Vanguard Neurologist

From News-Medical.net

There is no evidence that antioxidant supplements interfere with the therapeutic effects of chemotherapy agents, according to a recent systematic review of the use of antioxidants during chemotherapy.

In fact, they may help increase survival rates, tumor response, and the patient’s ability to tolerate treatment. This conclusion has important implications for patients whose oncologists discourage the use of antioxidant supplements during treatment. Until now, their concern has been that these supplements may counteract the tumor-shrinking abilities of the chemotherapy.

“This review demonstrates that there is no scientific support for the blanket objection to using antioxidants during chemotherapy. In addition, it also appears that these supplements may help mitigate the side effects of chemotherapy,” said Keith I. Block, MD, lead author of the study and Medical Director of the Block Center for Integrative Cancer Treatment. “This is significant because it increases the likelihood that patients will be able to complete their treatment.”

Co-author Dr. Robert Newman, Professor of Cancer Medicine at M. D. Anderson Cancer Center said, “This study, along with the evolving understanding of antioxidant-chemotherapy interactions, suggests that the previously held beliefs about interference do not pertain to clinical treatment.”

The analysis, titled “Impact of Antioxidant Supplementation on Chemotherapeutic Efficacy: A Systematic Review of the Evidence from Randomized Controlled Trials,” evaluated 845 articles from five scientific databases that examined the effects of taking natural antioxidant supplements concurrent with chemotherapy.

Out of the 845 studies that were analyzed, 19 met all evaluation criteria. These included the use of randomized trials with a control group, and the reporting of treatment response (tumor shrinkage) and survival data. The 1,554 patients represented had a variety of cancer types, and most had advanced or relapsed disease. Some of the antioxidants used in the trials included glutathione, vitamin A, vitamin C, vitamin E, ellagic acid, selenium and beta carotene.

Among the findings:

All of the studies that included survival data showed similar or better survival rates for the antioxidant group than the control group.

None of the trials supported the theory that antioxidant supplements diminish the effectiveness of chemotherapy treatments.

All but one of the studies that reported treatment response showed similar or better response in the antioxidant group than in the control group.

15 of 17 trials that assessed chemotherapy toxicities, including diarrhea, weight loss, nerve damage and low blood counts, concluded that the antioxidant group suffered similar or lower rates of these side effects than the control group.

The authors noted that reducing side effects may help patients avoid having to cut back on their chemotherapy dosing, interrupt scheduled treatments, or abandon treatment altogether. This in turn, is likely to favorably impact treatment outcomes. A recent study of a group of colon cancer patients indicated that those who completed their full prescribed schedules of chemotherapy had survival rates nearly double those of patients who abandoned their chemotherapy treatment prematurely.

This new study encourages further exploration of the potential importance of antioxidant supplements as a means of improving cancer survival.

The full study is currently available on line at http://www.sciencedirect.com/science/journal/03057372.

http://intl.elsevierhealth.com/journals/ctrv/

From Chicago Tribune

Building hope for one pill to prevent many cancers, vitamin D cut the risk of several types of cancer by 60 percent overall for older women in the most rigorous study yet.The new research strengthens the case made by some specialists that vitamin D may be a powerful cancer preventive and most people should get more of it. Experts remain split, though, on how much to take.

The findings … are a breakthrough of great medical and public health importance,” declared Cedric Garland, a prominent vitamin D researcher at the University of California-San Diego. “No other method to prevent cancer has been identified that has such a powerful impact.”While the most reliable yet, the study does have drawbacks. It was designed mainly to monitor how calcium and vitamin D improve bone health, and the number of cancer cases overall was small, showing up in just 50 patients.

“It’s a very small study,” said Dr. Edward Giovannucci, who researches nutrition and cancer at the Harvard School of Public Health. “I don’t think it’s the last word.”

In either case, the study takes an important step in extending several decades of research that began with observations that cancer rates among similar groups of people were lower in southern latitudes than in northern ones. Scientists reasoned that had to do with more direct sunlight in southern regions.

The skin makes vitamin D when exposed to sunlight’s ultraviolet rays. This study used that same form of the vitamin, known as D3 or cholecalciferol. Multivitamins usually carry a much weaker variant known as D2, but D3 is available in stand-alone dietary supplements.

Earlier research has shown that vitamin D helps regulate cell growth, a fundamental biological process that goes haywire in cancer. Most other supplements have tended to target specific types of disease in early testing, like selenium or vitamin E for prostate cancer.

