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Diet and Nutrition By popular demand our nutritional message board. This board will be monitored by a Registered RD who is certified in oncology by the American Dietetic Association

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Old 06-24-2013, 06:54 PM   #1
moebean
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Cool Supplements with chemo/Herceptin

Dear all,

Looking for an idea of supplements/herbs that may reduce the side effects of TCH chemotherapy and keep the body as healthy as possible.

Has anyone supplemented with Hawthorn for heart health while on chemotherapy? How about something to reduce the possibility of chemo-brain?

What are some things that have been Okay-ed by your oncologists and worked well?

I am scheduled to start chemotherapy Friday but the nutritionist will not be available to meet with me until mid July. The only suggestion is to stop all antioxidants while on chemotherapy.

Any comments are welcomed!
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Old 06-25-2013, 06:00 AM   #2
jaykay
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Re: Supplements with chemo/Herceptin

I never took any supplements during chemo. The only thing I was permitted to take was Vitamin D. You should check with your oncologist to see what may interfere during the TCH treatments.

I don't want to jinx myself, but I don't think I ever developed chemo brain - just normal aging stuff ;-)

Best
Janis
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March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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Old 06-25-2013, 07:52 AM   #3
giapeterson
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Re: Supplements with chemo/Herceptin

moebean, I wanted to respond bc you and I have very similar situations - I am her2+ (but er and pr + as well) I tried treating it holistically for about 5 months but now that I understand the incredibly dangerous nature of this particular diagnosis I understand that there is a place and an absolute necessity for coventional. I start my TCH treatment just a few days after you - on wed 7/3 - I am very, very interested in hearing the reply to this thread from more experienced survivors. My onco said that I could continue my holistic protocol while undergoing tch - he said he has many patients that do many of the things I do (I am basically doing the "bill henderson protocol" not sure if you've heard of it or not). I plan on not taking any of the supplements the day before chemo, day of and day or two after, but otherwise sticking with it to help my immune system bounce back. And I also plan on doing it for the rest of my life. I have not filled out my profile yet, but when I do I think we'll have a lot in common. I am 41 and I have 3 little girls ages 3(today - happy birthday sweetie) 5 and 7. Stay strong - we will beat this using combined holistic/conventional and compare notes! One last thing - I will also have a holistic/integrative md monitoring me.
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Old 06-25-2013, 08:01 AM   #4
TanyaRD
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Re: Supplements with chemo/Herceptin

We recently discussed this on another thread. It is always a topic which raises many questions. Please see below.

Re: Should I take anti-oxidants prior to, during, and post treatment?
This topic, like many in cancer care, is controversial. Generally, it is not recommended for patients undergoing chemo/radiation to take extra antioxidants--though they are not restricted in the diet. The idea is that we can consume very high doses in supplemental form vs smaller doses in food. Some research has shown that taking high dose antioxidants decreases the effectiveness of some chemotherapies. Other research has shown a synergistic effect with antioxidants enhancing certain chemotherapy drugs. I think it is important to recognize that we use the term "chemotherapy" very broadly when in reality each drug is very different in its mechanism of action and the effect of antioxidants on each of these drugs is likely different. I continue to caution patients against using high dose supplements but do recommend a diet with plenty of fruits and vegetables.

Here are two opposing reviews.

CA Cancer J Clin. 2005 Sep-Oct;55(5):319-21.
Use of antioxidants during chemotherapy and radiotherapy should be avoided.

D'Andrea GM.
Source

Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

Abstract

Many patients being treated for cancer use dietary supplements, particularly antioxidants, in the hope of reducing the toxicity of chemotherapy and radiotherapy. Some researchers have claimed, furthermore, that antioxidants also increase the effectiveness of cytotoxic therapy and have explicitly recommended their use. However, mechanistic considerations suggest that antioxidants might reduce the effects of conventional cytotoxic therapies. Preclinical data are currently inconclusive and a limited number of clinical studies have not found any benefit. Clinicians should advise their patients against the use of antioxidant dietary supplements during chemotherapy or radiotherapy. Such caution should be seen as the standard approach for any unproven agent that may be harmful.


