By Keith I. Block, MD
In the preceding blog I delved into some of the ways nutritional and herbal supplements can enhance the effectiveness of chemotherapy and radiotherapy. I will now explore ways in which specific supplements can also help reduce the adverse side effects of chemotherapy.
Although chemotherapy can improve survival for patients with metastatic cancer, there are often significant side effects to contend with. In many cases, these side effects may require a disruption in the treatment schedule and/or a reduction in dosing. And in some cases, treatment may need to be discontinued altogether. All of these can impact not only disease progression, but impact survival. One of the main reasons for these adverse effects is the generation of free radicals by many commonly used chemotherapy drugs. This increased free radical burden comes at a cost, possibly accounting for most of the toxicities experienced by people who receive these treatments.
For this fundamental reason, many dietary or supplemental antioxidants may play a key role in reducing treatment-related toxicities (my colleagues and I published research about the use of antioxidant supplements during chemotherapy in the 15 September 2008 issue of the International Journal of Cancer). Some of these toxicities include damage to the brain, heart, and kidneys. In my clinical experience, individuals receiving chemotherapy often fare dramatically better – that is, enjoy a better quality of life – when they eat a diet abundant in antioxidant-rich superfoods, and take an individually-tailored supplement regimen that includes antioxidants.
Let’s briefly consider some key examples:
Coenzyme Q10: Coenzyme Q10 is a vitamin-like antioxidant found in small amounts in many foods and which the body produces on its own. In clinical trials and experimental studies, supplementing with coenzyme Q10 was shown to reduce the toxic effects of doxorubicin on the heart (cardiotoxicity), as reviewed in the June 2005 issue of Integrative Cancer Therapies. It’s important to understand that the cardioprotective benefits of doxorubicin occur without in any way diminishing the tumor-killing effects of the drug.
Gingko and Ginseng: Two antioxidant-rich herbals, Gingko biloba and Panax ginseng, may afford substantial protection against chemo’s toxic side effects. Supplementing with these and other phytochemicals may reduce the collateral damage often linked with chemotherapy and radiotherapy, making these treatments far more tolerable. Gingko may have special value in terms of reducing chemobrain, the term commonly used to denote the brain fog associated with chemotherapy.
Curcumin: Curcumin has potent antioxidant and anti-inflammatory effects. A scientific report in a 2010 issue of Nutrition & Cancer reported that curcumin enhances the effectiveness of both chemotherapy and radiotherapy while selectively protecting normal, healthy tissues against these treatments. Our clinical experience suggests that curcumin works synergistically against cancer when combined with boswellia and green tea.
L-Carnitine: L-carnitine, a common supplement used for weight control, has been shown to significantly reduce the fatigue caused by the chemotherapy drugs, cisplatin and ifosfamide. This amino acid also may limit the nerve-damaging effects of taxol and cisplatin, as well as the cardiotoxic effects of doxorubicin. In combination with alpha lipoic acid, acetyl-L-carnitine can help regenerate the mitochondria, tiny energy factories inside our cells that are damaged by chemotherapy and by the disease itself.
Theanine: This amino acid, a major ingredient in green tea, appears to reduce the toxic side effects of various chemotherapy drugs. But simply drinking green tea just won’t do it - unless you happen to have a gargantuan bladder! To achieve the desired concentration of theanine, I estimate that one would need to drink several gallons of green tea every day! Therefore, we use a green tea supplement in our clinic that concentrates approximately 41 cups worth of green tea in a single day’s oral dose.
Silymarin (milk thistle): Milk thistle is best known for its protective effects from chemical toxicity. The Block Center has been using it for nearly three decades with chemotherapy patients. It has a restorative influence that can speed up regeneration of new liver cells.
Omega-3 fatty acids (found in fish oil supplements): Diets that are high in EPA-rich fish oil may help cancer patients suffering from cancer cachexia, a type of malnutrition associated with an underlying inflammatory condition produced in part by cancer cells, diet and lifestyle. This can cause appetite suppression, muscle wasting, weight loss, and weakness. Cachexia can be a serious problem for some cancer patients, as there is research that suggests that 20%-30% of cancer patients die from complications of malnutrition, not from the cancer itself. In addition, 80% of cancer patients suffer from some form of clinical malnutrition! Diets that are high in EPA-rich fish oil may help cancer patients suffering from cachexia to gain weight and improve their nutritional status. In addition, very significantly, fish oil can make cancer cells more sensitive and vulnerable to chemotherapy agents, boosting the kill effect of the drug to the cancer cells.
The supplements I’ve identified in this article are just the tip of the iceberg in terms of the potential of natural agents to help reduce some of the side effects of cancer treatment. With the proper coupling of specific antioxidants with anti-cancer drugs – as part of a comprehensive, individualized integrative program – it becomes far more feasible to reach and maintain optimal dosing and scheduling for the chemotherapy regimen, and obtain treatment benefits that may far surpass those seen in the conventional oncology setting alone.
So would it be safe to take coq10 supplements during chemotherapy or before and after? My daughter is on doxorubicin right now for her cancer and not sure when to give the coq10. Thank you so much
Posted by: Mark Fairbrother | 02/21/2013 at 10:57 PM