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by Esther Trepal MS RDN on August 26, 2015
by Esther Trepal MS RDN on August 26, 2015
Use of supplements is common practice among cancer patients. According to the Journal of American Dietetic Association (which cited a number of studies in its research), 52% of American adults swallow some kind of supplements daily. But among adult cancer patients, the figure rises from between 64% and 81%.
I see this all the time in my practice. Here is a typical conversation I might have with a patient:
Me: “Do you take supplements?”“
Oh, yes,” the patient might reply. “I take a green capsule (red flag!) before each meal. Then the gel tab after lunch. I think it’s for digestion (red flag!). Then another gel in the afternoon.
Might be vitamin E (red flag!). And every evening I have a cup of this really nasty tasting Chinese tea (red flag!).
“What do you take them for?” I might ask her.
“I can’t remember exactly (red flag!). I read things in magazines or on the net. And the guy at the health food store has been really helpful (red flag!). They’re all good for cancer.”
I have one last question for her. “Does your oncologist know which supplements you’re taking?”
The patient responds, “Not really (red flag!). She doesn’t approve, so I don’t like to talk to her about it.” After a pause, she added, “That doesn’t sound too good, does it?”
While such a patient is trying to be pro-active in her fight against cancer, her comments raise a lot issues. When delving into the question of taking supplements, you are delving into controversial territory. There is a way to approach this issue intelligently, so that both you and your healthcare team will be comfortable with your choices.
Supplements include vitamins, minerals, herbal products and other nutrients in therapeutic doses. While supplements may be helpful, keep in mind that they cannot make up for poor food choices. There is no substitute for a well-balanced diet that includes a variety of fruits, vegetables, whole grains and lean protein.
Outlandish Claims or Real Benefits?
Frequently, cancer patients use supplements not as a cure for cancer, but as a way to manage side effects, boost their immune system or relieve pain. When considering taking supplements, have a clear notion of what it is you want to accomplish. Monitor your progress and give yourself a time limit. If you are not getting the desired results, discontinue using the supplements.
Following vague recommendations from friends or buying into outlandish promises posted on the web are two major “no-no’s.” If you are interested in alternative therapies, consult with a healthcare provider with experience in this area. Although natural, supplements are powerful. The practitioner should take into account your specific cancer, your current treatment and medications, as well as any other medical conditions you have. Ask your practitioner what results they have seen in the past and how long you need to take the supplements. If you are unable to locate an expert in this area, find a sympathetic member of your healthcare team, including doctors, nurses and dietitians, to help explore these issues with you.
While many studies have been conducted on supplements, results are decidedly mixed. Instead of a definitive recommendation, look for a balanced report summarizing outcomes and listing benefits, side effects and interactions with other drugs or supplements, and especially chemotherapy or radiation. The Natural Standard Professional Database and the Natural Medicine Comprehensive Database are two fee-based organization that provide excellent summaries.
Docs to the Doc
Armed with this information, you can make an intelligent decision and feel more confident in your choice. Bring any written information you have to your oncologist. You must do this. Even if your doc doesn’t agree with what you are doing, he/she needs to be informed. Providing them with written information can go a long way to opening up a discussion on this topic.
You should also provide your physician with details of the specific product you are taking, including brand and dosages. Oftentimes the manufacturer’s website will carry a label that you can print. If not, copy the information from the bottle or bring it with you to the office.
And speaking of bottles, when buying products, think quality. Supplements are a poorly regulated industry in the U.S. There is no federal agency that routinely checks supplements for purity or for content that is consistent with the label. That’s left up to private companies, which do it for a fee. Two of these are USP (US Pharmacopeia) and NSF (National Sanitation Foundation). Look for their seal on the label. Another subscription-only organization, Consumer Labs, also verifies content. Alternatively, your healthcare practitioner should be able to guide you to high-quality products.
Why is My Oncologist Against Supplement Use?
One of the most hotly contested areas of supplementation is using antioxidants during chemotherapy and radiation. Antioxidants include vitamins C, E and A, as well as selenium and Co-Q10, to name just a few. Laboratory tests suggest that antioxidants enhance conventional therapies by protecting normal cells from being damaged. For this very reason, many oncologists believe that they may actually interfere with treatment by protecting cancer cells as well. Human studies have not come up with a definitive answer.
It all goes back to seeking out a professional who has some experience in this area, discussing your plan with your oncologist (remember, getting written information about the products you plan to use can be very helpful here), and using high-quality products.
Oh yes, and don’t forget to put food first!