Milk Thistle and Chemotherapy

[ElaineM]

I am not sure I am putting these links in the right place, but since there has been several discussions about milk thistle from time to time I thought some of you might be interested in the results of studies done on milk thistle and chemotherapy.

1. From the National Cancer Insitute
http://www.cancer.gov/cancertopics/pdq/cam/milkthistle/patient/allpages/print
2. From Science Daily
http://www.sciencedaily.com/releases/2009/12/091215172325.htm
3. Annie Appleseed Project
http://www.annieappleseedproject.org/milthisexfor.html
4. Medscape Article
http://www.medscape.com/viewarticle/713797

According to the article it helps protect the liver during chemotherapy and reduces the chances of problems with the liver enzymes during chemotherapy.

[Jackie07]

Thanks, Elaine.

Milk Thistle also has good effect on Renal cells:

http://www.ncbi.nlm.nih.gov/pubmed/21591838

Full-text of the Medscape article from one of the links in you post:

December 14, 2009 — Hepatoxicity caused by chemotherapy can be successfully treated with milk thistle (MT), according to a study of children with acute lymphoblastic leukemia (ALL) published online December 14 in Cancer.

"Currently, there are no substitute chemotherapy agents that provide the same effectiveness against ALL yet preserve liver function. There are also no hepatoprotective medications that allow chemotherapy to continue to be administered while preserving liver function," write Kara M. Kelly, MD, from the pediatric oncology department at Columbia University Medical Center, New York City, and colleagues. "Thus, adjunctive agents that may enable optimal doses of chemotherapy to be administered without necessitating a decrease in the recommended doses of chemotherapy are of clinical significance and may further improve survival in children with ALL."

Earlier studies have shown that MT reduces liver damage caused by cirrhosis or ingested toxins. The goal of this MT evaluation was to determine whether the herb can safely and effectively remedy chemotherapy-induced liver inflammation — a common adverse effect that can necessitate reduction or suspension of the cancer treatment.

The randomized controlled, double-blind study consisted of 50 children with ALL who were in the maintenance phase of therapy and had a hepatic toxicity of grade 2 or greater on amino alanine transferase (ALT), aspartate amino transferase (AST), or total bilirubin (TB) levels.

For a period of 28 days, patients received either MT (5.1 mg/kg/day) or a placebo. Patient visits and reports and chart reviews were used to monitor the safety of MT. Liver inflammation was determined by blood level increases of AST and ALT.

On day 28, there were no noteworthy alterations in mean ALT, AST, or TB levels. However, the authors write, "at day 56, the MT group had a significantly lower AST (P = .05) and a trend toward a significantly lower ALT (P = .07)." Ingesting MT seemed to produce no negative effects, and the herb did not reduce the effectiveness of chemotherapy. Furthermore, patients taking MT were more likely to maintain their prescribed chemotherapy dosages.

"Although not significantly different, chemotherapy doses were reduced in 61% of the MT group compared with 72% of the placebo group. In vitro experiments revealed no antagonistic interactions between MT and vincristine or L-asparaginase in CCRF-CEM cells," the authors write.

The study authors noted that their research was made stronger by product quality analysis, stability testing, and a goal of quantifying plasma levels of silibinin. They also reported several limitations. These included the study's small sample size and an MT dose that may have been smaller than necessary. They also acknowledged that those taking MT had a rate of compliance that was appreciably lower than that of the placebo group. Overall, however, they hailed their findings as an important step toward using MT to treat hepatotoxicity in cancer patients.

"Despite our study's limitations, it provides preliminary evidence that MT may be a safe, effective, supportive-care agent," the authors write. "Future investigations are needed to determine the appropriate dose and duration and to identify populations that may gain the largest clinical benefit."

The American Institute for Cancer Research, the Tamarind Foundation, and the National Cancer Institute supported this study. The study authors have disclosed no relevant financial relationships.
Cancer. Published online December 14, 2009.

[pibikay]

Thanks.
I was giving Hema silymarin capsules.I stopped the same when the last PET scan disclosed no nodules in the liver which were there originally.But now she has lost her appetite

[ElaineM]

I have been taking milk thistle every day since I was diagnosed. I never had liver mets. I never had problems with abnormal liver enzymes.
I am glad the nodules on Hema's liver are gone. Good health to you both.

[TanyaRD]

PibiKay,
It is great to hear that Hema had a good PET scan result! Sorry to hear that she has lost her appetite. I know you have worked with this before but small, frequent meals are often helpful until appetite improves. Cool foods may also be better tolerated. Best wishes.

[Mtngrl]

This is interesting, but it's important not to over generalize. The study is the first double-blind randomized study of using milk thistle to help counter liver inflammation caused by leukemia drugs. There were only 49 subjects in the trial. It didn't seem to interfere with that particular drug. They didn't get as good a response as they hoped. The study authors say further study is needed.

It would be inappropriate to conclude from this that milk thistle will prevent or cure liver mets, or that it is safe to use with whatever cancer drugs you're on.

This is from the NCI link that Elaine posted:

"A number of clinical trials have studied milk thistle or silymarin in the treatment of patients with hepatitis (http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46371&version=Patient&language=English), cirrhosis, or disorders of the bile ducts. These trials have used a wide range of doses with mixed results. In a trial of biologic therapy (http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45617&version=Patient&language=English) for patients with chronic hepatitis, patients taking silymarin had fewer symptoms and a better quality of life (http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45417&version=Patient&language=English) compared to patients not taking silymarin. The beneficial effects of silymarin shown in some studies suggest it might play a role in preventing hepatitis and/or liver cancer (http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44242&version=Patient&language=English), but no clinical trials have studied the use of silymarin for prevention (http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=439419&version=Patient&language=English)."

Remember, if you have mets to your liver or bones or brain it is breast cancer in your liver, bones or brain, not liver cancer, bone cancer or brain cancer. Nothing posted today indicates any studies of milk thistle in connection with breast cancer.

[Rich66]

Additional milk thistle info:
http://her2support.org/vbulletin/showthread.php?p=218176#post218176

[sdstarfish]

I've been taking it since I was diagnosed in 2007. The main reason is that meds take a toll on the liver, as well as environmental toxins. I figure it's best to keep my liver in optimal shape in order to help fight recurrence of breast cancer. Just my take :)

Lisa
www.pinkkitchen.info (http://her2support.org/vbulletin/www.pinkkitchen.info)