~Cancer: Should Patients Take Dietary Supplements?

~Cancer: Should Patients Take Dietary Supplements?
Reprinted with permission of Life Extension®.

Introduction

No one has definitively shown what supplements a cancer patient should take nor at what stage in the disease process the supplements should be initiated. It could be that some dietary supplements are of benefit at some phases of cancer treatment (such as enhancing immune function), but detrimental in others (such as protecting cancer cells against the effects of certain chemotherapy drugs).

Most people familiar with published scientific literature are surprised that there is any argument over the value of dietary supplements and cancer treatment. The problem is the complexity of cancer compared to other diseases. For instance, there is a scientific consensus that folic acid is beneficial in cardiovascular disease patients because it lowers homocysteine and protects the arterial system via other mechanisms; no one argues against this. There is also substantial evidence that folic acid dramatically lowers the risk of many forms of cancer; few scientists disagree with this premise either. However, the role of high-dose folic acid in the treatment of cancer is not as clear-cut. Every human and animal cancer study indicates that folic acid improves survival, yet those familiar with the molecular actions of folic acid are concerned that very high amounts could potentially facilitate cancer cell propagation.

Dr. Charles Simone, a respected voice in natural medicine, cited more than 350 studies involving 2000 cancer patients that showed that antioxidants extended the life span of cancer patients and improved quality of life. One such study involved 50 early stage breast cancer patients, some of whom were relegated to radiation therapy and others to a combination of radiation and chemotherapy. All participants (in union with conventional therapies) took large doses of nutrients. More than 90% of both groups noted improvement in their physical symptoms, cognitive ability, sexual function, general well-being, and life satisfaction. Not one subject in either group reported a worsening of symptoms (Simone et al. 2000). There continues to be controversy as to whether cancer patients should take certain vitamin and mineral supplements. Some in mainstream medicine have attacked the use of vitamin supplements as being potentially harmful, despite published scientific evidence indicating that cancer patients who supplement benefit. The criticism about cancer patients taking supplements is not limited to conventional oncologists. There have also been debates among Life Extension advisors as to what supplements are best for cancer patients to take.

Unlike heart disease, cancer is a very complicated disorder. No one has definitively shown what supplements a cancer patient should take nor at what stage in the disease process the supplements should be initiated. It could be that some dietary supplements are of benefit at some phases of cancer treatment (such as enhancing immune function), but detrimental in others (such as protecting cancer cells against the effects of certain chemotherapy drugs).

Most people familiar with published scientific literature are surprised that there is any argument over the value of dietary supplements and cancer treatment. The problem is the complexity of cancer compared to other diseases. For instance, there is a scientific consensus that folic acid is beneficial in cardiovascular disease patients because it lowers homocysteine and protects the arterial system via other mechanisms; no one argues against this. There is also substantial evidence that folic acid dramatically lowers the risk of many forms of cancer; few scientists disagree with this premise either. However, the role of high-dose folic acid in the treatment of cancer is not as clear-cut. Every human and animal cancer study indicates that folic acid improves survival, yet those familiar with the molecular actions of folic acid are concerned that very high amounts could potentially facilitate cancer cell propagation.

In the following section, we review all studies involving the use of dietary supplements by human cancer patients. We also discuss reasons why some scientists believe that cancer patients should approach supplementation with a degree of caution.

The reader should know that no organization has ever methodically analyzed the scientific literature to address the complex issue of using dietary supplements in the treatment of cancer. Although articles have been written about isolated effects of certain nutrients, there has not been an attempt to consolidate this knowledge in a way that provides practical guidance for the cancer patient.

Human Research on Cancer and Dietary Supplements

Although there are hundreds of published studies showing that the ingestion of certain nutrients may reduce cancer risk, relatively few investigate the effects of dietary supplement intake by those already stricken with cancer. This paucity of data has enabled mainstream oncologists to speculate that certain dietary supplements might protect cancer cells from apoptosis (programmed cell death). The assertion made by some oncologists is that there may be a risk when cancer patients take certain dietary supplements.

To get the bottom-line facts on what happens to cancer patients who take dietary supplements, a MEDLINE search was conducted using key words to access all peer-reviewed published studies relating to groups of cancer patients who used various dietary supplements. The criteria for the studies selected was that the dietary supplement had to show an effect on the clinical outcome of the patient--preferably relating to long-term survival--as opposed to therapies that offer a short-term benefit, such as mitigating chemotherapy toxicity. Oncologists generally acknowledge that supplements can mitigate chemotherapy and radiation therapy side effects. The question is whether cancer patients taking supplements are actually surviving longer.

