Do Nutrients Interfere with Chemotherapy?
If you or someone close to you has been diagnosed with cancer, then you are likely familiar with the most common treatment methods prescribed by traditional (western) medical practice. Chemotherapy, radiation, and surgery are used as a means to “kill” cancer cells or physically remove them from the body.
The focus of this article will be on chemotherapy, how it works, and the influence of nutrient therapies as conjunctional or stand-alone treatment options in cancer patients. As a clinician, I have had many of my cancer clients tell me that their oncologist warned them not to take any nutritional supplements while undergoing chemotherapy and/or radiation. There are a number of reasons why the oncologist may have suggested this, but the question we will answer in this article is “Do nutrients interfere with chemotherapy or radiation treatments?”
How Does Chemotherapy Work?
Chemotherapy, sometimes called chemo, most often refers to the treatment of cancer through the introduction of cancer-killing drugs into the body. Currently there are over 100 chemotherapy drugs being used in cancer treatment which are separated into categories based on how they work in the body to inhibit cancer growth (1).
Chemo drugs are categorized among the following categories: alkylating agents, anti-estrogens, antimetabolites, antitumor antibiotics, plant alkaloids (synthetic), topoisomerase inhibitors, and unclassified cytotoxic agents. Although, as a patient, it can be overwhelming trying to understand exactly how all of these drugs work, they ultimately are designed to target and disrupt the cell cycle of rapidly dividing cells.
Cell cycle simply refers to the process through which cells grow and divide. Cancer cells progress through this process at an abnormally high rate. Because proper cell division requires the copying of DNA, many chemotherapy drugs are designed to block or interfere with the DNA replication process. By doing so, the cells become severely damaged and are destroyed through a process called apoptosis.
Chemotherapy Treatment Dangers
Although researchers claim that developing chemotherapy treatments are increasingly targeted towards cancer cells, chemo agents generally do not know the difference between healthy and cancerous cells. This can result in damage to both and, potentially, limit the body’s natural healing capacity towards cancer.
Specifically, the chemicals used in chemotherapy have shown to cause damage in the nervous system, liver, kidneys, heart and digestive tract. All of these systems are critical for optimal health and, especially in cancer treatment, must be supported nutritionally to maximize long term health outcomes.
Oncologists And Nutritional Therapy
There are many chemotherapy agents being used in today’s medical oncological practices; all with varying mechanisms of action. Primarily, cancer drugs inhibit the DNA replication process so that cells are unable to divide.
It is generally held that chemotherapy works by promoting the formation of free radicals (oxidative stress) that damage cancer cell (as well as healthy cell) DNA and lead to apoptosis of the damaged cells. Some oncologists are skeptical of patients receiving nutritional therapy as many nutrients have the ability to neutralize these free radicals and, as a result could inhibit the effect of treatment.
Fortunately, the rapidly developing field of nutraceutical science (which studies the medicinal qualities of foods and plant-derived nutrients) has uncovered several safe and natural compounds that can be used alongside chemotherapy to protect healthy cells, limit side effects, and significantly improve long-term health outcomes.
Anti-Oxidants and Cancer Therapy
Certain antioxidants, such as quercetin, in particular have actually demonstrated the ability to enhance chemotherapy effectiveness by protecting healthy cells and mitigating side effects (2). This is significant for long-term health as it relates to preventing unchecked oxidative stress (3). By combining nutrient therapies with chemotherapy, the benefits of treatment can be maximized while dramatically lowering negative side effects and complications.
A 2007 review of nutritional therapy for cancer patients showed that “since the 1970s, 280 peer-reviewed in vitro and in vivo studies, including 50 human studies involving 8,521 patients 5,081 of whom were given nutrients, have consistently shown that non-prescription antioxidants and other nutrients do not interfere with therapeutic modalities for cancer. Furthermore, they enhance the killing of therapeutic modalities for cancer, decrease their side effects, and protect normal tissue. In 15 human studies, 3,738 patients who took non-prescription antioxidants and other nutrients actually had increased survival.” (18).
