Four studies on vitamin use and cancer seem to reach different conclusions.

8th Thursday, 2010  |   Breast Cancer, Herb or Compound, Prostate Cancer  |  no comments

Four studies on vitamin use and cancer seem to reach different conclusions. Are vitamins a benefit or a danger? I guess like all of these studies it depends; depends on the type of vitamin, the form of the components ie methylate form or not, and the combinations of vitamins therein. I think it is wise to use vitamins with clear intention, that is, what is attempted by their use, what is being treated and for how long will they be used. The last study concluded that multivitamin/mineral supplement use may prevent cancer in individuals with poor or suboptimal nutritional status, which does make sense BUT we need to measure that nutritional status to ensure we are treating the correct deficiency. The last study also points out the difference in gender and the impact of vitamins – interesting.

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The link between obesity, inflammation and cancer has been well established

6th Tuesday, 2010  |   Breast Cancer, Herb or Compound, Prostate Cancer  |  no comments

The link between obesity, inflammation and cancer has been well established. A new paper on bitter melon, a common food that has shown blood sugar regulating function has indicated it has anticancer action. I also include an older article on obesity and cancer.
Obesity is a growing health problem in developed nations and in countries that are in the process of westernisation like India. Obesity is linked with several health disorders such as hypertension and cardiovascular diseases, Type 2 diabetes, dyslipidemia and certain cancers. Currently, obesity-related malignancies, e.g., cancers of the breast, prostate and colon are the leading cancers in the industrialized societies. continue reading

Complementary/alternative medicine use in a comprehensive cancer centre

Complementary/alternative medicine use in a comprehensive cancer centre Oncologists are aware that their patients use complementary/alternative medicine (CAM). As cancer incidence rates and survival time increase, use of CAM will likely increase. This study assessed the prevalence and predictors of CAM use in a comprehensive cancer centre. SUBJECTS AND METHODS: Subjects were English-speaking cancer patients at least 18 years of age, attending one of eight outpatient clinics at The University of Texas M.D. Anderson Cancer Centre, Houston, TX, between December 1997 and June 1998. After giving written informed consent, participants completed a self-administered questionnaire. Differences between CAM users and nonusers were assessed by chi(2) and univariate logistic regression analysis. A multivariate logistic regression model identified the simultaneous impact of demographic, clinical, and treatment variables on CAM use; P values were two-sided. RESULTS: Of the 453 participants (response rate, 51.4%), 99.3% had heard of CAM. Of those, 83.3% had used at least one CAM approach. Use was greatest for spiritual practices (80.5%), vitamins and herbs (62.6%), and movement and physical therapies (59.2%) and predicted (P <.001 by sex younger age indigent pay status and surgery. after excluding spiritual practices psychotherapy of participants were aware cam those had used cam. use was predicted education chemotherapy. conclusion: in most categories common among outpatients. given the number patients combining vitamins herbs with conventional treatments oncology community must improve patient-provider communication offer reliable information to initiate research determine possible drug-herb-vitamin interactions.

More on Antioxidants and Cancer Treatment

No issue better exemplifies the differences between conventional medical practice and that of complementary/integrative medicine than their recommendations about the use of herbs, vitamins, and nutraceuticals involving antioxidants (AO) in the treatment of cancer. Oncologists who practice conventional medicine typically recommend against supplements, based on their belief that they may interfere with the treatment benefits of radiation and chemotherapy (4).
Physicians who practice complementary medicine typically recommend in their favour, although often with caveats, because supplements can ameliorate the side effects of conventional treatment, and may also increase the effectiveness of conventional oncology protocols. Given that a high percentage of cancer patients use supplements, evaluating these opposing views is of considerable importance.
There have been numerous previous reviews of the evidence on this issue and many are conflicting (1-3), some recommending in favour of supplements and some against. In part this reflects the complexity of the issue, as there are many different kinds of supplements, each of which may have multiple properties. Moreover, radiation and chemotherapy may themselves be affected differently by supplements, as may different chemotherapy agents.
For any given cancer patient, whether to use or not use supplements is a complex decision. The greatest mistake is to adhere to a “one size fits all” approach. If conventional treatment for the patient’s malignancy has a high rate of success, prudence would suggest that a conservative approach is in order, although for some situations, such as radiation for head-and neck cancer, the side effects, while temporary, can be extremely debilitating. But for the great majority of cancer patients, conventional treatment is not effective, so that any detrimental effect of supplements, assuming that there were such an effect, is unlikely to change the treatment outcome. Moreover, given that some supplements have clear clinical evidence of providing benefit (melatonin, Vitamin D, PSK, and fish oil), while others have impressive support from animal models (curcumin, silibinin, lycopene, genistein, green tea, and ellagic acid), the possible benefits greatly outweigh the hypothetical harm. The most difficult part of the issue is the status of the most common AOs, vitamin A, beta-carotene, Vitamin C, and Vitamin E. While various combinations of these have been shown to reduce toxicity of conventional treatments, and there is no persuasive evidence that they interfere with conventional treatment outcomes, there is also no solid clinical evidence that they improve outcomes either. If they are to be used, it seems prudent to follow the advice of Prasad (1) and others to use them in combination at high doses. Experimental data and limited human studies suggest that use of these nutritional approaches may improve oncologic outcomes and decrease toxicity.

In cancer medicine, fewer than 5% of all patients in the US enter clinical trials

31st Wednesday, 2010  |   Others  |  no comments

In a recent article by John L Marshall, the Director of the Otto J Ruesch Centre at Georgetown University in The Weekly Guardian (5 March 2010) states that, “In cancer medicine, fewer than 5% of all patients in the US enter clinical trials. That means more than 95% are treated with the standard of care, a legal term denoting minimum level of care for an all or injured person… How did we end up here? The answer is simple: cancer patients are scared for their lives and will accept what is offered, and we oncologist want to offer improved outcomes and recommend the best treatments we can.” Dr Marshall goes on to say: “Insurance will pay for these treatments. A portion of fees collected by doctors and hospitals is based on how much chemotherapy we administer. So the more drugs we give, the more radiation we give, the more we collect from health insurance .”

Later Dr Marshall says, “A major focus of healthcare reform is for doctors to practice evidence-based medicine. The problem in cancer medicine is that we have very little evidence to support what we are doing. Because so few of our patients enter clinical trials, we have no way of tracking their outcomes collectively. Our understanding of cancer therapies comes from the 5% who enrol in trials…”

We know cancer patients facing death are desperate and accept toxic treatment after toxic treatment hoping to extend their lives, but do they? No one knows. There are no trials comparing older (and cheaper) forms of chemotherapy over the newest (and exceedingly expensive) new ‘breakthrough’ drugs. Doctors are under pressure to prescribe the latest and newest drugs but cannot get the simplest information on comparing life expectancy between these older and newer drugs. 

When I as a complementary oncologist get told I should show the RCTs for what I offer to patients, I only point our the painful truth, none of us, orthodox or complementary practitioners have the opportunity to track our outcomes collectively. This should change for the benefit of the patient and our only ethical concern should be their well being and not inter-disciplinary point scoring.