PMID:16166076[PubMed - indexed for MEDLINE]
Integr Cancer Ther. 2006 Mar;5(1):63-82.
Should patients undergoing chemotherapy and radiotherapy be prescribed antioxidants?

Moss RW.
Source

Cancer Communications, Lemont, Pennsylvania 16851, USA. ralph@cancerdecisions.com

Abstract

In September 2005, CA: A Cancer Journal for Clinicians published a warning by Gabriella D'Andrea, MD, against the concurrent use of antioxidants with radiotherapy and chemotherapy. However, several deficiencies of the CA article soon became apparent, not least the selective omission of prominent studies that contradicted the author's conclusions. While acknowledging that only large-scale, randomized trials could provide a valid basis for therapeutic recommendations, the author sometimes relied on laboratory rather than clinical data to support her claim that harm resulted from the concurrent use of antioxidants and chemotherapy. She also sometimes extrapolated from chemoprevention studies rather than those on the concurrent use of antioxidants per se. The article overstated the degree to which the laboratory data diverged in regard to the safety and efficacy of antioxidant therapy: in fact, the preponderance of data suggests a synergistic or at least harmless effect with most high-dose dietary antioxidants and chemotherapy. The practical recommendations made in the article to avoid the general class of antioxidants during chemotherapy are inconsistent, in that if antioxidants were truly a threat to the efficacy of standard therapy, antioxidant-rich foods, especially fruits and vegetables, ought also be proscribed during treatment. Yet no such recommendation is made. Furthermore, the wide-scale use by both medical and radiation oncologists of synthetic antioxidants (eg, amifostine) to control the adverse effects of cytotoxic treatments is similarly overlooked. In sum, this CA article is incomplete: there is far more information available regarding antioxidant supplements as an appropriate adjunctive cancer therapy than is acknowledged. Patients would be well advised to seek the opinion of physicians who are adequately trained and experienced in the intersection of 2 complex fields, that is, chemotherapeutics and nutritional oncology. Physicians whose goal is comprehensive cancer therapy should refer their patients to qualified integrative practitioners who have such training and expertise to guide patients. A blanket rejection of the concurrent use of antioxidants with chemotherapy is not justified by the preponderance of evidence at this time and serves neither the scientific community nor cancer patients.
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Old 06-25-2013, 08:56 AM   #5
giapeterson
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Re: Supplements with chemo/Herceptin

Tanya, I sincerely and deeply thank you for such a thorough and thoughtful response that was packed with valuable and consice information. That was extremely helpful to me!!!
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Old 06-28-2013, 08:42 AM   #6
moebean
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Re: Supplements with chemo/Herceptin

Glad to hear you have not developed Chemo brain. Given all the dementia in my family this is a concern of mine... Did check with the oncologist yesterday and he is referring me to someone he trusts for an integrative consult. Which is great!
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Old 06-28-2013, 08:51 AM   #7
moebean
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Wink Re: Supplements with chemo/Herceptin

Gia,

Yes it sounds like we do have a lot in common..in addition I am also 41 and live near by in NC. Sooo did me with oncologist yesterday and he is Ok with Vit D, Magnesium/Potassium, Curcumin and DIM. He asked me to hold off with B vitamins until 5 days before and 5 days after.

Oncologist has referred me to an integrative person that HE trusts (versus my guy) who will answer questions about intravenous vitamin C, Hawthorn for heart health etc...

I will actually now be starting on July 2nd..one day before you. Know all that healthy juicing, super smoothies..detox etc... has to be good for something we will go in super healthy so recover much quicker I am sure!
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Old 06-28-2013, 08:52 AM   #8
moebean
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Re: Supplements with chemo/Herceptin

Much controversy for sure. Thank you so much Tonya for the indepth and quite informative response!
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Old 06-29-2013, 08:46 AM   #9
Cat
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Re: Supplements with chemo/Herceptin

Hi Tanya,

What would high dose supplements consist of?

I take Vit D 2000 iu, multi vitamin (mature multi), fish oil 1200 mg and iron (ferrous gluconate)27 mg besides my prescription meds. I have recently started holding the vit., fish oil and D a day before, the day of and the day after my kadcyla tx. I continue to take the iron.

