Joan Amtoft-Nielsen, MD, PhD, DC

Cancer, Nutrition & Supplementation

An internationally-trained alternative physician offers guidelines and suggestions for supplementation during chemotherapy and radiation.

“First do no harm…Natural forces within us are the true healers. Let your food be your medicine and your medicine your food.”

Hippocrates, Father of Medicine

Biography

Joan Amtoft-Nielsen

Dr. Joan Amtoft-Nielsen is a European-trained physician who has practiced and taught state-of-the-art alternative and integrative medicine at facilities in Germany and Denmark. While in Denmark, Dr. Nielsen held the post of consulting physician to the royal family.

Relocating to the United States in 1985, Dr. Nielsen has been in private practice, specializing in orthomolecular and environmental medicine; she is recognized as a national expert in natural methods of detoxification. She has extensive training in neurophysiology (PhD), chiropractic (DC), naturopathic medicine (ND), pain management, acupuncture, homeopathy, and she has studied botanical medicine with master herbalist James Duke.

Dr. Nielsen was a Medical Advisor for The National Foundation for Alternative Medicine in Washington DC and currently serves on the Scientific Advisory Board of the Journal of Longevity, on the Advisory Board of the C.A.R.E.S. Foundation and on the Board of Governors for the South Carolina Naturopathic Physicians Organization. She has served in the past as the Preceptor in Alternative Medicine for medical students at Duke University. In 2002 Dr. Nielsen was honored with the Medical Achievements for Mankind Humanitarian Award at Temple University for her outstanding contributions in the field of alternative medicine. She is fluent in several European languages.

Although retired from active medical practice in 2006, Dr. Nielsen offers wellness consultations by phone. For more information, please send her an email with times you are available for a phone consultation.  She'll be in touch to arrange payment.  Her rate is $150/hour.  Email is joannielsen @ mac.com.

Read why Dr. Nielsen became a doctor and her personal mission statement.

Why Nutrition is an Issue for Cancer Patients

Although not an oncologist, over the past 35 years, Dr. Nielsen has treated numerous cancer patients with malignancies covering the entire spectrum of type, grades and involved organs. In addition to all the treatment protocols, good nutrition and whole foods are essential in overcoming this condition. Even today, hospitalized cancer patients are often eating the wrong foods and receive no dietary advice for their follow-up treatment.

Research over the past several decades has found that significant numbers of people lack adequate levels of various nutrients. This almost immediately focuses attention on cancer and dietary connections. Administration of vitamin C or E with selenium prior to radiation therapies markedly reduces rates of malignant cellular transformation. We know that DNA damage caused by reactive oxygen species (ROS) and certain lipid peroxides produce a large array of altered molecules. Metabolic activity in cellular mitochondria also produces ROS called superoxides: negatively charged oxygen molecules that normally are converted into hydrogen peroxide by the enzyme superoxide desmutase (SOD). Disease is connected to cellular mitochondria. Various lines of research and experience suggest that the health of a cancer patient improves gradually through enhancement of cellular respiration.

The level of intestinal flora is also vital in maintaining the body’s equilibrium, since such flora are barriers to colonization by pathogenic germs and act as a primary component of the human immune system.

Most cancer patients suffer from nutritional deficiencies before diagnosis and even more so during the early conventional treatment of their disease, since chemotherapeutic agents affect levels of such nutrients as glutathione, vitamin B6, vitamin E and beta carotene. Inappropriate foods consumed during the course of disease may linger in the body longer since they are improperly digested, absorbed and excreted. The greater the body’s toxicity, the lower the functioning of the immune system.

So much food is now industrially processed and natural ingredients are often removed. It is also difficult and expensive for patients to have regular access to organic foods. This is why dietary supplements have become essential for most cancer patients.

Some Whole-Person Healing Suggestions for Cancer Patients

It is not possible, within the scope of this short chapter, to address a complete alternative or complementary protocol for fighting cancer nutritionally, and indeed, this should not be a self-help topic, as it requires professional supervision. The following suggestions offer a jumping off point—a place to begin.

Dr. Nielsen recognizes that many patients will consider chemotherapy or radiation therapy at some point during their battle their cancer. In her practice, she often supported patients who made this choice with nutritional guidelines and a customized list of supplements to optimize the effectiveness of the chemotherapy and/or radiation, while keeping the body and immune system as healthy and strong as possible during this process.

Chemotherapy

Many of the drugs used in chemotherapy interfere with cell division, because cancer cells divide faster than most normal tissue cells. When a drug interferes with cell division, the rapidly dividing cells are affected the most. This includes not only cancer cells, but also the epithelial tissues that line the mouth, throat, and intestines. In the mouth, chemotherapy can cause mouth sores, tender or bleeding gums, sore throat, and difficulty swallowing. In the stomach it causes nausea and in the intestines, diarrhea.

