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

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.

• In general, an alkaline diet, as organic as possible, is recommended. This would include 7-8 servings a day of fresh vegetables and fruits. Juicing can be used to make this easier. You can check your first morning urine with pH testing strips; it should ideally be around 7.0. Cancer thrives in an acidic environment.
• Supplemental digestive enzymes are suggested, as a compromised digestive system makes optimal assimilation of nutrients difficult. This is particularly important for cancer patients.
• A comprehensive amino acid supplement, including the eight essential aminos, is suggested for the same reason.
• Supplemental probiotics such as acidophilis support the flora of the intestinal tract—also vital for digestion and assimilation.
• A comprehensive healing program might include the use of art or music therapy to engage the right brain and emotions in the healing process.There is much research to support the use of the creative arts in this fashion.
• Consider private or group psychotherapy to deal with mental and emotional issues and stress that can seriously and directly depress the immune system.
• Consider energy healing such as reiki, vibrational healing techniques, and energy medicine.
• Physical practices such as yoga, qi gong and tai chi, various types of bodywork can help remove energy blockages in the body and get the body’s intrinsic healing energy moving again.
• A customized program for detoxification of the body is required, due to the plethora of environmental toxins that surround us. Cancer patients are generally highly toxic.
• Under the guidance of a healthcare professional, create a customized program of supplements, including vitamins, minerals, homeopathics, herbs, amino acids, immune stimulants and other products as appropriate. Be sure to use a product line that is known for its purity and potency.
• A source of pure water is required for optimal hydration of the body.
• Proper rest and a plan to reduce stress and address psycho-spiritual imbalances in your life. You might consider meditation or visualization.

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:

• Vitamin E – Take 1,600 IU as mixed tocopherols. Get part from the multivitamin and the remainder from the antioxidant supplement.
• Vitamin K – Take this vitamin as a part of a multivitamin supplement. Large doses of vitamin E require extra vitamin K.
• Mixed carotenes – Take 100,000 IU as mixed carotenes. Get part from the multivitamin and the remainder from the antioxidant supplement.
• Multivitamin/mineral formula – Take the “optimal” recommended dosage stated on the bottle.
• Antioxidant formula - This should contain vitamin C, vitamin E, beta-carotene and mixed carotenes and selenium. Some comprehensive formulas also contain green tea extract and silymarin.
• Fish oil (EPA) – Take 1,000 – 6,000 milligrams EPA as fish oil. The amount of EPA per capsule and gram of fish oil differs depending on the source. Check the bottle for EPA levels.
• Coenzyme Q10 – Take 200 milligrams
• Cysteine or N-acetylcysteine – Take one or two grams of this amino acid every eight hours.
• Cruciferous vegetables – Take four ounces of fresh juice. This can be added to carrot juice or apple juice, or to soups or stews after cooking.
• Rice bran – Work up to 1 tablespoon a day.
• Silymarin (milk thistle seed extract) – Take 100 milligrams two to three times a day.
• Reduced Glutathione – Take 300 milligrams a day.
• Green Tea – Drink one or two cups a day, or take green tea extract in capsule form.
• Pycnogenol or grapeseed extract
• Wheatgrass or other sprouted grasses—these can be taken fresh or in pure powdered form
• Graviola –a potent stimulant of the immune system from the Amazon rain forest.

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

• Vitamin E (1,600 IU daily) may help prevent hair loss when taken seven to ten days before the start of therapy.
• N-acetylcysteine, an amino acid, may help to protect healthy cells when taken seven to ten days before the start of therapy.
• Reduced Glutathione may also help to protect healthy cells when taken the week before treatment.

During Treatment

• Vitamin E, vitamin A, and garlic may increase the effectiveness of chemotherapy.
• Bovine cartilage may prevent angiogenesis (new blood vessel growth), which is necessary for the tumor to grow and spread.
• Reduced Glutathione
• Immune stimulants

To Prevent or Slow Cancer’s Growth

• Fish oil has EPA and DHA that decrease the ability of cancer cells to stick.
• Fiber-rich foods keep blood sugar levels even. This will help to “starve” the glucose-hungry cancer cells. Cancer cells have a high requirement for sugar.
• Eliminate sucrose and all sugar; they may also depress immune function.

