Supplements and Cancer

Supplements which can help cancer.

I was recently asked by a patient's specialist to justify the supplements I suggested he could take to help in his fight against cancer.
I thought I might place the answer here on my blog as well:

In response to your doctor's letter re the value of supplements and cancer:

It is important to remind people, especially the medical profession, of reality. Requesting "need to justify this advice with clear evidence from medical literature for the use and the client scenario", suggests that "conventional medical treatment" has passed through the same rigorous process, whereas we know this is not true. For example in writing an editorial in the British medical Journal, Dr Richard Smith the editor states "only about 15% of medical interventions are supported by solid scientific evidence….This is because only 1% of the articles in medical journals are scientifically sound and partly because many treatments have not been assessed at all." (British Medical Journal, 1991:303:798) The vast majority of papers written to support the value of drugs are either initiated by, sponsored by or paid for by the pharmaceutical industry manufacturing the drug, and in many cases the articles are ghostwritten by the pharmaceutical industry. Fortunately these days the situation is improving as people are realising just what has happened in the past. As far as the newer anti-cancer treatments are concerned, and to some extent the older ones, the pharmaceutical industry is deeply involved in the studies and reports.

It has been quoted that to do a study that would be acceptable, costs about $2 million dollars, making it extremely unlikely that most nonpharmaceutical therapies will ever have "acceptable" scientific evidence, no matter how effective they are.

So accepting that the scientific evidence behind many drug treatments is poor, and the same can be said for complimentary therapies, the logical answer is to use what appears to be scientifically and logically the best therapies for the individual patient.

Having said that, I would like to justify my recommendations for additional treatment for your patient:

I believe that he should be being treated with what is potentially beneficial, should do little harm, and would not interfere with current medical therapy.

Optimal nutrition – Undergoing chemotherapy is an arduous time, and I don't think anybody would restrict the food intake of a cancer patient, with the possible exception of high levels of sugars. Unfortunately chemotherapy does blunt the appetite, may possibly affect absorption, and certainly makes it more difficult to receive all that the body requires. Many physicians suggest the patient should graze rather than have 3 large meals per day. It thus seems logical to add a quality multivitamin and multi mineral supplement to provide complete nutrition.

In addition to the chemotherapy and radiotherapy, the body's immune system is a major if not the major component in suppressing and hopefully killing the cancer. To optimise its function the immune system needs optimal nutrition.

While it is possible to provide supplements individually, it does seem much more logical to take a single multivitamin and multi mineral tablet.
Just to comment on a few of the contents of a multivitamin and multi mineral:

selenium – this has been shown to have anti-cancer effects in animals and also humans, and in the Arizona study (Journal of the American Medical Association 1996, December 24) of 1300 patients, half receiving supplementary selenium and half not, those taking selenium over 6 years have a 63% reduction in prostate cancer, and a 50% reduction in cancer deaths.. These deaths suggest that many of the patient's had cancer before they started selenium.

Multivitamins – In the women's health nurses study, women who took multivitamin tablets for more than 15 years reduce the risk of developing: a number of other cancers by between 50 and 70% (Annals of Internal Medicine 1998, October: 517)

Individual vitamins – while there is some cloud over vitamin A and beta-carotene in large doses, the B vitamins have many beneficial effects in patients receiving chemo. For example it is highly likely that B12 and folic acid would be beneficial in reducing the incidence or severity of peripheral neuropathy very common with chemotherapy, vitamin C is an antioxidant and given intravenously does seem to have anti-carcinogenic effects, but even orally in the production of collagen it is likely to be beneficial in strengthening the tissues and maybe even reducing spread.

Vitamin D has been postulated in many cases is having anti-cancer effects, (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470481/) unfortunately the amount of vitamin D allowed in tablets in this country are less than desirable, but nevertheless the amount of a good multivitamin tablet must have some beneficial effect.

Vitamin E is an antioxidant, provided it is not given in high doses which could potentially or theoretically affect chemotherapy, can reduce the side-effects of chemotherapy, as well as protecting the body from free radicals. Vitamin K has also been suggested as having anti-cancer effects .