The severity of chemotherapeutic side effects is related to the drug used, size of dosage, length of treatment, and your individual response. Not everyone will have side effects. Some people breeze through the whole experience without giving it much thought. For others, chemotherapy becomes a full-time job. Nutritional therapy during chemotherapy allows you to support healthy tissue while enhancing the toxicity to cancerous tissue. Cancer patients who have proper nutritional balance during chemotherapy have a better response and success rate with treatments.

NOTE: The following suggestions for supplementation are generally considered safe, however Dr. Nielsen states an individualized program for each cancer patient is critical. This is definitely not a “one size fits all” protocol and other supplements may be added or some not included in certain cases. You MUST work with your own healthcare professional to determine appropriateness for your particular case.

Suggested Supplement Support for Chemotherapy

Of course the ideal way to obtain optimal nutritional support of the body during chemotherapy is through the use of organic food, including raw choices. This will give you many powerful phytonutrients, including some not even recognized by modern science yet. Not all supplements are prepared properly and there are often unnecessary or even toxic elements included in some formulations. It is therefore imperative to find a trusted brand. Under the advice of your physician or other healthcare professional, consider the use of some of the following supplements each day you are receiving chemotherapy:

Warning: When supplementing any fat-soluble vitamin or oil, you must also take vitamin E supplement to protect against oxidation.

Nutritional Checklist for Chemotherapy

Before Treatment

During Treatment

To Prevent or Slow Cancer’s Growth

To Protect Healthy Cells

To Increase Detoxification of Chemotherapeutic Drugs

Natural Agents for Use with Chemotherapy Side Effects

Constipation
Flaxseed meal
Increased fiber (greater than 30 gm/day) magnesium (400 mg)
Myelosuppression (bone marrow)
Vitamin E (mixed tocopherols) 400-800 IU/day
Ashwaganda
Luekopenia—decrease of leukocytes (white blood cells)
Vitamins C and E, zinc, selenium, astragalus, panax ginseng (1000 mg, tid), siberian ginseng, echinacea, alklglycerols (100 mg 3X/day), ashwaganda, oregon grape root or goldenseal (500 mg 3X/day), glutamine (2-4 mg/day)
Thrombocytopenia—decrease of thrombocytes (white blood cells)
Alkylglycerols (100 mg 3X/day)
Ashwaganda
Anemia
Liquid liver extract, alkylglycerols (100 mg 3X/day), folate (400-800 mcg/day), Vitamin B12 (1000-3000 mcg/day)
Fatigue
Astragulus, Vitamin E (up to 1600IU/day)
Vitamin B12—1000 mcg sublingual or weekly injections
Chamomile tea for relaxation and sleep
Depression
St. John’s Wort (300 mg 0.3% hypericin, three times/day) – cannot take this continually-- must take a break
GABA (amino acid)
IMPORTANT: Do NOT use either of these if you are taking MAO inhibitors (anti-depressants)
Nausea and vomiting
Ginger (2-4 gm/day)
Acupuncture
Ashwaganda
***Maharishi Amrit Kalash: This is a potent Ayurvedic herbal mixture Dr. Nielsen has prescribed with excellent results for the nausea associated with many chemotherapeutic drugs.
Mucositis (inflammation of mucous membranes)
Topical Vitamin E
Homeopathic remedies
Mucosa Compositum
Natrium Homaccord
Bromelain
Indigestion
Digestive bitters, digestive enzymes, pancreatin, bromelain, glutamine, Slippery elm
Diarrhea
Carob powder (2 T. twice daily), lactobacillus, acidophilus
European remedy: dark beer

Nutrition-Related Side Effects of Chemotherapeutic Drugs

Type of Drug: Alkylating Agents

Alkylating agents are used in treatment of chronic leukemias, Hodgkin’s disease, lymphomas, and some cancers of the lung, breast, prostate, and ovary. They work by substituting an alkyl group for a hydrogen atom. They are cell cycle phase nonspecific, which means they do not act on cells during any specific phase of cell division. These drugs work by interfering with DNA replication and RNA transcription.

Nutritional Side Effects
Nausea, vomiting, sore mouth and throat, sores on tongue or other areas of the mouth and throat, bladder inflammation.
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Take acidophilus, and ginger tea.

Type of Drug: Nitrosoureas

Nutritional Side Effects
Nausea, vomiting, sore mouth and throat, sores on tongue or other areas of the mouth and throat, bladder inflammation.
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Take acidophilus, ginger tea and reduced glutathione.

