The use of supplements in cancer patients has been studied at length. Over the past several years there has been an increase in the use of non-prescribed supplements in this population, regardless of cancer type or geographic location of the patients. The rationale behind its use has been mostly in an effort to try to improve prognosis and counteract the side effects of various cancer therapies.
Medically speaking the reason behind some of the healthcare practitioners to recommend the use of multivitamins on cancer patients is the lack of a normal nutrition, either secondary to nausea, taste alterations or other symptoms. As we evolve on our treatment strategies in an effort to control cancer we understand more the need to supplement certain vitamins and minerals like B12 and folate in patients being treated with medications such as premetrexed.
Since most vitamins, minerals and botanicals don’t require prescription patients have the feeling that they are safe. However, most patients don’t realize that some of the supplements can be detrimental to their care. Two examples are the SELECT and the CARET studies. In the SELECT study we randomized patients to receive vitamin D, selenium or the combination of both in an effort to prevent prostate cancer; however, the results showed an increase in the incidence of the disease. In the CARET study vitamin A was used in smokers finding an increased incidence of cancer as well. The medical explanation of these findings could be the presence of high doses of antioxidants in the supplements that end up protecting the cancer cells or even protecting the premalignant cell in an at risk population. If indeed antioxidants could be good as antiaging strategies, when cells start to develop mutations and they are protected from undergoing apoptosis (cell death), they continue to mutate and develop into malignant cells.
Could this be a fact in all antioxidants? It does not appear to be case. Some of the more natural strategies that have been found to be safe is the use of beta-carotene at lower doses. Even though it didn’t show to be a good preventive strategy it is at least safe on patients already diagnosed with a malignancy. Moreover, they (antioxidants) remain important in many nutritional pathways and important to be at good levels during all stages of life.
The other interesting feature of a well-developed nutritional supplement is to look for common symptoms that patients might have and to try to counteract them with a more natural supplement rather than with another medication that might cause other side effects. In my clinical practice the most common complaints of patients and families is the extreme fatigue that accompanies the cancer therapies. Many botanicals have been studied in this setting especially the adaptogenics. Adaptogenics are substances that help regulate the level of “energy” as it is perceived by the patient and ashwaganda is likely the most important of this group. Other substances such as turmeric might enhance the anti-inflammatory effect that will allow for a better activity of the commonly known cancer therapies.
I usually recommend to my patients that when selecting a supplement, they need to follow some simple rules of looking for one that was design for their specific condition, with reputable ingredients free of contamination, and with all the ingredients being listed in their “true” content and no proprietary blends that might not be delivering the doses needed. They should be produced in a facility that follows good manufacturing practices with the appropriate certifications. Not all supplements are created equal and multivitamins that are not designed with a specific condition in mind could be harmful if taken by populations at risk.
Written by Dr. Mike Cusnir
For additional reading about the importance of choosing multivitamins, visit https://www.positivehealthwellness.com/diet-nutrition/one-guide-multivitamins-women-30s/
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