Below is a synopsis of the MEDLINE findings:
  1. A study was conducted on non-small cell lung cancer patients over age 60 that had already had the primary tumor(s) surgically removed. The prognosis for this type of cancer is grim. The doctors compared vitamin users to nonusers and measured blood folate as an indicator of folic acid intake. The median survival for the nonusers was only 11 months compared to an astounding 41 months for the vitamin users. Supplement users, in other words, survived almost four times longer than nonusers. In those patients with higher blood levels of folate, there was a 68% improvement in survival. Because the doctors adjusted for other mortality factors, the findings of this study suggest that cancer patients should take vitamin supplements (Jatoi et al. 1998).

  2. A more specific study looked at a group of transitional cell bladder cancer patients. One group was given BCG (tuberculosis vaccine) immune-augmentation therapy plus the recommended daily allowance (RDA) of vitamins. The second BCG-treated group received the RDA plus 40,000 IU of vitamin A, 2000 mg of vitamin C, 400 IU of vitamin E, 100 mg of vitamin B6, and 90 mg of zinc. After 5 years, the tumor recurrence rates were 91% in the group receiving the low-potency RDA vitamins, but only 41% in the mega dose vitamin group. In this study, large doses of vitamins resulted in a 55% reduction in tumor recurrence (Lamm et al. 1994).

  3. Malignant melanoma is virtually impossible to stop once it has spread beyond the primary lesion. A rare form of melanoma occurs in the iris of the eye, and it is considered high risk because it is often found too late. Nine random high-risk patients with T3 melanoma of the eye first underwent standard conventional therapy to eradicate the primary tumor. These patients were then put on a supplement regimen consisting of folic acid, trace minerals, amino acids, and fatty acids. After 80 months of follow-up, none of these nine patients experienced recurrent disease, which was significantly better than a similar group of high-risk melanoma patients who did not receive these supplements. (The control patients consisted of similar adjusted T3 cases selected from the Swedish official registries and T2 patients from Germany.) Because 100% of these high-risk patients were free of disease after almost 7 years, this provides further piece of evidence of the potential value of dietary supplementation in the cancer patient (Tallberg et al. 2000).

  4. Breast cancer patients commonly undergo chemotherapy to reduce the risk of future metastasis. Despite the severe toxicity of chemotherapy, many women experience aggressive metastatic disease and die. Once metastatic disease manifests, the 5-year survival rate is only 15%. A review was conducted of various chemotherapy regimens in order to ascertain the percentages of objective remissions in metastatic breast cancer patients. Of the drugs tested, 5-fl o u o rouracil (5-FU) came in last, but when folic acid was added, objective remissions increased significantly (Kreienberg 1998).

  5. The drug 5-fluorouracil (5-FU) is commonly used in visceral cancers (such as colon, liver, pancreatic), but has not shown a high degree of efficacy. A randomized trial of patients with metastatic colorectal carcinoma compared the effects of 5-FU administered alone and in combination with folic acid. Both groups were comparable in respect to age, sex, and numbers of metastases. Compared to the group receiving 5-FU by itself, the patient group receiving the 5-FU plus folic acid experienced a 40% arrest of tumor growth and a 76% overall reduction in tumor progression indicating a 47% difference between the 5-FU and folate group and the 5-FU group. Survival time in the group receiving the 5-FU plus folic acid was 47% greater than the group receiving the 5-FU by itself. The addition of folic acid to this chemotherapy drug regimen resulted in an improvement in the therapeutic profile and a significant prolongation of the survival time (Loffler et al. 1992).

     

    5-FU Folic acid and 5-FU Difference
    Complete or partial remission 9% versus 16% 7%
    Arrest of tumor growth 20% versus 60% 40%
    Progression 71% versus 24% 47%
    Total 100% of patients in group 100% of patients in group  
     
  6. Advanced cancer patients exhibit multifaceted defects in their immune capacity that are likely to contribute to an increased susceptibility to infections and disease progression. This immune impairment also constitutes a barrier to effective immunotherapeutic interventions. A chronic inflammatory condition associated with increased oxidative stress has been suggested as one of the responsible mechanisms behind the tumor-induced immune suppression. A study was conducted on 12 advanced colorectal cancer patients to ascertain if supplementation with the antioxidant vitamin E could enhance immune functions. These colorectal cancer (Dukes's C and D) patients received a daily dose of 750 mg of vitamin E beginning 2 weeks prior to intervention with chemotherapy or radiation treatment. The results showed that short-term supplementation with vitamin E led to increased CD4:CD8 ratios and enhanced capacity of their T-cells to produce the T helper 1 cytokines, interleukin 2, and IFN-gamma (Malmberg et al. 2002).
There are other human studies showing a benefit when cancer patients take dietary supplements. We could find no studies on MEDLINE indicating a detrimental effect. The findings from animal studies (reported on next) support the positive human findings that show that dietary supplements appear to enhance survival.

