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Dietary Supplements

Posted 5/22/2013

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  This is another controversial and frequently misunderstood topic. Many, if not most, cancer patients at least think about their diets and wonder if there are foods that can be added or subtracted that would make a difference in their cancer progression. As far as I know (and I do try to keep up), there is zero proof that anything we eat or don't eat causes cancer or cures cancer or even has an impact on recurrence risk or progression. Certainly there is a great deal known about healthy eating, and the usual advice is the usual advice: meaning eat lots of fruits and vegetables, minimize the amounts of red meat, white flour, sugar. Today's article takes this all a step further with a careful look by the Clinical Practice Committee of the Society of Integrative Oncology at commonly used nutritional supplements.

  Many patients do not talk with their oncologists about what they are eating/not eating, and many doctors don't really know much about it. Clearly it is important to be open and honest with your doctor about anything you are ingesting while you are on active cancer treatment, either chemotherapy or radiation therapy. There are some known risks of certain vitamins during this time, and it would be pretty stupid to endure serious cancer treatment while simultaneously doing something that might interfere with its effectiveness.

  Here is the abstract from the article from Integrative Cancer Therapies and a link to read more:

Integrating Dietary Supplements Into Cancer Care
Moshe Frenkel, MD1,2,*, Donald I. Abrams, MD3, Elena J. Ladas, MS, RD4,
Gary Deng, MD5, Mary Hardy, MD6, Jillian L. Capodice, LAC, MS7,
Mary F. Winegardner, PA-C, MPAS8, J. K. Gubili, MS5, K. Simon Yeung,
PharmD, MBA, LAc5, Heidi Kussmann, ND, FABNO9, and Keith I. Block, MD10

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.


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