~Cancer Radiation Therapy, Part 3

SHOULD ANTIOXIDANTS BE USED DURING RADIATION THERAPY?
  • Improve Chances of Survival
The risk of pneumonitis may be reduced by antioxidant therapy. There are several specific nutrients that can be taken to improve the immune system after radiotherapy. General supplementation with antioxidants, such as vitamins A, C, and E, and with the sulfur amino acids cysteine and glutathione is known to reduce free-radical damage caused by radiation therapy. While protection of healthy tissue would best be accomplished if these nutrients were administered prior to radiation therapy, some scientists are concerned that these nutrients might help protect the tumor cells against the radiation-generated free radicals needed to kill all of the cancer cells.

Other scientists point to studies and case histories indicating a neutral or beneficial effect when antioxidants are consumed prior to radiation treatment. A radiation oncologist who has prescribed high dose antioxidants to cancer patients prior to radiation therapy for over 20 years states that the potent amount of radiation delivered to the tumor during therapy would overwhelm the free-radical-quenching effects of orally ingested antioxidants (Smith 2002). According to this physician, antioxidants protect against many of the side effects of radiation therapy such as immune suppression and peripheral tissue damage.

In addition, improved survival in cancer patients has repeatedly been shown to be associated with superior performance level and with improved self-perceived overall quality of life. Many elderly patients experience prompt improvement in performance level and prompt improvement in self-perceived quality of life when antioxidants such as vitamin C (1 gram 3 times daily), vitamin E (400 IU 3 times daily), and selenium (50 mcg 3 times daily) are added as food supplements.

As noted earlier, other experts are concerned that any type of antioxidant consumed before, during, or within 3 weeks after radiation therapy is concluded could protect the cancer cells against the radiation-induced, free radical activity that is needed to kill cancer cells.

Yet a 2002 study on this subject showed that tocopheryl succinate (dry powder vitamin E) enhanced radiation damage to ovarian and cervical cancer cells, but protected healthy cells. This study showed that both cancer and normal cells absorbed a similar amount of tocopheryl succinate, but only the cancer cells were sensitized to the radiation by this form of vitamin E. The use of alpha- tocopheryl succinate during radiation therapy may improve the efficacy of radiation therapy by enhancing tumor response and decreasing some of the toxicities on normal cells (Kumar et al. 2002).

High Dose Antioxidant Therapy May Improve Chances of Survival

An investigative study conducted by the Department of Radiation Oncology, Henry Ford Hospital in Detroit, MI, and the Department of Radiology, University of Colorado Health Science in Denver, CO, between March 1998 and December 2000, explored nutritional and high dose antioxidant interventions during radiation therapy (RT) for breast cancer. The researchers examined 48 randomized patients with Stage I-III breast cancer, 26 of whom received high dose antioxidant vitamins and followed a 10% low fat diet during their radiation treatment. Another 22 patients received only radiation treatment. Of the 48 patients, all were followed for a minimum of 14 months after radiation and evaluated with regard for local recurrence, skin reaction, vitamin levels, quality of life, and cholesterol levels pre-RT, during RT, and post-RT (Anon. 2002).

The researchers found that the addition of high dose antioxidant vitamins during radiation therapy for breast cancer had no increased risk of local recurrence or new cancer 1 year after treatment. However, in patients receiving no treatment other then radiation, one developed a new cancer in the opposite breast and another developed LCIS (lobular carcinoma in situ, defined as the growth and accumulation of large numbers of abnormal cells within the lobules of the breast tissue) in the opposite breast. No other statistically significant differences were observed. However, there were significant changes in the blood cholesterol values from pretreatment to post-treatment in the group receiving antioxidants and diet modification with significant increases in HDL (good) cholesterol and reductions in LDL (bad) cholesterol blood levels. The researchers concluded that further randomized studies should be conducted to determine the potential long-term benefits of high dose antioxidant vitamins and diet modification in early stage cancer.

Antioxidant vitamins could be an important adjuvant to standard treatment of human cancers (Prasad et al.1999; Prasad 2003).

The debate over whether antioxidants are beneficial before, during, and after radiation therapy continues. However, research is mounting that shows quality of life and long-term survival may be improved by combining high dose antioxidant therapy with traditional cancer treatments (Prasad 2003). Research also indicates that antioxidant therapy that is continued post-treatment may exert anticancer benefits.

An in-depth discussion of this debate can be found in the following protocols: Cancer: Should Patients Take Dietary Supplements? and Cancer Chemotherapy.

SEXUAL DYSFUNCTION AFTER RADIOTHERAPY
  • Shark Liver Oil for 30 Days
One of the unpublicized side effects of radiotherapy is male impotency, especially in those patients being treated for prostrate cancer. A high percentage of men experience impotency after radiotherapy with little hope for recovery (Turner et al. 1999). However, treatment of erectile dysfunction with the drug Viagra after radiation therapy for prostate cancer was reported a success (Incrocci et al. 2003).

To determine the response to Viagra in patients with erectile dysfunction after radiation therapy for localized prostate cancer, 21 patients presenting with erectile dysfunction after radiation treatment for clinical T1-2 prostate cancer were studied: Two patients had undergone iodine-125 seed implantation; the remaining 19 had undergone conventional external beam irradiation.

All 21 patients were considered to have erectile dysfunction as assessed by the International Index of Erectile Function and were prescribed sildenafil (Viagra) at a dosage of 50 mg, with a titration to 100 mg if needed: 71% of patients had a positive response, with a corresponding spousal satisfaction rate of 71%. No patient discontinued the drug because of side effects (Kedia et al. 1999).

