so he called an imaging review meeting with our oncologist and radiologist which resulted in consensus that there is something going on which isn't a good new.
    so on Monday they are going to remove the obstruction trough endoscopy or open surgery.

    After having gone through your article i concluded that we should do following:
    - Keep sodium free low sugar diet
    - Add curcumin to daily food
    - Take fruits and vegies only

    - Start Flax Seed Oil or Fish Oil
    - Start Quercetin
    - Take Carbohyderate, Protien and Vitamin D enrich food

    Questions:
    1. Did i summarized right?
    2. Should we chose either of Flax and Fish Oil, or should we take both?
    3. Is Fish Oil better of Cod Liver Oil, as Cod Liver Oil has high Vitamin D?

    Thanks in anticipation for your help, I am committed to not give in this battle, and by the help of God we are going to win

    ReplyDelete
  13. Yes, you are summarizing the article correctly. In the years I have been dealing with this issue I have observed that people know when they need food again--don't get terribly distressed if all that you prepare is not wanted immediately. I have come to have a higher regard for cod liver oil than for encapsulated fish oil because of the greater vitamin content. I just suggest that if the smell is a problem don't try to force it. In terms of anti-inflammatory power, cod liver oil is equal to fish oil and both are better than flaxseed oil, but personal responses are key. I certainly wish your father, your extended family, and yourself all the best. Robert

    ReplyDelete
  14. Thanks a bunch for your agile response. I am going to start it right after his surgery after asking our gastroenterologist, only to make sure that he does not suspects any reaction with the medication he has planned.

    Thanks! I'll keep you updated :-)

    Just in the case you are interested in going through his case completely for study purpose, give your email address and i'll send you everything. My email address is sh.abdullah@gmail.com

    ReplyDelete
  15. (I removed your email address from the public posting--Robert) Thanks a bunch for your agile response. I am going to start it right after his surgery after asking our gastroenterologist, only to make sure that he does not suspects any reaction with the medication he has planned.

    Thanks! I'll keep you updated :-)

    Just in the case you are interested in going through his case completely for study purpose, give your email address and i'll send you everything. My email address is

    ReplyDelete
  16. hello,,thanks a lot for your advices,,you add for me alot,,,my dad suffering from pancreatic mass still do not know its nature,,im doctor in egypt,,,radiologest,,,im searching through net to help him,,,pancres enlarged,,wtith dilaed pancreatic duct,,with mass in head of panceas ,,i made for him act abdomen and several labs,,can u advice for me site where i can send for theem his investigations to have an opinoin on way of treatment,,,,i start yr dietery advice for him ,,my mail
    nahae_gizawy@hotmail.com

    ReplyDelete
  17. Hello, Sir! I know a few doctors in Egypt so today I have asked for some additional guidance. It's always better if you can speak with someone in your own country and in your own language. I don't have recommendations specifically for your father. Actually, it would be illegal for me to give them to you! But I do have care for your situation and I will contact you again later. Robert

    ReplyDelete
  18. Hello, Nahae!

    I had a conversation with a cancer specialist in Egypt this evening. He was telling me that surgery at university hospitals gets results that are as good or better than in the US, the relatively better survival possibly due to the fact that you can't get "everything" in Egypt and your father may be exposed to less that is toxic.

    I would say that if it is at all possible to get competent surgery and your father can stand the procedure (it's very hard surgery) that is probably fundamental to survival--removing the cancer if it is resectable. I of course cannot give you any kind of medical advice but I am very happy to continue our conversation and see if I can find other information for you. Robert

    ReplyDelete
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