Of the more than 1.4 million people diagnosed with cancer each year in the United States, most are given one or more chemotherapy drugs at some point in their treatment. Currently, more than 50 different chemotherapy drugs are used to treat cancer. While the type of chemotherapy depends on the type of cancer, some of the more common chemotherapy drugs include carboplatin, cisplatin, paclitaxel, fluorouracil, and doxorubicin.
Chemotherapy: The Basics
Simply stated, the goal of chemotherapy is to kill rapidly dividing cells, which is a common characteristic of cancer development. Unfortunately, chemotherapy drugs also kill other rapidly dividing—healthy—cells, resulting in unwanted side effects. In some cases, chemotherapy can even cause secondary cancers.
“Side effects of chemotherapy vary depending on the agent used and the person’s sensitivity to the drug,” explains Lise Alschuler, ND, director of naturopathic medicine at Midwestern Regional Medical Center. “Side effects can range from mild and manageable to severely debilitating and, in some cases, life-threatening.”
Common adverse effects of many chemotherapy drugs include
nausea and vomiting
mouth sores or dry mouth
constipation or diarrhea
fatigue and weakness
bleeding, blood count issues, or anemia
taste impairment or loss of appetite
neuropathy (numbness and tingling).
Quality-of-life issues associated with chemotherapy have recently received special attention from conventional medical researchers and have always been a priority with natural medicine proponents. In the past, chemotherapy dosing was primitive and imprecise. Traditionally, chemotherapy was given at the highest dose the body could tolerate, bathing the cancer cells and the patient in the toxic substance. While the cancer cells died, sometimes so did the patient. Today, lower and pulsed doses are more frequently used, as well as drugs designed to target a specific cancerous cellular action, making this therapy a little easier to tolerate and hopefully more effective.
“Advances in chemotherapy research have created drugs and dosing strategies that are better tolerated. However, side effects still occur often,” explains Dr. Alschuler. “The incorporation of natural complementary therapies can help make chemotherapy more tolerable and less frightening and dangerous.”
As with any drug, a cautious and individualized risk-to-benefit analysis is important. Given the risks associated with most chemotherapy drugs, it makes sense to find ways to reduce those risks, as well as to ease uncomfortable side effects. This is a new and exciting area of interest among integrative oncology researchers.
Many studies support the use of some herbs, nutrients, and other therapies during chemotherapy. Some examples include the following:
Coenzyme Q10 and L-carnitine can help protect the heart.
Coenzyme Q10 can help with fatigue.
Vitamin E, L-glutamine, and vitamin B6 can help prevent nerve damage (neuropathy).
Fish oil can help prevent malnourishment and cachexia, a wasting syndrome associated with cancer and chemotherapy usage.
Vitamin E, L-glutamine, honey, and deglycyrrhizinated licorice (DGL; glycyrrhizin in licorice can potentially raise blood pressure so it is important to take DGL) to ease the discomfort of mouth sores.
Acupuncture and ginger may help reduce nausea.
L-glutamine and probiotics can alleviate diarrhea.
Zinc can help minimize changes in the sense of taste.
Melatonin can help reduce cancer-related sleep disturbances.
Anemia is a common side effect of chemotherapy. However, it is typically not related to low iron levels. While supplemental iron is very effective at correcting anemia due to iron deficiency, taking this mineral won’t help if iron deficiency is not the cause. In fact, iron may even be harmful if taken with some chemotherapy drugs.
“Too much iron can promote tumor growth and actually worsen chemotherapy side effects,” warns Dr. Alschuler. “Supplemental iron is only recommended when iron deficiency has been confirmed by blood tests.”
You should not assume your anemia is caused by an iron deficiency, she adds. Unless recommended by your oncologist, don’t take supplemental iron.
The use of herbs and nutrients to support chemotherapy has great potential, but this is an extremely complex area of study that requires more research. It is absolutely critical to inform all of your doctors about every nutritional supplement you are taking.
Preliminary research shows us that some nutrients can interfere with some chemotherapy drugs.
N-acetylcysteine can interfere with the anticancer effects of several chemotherapy agents (see chart).
While vitamin B6 can help prevent neuropathy, dosages higher than 300 mg daily may interfere with cisplatin.
Curcumin and quercetin are strong anticancer flavonoids, but they may interfere with the antitumor activity of cyclophosphamide.
Some herbs should also be used with caution when taking chemotherapy. Examples include silymarin, kava, willow bark, and St. John’s wort. Herbs should be avoided completely with irinotecan, etoposide, and doxorubicin.For more information on supplement interactions with commonly used chemotherapy agents, refer to the chart on page 21 and consult your healthcare provider.