For most people, being diagnosed with cancer is the worst thing they could experience in a lifetime. Often a cancer diagnoses instills a sense of emergency and panic, leading to an immediate search for treatment. Patients inured in cultures supporting traditional medical methodologies seek out the medical oncologist as he represents the most in depth source of knowledge in cancer-related matters. It is possible then that these patients are not receiving all the information available for effective treatment options
Although the sense of urgency following a cancer diagnoses is justified, it is important to know all options before beginning treatment. Starting a chemotherapy treatment without proper nutritional support may increase the chances of one’s experiencing brutal side effects and may even accelerate cancer growth in some cases. Even when treatment is deemed successful, the damages caused by chemo drugs may eventually promote the development of secondary cancers because normal cells were unable to heal DNA damage induced by them.
Additionally, an absence of a targeted nutritional therapy program can lead to harmful dietary recommendations (such as excess sugar, which is the primary fuel for cancer cells, synthetic nutrients, and other calorically dense combinations) which are made with a goal of prioritizing weight gain (“regaining one’s strength”) In reality, it is critical that dietary habits be focused toward a broad range of nutrients and studied supplements that will build the body’s defenses against chemotherapy damages and improve treatment effectiveness.
There are studies demonstrating how fasting and ketosis work to improve the efficiency and reduce side effects of chemotherapy on rats and human patients, yet most oncologists have no idea about this (16,17).
How Nutrient Therapies Work
At one time there was a vast array of research showing the potential therapeutic effects of chemotherapy on cancerous conditions while very little evidence was available on the benefit of nutritional therapy. More recently, increasing evidence has highlighted how treatments such as nutritional, plant-based therapies can dramatically alter the cancer healing process in a beneficial way.
For patients under chemo treatment, nutritional therapy can enhance treatment through three primary targets: by protecting the organ systems vital for health, by mitigating debilitating side effects, and targeting cancer stem cells.
Protecting Organ Systems
It is now well established through research what a profound effect that naturally occurring phytonutrients can have on one’s health, particularly in the case of cancer. Although many of these phytonutrients have anti-cancer effects in absence of chemotherapy treatment, they can provide a significant benefit in combination as well.
One aspect that is often overlooked when traditional and nutrient therapies are combined is how well one can utilize those nutrients and transport them around the body. In other words, after consuming nutrients, what proportion of them are actually absorbed into the body. Chemotherapy damages many of the systems necessary for proper nutrient absorption, conversion, and transport; making it vital that this issue be addressed for maximized benefit.
After consumption, nutrients are absorbed through the digestive tract, passed to the liver to be filtered and converted to bioavailable forms, and circulated throughout the body by the cardiovascular system. Any toxins generated in the process are sent to the liver and kidneys to eventually be removed.
Additionally, the brain and nervous system can take on significant damage from chemo, potentially making it difficult for the brain to effectively transmit and receive electrical signals throughout the body. A properly functioning nervous system is one of the most important factors in promoting overall optimal function of the body.
These systems are known to accumulate significant damage when introduced to chemo drugs but luckily several natural compounds can help. Because chemo can inhibit nutrient absorption and transport, it is important that nutrient therapies be started before chemotherapy so that they can exert protective effects on these critical organ systems.
Protecting the Nervous System
It has been traditionally held that chemotherapy does not affect the components of the nervous system. This is derived from the assertion that brain and nerve cells do not divide fast enough, or at all, after childhood to be affected by chemo. We now know, however, that brain cells divide well into adulthood. Troubling side effects associated with chemotherapy are being noted for which preventative measures can be implemented.
A symptom known collectively as “chemo-brain” has been documented for some time. Complaints of cognitive impairment after chemo treatment are now routinely anticipated. This degradation is attributed to factors like stress and depression. As recent research has uncovered however, damage to the nervous system may be involved. Acute and long-term effects have been documented after chemo administration such as immediate injury to progenitor cells (responsible for replacing damaged cells) and delayed damage to the myelin (needed for impulse conduction)(4).
Peripheral neuropathy is also rapidly becoming a common complication for chemo patients (5). Many patients retain cognitive impairment several years after treatment has ceased (6). Because the nervous system is the central hub for all bodily processes and ensures the requisite complementary interaction of same, protecting it and optimizing it may be one of the most important measures to ensure proper healing.