Antibiotics

Antibiotics are used to treat a wide variety of malignancies. They are used to kill cancer cells in much the same way they kill bacterial, by preventing cell division. This is done by binding to DNA and interfering with RNA transcription.

Nutritional Side Effects
Nausea, vomiting, inflammation of the mucous membranes, sores on the tongue, mouth or throat, gastrointestinal upset.
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Take acidophilus, and ginger tea, reduced glutathione.

Type of Drug: Antimetabolites

Antimetabolites may be useful in the treatment of acute and chronic leukemias, choriocarcinoma, and some cancers of the gastrointestinal tract, breast, and ovary. They are substituted for purines or pyrimidines, necessary for normal cell division. Although these drugs fit into the spaces provided, they do not work once they are in.

Nutritional Side Effects
Nausea, vomiting, diarrhea, damage to the liver, inflammation of the mucous membranes.
Methotrexate acts as a folate antagonist and may decrease absorption of vitamin B12, fat, and xylose.
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Take acidophilus, and ginger tea, reduced glutathione. Avoid alcohol, which may increase the toxic effects of this drug, causing liver damage.

Hormones

Hormones are not toxic to cancer cells, so they are used to prevent further cell division and growth of hormone-dependent tumors. They work by changing the hormonal environment, making it unfriendly for tumor growth.

Nutritional Side Effects
Increased appetite, sodium and fluid retention, gastrointestinal upset, glucose intolerance, potassium wasting, osteoporosis, negative nitrogen balance, loss of appetite, hypercalcemia, vomiting.
 
Nutritional Coping Strategies
If you take prednisone for a prolonged period, your doctor may want you to eat a potassium-rich diet. This drug may also decrease the effectiveness of insulin and other diabetic drugs.

Heavy Metals

Heavy metals cause cross-linking of DNA strands, which inhibits DNA synthesis.

Nutritional Side Effects
Nausea, vomiting, kidney toxicity, and low serum levels of magnesium, calcium, and zinc.
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Take reduced glutathione and N-acetylcystine

Plant (Vinca) Alkaloids

Plant alkaloids are commonly used to treat acute lymphoblastic leukemia, Hodgkin’s and non-Hodgkin’s lymphomas, neuroblastomas, Wilms’ tumor, and cancers of the lung, breast, and testes. They block cell division by not allowing spindle formation.

Nutritional Side Effects
Nausea, vomiting, constipation, and stomach cramps.
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems.

Enzymes

Enzymes inhibit protein synthesis by depriving cells of asparagines

Nutritional Side Effects
Nausea, vomiting, hypoalbuminemia (low albumin content of the blood), high sugar, inflammation of the pancreas, weight loss, stomach cramps, and uremia (buildup of uremic acid in the blood).
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Take acidophilus, and ginger tea

Biologic Response Modifiers

Biological agents such as interferon and interleukin are used in patients with advanced cancer or cancer that has not responded to standard therapy. They destroy tumor cells by modifying the host’s response to the tumor. They are the immune army with weapons specific for cancer.

Nutritional Side Effects
Nausea, vomiting, loss of appetite, and weight change (up or down).
 
Nutritional Coping Strategies
Drink extra fluids to prevent kidney and bladder problems. Also, drink astragalus tea, reishi (mushroom) tea and ginger tea.

Radiation Therapy

Because of the side effects of radiation therapy, people undergoing this treatment may consider the following suggestions for supplementation, to give the body extra protection and strength.

Radiation therapy is used to treat localized tumors such as cancer of the skin, tongue, larynx, brain, and cervix. Treatment exposes a defined area of tissue to ionizing radiation, damaging DNA of all cells it reaches. The cancerous cells die from the injuries, but most normal cells will be able to repair themselves.

Gamma rays and x-rays are the two forms of photon energy used in external radiotherapy. They both have the same effects on cells and the same side effects. Cancerous cells can also be exposed to radiation using the technique of internal radiotherapy. Here, radioactive implants are placed inside a tumor or body cavity. Internal radiation is often used for cancer of the tongue, uterus, and cervix. Radiation therapy can be used alone or in combination with chemotherapy or surgery.

Nutritional supplementation during radiation therapy keeps the body nourished when side effects diminish appetite. It protects the healthy cells from the effects of the radiation, makes the cancerous cells more vulnerable to the radiation, and speeds the healing of tissues damaged by radiation.

Radiation treatment can cause damage to the lining of the intestines, resulting in an inability to properly absorb protein, carbohydrates, fats, and other nutrients, as well loss of fluids and electrolytes.

Suggested Supplement Support for Radiation

Under the advice of your physician or other healthcare professional, you may consider taking the some of the following supplements each day while you are receiving radiation therapy:

Warning: When supplementing any fat-soluble vitamin or oil, you must also take a vitamin E supplement to protect against oxidation.