This study, published Friday in the American Journal of Clinical Nutrition, is the first time that researchers significantly boosted — and measured — blood levels of vitamin D and then followed identical groups of patients from start to finish.

That’s why, despite its modest size, the research was generating excitement. Nearly all other work has compared disparate groups of patients.

The researchers at Creighton University in Omaha focused on 1,179 seemingly healthy women with an average age of 67. The women were divided into three groups: 446 got calcium and vitamin D3 supplements, a similar number got calcium alone, and 288 took dummy pills.

The research team gave 1,000 daily international units of vitamin D, more than current guidelines calling for 200 to 600 units depending on a person’s age.

The researchers intended to check mainly for the effects of calcium on bone health. Their interest in cancer risk was secondary.

But the lower cancer risk stood out. Only 13 women, or 3 percent, developed cancer over four years of calcium and vitamin D supplements. With calcium alone, 17 women, or 4 percent, got cancer. With dummy pills, cancer appeared in 20 women, or 7 percent.

That shows a 60 percent lower cancer risk over four years in the group taking both supplements, compared to patients taking placebos. And when the first-year cancers were excluded — the ones mostly likely present before the study began — the findings were stronger still: a 77 percent lower risk for the combo group.

While the calcium-only group lowered its four-year cancer risk by 47 percent compared to the untreated group, it did no better when early cancers were excluded. That suggests calcium alone may have done little in this experiment, the researchers said.

Experts reviewing the study focused on vitamin D as the powerful agent in the combo group, but it can’t be ruled out that calcium might somehow amplify the effect of vitamin D.

While numbers were limited, these women developed a broad range of cancers, including disease of the breast, colon, lungs and blood. Dr. Michael Holick, of Boston University Medical Center, who sat on the professional panel that issued the 1997 guidelines for vitamin D, said this study shows that enough vitamin D “markedly reduces the risk of developing the most serious deadly cancers.”

He supports raising the recommended amount of the vitamin and said 1,000 daily units of vitamin D3 would now be reasonable for most people.

On the other hand, Dr. Michael Thun of the American Cancer Society favors keeping the current recommendation of 200 to 600 IUs for now. And he cautioned that more than 2,000 units is viewed in the guidelines as potentially dangerous.

Joan Lappe, the study’s lead researcher, said it “just adds to the great bunch of evidence that we need to have better vitamin D nutrition.” Some foods carry the vitamin, like salmon, tuna and fortified milk, but diet accounts for little of the vitamin circulating in the body. Overexposure to the sun can cause skin cancer.

Still, people should consult their doctors before boosting their vitamin dosage, several experts also warned.

More study is needed to determine if the effects in this study hold true for large groups of people and men as well as women.

From ABCNews:

When Joanna Fuchs was diagnosed with colon cancer last year, a blood test revealed she was severely deficient in vitamin D.

“I was obviously very concerned and very worried,” Fuchs said.

So, too, was her husband, Dr. Charles Fuchs of the Dana Farber Cancer Institute, who is the senior author of a study published today that found colon cancer patients deficient in vitamin D were almost twice as likely to die over a 10-year period than patients with healthy levels of the nutrient.

“These findings make considerable sense,” Dr. Fuchs said, “because in the laboratory we find that vitamin D reduces the growth of colon cancer cells, prevents its spread to other organs, and actually reduces the growth of blood vessels to these tumors.”

Fuchs’ work is just the latest in a wave of new studies on vitamin D. Vitamin D deficiency has been linked to a greater risk of autoimmune diseases, including type 1 diabetes, multiple sclerosis and rheumatoid arthritis. It has also been linked to a doubling of heart attack risk among men, a 73 percent greater risk of dying from breast cancer, and more frequent asthma attacks among children.

“Vitamin D seems to be very helpful in making your immune system do what it is supposed to do,” Dr. Tanya Edwards, director of Integrative Medicine at the Cleveland Clinic.

The government recommends getting 200 to 600 international units of vitamin D a day. But those levels were set 11 years ago, primarily to keep bones healthy. To prevent other diseases, many researchers now say more is needed.

Most people used to get all the vitamin D they needed from the sun. But with Americans now using more sunscreens, more often  or just staying out of the sun  more people are becoming deficient in this nutrient.

The solution could be taking a daily supplement. But doctors recommend patients first get a blood test to determine just how deficient they may be.

That’s what Joanna Fuchs did. And now, with a daily vitamin D pill, she hopes to remain cancer-free.