Effective measures include increased levels of antioxidant activity and inflammation control which protect against DNA damage. Key nutrients to be introduced include alpha lipoic acid, curcumin, quercetin, and magnesium.
Chemo and the GI Tract
Corresponding research has shown that the gastro-intestinal (GI) tract can be significantly damaged by chemotherapy drugs through severe inflammation and decreased mucosal secretions necessary for proper function. In addition, some chemo drugs have the ability to trigger the nausea center in the brain, making it difficult to consume and retain food without vomiting. Even more serious perhaps is the inhibition of digestion which can cause mild to severe malnutrition if nutrients aren’t being absorbed.
One particular complication that can severely inhibit the cancer healing process is the development of leaky gut syndrome. Leaky gut is when holes develop in the intestinal lining and allow large food molecules to pass through before being fully digested. This is a problem because these food molecules are foreign to the body and the immune system tags them as invaders. Once tagged, eating those same foods will often cause allergic reactions. This immune system behavior is detrimental to the body and detracts from the important job of destroying cancer cells.
The Problem With Leaky Gut
These side effects not only inhibit one of the body’s critical survival processes, but also make it physically unpleasant to endure chemotherapy. In addition to leaky gut, destruction of the microbiome (healthy gut bacteria), loss of digestive enzymes, and inhibition of stomach acid production can occur leading to significant malnutrition. Introduction of certain nutrients into the diet, especially prior to beginning treatment, can ensure the digestive tract remains intact.
The best nutrients for protecting the digestive tract during chemotherapy treatment are those which will control inflammation, support a healthy microbiome, and promote the production of mucous that acts as a protective barrier to the GI lining. Nutrients showing powerful anti-inflammatory effects in the GI tract are quercetin, curcumin (in turmeric), L-glutamine, Vitamin E (succinate), and several flavonoids found in vegetables (7, 8, 9, 10).
To increase mucosal secretions in the GI tract the use of one or a combination of ginger, licorice root, marshmallow root, or fennel. Finally, an effective introduction of a high quality probiotic supplement along with a diet high in prebiotic fibers will ensure one’s GI tract remains populated with a healthy range of bacteria. I use my Gut Healing Protein powder, which has all of these components with my cancer clients to help protect the gut.
Chemo and The Body’s Detox Systems
The liver and kidneys are two of the body’s most important eliminators of toxic materials. Together these organs detoxify the blood and ensure that a healthy balance of nutrients is being delivered to the tissues. Both organs tend to take on extensive damage trying to detoxify the drugs and byproducts of cancer cell destruction so supporting them through nutrient therapies will help mitigate these effects.
Although it is the primary role of the GI tract to absorb nutrients into the blood stream, they must then be shuttled to the liver where toxic materials are removed and nutrients are converted to forms that are useable by the body. The liver is also responsible for processing drugs, such as chemotherapy, before being distributed throughout the body. The kidneys are responsible for filtering toxins and excreting them through the urinary system.
A damaged liver, or one that has been diminished in its detoxification ability, will allow toxins to build up in the bloodstream and increase chances of complications and possibly cause for temporarily halting treatment. When treatments are temporarily stopped, cancer cells tend to develop resistance to chemo drugs and become harder to kill.
Incorporation of certain nutrients can mitigate these detrimental effects significantly. Ideally, these nutrients would be consumed routinely starting before chemotherapy to fortify the liver and kidneys. Because of the complexity and enzymatic coordination involved in the detoxification process, a combination of nutrients is recommended for best results.
In the liver there are three phases of detoxification:
Phase I: Converts toxin to form that is able to be metabolized by Phase II Enzymes
Phase II: Toxin is made water-soluble by attaching it to a carrier molecule
Phase III: Transport proteins carry toxin to gallbladder or kidneys for excretion
For effective detoxification, all three phases must be supported. Natural compounds have been identified that provide this effect. Nutrients that support Phase I detoxification often seem to also support Phase II. The most effective nutrients for Phase I/II detox support are calcium-d-glucarate (11) sulfur compounds (cysteine, methionine, sulforaphane), glutamine, ginger, milk thistle, glutathione, curcumin, magnesium, and EGCG (12).
