Does it work?  Is it safe?  How do we know?

   Vitamins, minerals, amino acids, herbs (botanicals), enzymes, hormones, infra-red, ultraviolet, and the list goes on of potential CAM treatments for cancer. Some have potential benefit, while others either have no effect or can actually cause harm, but how do you know which are which? The problem is compounded by claims from salespersons including some “doctors” and scientific studies that contradict other studies.

   Not a day goes by in practice that I’m not asked about some new herbal or other treatment for cancer. I base my advice on a few guidelines which I have described here for OncTalk visitors. I hope you will find this a useful tool for finding your way through the jungle of claims and suggestions on the internet, from salespersons and well-meaning relatives and friends.

Does it work?

   When treating human ailments, especially cancer, you first want to know if the treatment works on humans. Test tube and animal testing are interesting for researchers but are not able to predict usefulness or safety in humans. Our complex chemistry and physiology are not accurately mirrored by any laboratory animal or cell line. There are literally thousands of treatments that have worked perfectly in vitro and in animal studies that were abject failures in human trials. Too bad, since some looked like a real answer to cancer, but that is the unfortunate reality.

   Be certain that the data you are reading applies to you. For example, herbal estrogen analogs that are suggested to be helpful with prostate cancer may actually increase the risks for breast cancer. There are (amazingly) companies marketing these estrogens to breast cancer patients.

   Avoid the idea that, if a little bit is good a lot must be better. There is a concept known as the therapeutic index, or therapeutic window. Dosages below the window may not be effective, while dosing above the window may introduce new, adverse effects. Always stick with the dosage recommended on the bottle unless changed by your doctor.

   When researching an interesting product, read the whole report, not just the abstract. It is not uncommon for abstracted data to gloss over important information that matters to you.

   Single studies are sometimes not repeatable or accurate, so it’s important that you find at least 2 studies, from different institutions without conflict of interest with the product, before assuming that it works.

   Check your sources. There are “journals” listed with the National Library of Medicine that are owned, published and edited by companies selling the products in the “journal”. As you can imagine, their reports are frequently glowing but often contrary to other information in legitimate publications.

   If the data are conflicting, some of it positive and other negative, look for differences in the way the studies were conducted. For example, synthetic (trans) beta-carotene in high doses appears to worsen some lung cancer patients whereas rational doses of natural (cis) beta-carotene appear to be helpful. You may want to call on an expert for help with conflicting research data to help you make the right decision.

Is it safe?

   When we assess safety, we consider how the treatment acts in the body, dosage, timing as well as the patient’s specific condition and other treatments.

   Some CAM treatments have more than one definable action that is important. Vitamin E, for example, is a powerful antioxidant that also reduces coagulation of blood (”thins the blood”). In terms of safety, the antioxidant activity at high levels can interfere with some radiation and chemotherapy regimes. Its anticoagulant activity means that we need to dose very carefully with surgical patients (including some dental procedures), those with blood disorders that can affect bleeding, and with some treatments that effect bleeding times.

   If there are no complicating factors (check with an expert, since there are additional risk factors not in the list above that should be considered and everyone is different), then vitamin E supplementation may be fine.

   Timing is important. Nutritional supplements, like other medicines, have a specific time during which they are active in your body, and these times can be calculated with reasonable accuracy. So, for example, if you want to use a lot of antioxidants but your particular chemotherapy is vulnerable to interference, we would time the use of the antioxidants for periods when the chemo drug is not active and thus avoid any chance of interfering. The same applies to surgery, radiation and even specific natural medicine treatments that may interfere with each other.

So what’s the bottom line?

   The bottom line is simple. If the potential benefits outweigh the potential risks, it may be worth trying. Potential benefits of CAM therapies for cancer survivors include primary and secondary prevention (primary prevention = preventing a first occurence; secondary prevention = preventing a recurrence), and managing cancer and non-cancer status issues such as digestion, elimination, insomnia, hot flashes, weight loss, fatigue, headaches, neuropathy (numbness), joint aches, muscle cramps and more.

  The potential risks of CAM therapies include increased cancer risk, worsening status, interfering with conventional cancer treatment, and cost for some proprietary clinics.

   So you can see why our group is so careful about recommending treatments. The risks can be quite serious. Unfortunately it is not always possible to figure out which treatment caused a particular symptom. I had a patient come to me after more than a year of debilitating diarrhea. He couldn’t walk 4 blocks from his condo to his work without risk of an accident. It turned out he was using a supplement with a little too much magnesium, but this bright, knowledgeable individual never made the connection because it was not at all obvious and the symptoms started some time after he had started that supplement. He blamed the problem on his oncologist and his past chemo, which may have made him a little more vulnerable, but the real problem was the magnesium.

  While there is certainly a lot of promise in the field, there are few definitive answers yet. There are many potential CAM therapies that can improve the lives of most cancer survivors with minimal risk. There are experts who can guide you through the process of coming up with a good natural medicine plan that is both safe and effective, and many are now covered by insurance.
Dan Labriola ND
Director, Naturopathic Services
Swedish Cancer Institute
Seattle, WA