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Cancer - doing well on treatment
Integrative cancer care is very controversial. Oncologists and governments are justified in their skepticism because patients are desperate and very vulnerable to any treatment that may offer hope. That being said, there are a handful of so-called 'alternative' cancer therapies with a rational scientific basis - and many are supported by human clinical trials. These approaches, when used in conjunction with conventional treatment, may improve your symptoms during treatment - and your odds of survival.
WHAT TO AVOID DURING CHEMOTHERAPY
Several herbs that should not be used during chemotherapy. In some cases, this is because they are handled by the cytochrome p450 system of the liver, which also handles many chemotherapeutic drugs. In other cases, it is because they interfere with a specific anticancer effect of one or more drugs. As a general rule, you should avoid using herbs for 2-3 days before and after chemotherapy, but this should definitely done with the following herbs:
- Berberine
- Black cohosh
- Devil's claw
- Echinacea family
- Feverfew
- Garlic
- Ginkgo biloba
- Peppermint
- Quercetin
- Red clover
- St. John's wort
- Valerian
Some supplement therapies block the effects of certain specific chemotherapy drugs. Pay particular attention and avoid the following:
- Quercetin with cyclophosphamide, paclitaxel or docetaxel
- Glucosamine with adriamycin or etoposide
- N-acetyl cysteine with carbaplatin, cisplatin or oxaliplatin
- Alpha lipoic acid with carbaplatin, cisplatin or oxaliplatin
- Beta carotene with mitomycin-C
- Curcumin with adriamycin, doxorubicin, cyclophosphamide
WHAT TO AVOID DURING RADIOTHERAPY
A short list of supplements will interfere with radiation-induced damage to cancer cells. These should be avoided for 7-14 days before and after radiation:
- Beta carotene
- Vitamin E
- Coenzyme Q10
A NOTE ON ANTIOXIDANTS
One of the biggest sources of conflict, anxiety and confusion for patients, oncologists and integrative practitioners surrounds the issue of combining alternative therapies with chemotherapy and radiation therapy. Patients are sometimes told that they must discontinue their 'antioxidants' because they will interfere with chemotherapy and prevent it from working. The specific concern is that antioxidants will protect cancer cells from the pro-oxidant effects of some chemotherapeutic drugs.
This myth, which has gained huge popularity among oncologists and in the popular press, comes from two sources. The first was an interview with Larry Norton, an oncologist at Memorial Sloan-Kettering Hospital, that was published in the New York Times. In the interview, Dr Norton discussed a study suggesting that folinic acid protects cancer cells from methotrexate. The problem is that he described it as folic - not folinic acid. Folinic acid has nothing to do with folic acid. The second source was a study in which cancer cells from mice absorbed more vitamin C than healthy cells in a test tube.
Dr. Charles Simone was a medical oncologist at the National Cancer Institute who helped establish the Office of Alternative Medicine at the US National Institutes of Health before entering private practice. In an authoritative recently published systematic review, he identified 61 human clinical trials involving 9617 patients that evaluated antioxidant therapies given in combination with chemotherapy and/or radiation therapy.
The results were astonishing. Not a single study found that antioxidants negatively affected response to therapy - or survival. In fact, virtually every antioxidant was found to either improve side effects, response to treatment or survival. This is because cancer cells behave very differently from healthy cells, and in many cases these compounds act as antioxidants in healthy cells but pro-oxidants in cancer cells. The review vitamins included in the review:
- 8 studies on vitamin A
- 2 studies on beta carotene
- 11 studies on vitamin E
- 1 study on alpha lipoic acid
- 15 studies on antioxidant combinations
- 1 study on nicotinamide
- 2 studies on B6
- 3 studies on folic acid and B12
- 1 study on vitamin D3
- 2 studies on vitamin K3
- 15 studies on glutathione/selenium
TREATING SIDE-EFFECTS
The most common reason that our patients give us for hesitating about chemotherapy is the risk of side-effects. Some of these are a minor nuisance, but others can be long-lasting with serious consequences. While the decision to undergo chemotherapy should always be made on a case-by-case basis with the help of your oncologist and your integrative practitioner, it is reassuring to know that in many cases, the risk can be reduced with preventive therapy. The treatments that are supported by clinical trials include:
- Neuropathy vitamin B6, L-glutamine, Vitamin E, melatonin (including hand-foot syndrome)
- Kidney damage L-glutamine, L-carnitine
- Cardiac damage L-carnitine, coenzyme Q10
- Blood and bone marrow Melatonin, vitamin B6
- Mouth ulcers DGL (deglycyrrhized licorice)
- Inner ear damage Vitamin E
- Intestinal damage Fish oil
- Radiation fatigue L-carnitine, exercise
- Immune suppression Maitake mushroom