Vitamins and Supplements for Cancer Survivors

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1 Vitamins and Supplements for Cancer Survivors Moving Beyond Cancer to Wellness Fred Hutchinson Cancer Research Center Dan Labriola ND Lisa Price ND Tara Stacker ND Carrie Dennett RD, MPH Northwest Natural Health A Specialty Care Clinic Specialty Care Clinic 1

2 Objectives What is new with nutrition, supplements and cancer What works What doesn t work How natural medicine can affect your conventional cancer treatment Specialty Care Clinic 2

3 Objectives -Learn how vitamins and supplements can be a safe, sensible and scientific addition to your care Specialty Care Clinic 3

4 Where Patients Get their Information Specialty Care Clinic 4

5 What s Really Important? Stay strong and healthy Avoid interactions with treatment Respect the Protected Zone Prevention for the future Specialty Care Clinic 5

6 A Plan that works Maintain quality of life before, during and after treatment in every way Overall Health Cancer specific issues Take back control of your life. Do most or all that you could do prior to being diagnosed Control adverse effects from treatment Manage Co-morbidities Specialty Care Clinic 6

7 Omega 3 Essential Fatty Acids Important Benefits and Risks Omega 3 Essential Fatty Acids are important for almost every body function from immune system to skin Not all omega 3 Essential Fatty Acids are the same Specialty Care Clinic 7

8 Omega 3 Essential Fatty Acids Important Benefits and Risks Potential Benefits Reduce cancer risk Reduce Triglycerides Reduce heart attack risk Reduce clot formation Slow RA progression Help mood (depression and anxiety Helped learning impaired children Help atopic dermatitis Help with autism Potential Risks Increased bleed times Reduced glycemic control with diabetics Hypervitaminosis A and D Rancidify easily Specialty Care Clinic 8

9 The Omega 3 - Flaxseed Oil Debate The problems with flax oil (seeds are OK) Very low conversion rate Some Carcinogenic results Specialty Care Clinic 9

10 EFA Conversion ALA (Flax Oil) Delta 6 desaturase EPA Delta 5 desaturase DHA Specialty Care Clinic 10

11 Echinacea and cancer A great herb with many uses Use with caution with cancer Specialty Care Clinic 11

12 Echinacea and cancer Many species White blood cell stimulator Microbial considerations Unknown effects on immature immune systems therefore not recommended below age 14 (or pregnancy or lactation) Hepatic metabolism Counteracts immune suppression treatment Specialty Care Clinic 12

13 Potential Echinacea Side Effects Allergic including anaphylaxis, asthma Thrombocytopenia Purpurea Leucopenia Disrupted WBC differential Abdominal pain Dysuria Arthralgia Myalgia Dizziness Dry mouth Specialty Care Clinic 13

14 Herbal combinations General Considerations Many species, actions, interactions Microbial considerations Pediatric dosage may not be proportional to weight Unknown effects on metabolism, immature immune systems, development. Evaluate each ingredient Hepatic metabolism Specialty Care Clinic 14

15 Homeopathics Very low dosages, highly diluted Immune mediated theory of action Minimal evidence Extensive anecdotal history Experienced, responsible, licensed provider Specialty Care Clinic 15

16 More strategies Quality control of natural products is important Prevention is more important now than ever Survivorship strategies can change your life Herb and nutrition interactions are important Specialty Care Clinic 16

17 Natural Product Quality Control DSHEA GRAS CGMPs No microbial or heavy metal rules Label accuracy? Specialty Care Clinic 17

18 Survivorship Strategies Avoid Possible interactions with cancer treatment Chemotherapy Radiation Surgery Targeted Therapies Specialty Care Clinic 18

19 Evidence Overview: Antioxidants during treatment Placebo Antioxidants Years Cancer-free Survival Ref: Bairati et al A Randomized trial of Antioxidant Vitamins to Prevent Second Primary Cancers in Head and Neck Cancer Patients Int J Cancer 2006 Nov 1:119(9): Specialty Care Clinic 19

20 Primary Prevention Diet and Nutrition Vitamin B12 Folate Vitamin D Fiber Fruits and vegetables Fish Some antioxidants Specialty Care Clinic 20

21 More Nutritional Treatments Vitamin E Selenium Calcium, vitamin D, phosphorus Zinc Beta carotene Antioxidants in general Consider IV delivery Specialty Care Clinic 21

22 Frequent Questions Combining Complementary and Alternative Medicine with Conventional Therapy Specialty Care Clinic 22

23 Phytoestrogens Including Soy Isoflavones? Safe Replacement for Hormone Therapy? Answer: Probably the same risk as HRT Ask for Patient Briefing Paper Specialty Care Clinic 23

24 Strategies that work Maintain quality of life before, during and after treatment Cancer and treatment specific issues that can be helped even if they existed prior to treatment Fatigue Hot flashes and other menopausal symptoms Gas (belching, flatulence) Bloating Stomach upset Constipation Diarrhea and bowel urgency Specialty Care Clinic 24

25 Strategies that work (Continued) Maintain quality of life before, during and after treatment Cancer and treatment specific issues that can be helped Urination urgency Joint and muscle aches (including fibromyalgia) Headaches Sleep quality Pain Weight gain or loss Headaches Specialty Care Clinic 25

26 Strategies that work (Continued) Maintain quality of life before, during and after treatment Cancer and treatment specific issues that can be helped: Treatment side effects Neuropathy Muscle cramps Restless leg syndrome Skin rashes Blood sugar metabolism Specialty Care Clinic 26

27 Questions? Comments? Dan Labriola ND Lisa Price ND Tara Stacker ND Carrie Dennett RD, MPH Northwest Natural Health, A Specialty Care Clinic 7 convenient locations nwnaturalhealth.com Specialty Care Clinic 27