Friday, December 28, 2007

Nutritional Supplements With Immune-Boosting Cancer Therapies

Patients should ask their physicians for assistance in obtaining information on ongoing cancer vaccine and other immunotherapy clinical studies, and the criteria for subject enrollment and participation. Immunotherapy patients should consult their physicians before starting to use any nutritional supplements while receiving treatment. In addition, if using nutritional supplements, they should ask their physicians for assistance in ensuring the implementation of blood tests and diagnostic procedures that are essential in monitoring the effectiveness of any adjuvant therapy for cancer.

Some guidelines for using nutritional supplements with immune-boosting cancer therapies include:

Zinc—20 to 50 milligrams (mg) daily (Hercberg S et al 1998; Kohn S et al 2000)
Vitamin C—120 mg daily (Hercberg S et al 1998)
Vitamin E—800 international units (IU) of d-alpha tocopheryl succinate daily for two weeks (Malmberg KJ et al 2002); 400 IU daily for long-term use (Calder PC et al 2002b; Pallast EG et al 1999)
Folic acid—800 micrograms (mcg) daily (Fenech M 2001)
Vitamin B12—7 mcg daily (Fenech M 2001)
Vitamin B6—2.1 to 2.7 mg (one B-complex capsule) daily (Kwak HK et al 2002)
Selenium—100 mcg daily (Broome CS et al 2004)
Glutamine—30 grams (g) daily (Yoshida S et al 1998)
Ginseng, panax—100 mg daily (Anderson GD et al 2003)
Melatonin—20 mg daily, at bedtime (Lissoni P et al 2000)
Garlic—250 mg daily (Dhawan V et al 2004)
Mushroom extract—active hexose correlated compound: 3 g daily (Matsui Y et al 2002)
Fish oil—containing EPA: 4.7 g daily (Kew S et al 2004).
Note that most cancer patients take higher doses of vitamin C (2000 to 20,000 mg/day), selenium (200 to 400 mcg/day), vitamin B6 (100 to 750 mg/day), and vitamin B12 (100 to 300 mcg/day). These doses are considerably higher than the doses used in the studies cited above.


Blood Test Availability
Tests for PSA, CEA, selenium, vitamin B12, and folate serum levels are available via Life Extension/National Diagnostics, Inc., and may be ordered by calling 1-800-544-4440 or by ordering online at http://www.lef.org/bloodtest/.

Tumor antigen profile can be determined via Genzyme Genetics (http://www.genzymegenetics.com) and may be ordered by a physician by calling 1-800-966-4440.

Tests for immune cell function, serum growth factor levels, and immunosuppressive agents (IL-10) are available at UCLA’s Jonsson Comprehensive Cancer Center (http://www.cancer.mednet.ucla.edu/).

X-rays, scans, and physical examinations can be arranged through your physician.

Cancer Vaccines and Immunotherapies Safety Caveats
An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

EPA/DHA

Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Folic acid

Consult your doctor before taking folic acid if you have a vitamin B12 deficiency.
Daily doses of more than 1 milligram of folic acid can precipitate or exacerbate the neurological damage caused by a vitamin B12 deficiency.
Garlic

Garlic has blood-thinning, anticlotting properties.
Discontinue using garlic before any surgical procedure.
Garlic can cause headache, muscle pain, fatigue, vertigo, watery eyes, asthma, and gastrointestinal symptoms such as nausea and diarrhea.
Ingesting large amounts of garlic can cause bad breath and body odor.
Ginseng

Consult your doctor before taking ginseng if you have high blood pressure. Overuse of ginseng can increase blood pressure.
Consult your doctor before taking ginseng if you take nonsteroidal anti-inflammatory drugs (NSAIDs) and/or warfarin (Coumadin). Taking NSAIDs or warfarin with ginseng can increase the risk of bleeding.
Consult your doctor before taking ginseng if you have diabetes. Taking ginseng can cause an extreme drop in your blood glucose level. Ginseng can cause breast pain, vaginal bleeding after menopause, insomnia, headaches, and nosebleeds.
L-Glutamine

Consult your doctor before taking L-glutamine if you have kidney failure or liver failure.
L-glutamine can cause gastrointestinal symptoms such as nausea and diarrhea.
Melatonin

Do not take melatonin if you are depressed.
Do not take high doses of melatonin if you are trying to conceive. High doses of melatonin have been shown to inhibit ovulation.
Melatonin can cause morning grogginess, a feeling of having a hangover or a “heavy head,” or gastrointestinal symptoms such as nausea and diarrhea.
Selenium

High doses of selenium (1000 micrograms or more daily) for prolonged periods may cause adverse reactions.
High doses of selenium taken for prolonged periods may cause chronic selenium poisoning. Symptoms include loss of hair and nails or brittle hair and nails.
Selenium can cause rash, breath that smells like garlic, fatigue, irritability, and nausea and vomiting.
Vitamin B6

Do not take vitamin B6 if you are being treated with levodopa, unless you are taking carbidopa at the same time.
Do not take high doses of vitamin B6 (5 milligrams or more daily).
Vitamin B12 (cyanocobalamin)

Do not take cyanocobalamin if you have Leber's optic atrophy.
Vitamin C

Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.
Vitamin E

Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
Consult your doctor before taking vitamin E if you have a history of any bleeding disorder such as peptic ulcers, hemorrhagic stroke, or hemophilia.
Discontinue using vitamin E 1 month before any surgical procedure.
Zinc

High doses of zinc (above 30 milligrams daily) can cause adverse reactions.
Zinc can cause a metallic taste, headache, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea.
High doses of zinc can lead to copper deficiency and hypochromic microcytic anemia secondary to zinc-induced copper deficiency.
High doses of zinc may suppress the immune system.

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