Phase III detox is improved significantly with the inclusion of dandelion extract, fenugreek, and fennel. Several of these nutrients also stimulate bile flow, which is considered a crucial final step in liver detoxification as some toxins are eliminated through the bile.
The liver and kidneys can further be supported by improving NRF2 signaling and consuming nutrients that can bind toxins in the blood (13). NRF2 is what is known as a transcription factor and this one in particular is responsible for the upregulation of powerful antioxidant and detoxification genes. There are a wide variety of nutrients that may enhance NRF2 signaling such as glucorophanin, turmeric, and green tea extract. To help bind toxins in the blood, chlorophyll rich foods such as wheatgrass or chlorella have shown to be beneficial.
Other considerations to take into account when detoxing high levels of toxins are adequate water consumption, consistent exercise or movement practice, and intermittent fasting. A higher than normal hydration level may be necessary to aid the elimination of toxins through urine and sweat. Exercise is important because it increases nutrient absorption and mobilization of lymph. Intermittent fasting may aid in the detoxification process by allowing more time between meals for the body to devote energy to such processes.
Chemo and the Blood Systems
Once nutrients have been absorbed through the GI tract and passed through the liver, it is up to the cardiopulmonary system to circulate and deliver them to cells around the body. As another crucial link in the chain of whole-body nourishment, it is important that the cardiopulmonary system is working optimally.
It is also important to protect the integrity of blood-producing tissues as they are what produce oxygen-carrying and immunity-regulating cells. Cancer cells thrive in a low oxygen environment and are evasive to the immune system. It is vitally important to maximize oxygenation of tissues and strengthen the immune system fully by protecting tissues that are responsible for doing so.
Certain chemo drugs can damage the heart, blood-forming cells, and lungs. Together these systems deliver nutrients to cells and toxins out. Using nutrients to protect these systems will ensure complications are limited and benefits are maximized. To optimize the cardiopulmonary system while enduring chemo treatment, three components must be addressed: protecting the heart from cardiotoxicity, protecting the blood-forming tissues from being damaged, and fortifying the structures of the lungs.
Proper Nutrients For Cardiovascular System
Cardiac toxicity is a major condition associated with chemotherapy and can lead to a weakened heart or even heart failure. Vitamin E Succinate, Vitamin C, and n-acetyl-cysteine (NAC) have been shown to help protect the heart from acute damage while CoQ10 and melatonin can protect from long term damages (14).
Suppression of blood-cell producing tissues can be devastating as they play a major role in tissue oxygenation and immunity. To protect the tissues that produce blood cells, consumption of curcumin and a multivitamin containing adequate levels of folate, methylcobalamin, pyridoxal-5-phosphate, vitamin c, vitamin E succinate, and niacinamide, can offer powerful support.
Although less frequently evidenced, damage to the lungs can occur with certain chemotherapy drugs. Since the lungs are responsible for the ingestion of oxygen and the expiration of certain wastes, damage to them will only exaggerate the complications of cardiopulmonary insufficiency. To protect the lungs, it is important to consume curcumin, EGCG, and vitamin E succinate.
Killing Cancer Stem Cells
Cancer stem cells are responsible for the development of new cancer cells and are very resistant to chemotherapy treatment. Even after several rounds of chemotherapy, cancer stem cells often survive and become more aggressive. This is where nutrient therapies can especially succeed.
Several nutrients have been identified as cancer stem cell inhibitors and combining them with chemotherapy will improve the chances of successful treatment. Some of the most powerful nutrients with the ability to target cancer stem cells are vitamin-D, curcumin/piperine mixture, quercetin, EGCG, sulforaphane, and anthocyanins (15).
As you have just read, nutrient therapies do interfere with chemotherapy in a very positive way. They provide a powerful integrative approach to heal cancer when a patient has chosen to receive chemotherapy. In contrast to what some oncologists believe, many nutrients act to strengthen the specificity of chemo drugs while protecting healthy cells and mitigating side effects.
Although it is helpful to begin consuming the nutrients mentioned in this article, to maximize results it is important to consult with an authoritative resource who can provide accurate information regarding quality and efficacy of these effectively proven supplemental sources for the targeted nutrients referred to in this article.