If you are experiencing impotency, consider consulting your physician and requesting that he or she prescribe 50-100 mg of Viagra daily to correct this sometimes overlooked adverse side effect of radiotherapy. Viagra is not without side effects. It may be causing more heart attacks than have been reported. If you have any kind of coronary artery occlusion, you may want to avoid Viagra, even if you are not taking nitrate drugs.

Shark Liver Oil for 30 Days

Shark liver oil containing standardized alkylglycerols can prevent immune impairment and irradiation injury to healthy tissues (Brohult et al. 1977). Shark liver oil can also help boost blood cell counts. Cancer patients should considersix 200-mg standardized shark liver oil capsules a day for 30 days. Shark liver oil can cause an overproduction of blood platelets, so high doses of shark liver oil should not be taken for more than 30 days.

SUMMARY

The following therapies may enhance the cancer cell-killing effects of radiation therapy:
  1. Arginine: Consuming 20-30 grams of arginine 30-60 minutes prior to each radiation session could dramatically improve the number of cancer cells killed. This is because cancer cells thrive in a low oxygen environment. Arginine enhances blood flow to tumors, thus enabling the radiation to generate more cancer cell-killing free radicals. Some people find it difficult to consume 20-30 grams of arginine orally. As an alternative, a physician could administer the arginine via an IV infusion 30 minutes before each radiation session. Arginine is available to doctors in IV dosing packs for the purpose of testing pituitary growth hormone response. Conventional doctors, however, are reluctant to try innovative approaches. Patients seeking to use high dose arginine prior to each radiation session have the following options:

    • Swallowing 23 - 33 arginine (900mg) capsules.

    • Mixing 2.5 - 3.5 tablespoons of unpleasant-tasting arginine powder in water and drinking the mixture.

    • Taking 4 - 6 tablespoons of an arginine-based drink called sugar-free PowerMaker II. This makes normally unpalatable arginine taste acceptable.

    • Finding a physician in your area who will have his or her nurse administer the 20 - 30 grams of arginine by IV therapy prior to each radiation session. To find an innovative physician who might accommodate this IV arginine request, call (800) 544-4440.

      To further saturate the tumor with oxygen, some patients breathe 95% oxygen during the radiation therapy (Kaanders et al. 2002).

  2. Check the oxygen-carrying capacity of blood by testing the blood for red blood cell count, hematocrit, and hemoglobin. It is critical that these blood oxygen indictors be in the upper one-third level of normal. This can be accomplished with the drug Procrit, which must be prescribed by your oncologist. It may take as long as 6 weeks for Procrit to achieve maximum effect. For Procrit to be effective, there must be adequate iron present. Supplementing with 30 mg a day of iron protein succinylate, sold under the brand name Iron Protein Plus, will provide additional iron to help Procrit work effectively.
Certain nutrients may help prevent cancer cells from developing resistance to radiation therapy. Since these nutrients also function as antioxidants (meaning they suppress free-radical activity), you may decide to use them 3 weeks after radiation therapy rather than during radiation therapy. These nutrients are:
  1. Curcumin, 900 mg with 5 mg piperine (an alkaloid from Piper nigrum), 3 capsules, 2 - 4 times a day. (Super Curcumin with Bioperine is a formulated product that contains this suggesteddosage.)

    Warning: Use caution when combining curcumin with drugs. Take 2 hours away from all medications. Do not take with the chemotherapy drugs irinotecan, Camptosar, or CPT-11. Watch for NSAID-like side effects such as gastric ulceration because curcumin is a COX-II inhibitor. Do not take curcumin if there is a biliary tract obstruction. Note that curcumin is a potent antioxidant.

  2. Ultra Soy Extract (40% isoflavones), five 675mg capsules four times daily.

  3. Green tea extract (93% polyphenols), two to three 7250mg capsules with each meal. These are available in decaffeinated form for those who are sensitive to caffeine or who want to take the less stimulating decaffeinated green tea extract capsules in their evening dose.

  4. Alpha-interferon and Accutane: Consult your physician. A study reports on dosages of 6 million units of alpha-interferon and 1 mg per kilogram of body weight of the retinoid drug Accutane daily for 12 days prior to radiation therapy. (During the radiation therapy sessions, the dosages were reduced to 3 million units of alpha-interferon 3 times a week and 0.5 mg per kilogram of body weight of Accutane until the maximum dosage of radiation was achieved).

  5. Vitamin A, 25,000 IU a day. (Refer to Avoiding Vitamin A Toxicity.)

  6. Ginseng, two to four 200-mg standard dosage Sports Ginseng capsules daily.
The following drugs and supplements may reduce side effects and damage caused by radiation therapy:
  1. Pentoxifylline and vitamin E (tocopheryl succinate), one 400-mg pentoxifylline tablet taken twice daily with two 400-IU capsules of vitamin E and 1 capsule of Gamma E Tocopherol w/Sesme Lignans.

  2. Melatonin, 20 mg nightly. Dose may be reduced to 3-10 mg each night after 30 days if morning drowsiness occurs.

  3. Taurine, 2000 mg daily.

  4. Shark liver oil, six 200-mg standardized shark liver oil capsules a day for 30 days prior to radiation therapy.

    Caution: Shark liver oil can cause an overproduction of blood platelets, so high doses of shark liver oil should not be taken for more than 30 days. Platelet levels should be closely monitored (at least every month).

  5. Vitamin C, 4000-12,000 mg a day, in divided doses.

  6. Se-methylselenocysteine (SeMSC), 200-400 mcg daily.

  7. N-acetyl-cysteine (NAC), 600 mg 1 time each day.

  8. Whey protein concentrate isolate, 10-20 grams three times a day, at least 10 days before beginning therapy and during therapy and then continuing with the whey protein for at least 30 days after completion of the therapy.


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