As far as minerals concern, we have discussed the trace element selenium, but it is very likely that other minerals might also be beneficial in the routine amount found in a normal diet, which is what a multivitamin should be providing. Magnesium for example does relax smooth muscle, and can reduce cramps and possibly some of the other peripheral effects common in patients with chemotherapy and also cancer.

While it is possible for all of these to be achieved by taking the products individually, taking one or 2 good multi tablets a day does seem to be logical and practical.

Lycopene found in tomatoes this does appear to have a beneficial effect on prostate cancer, and the Harvard University study (Journal of the National Cancer Institute, 6th of March 2002, page 291) of 47,000 health professionals followed over 12 years those eating 4 to 7 servings of tomato sauce per week had 20% less prostate cancer, those having 10 servings per week had 45% less. This does suggest that lycopene has a beneficial effect upon the prostate, and it is likely to also be beneficial in the presence of cancer.
Lycopene is often taken with saw palmetto which is helpful for benign prostatic hypertrophy.  We do not know if it has and effect  on prostate cancer (but in animals it can increase the sensitivity of prostate cells to radiation.( https://www.mskcc.org/cancer-care/integrative-medicine/herbs/saw-palmetto)

Omega-3 fish oils are known to have numerous effects from the cardiovascular system through to the nervous system and are considered an essential oil. Eating a lot of fish will provide this, but usually provides a dose of mercury which in cancer patients would be undesirable. There is a small study in Sweden involving 11,000 men which showed a 2 to 3 fold increase in prostate cancer in those men who did not eat fish (Lancet 2001; 2 June: 1764) in addition it may also be beneficial in the peripheral nervous effect and other effects of chemotherapy.

Melatonin – this hormone is created in the pineal gland, and is very helpful for sleep, a problem often difficult in cancer patients. Apart from this beneficial effect, in the United States nurses study, those nurses who work night shifts (who are likely to have low doses of melatonin) for more than 30 years, had a 37% higher incidence of cancer, and in the review of 10 randomised trials (Journal of pioneer research, 2005, November, 39 (4): 360 to 6). Involving 643 patients, cancer patients given melatonin in high doses (10 to 40 mg at night, reduce the risk of death at 1 year by 34%.

Coenzyme Q 10 – one of the most debilitating symptoms of both cancer and particularly chemotherapy is the crashing fatigue which they develop. Coenzyme Q 10 which essentially carries the energy from the mitochondria in the cell to the nerves and myofibrils, may help with this. It certainly has been shown to improve energy in many other situations.

Turmeric or curcumin has been shown to have anticancer properties in animal studies some of them quite spectacular.  These are reviewed (http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/turmeric) and although there are no blinded studies, many people (including oncologists) believe that this product is a useful adjuvant to chemotherapy and other cancer treatments.,

Milk Thistle this contains a number of compounds including Silymarin.   It has been shown to directly destroy prostate cancer cells and slow their growth, as well as increase the sensitivity of cancer cells to some forms of chemotherapy (http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/milk-thistle-and-liver-cancer).

Frankincense – derived from boswellia tree has strong anti-inflammatory actions, and may possibly be beneficial in cancer, probably best put on the skin as aromatherapy.  Its uses are reviewed here (https://www.medicalnewstoday.com/articles/314366.php).

Low dose naltrexone – I am certainly no expert on this, but it is a very interesting development, and is being used by many of my colleagues. Naltrexone is used to assist patients coming off opioids and alcohol. This is usually at the dose of 50 mg and above. It works by blocking the opioid receptors. Low dose naltrexone (usually 0.5 to 1.5 mg taken at night blocks the receptors overnight. It is believed that this up regulates the receptor  sensitivity, and possibly even increases the number of receptors. During the day following this, the normal endorphans and similar hormones are thus potentially more active. This can reduce pain, and other symptoms without any obvious adverse effects. LDN is used in a number of situations including multiple sclerosis, lupus, inflammatory bowel disease, chronic fatigue syndrome , fibromyalgia, restless leg syndrome and depression. It has been suggested from animal studies  that it may also suppress tumour growth, although the mode of action has yet to be established. (Biochemical pharmacology 67, number 7 (April 2001: 7792786.)