Animal Research on Cancer and Dietary Supplements

To obtain additional information about what happens when an organism afflicted with cancer is administered dietary supplements, we extended our MEDLINE search to in vivo animal studies. As was done with the human study search, keywords were aimed at accessing all peer-reviewed published studies relating to the effects of dietary supplements on animals with different forms of cancer. The criteria for studies selected were that the dietary supplements had to show an effect on survival.

Below is a synopsis of the MEDLINE findings:
  1. A debate among medical oncologists relates to the combined use of certain dietary supplements and chemotherapy. A study on rat mammary tumors provided some interesting data but also revealed part of the controversy. In this study, rats were administered one of three chemotherapy drugs (5-FU, doxorubicin, or cyclophosphamide) and then provided with a wide dosage range of folic acid. In the folic acid-deficient group, tumor growth was impeded. However, when higher amounts of folic acid were administered, even greater tumor growth-inhibiting effects were observed. When looking at the data, low folate inhibited tumor growth by an average of 41%, moderate folic acid supplementation inhibited tumor growth by an average of 67%, and very high folic acid administration resulted in an average of 75% in tumor inhibition. Folic acid supplementation doubled the efficacy of one of the drugs (cyclophosphamide) and improved survival in the 5-FU treated animals (Branda et al. 1998).

  2. In a group of mice with ascites sarcoma, a four- to six-fold surplus of folic acid in oral application reduced the toxicity of the chemotherapy drug methotrexate. Moreover, adding these high amounts of folic acid into their drinking water prolonged the survival of these mice (Motycka et al. 1975).

  3. In a group of mice bearing leukemias and solid tumors, a combination of oxidized vitamin C and vitamin B12 inhibited division of the cancer cells. The mice were injected with the vitamins and after 19 days, all of the controls had died, whereas more than 50% of the mice were alive after 60 days in the vitamin-treated group. This study demonstrated that when B12 is combined with vitamin C, the cobalt nucleus of B12 attaches to vitamin C, forming cobalt ascorbate. Additional tests proved that cobalt ascorbate plus vitamin C inhibited tumor cells (Poydock 1991).

  4. The effects of methylcobalamin (vitamin B12) were examined in mice with liver, lung, and Ehrlich ascites tumor cells. The growths of tumors in some groups of the mice were suppressed by the 7-day administration and their survival was longer than that of untreated mice (Shimizu et al. 1987). In a contradictory animal study, the effect of methylcobalamin and vitamin B12 reduced the survival of rats with liver cancer. This is the only study where vitamins actually inhibited survival (Kal'nev et al. 1977).

  5. Cancer spreading (metastasizing) throughout the body often culminates in death. Immune suppression is one mechanism that cancer cells use to establish colonies (metastatic lesions). Scientists investigated the effects of an antioxidant called astaxanthin in stress-induced, immune suppressed in mice. When exposed to stress, the number of natural killer cells (NK) and other immune cells was reduced and an increase in liver lipid peroxidation was observed. After 4 days of astaxanthin administration, immune dysfunction induced by stress improved. In this same study, cancer cells were injected into mice and the effects of tumor development and metastatic lesions were evaluated in response to induced stress. Daily administration of astaxanthin for 14 days markedly attenuated the promotion of hepatic metastasis induced by stress. The results of this study suggest that the antioxidant, astaxanthin, improves antitumor immune response by inhibiting lipid peroxidation induced by stress (Kurihara et al. 2002).
Despite these studies indicating that supplements confer a significant anticancer benefit, there are certain supplements that cancer patients might consider avoiding, at least during active treatment. These issues are addressed in the next section and in the protocols entitled Cancer Chemotherapy and Cancer Radiation Therapy.

Continued . . .


Free Shipping in the Continental U.S. on Orders over $50
The statements made here have not been evaluated by the FDA. The foregoing statements are based upon sound and reliable studies, and are meant for informational purposes. Consult with your medical practitioner to determine the underlying cause of your symptoms. Please always check your purchase for possible allergins and correct dosage on the bottle before use.

While we work to ensure that product information is correct, on occasion manufacturers may alter their ingredient lists. Actual product packaging and materials may contain more and/or different information than that shown on our Web site. We recommend that you do not solely rely on the information presented and that you always read labels, warnings, and directions before using or consuming a product. For additional information about a product, please contact the manufacturer. Content on this site is for reference purposes and is not intended to substitute for advice given by a physician, pharmacist, or other licensed health-care professional. You should not use this information as self-diagnosis or for treating a health problem or disease. Contact your health-care provider immediately if you suspect that you have a medical problem. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease or health condition. Life Ex Online assumes no liability for inaccuracies or misstatements about products.