I generally eat fairly good and love most varieties of fruits and vegetables although I unfortunately supplement them with "junk food" which I try to avoid. I like fish. I also drink a cup of green tea and white tea in the morning and just ordered some green matcha tea to try. So I think I'm getting a fairly good diet without going crazy over it.

I am very confused over all the reports of this that and the other regarding diet, antioxidents, and the immune system.

My onc said to not take my multi around tx day. I have not asked for a referral to a specialist.

My main question is what is considered an antioxident?

Thank you, Cathy
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3/06 DX stage III er-pr-her2+++ breast, 1+node
age 49 and 364 days
3XAC 4X taxol and herceptin continue herceptin one year
bilat mastectomy w/TRAM
32 rads
9/08 recurrance 4 sternal nodes
mediastinoscopy, able to remove 3
taxotere, carboplatin, herceptin, x6
continue herceptin indefinately
5/10 recurrance in same node/area
mediastinoscopy, removed nodes
added tykerb
27 rads
10/18/10 PET shows inflammation no active disease
8/2011 recurrence one right mediastinal node, xeloda and proton radiation to node.
D/C xeloda due to toxicity
12/5 PET scan clear
2/2012 colon blockage, breast cancer
(never thought it could go there! thought I was constipated)
start abraxane, herceptin, continue tykerb
10/2012 Kidney ablation (renal CA!)
3/2013 CT and biopsy R kidney (BC met to R kidney)
4/4/2013 Begin Kadcyla
7/30/13 Craniotomy cerebellar mets, 1.7cm 3cm
Sept 4-6 post op cyberknife
Sept 23 ablation right kidney (blow up pesky breast ca met)
Oct headaches MRI Oct 10 (only surgical changes ! Yay!)
Short of breath. CT, pulmonary function, echo
New crap in right lung heart good. Pooh!
12/13 DC kadcyla. Begin halaven
2/14 MRI brain NED Yay!
4/3/14 CT mostly stable but breast mets r kidney growing
4/16/14 ablation right kidney again
Continue halaven, tykerb
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Old 07-01-2013, 06:17 AM   #10
TanyaRD
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Re: Supplements with chemo/Herceptin

Hi Cathy,
This is a confusing subject! Antioxidants include a HUGE category of nutrients. To name a few common antioxidants I would include Vitamins A, C, E, Curcumin, compounds in Garlic, resveratol, Lycopene, Beta-carotene, etc. There are so many compounds. Generally speaking, I don't have my patients on chemo and/or radiation take high doses of supplemental antioxidants but generally encourage a diet rich in fruits/vegetables, whole grains (plant based diet). The rational is that we don't get such high doses in diet form as we might if we take supplemental forms.

Here are a couple of websites I like regarding the topic.

http://www.nlm.nih.gov/medlineplus/antioxidants.html

http://www.mskcc.org/cancer-care/int...other-products

Best Wishes,
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Old 07-01-2013, 09:06 AM   #11
Cat
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Re: Supplements with chemo/Herceptin

Tanya,
Thank you for getting back to me. I probably should have asked if a multi is considered an issue since it contains those vitamins you list. Do your patients take a multi vitamin?
Thank you for your help,
Cathy
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Old 07-15-2013, 10:21 AM   #12
bmorr7
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Re: Supplements with chemo/Herceptin

Thank you! So is the concensus that supplements probably do not interfere with chemo but that it's still best to discuss supplements with the oncologist?
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Old 07-15-2013, 11:26 AM   #13
'lizbeth
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Re: Supplements with chemo/Herceptin

Every oncologist varies with their opinion of supplements. It is good to have a discussion to find out what your oncologist believes and why.

I am a big fan of supplements. The challenge is to find the right ones, and amount for the individual. There are many ladies who have worked with alternative and integrative doctors who have experience with this, and can help you with testing for deficiencies and excess toxin.

The enzymes found in raw food such as avocados, bananas, papayas, pineapple, . . .( the list goes on) are important to create the cleanup crew to keep the neurotransmitters, etc generated in balance from the supplements. Raw foods create more risk of infections with low blood counts. Chemo patients can be advised to avoid raw fruits and vegetables until their immune system recovers.

You can use the search function to read some of the prior posts from Tanya, Andi and others on the boards discussion of supplements.
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Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
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