While I would have no way suggest to Stephen that LDN is essential for his cancer, it might possibly reduce some side-effects symptoms.

As mentioned in my opening paragraph, the evidence for many therapies is not strong for the scientists, but in the situation where we are doing our best for our patients, logical therapies combined with Hippocrates "1st do no harm" philosophy is what most doctors try and practice.

In Stephen's case he has not been well served by the profession, he is very likely to get side-effects from both the cancer and the chemotherapy, and the above supplemental recommendations potentially may help him, but given in physiological doses, will do him no harm.

I would like to stress again that we need to be supporting our bodies a great deal more than we currently do.   Our immune system and body's defences have been ignored in much of our current medical therapies.

Medicine in 2016 - a Happy New Year?

2016 looks like becoming a very important year in the development of medicine. Over the last few years people have been looking more critically at the direction of modern medicine, at the way in which it has been driven by procedures and drugs, and questioning whether the cost of modern medicine is sustainable and is providing the benefits that are claimed.

 I can see huge changes in the two major killers in today's world – cancer and heart disease.

Cancer – in the past chemotherapy has been blunderbuss essentially damaging the most rapidly dividing cells which are assumed to be the cancer cells but at the same time knocking off any rapidly dividing normal cells in the body as well – giving the well-known side-effects. In recent years however much more selective chemotherapies have been developed which target the cancer cells specifically, giving much fewer side-effects, but more importantly a much better outlook. Unfortunately because the selective drugs are only applicable to selective cancers, the number of patients receiving them are relatively small, and thus it is difficult for the drug firms to recoup their research costs. This makes them extremely expensive, and insurance companies and Governments are going to have to decide which ones to fund, and for how long. While this is a real problem, it does give a real opportunity for quality and increased duration of life for many cancer patients. Example of these drugs include treatments for melanoma, myeloma, lung cancer, prostate cancer, pancreatic cancer and others.
Thus the diagnosis of even widespread cancer no longer needs be seen as a death sentence as it has in the past.

Heart disease – this has tended to be the pinup boy of medicine over the last couple of decades, as doctors have discovered bypass surgery, angioplasty and stenting. The same time the pharmaceutical industry has come up with a variety of drugs both to treat symptoms and to try and reduce the incidence of heart disease.  .

There has been a very strong emphasis on lowering cholesterol, and even though only one of the cholesterol-lowering drugs that have ever been shown to reduce heart disease (the statins),
The emphasis on cholesterol has continued, but more and more conventional doctors are looking critically at the evidence and the advice we have been giving to our patients in the past. By telling people not to eat fat, we have forced them into eating food containing lots of carbohydrates, which is led to an obesity epidemic. Doctors are now looking at whether we should be giving statins as frequently as we are recommending -for most doctors there is no debate - patients with definite heart disease should be on statins, their value in other situations is very debatable, in fact dubious.
People are also looking at the benefits of angioplasty which is being done every time doctors see what appears to be a significant lesion in a coronary artery. The evidence appears that only lesions that are symptomatic should be treated, and there is very little evidence that stenting any
lesion actually reduces the risk of heart attack or death. Over the forthcoming years, I suspect the number of angioplasty procedures will drop significantly.

Because of the increased cost of effective cancer treatments, I suspect that governments and insurance bodies may well be looking more closely at all other procedures, and confirm that they are value before funding them.

But perhaps the most frightening aspect of health which has the prospects of returning us to the Middle Ages is the development of drug resistant bacteria which could render most of our antibiotics impotent. Because of the speed of development of resistance, and the cost of developing new forms of antibiotics, the drug industry is unlikely to be spending a great deal of money on this problem.