June 4, 2001
Bernadette Festa, MS, RD
We are not recommending any use of herbs. This is informational only
Special Cautions for Cancer Patients:
If you are planning surgery:
Avoid these herbs as they may prolong bleeding time: Gingko Biloba, garlic, ginger, ginseng, feverfew
Avoid these if you are getting anesthesia:
St. John's Wort, Kava Kava, Valerian
...Greater than 10,000 herbs
That's the number of herbs available in China for herbal medicine. In this country the availability is approximately 1,000. I had exposure to a small amount of these on a recent visit to Chinatown with a Chinese medicine practitioner. It was an indulgence for the senses; small bins revealing the smells and sights of herbs that appeared to have a wisdom hidden in their gnarled , shriveled bodies. Plant forms that were once swollen and thriving with life, now available just for us, to give us more life and balance. Bins filled with immuno-stimulating herbs, devoid of American names, their secret enclosed in Chinese characters. Herbs which can be concurrently given with chemotherapy to minimize side effects. Of the herbs, Ginseng was recognizable. The practitioner cautioned us about the downside of taking certain ginsengs and other immuno stimulating herbs.
American Ginseng is mild, OK for kids, not too 'hot' or 'cold' by Chinese standards. Korean Ginseng is strong, 'hot', a lot of fire, meaning one could get dry mouth, questionable if it could promote dehydration. According to the practitioner, if one had low energy, don't take ginseng. Siberian Ginseng is not a ginseng at all.
Chinese Medicine is based on a system of balances, to indiscriminately take herbs is not advisable. Some herbs are milder, like a tonic, akin to our Western approach about taking one aspirin a day for better heart health. Other can have serious side effects, such as being toxic for the liver. The integration of East and West Medicine continues. In the meantime, if you are seeking or working with an Eastern practitioner, remember to ask about their training; our guide today studied 6 years in China, others may only have studied for 100 hours.
During cancer, treatment and post treatment, we are a very vulnerable group, wanting the best, tempted to try the latest thing in the news, on the internet, that our well-meaning friends and family suggest.
Currently not a lot of solid research has been done on herbs. There are some preparations being studied for minimizing side effects of treatment, however the current thinking is to minimize or avoid most herbs during treatment, due to the possibility of herbs interfering with treatment. Herbs can be very powerful. Some of our chemotherapy medications are derived from herbs. For example, the Vinca family - Vincristine, Vinblastine -- are derived from the herb periwinkle. Taxol is also from a plant/tree in the northern rain forest. For those on chemotherapy, medication, herbs are not without some side effects. It is therefore always very important to keep your medical team informed of what supplements you are taking.
A recent study showed that where you live may determine popularity of various herbal use, for example essiac is a common therapy in Canada, mistletoe prevalent in central Europe. (Cancer, 2001)
nutrients found in fruits, vegetables and other dietary supplements. Neutralize free radicals or substances that can damage cells. Certain types of chemotherapy (for example doxorubicin, cisplatin, cyclosphamide) work by interacting with free radicals and thus some researchers question the use of antioxidant supplements when on certain chemotherapy agents. www.cancersupportivecare.com/pharmacy.html Usually there is not a problem with food sources of these.
Used in Asia for thousands of years as an immune-stimulant. Presently there are no good clinical studies on its effectiveness. In the lab, it may improve the immune system by increasing T-lymphocytes, stimulating interferon, and enhancing macrophage activity.
Has been studied for boosting the immune-system, supportive therapy for colds/chronic infections of the respiratory tract. The Commission E (regulatory agency in Europe) recommends that we don't exceed 8 weeks of usage at a time. The thought is that we should take it in a window of time only when we need it rather than always stimulating the immune system. During cancer treatment, one of the usual effects is that your immune system may dip because of the treatment, it is unrealistic to take Echinacea during this time. The expected effect of most radiation and chemotherapy is that your cell count will fall, and it would not be advantageous to take Echinacea during this time. Caution: avoid Echinacea if you have an immune-related condition as Lupus, HIV/AIDS. Avoid usage if taking methotrexate or cyclosporin.
Made up of 4 different herbs: burdock, turkey rhubarb, sorrel, slippery elm. Developed by a nurse, Caisse (essiac spelled backward), who used it to treat her own breast cancer. Studies have not confirmed this effect or benefit.
useful to treat nausea during chemotherapy, generally 0.5 - 2.0 gms. daily in capsules/powder. Make your own tea using sliced ginger root steeped in a few cups of hot water; crystallized ginger candy is also used by patients as a portable ginger source. Remember to always store ginger in a cool place and protect from light. Cautions: avoid ginger use if your platelet count is low.
Milk Thistle -
used as a liver protective agent, although the research has mainly been in the area of alcoholism and liver protection associated with cirrhosis. There are some studies looking at the protective role for the liver when taking certain chemo-medications as cisplatin, acetaminophen and vincristine, although there are no long-term studies to verify this. The active ingredient is silymarin. A food in this family which one can incorporate into their diet is the artichoke. The usual dosage is 140-420 mg in divided doses, 2-3 times a day of 70-80% silymarin.
Mistletoe (Iscador, viscum album, European mistletoe) -
Approved by Commission E (European regulatory agency) for use as adjuvant tumor therapy. Approved for use in Austria, Switzerland and W. German; not approved in the U.S. Extracts shown to kill cancer cells in the laboratory and to stimulate the immune system however no evidence from clinical trials that it is an effective treatment for human cancer. Summary of human studies done: too few patients studied, no antitumor response. Usually given by injections, intravenously, but can also be taken orally.
St. John's Wort -
a 5 petaled yellow flower which grows abundantly in Northern California and Oregon. It is known as a mood enhancer and has been shown to help with promoting positive mood when used for a period of time. Often this is taken by people with cancer as we are very vulnerable to depression. The big downside: this herb can be very dangerous when you are taking other medications. It affects the liver's metabolism of other medications, making them less available to the body. For this reason, if you are on other medications, be sure to inform your medical team. Do not abruptly start or stop St. John's Wort as this will influence your availability of a lot of other drugs that use our liver's system of drug metabolism, namely the cytochrome 450 cycle.
polysaccharide fractions inhibit tumors in animal models.
Purported to help with tumor inhibition, anti-tumor effects appear to be mediated by immune system activation, including natural killer cells, cytotoxic T cells, interleukin-1 and 2, and superoxide anion. D'fraction is active component. Clinical trial are currently taking place at Memorial Sloan Kettering in NYC.
Note: these mushrooms can be easily purchased as fresh or dried, and used in your favorite dishes.
Cassileth, BR, Scharub S, Robinson E, Vickers A. Alternative medicine use worldwide: the International Union Against Cancer survey. Cancer. 2001; 91:1390-1393.
Iscador/Misteloe/Viscumalbum Unconventional Cancer Therapies, BC Cancer Agency; 2/2000.
PDR for Herbal Medicines, 2nd Edition, 2000 Medical Economics Company, Inc. Montvale, NJ
Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: American Botanical Council, 2000:479-80.
Sarubin, A., The American Dietetic Association, The Health Professional's Guide to Popular Dietary Supplements, 2000.
Your Favorite dietitian,
Bernadette Festa, MS, RD