Anticancer supplements

The public was warned recently by the Philippine Food and Drug Administration (PhilFDA) and the Philippine Society of Medical Oncologists (PSMO) about the exaggerated claims of some food supplements as anticancer treatments.

A commercially available guyabano product was recalled earlier this year by the PhilFDA because it was “fraudulently labeled as 10,000 times stronger than chemotherapy and that they contain Adriamycin that can kill cancer cells.”

The PhilFDA warned the public against falling for the clever marketing schemes of some of these products, which it described as “health scams.”

Other supplements which the PSMO said are not supported by high-level scientific evidence include: homeopathic products; high dose oral vitamins such as vitamin C and collagen; oral stem cell enhancers or fibroblast growth factor enhancers; vitamin A therapy above 5,000 IU a day; vitamin E during radiotherapy, ozone therapy and heavy metal chelation therapy.

Not enough evidence

The society of cancer specialists added that there was also not enough scientific evidence to suggest the use of transfer factor, malunggay oil, mangosteen extract pills, guyabano extract pills, resveratol or grape seed extract, and intravenous hydrogen peroxide as anticancer supplements.

In a media report, a cancer patient was even said to be dying from severe lactic acidosis after taking large doses of mangosteen juice daily for a year. To be fair to mangosteen juice, it would be very difficult to identify it as the most likely cause of what happened to the patient. Just as we warn the public against believing in isolated testimonials on the effectiveness of these so-called anticancer herbals, we should not scare them with isolated reports of adverse reactions which could have been due to an interplay of so many factors going on in a cancer patient.

If one takes, for example, the mangosteen or guyabano fruits, I don’t think one can ever consume a “toxic” amount of these fruits. I usually advise our patients that instead of buying the commercially prepared supplements which are frequently premium priced, it would be better to buy and eat the fresh fruits from where the supplements are being extracted. The level of the antioxidants and other beneficial active ingredients should be higher when you eat the fruits fresh. And you get to enjoy eating the fruits, rather than just taking capsules or an extracted juice form which may already contain some chemical preservatives.

Having said that, I agree with what Dr. Ellie May Villegas, PSMO vice president, advised the public, “Everything should be taken in moderation.”

The PSMO also gave a list of dietary supplements which are “supported by high-level scientific evidence.” This list includes omega-3 fish oil EPA/DHA, vitamin D3; medicinal mushrooms beta glucans such as coriolus, astragalus and maitake; coenzyme Q 10 (CoQ10); wheat germ extract such as avemar and IP-6 inositol hexaphosphate; bioavailable curcumin; green tea; bioavailable Silymarin phytosome; alpha lipoic acid; American ginseng, rhodiola and ashwagandha; calcium citrate/carbonate; ferrous sulphate/bisglycinate vitamin B12; whey protein/L-glutamine branched chain amino acids; and polyglycoplex.

I think they should include melatonin in the list. This commonly used sleep-aid dietary supplement has a good amount of scientific evidence based on well-designed clinical trials, which determined that it can be an ideal supplement for cancer patients. Administration of supplemental melatonin has been shown to be beneficial even in the supportive care of advanced and end-stage cancer patients. It helps lessen tissue wasting and weight loss, fatigue, weakness, and depression. It also helps enhance the immune function, improve wound healing and improve the quality of life of cancer patients.

Full approval

My take on this issue about the use of dietary supplements in cancer patients is that these patients should still be given the option to take supplements, which are generally regarded by the PhilFDA and the health experts as safe, and with some scientific evidence of benefit for cancer patients. They can also try other supportive or complementary treatments such as acupuncture, massage, music therapy and meditation. However, I support the PSMO advisory which states: “The use of complementary and alternative medicines must be done with caution and with the full approval of the attending physician.”

The attending physician should know because there are some potential interactions between dietary supplements and the other medicines including chemotherapy which the patient may be taking.

Dietary supplements should remain as complementary or supportive treatment, and should not be considered as a substitute for tried-and-tested anticancer treatments, unless these treatments can’t really be tolerated by the patient, or in advanced cases when treatment already shifts from curative to palliative or supportive.

When used prudently by the patient and with the approval of the attending physician, some of these dietary supplements can be a blessing, and not a bane, for cancer patients.