Vitamins and chemo

[beach sunrise]

Dividing Cancer Doctors
Nothing divides cancer doctors from “complementary and alternative medicine (CAM) more than the question of vitamins and chemotherapy. In fact, most serious scholars of the topic agree that mixing vitamins and chemotherapy is harmless. In fact, it is probably quite helpful. But some oncologists oppose this practice. Now the tide is slowly turning in favor of combined use, or at least against the prohibition of this practice.

Vitamins Can Fight Chemo’s Side Effects
Scientists in Egypt showed that vitamin D3 and vitamin B6 reduce some signals of harm in women treated for breast cancer. They reported markers of cancer “decreased significantly” in patients. In their words:

“Supplementation with vitamins D3 and B6 reduces the oxidative stress, the side effects of chemotherapy and radiotherapy such as vomiting and fatigue, in addition to interfering with angiogenesis.”
Cancer Patients Love Vitamins
Many patients take food supplements to decrease chemo’s side effects. Their goal is to also increase the effectiveness of standard treatment. One large trial showed that 48% of cancer patients take multivitamins, of whom:

20% take vitamin C, D, and omega-3 fatty acids
15% take vitamin E, B6, and folic acid
34% take calcium
But the opinion of their doctors was divided:

One-third agreed that they should start such usage.
10% said to stop taking a supplement.
7% said to stop all except a multivitamin.
The rest (51%) gave no advice.
Vitamins and Chemo
Oncologists have concerns that antioxidants might cancel the pro-oxidant effects of chemotherapy. But, usually, they fail to cite scientific studies in support of their opinions. So on this topic, they often come across as dogmatic. We routinely urge cancer patients to ask their health care provider for proof that such antioxidants use is harmful. Doctors rarely comply with this request, and there is in fact a dearth of randomized controlled trials to support this prohibition.

But there was a study at Columbia University that showed the opposite. Patients who began treatment with high blood levels of vitamins A, E, and carotenoids:

Required fewer chemo dose reductions.
Had fewer infections.
Had an improved quality of life.
Experienced less delay in chemo treatment
Had reduced toxicity.
Had fewer days spent in the hospital.
In addition, the genes of patients who had low antioxidant levels were more severely damaged by chemo than those of patients who had higher levels.

A 2018 update from India surveyed the world’s scientific literature on the combination of chemotherapy and antioxidants (including vitamins). Here are the authors’ conclusions:

“The effect of supplementation of thirteen different antioxidants in combination with chemotherapy has been compiled. The present review encompasses 174 peer-reviewed original articles comprising 93 clinical trials involving 18,208 patients, 56 animal studies, and 35 laboratory studies. Our comprehensive data suggests that antioxidants have the superior potential of ameliorating chemotherapeutic-induced toxicity. Antioxidant supplementation during chemotherapy also promises higher therapeutic efficiency and increased survival times in patients.”
Singh K, Bhori M, Kasu YA, Bhat G, Marar T. Antioxidants as precision weapons in the war against cancer chemotherapy-induced toxicity – Exploring the armory of obscurity. Saudi Pharm J. 2018 Feb;26(2):177-190. doi: 10.1016/j.jsps.2017.12.013. Epub 2017 Dec 19. PMID: 30166914; PMCID: PMC6111235, paraphrased)
We believe that this will eventually become the mainstream opinion. Patients can hasten that day by demanding proof from their doctors for any statement claiming that vitamins or antioxidants have a negative effect on patients’ outcomes.

[rp1954]

I'm obviously on board with specific vitamins, even "megadoses" of vitamins, having used them with my wife's continuous chemo for 8 years to improve her quality of life and to continuously improve her blood markers related to survival. In fact, some of her panels were better after 8 years of vitamin/nutrient fortified immunochemo than they were 50 years ago - not exactly the experience of the typical chemo patient.

The real dangers are purveyors of wrongful vitamin information (e.g. misinformed doctors, old line RDA centric dietitians, aggressive sellers, and even ill-informed advocates), chemical mismatches, and the wrong chemical content in poorly (mis)chosen supplements. One common problem has been that supposedly high quality / high status conventional sources may be misleading, or dead wrong. At least in the recent past.

In my opinion, a lot of the problems (QoL, (in)effectiveness) with chemo start with the fact that even the oldest and most common drugs were never optimized in several ways, including well chosen vitamins and supplements that are potentially therapeutic too. Substantial research suggested that standard practices were poorly matched to my wife's particular cancer and situation, so we were not going to snap at the profferred choices in desperation with such a lowball offer on survival time and suffering. Hence she had lots of carefully chosen vitamins, more 50 kilograms of IV vitamin C with her particular biochemistry and biomarkers, lots of a 5FU prodrug, and never any iri-, oxi-, Avastin, Erbitux, etc.

For CRC, more common mistakes include folic acid containing supplements and foods with 5 FU based chemo. I consider the common multivitamin-multimineral potentially one of the really bad choices - too much copper, iron, folic acid and potentially other ingredients, along with inadequate quantity/proportion and lower quality forms of many nutrients. Likewise the common B complex, B50, B100s are likely to have folic acid unless you check the specific content information for a brand.

People often make serious mistakes not consulting several better informed sources - including those providers who did lots of research and have more successful experience than the average or std doctor.

[beach sunrise]

100% agree. I have learned so much about vitamins, minerals, enzymes, off label drugs more than I ever wanted to and I like your wife see huge benefit to knocking down cancer and improving immunity. I'll say it again, if I had stayed in SOC I would not be here today. Outside the box treatments have saved my life twice so far.
I was taken aback most when labs came back with CoQ10 (who would have thought it) as being good for my cancer kill but makes sense since its part of transport chain and degrades after age 40. I must have had none or close to none. That really suprised me.
People need to really do their homework, get the expanded labs and consult with high expertise ND's.
Def not a fan of going off the rails self guiding with no detective work.

[Pagola44]

I've read conflicting studies and I'd be hesitant to take any vitamins during chemotherapy

[mozart13]

I think more people should be talking about this. There’s growing evidence that vitamins like D3 and B6 can actually reduce chemo side effects without hurting treatment and might even help. But a lot of doctors still advise against them without pointing to actual studies. This breakdown really shifted how I see the whole chemo + vitamins debate: https://federal-lawyer.com/bard-power-port/