Nutritional Checklist for Radiation Therapy

To Be of Service in The Medical Profession

By Joan Amtoft-Nielsen, MD, PhD, DC

I can remember that even as a small child, I always knew I would be a physician. I can still recall the joy one Christmas, when I received a children’s doctor kit. I always knew that I wanted to fix and help people. This idea was strongly reinforced throughout my many years of studies, where we were taught how to help people; to “fix” them so to speak. However, I gradually realized during my years of practicing medicine that fixing people is not what this profession is all about. The question “How can I help?” has become meaningful in recent years, but perhaps there is a deeper question to consider. Perhaps the question should truly be “How can I serve?”

Serving is different from helping, for helping is based on inequality. It is not a relationship between equals. When we help, we use our own strength to assist those of lesser strength or ability. If we are attentive to what is going on when we are helping, we will find that we generally give help to someone who is not as strong or more in need than we are in the moment. This inequality can be sensed by all involved. When we help, we may inadvertently take away from those we help more than we could ever possibly give to them. We may diminish their self-esteem, their sense of self-worth, their integrity and in fact their very wholeness.

But we do not serve with our strengths, we serve with ourselves. We draw from all our experiences to serve. Our limitations serve, our wounds serve, even our darkness can serve. The wholeness in us serves others and the wholeness in life. The wholeness in you is the same as the wholeness in me. Service is a relationship between equals. Helping incurs debt; when one helps another, there is a sense of being “owed” in some way. Yet serving, as with healing, is mutual. There is no debt; served and server are equal beneficiaries.

When one helps, one derives a feeling of satisfaction. When one serves, one derives a feeling of gratitude. These are clearly different blessings. Serving is also different from fixing. When one fixes another there is a perception of brokenness and a subsequent call to action. When one fixes, there is not the perception of the wholeness of the other, nor the trust in the integrity of the life within that person. When one serves, one trusts that inherent wholeness and responds to and collaborates with it.

When one individual is fixing another, there exists a necessary distance between the fixer and the one being fixed. Fixing is in fact a form of judgment and all judgment creates a distance, a sense of disconnection and an experience of difference. In fixing, there is an inequality of experience and expertise that can create a moral distance. Ironically, we can only serve that to which we are profoundly connected, that which we are willing to touch. This was Mother Teresa’s basic message: “We serve life, not because it is broken, but because it is holy.”

Healthcare in America is currently in a state of crisis. When we exist within these very challenging times, we must find something to sustain us. The pursuit of scientific and empirical truth alone is simply not sufficient to sustain us. In recent years, the practice of medicine has become far too difficult. The levels of stress, depression, cynicism and burn-out are so high that we must find something stronger than our science to hold onto, something more satisfying to nourish us as individuals and as healers.

I suspect that living well in times of crisis will require us to pursue meaning in much the same way that we have pursued knowledge in the past. We therefore must educate our physicians to pursue meaning, in the same way that we now educate them to pursue knowledge.

Patients with devastating illnesses are experts in living in a state of crisis. I have personally had the opportunity to listen to many of them and it has taught me that in times of distress, meaning is of the utmost importance for healing, and ultimately for living one’s life. Meaning does not change life; meaning changes our experience and perception of life—and our work as well. Doing work with a sense of meaning is very often lacking in the medical profession today.

Surviving the current crisis in healthcare may require each physician to re-examine and re-connect with not only what we came to do, but with why we chose to do it. Finding meaning means that we must cultivate a real relationship with our patients. We are closer to the true meaning of our work when we know our patients’ stories as well as we know their diagnoses. We are closer to the true meaning of our vocation when we know our colleagues’ stories and what they have sacrificed to their professions. Stories inspire and touch, they enliven and strengthen. Stories remind us of who we are, and why we continue to do what we do.

The original intention for the medical profession has not changed since the time of Hippocrates. The strategy used to fulfill this intention has changed radically. The original meaning of this profession was service, and science only the tool used to offer the service. All of us, doctor and patient alike, exist in the service of life itself. Service is not a technique or skill, nor is it a relationship between an “expert” and a patient with a problem to be solved. It is a relationship between two whole human beings.

Science may have distracted us; it may even have covered over the meaning of our work. We may have become alienated from the very life we are attempting to serve. Restoring a sense of service to the practice of medicine will require re-thinking the education of medical professionals. It will require a radical re-tooling of medical thought. At present, the predominant emphasis in medicine is on fixing, manipulating, controlling and gaining mastery over health and life. This is not service. We serve life, not because it is broken. We serve life because we possess a deep inner knowing that life is, by its very nature, holy and whole.