Integrating Dietary Supplements Into Cancer Care

Abstract

Many studies confirm that a majority of patients undergoing cancer therapy use self-selected forms of complementary therapies, mainly dietary supplements. Unfortunately, patients often do not report their use of supplements to their providers. The failure of physicians to communicate effectively with patients on this use may result in a loss of trust within the therapeutic relationship and in the selection by patients of harmful, useless, or ineffective and costly nonconventional therapies when effective integrative interventions may exist. Poor communication may also lead to diminishment of patient autonomy and self-efficacy and thereby interfere with the healing response. To be open to the patient's perspective, and sensitive to his or her need for autonomy and empowerment, physicians may need a shift in their own perspectives. Perhaps the optimal approach is to discuss both the facts and the uncertainty with the patient, in order to reach a mutually informed decision. Today's informed patients truly value physicians who appreciate them as equal participants in making their own health care choices. To reach a mutually informed decision about the use of these supplements, the Clinical Practice Committee of The Society of Integrative Oncology undertook the challenge of providing basic information to physicians who wish to discuss these issues with their patients. A list of leading supplements that have the best suggestions of benefit was constructed by leading researchers and clinicians who have experience in using these supplements. This list includes curcumin, glutamine, vitamin D, Maitake mushrooms, fish oil, green tea, milk thistle, Astragalus, melatonin, and probiotics. The list includes basic information on each supplement, such as evidence on effectiveness and clinical trials, adverse effects, and interactions with medications. The information was constructed to provide an up-to-date base of knowledge, so that physicians and other health care providers would be aware of the supplements and be able to discuss realistic expectations and potential benefits and risks.

Does perceived control predict Complementary and Alternative Medicine (CAM) use among patients with lung cancer? A cross-sectional survey

“…[19] A frank discussion is important to allow education of potential interactions and prevent toxicities. [12, 37] For example, despite the legitimate concerns among clinicians that some herbs and vitamins may affect chemotherapy levels or even be tumor protective from anti-cancer therapies,[7, 28] the most common forms of CAM used in our study were herbs and vitamins. Since over 60% of patients who used these modalities were actively receiving anti-cancer therapy, more research should focus on how to efficiently and effectively engage patients and providers to discuss CAM use in oncology setting.…”

Surveys of Cancer Patients and Cancer Health Care Providers Regarding Complementary Therapy Use, Communication, and Information Needs

“…13 This lack of communication is concerning given the potential for CAM to exacerbate or alleviate symptoms related to conventional treatments, as well as the risk of interaction with conventional medications. 14 HCPs have a responsibility to provide optimal care for their patients and this should include addressing the risks and benefits of CAM. Indeed, many patients assume that HCPs will do so.…”

Modification in the diet can induce beneficial effects against breast cancer

“…The effects of probiotics and fermented products on intestinal disorders have been the most extensively studied considering that these microorganisms enter the organism orally and can positively modulate the intestinal microbiota involved in many of these disorders. The benefits of probiotics on the gut immune system in the prevention of cancer has also been previously described [73,74] . There are many different mechanisms by which probiotics and fermented products containing viable LAB may lower the risk of colon cancer; among them, the modulation of the intestinal microbiota [75][76][77][78][79][80] , the inactivation of carcinogenic compound [81][82][83] , anti-oxidant effects [84][85][86] , and the modulations of the host's immune response [87][88][89] .…”