To Protect Healthy Cells

• Vitamin C and the other antioxidant nutrients – selenium, vitamin E, and mixed carotenes – provide protection from the free radicals used to kill cancer cells (friendly fire). Take these as part of an antioxidant supplement.
• Take Beta 1-3 D glucan

To Increase Detoxification of Chemotherapeutic Drugs

• Extra fiber will increase the fecal excretion of drugs.
• Cruciferous vegetables will increase the production of the enzyme glutathione.
• N-acetylcysteine, an amino acid, will increase the enzyme glutathione.
• Silymarin (milk thistle seed extract) is well known for its ability to protect the liver from toxic chemicals.
• Reduced glutathione – important detoxifier

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

• busulfan
• chlorambucil
• cyclophosphamide
• dacardazine
• ifosfamide
• mechlorethamine
• melphalan
• streptozocin
• thiotepa

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

• carmustine
• lomustine
• semustine
• Nitrosoureas cross the blood-brain barrier and are often used to treat brain tumors, lymphomas, multiple mylenomas, and malignant melanoma. These agents have a similar action to alkylating agents, as well as inhibiting the enzymes that repair DNA.

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

• bleomycin
• dactinomycin
• daunorubicin
• doxorubicin
• mitoxantrone
• mitomycin-C
• pilcamycin

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

• cytarabine
• methotrexate
• 5-fluorodeoxyuridine
• 5-fluorouracil
• 6-mercaptopurine
• 6-thioguanine

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

• diethylstilbestrol
• fluoxymesterone
• megestrol
• acetate
• prednisone
• tamoxifen

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

• cisplatin
• carboplatin

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

• vinblastine
• vincristine
• etoposide
• VP-16

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

• asparaginase
• pegaspargase

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

• interferon
• interleukin

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:

• Multivitamin/mineral formula – Take the “optimal” recommended dosage stated on the bottle.
• Antioxidant formula - This should contain vitamin C, vitamin E, beta-carotene and mixed carotenes and selenium. Some comprehensive formulas also contain green tea extract and silymarin.
• Mixed carotenes – Take 100,000 IU as mixed carotenes. Get part from the multivitamin and the remainder from the antioxidant supplement.
• Vitamin E – Take 1,600 IU as mixed tocopherols. Get part from the multivitamin and the remainder from the antioxidant supplement.
• Vitamin K – Take this vitamin as a part of a multivitamin supplement. Large doses of vitamin E require extra vitamin K.
• Fish oil (EPA) – Take 1,000 – 6,000 milligrams EPA as fish oil. The amount of EPA per capsule and gram of fish oil differs depending on the source. Check the bottle for EPA levels.
• Vitamin B complex – Take 50 milligrams B complex, sometimes called B-50.
• Leafy green juice (fresh) – Take four ounces. This can be added to carrot juice, protein shakes, soups, and stews.
• Glutamine – Take two to four grams.
• Vitamin B6 as pyridoxal 5 pyrophosphate – Take a total of 300 milligrams per day. Get part from the B complex supplement and part from the multivitamin/mineral supplement; any remaining can be taken as a pure supplement.
• Niacin as nicotinamide – Take as part of the B complex supplement or the multivitamin/mineral supplement.

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

• Shark oil (alkylglycerols) may enhance tumor regression.
• Glutamine may protect against radiation-induced enteritis.
• Vitamin B, niacin, Vitamin C, and the other antioxidant nutrients (selenium, vitamin E, and mixed carotenes) protect healthy cells from radiation damage.
• Vitamin C and leafy green vegetables make cancer cells more vulnerable to radiation. Eat at least two servings of leafy green vegetables a day. These make good additions to juices.