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Complementary Medications and Chemotherapy CAM therapy |
The use of herbal medications and supplements in conjunction with conventional Western medication is considered as complementary medicine. When medication is used as a substitution for conventional medication, it is called alternative medicine. Scientific data on benefits of alternative medicine are few, therefore, the use of alternative medicine is generally not recommended. However, scientific data suggests that the use of complementary medicine may be safe and effective when used with conventional medicine and followed by a health care professional.
As with all medications, safety and effectiveness must be considered when consuming herbal medications and supplements. The Food and Drug Administration (FDA) does not have stringent rules and regulations requiring proof of safety and effectiveness of these remedies. Only a few have been rigorously studied for safety and effectiveness. Secondly, the FDA does not require manufactures of herbal therapies to provide proof of the amount or quality. This contrasts with conventional medicine where laws and regulations require drug companies to prove the safety and effectiveness of drugs and require manufacturers to make drugs according to stringent guidelines. Therefore, when buying herbal supplements, purchase herbal medications from a reputable manufacturer.
Herbal medications are natural drugs and may have similar effects as conventional medications. There is a common misconception that herbal medicines are safe because they are from a natural source. All precautions that are taken with conventional medications should apply to herbal medications. Children, pregnant, and breast-feeding women should not use herbal therapies. Another issue that applies to both conventional and herbal medications is the potential for drug interactions. Most herb-drug interaction concerns include high-dose antioxidants and vitamins usage during chemotherapy, estrogenic properties of supplements, and blood thinning properties of supplements. Increase safety awareness by speaking to a health care professional about herbal remedies and supplements. Listed below in Table 1 are common herbal-drug interactions.
| Table 1. Common Herbal Product Precautions Table Of Contents |
||
|---|---|---|
| Antioxidant properties:
Garlic Grapeseed extract High-dose Vitamin E High-dose Vitamin C Ginko biloba Selenium Panax Ginseng Green tea Red Clover CoQ10 |
Interaction:
Theoretically may interfere with cancer cell killing effects of certain chemotherapy and radiation therapy |
Patients that should avoid use:
Patients undergoing radiation therapy Patients on chemotherapy: anthracyclines, alkylating agents, and podophyllum agents |
| Estrogenic properties:
Soy products Flax seed oil Black cohosh Chasteberry Ginko biloba Dong quai Red clover |
Interaction:
Estrogenic effect may stimulate estrogen-dependent tumor growth |
Patients that should avoid use:
Breast cancer patients (especially estrogen-receptor positive tumors) Endometrial cancer patients |
| Blood thinning properties:
Garlic Grapeseed extract Megadoses of Vitamin E Medgadoses Vitamin C Ginko biloba Selenium Panax Ginseng |
Interaction:
Inhibit platelet aggregation and increasing risk of bleeding |
Patients that should avoid use:
Patients undergoing surgery Patients with low platelet count Patients taking anticoagulant therapy (e.g. warfarin, heparin, aspirin, enoxaparin) |
| Photosensivity properties
St. John's Wort Chrysanthemum Dong quai Shiitake mushroom |
Interaction: Increase skin sensitivity or responsiveness to sunlight |
Patients that should avoid use: Patients undergoing radiation therapy |
| Others: St. John's Wort |
Interaction: Increase the metabolism of drugs that result in lower drug levels in the body |
Patients that should avoid use:
Patients on concurrent chemotherapy, antidepressants and drugs that undergo the same metabolic pathway as St. John's Wort |
| Echinacea | Interaction:
Boost the immune system |
Patients that should avoid use: Lymphoma patients Patients on concurrent immunosuppressive drugs |
| Shark cartilage | Interaction: Inhibit angiogenesis or blood vessel formation |
Patients that should avoid use:
Patients with hypercalemia Patients undergoing surgery Patients with vascular insufficiency (e.g. coronary artery disease) Pregnancy |
Cost is another issue of herbal therapy and supplements. The herbal industry is a multi-billion dollar industry in the United States. Herbal products may range from a few dollars to hundreds of dollars. Herbal remedies are usually not covered by health care insurance. Consult with a healthcare professional before buying herbal products and supplements to reduce cost.
Complementary medicines, including herbal therapies may be beneficial and safe when used properly. The best sources of information to help determine if herbal therapies and supplements are appropriate for you are your physician or pharmacist. For general information, several web-based resources may be useful such as Natural Medicines Comprehensive Database (www.naturaldatabase.com), MD Anderson Cancer Center Complementary and Integrative Medicine Educational Resource (www.mdanderson.org/departments/cimer), Memorial Sloan-Kettering Cancer Center (www.mskcc.org/aboutherbs), and National Center for Complementary and Alternative Medicine (www.nccam.nih.gov). Empower yourself with knowledge to get the most benefit from your therapy.
References:Herbal Medications
Table Of Contents
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1. Cassileth BR, Deng G. Complementary and alternative therapies for cancer. Oncologist. 2004;9:80-89.
2. Natural Medicines Comprehensive Database. Available at: www.naturaldatabase.com. Assessed May 14, 2004.
3. Wargovich MJ, Woods C, Hollis DM, Zander ME. Herbals, cancer prevention and health. J Nutr. 2001;3034S-3036S.
4. Weiger WA, Smith M, Boon H, Richardson MA, Kaptchuk TJ, Eisenberg DM. Advising patients who seek complementary and alternative medical therapies for cancer. Ann Intern Med. 2002;137:889-903.
5. Werneke U, Earl J, Seydel C, Horn O, Crichton P, Fannon D. Potential health risks of complementary alternative medications in cancer patients. Br J Cancer. 2004;90:408-413.
Zoe-lina Ngo, Pharm.D.
May 14, 2004
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