The tropical citrus fruit grapefruit has earned a popular name in the health and wellness community. There are thousands of articles written about it, highlighting the abundance of health benefits it has. One popular use: it is a natural diuretic. I knew about this, and the thought ran through my mind that I could use it against the edema (water retention) that my anti cancer medication, Sprycel, was causing. However, I also knew this: grapefruit is one of the most common foods with the ability of raising levels of certain medications to toxic and dangerous levels. An article published by Anna Wagstaff on Cancerwold.org states, “If a patient’s CYP3A4 (an important enzyme in the body that metabolisms medications) levels increase above the range considered normal, these drugs are likely to be broken down into inactive compounds and flushed from the system too quickly, giving them less chance to do their anticancer work – effectively an underdose. If levels of the same enzyme are too low, however, more of the drug remains active in the body for longer than intended – effectively an overdose that could lead to very serious side-effects.” It seems to be ironic that healthy foods such as these and many others, can be made dangerous. It's a slippery slope, when in treatment for cancer just a small amount of a good thing can very quickly become a bad one.
This is an important example of why the “natural healing, holistic approach” movement is not as positive as it may seem. Oncologists should be aware of Complementary and Alternative Medicine the patient is using; a patient trying to self medicate with CAM without their doctor’s awareness can affect other treatments or be dangerous.
According to the National Cancer Institute, “Cancer is among the leading causes of death worldwide. In 2012, there were 14 million new cases and 8.2 million cancer-related deaths worldwide.” Along with these unsettling statistics, cancer is “projected to grow by 59% in the next two decades.” (NCI) Cancer is a broad term given to many different diseases that share the same characteristic: cells of the human body begin to grow rapidly and out of control, causing tumors or crowding of healthy, normal cells. Some cancers are genetic, such as breast cancer in families. Other types of cancers, such as Acute or Chronic Myeloid Leukemia are caused by damage or a mutation of the DNA, signaling a rapid growth of immature white blood cells that crowd out the healthy and functioning cells.
The use of natural foods, herbs, medicines and other botanicals to be used for health, treating, and preventing diseases has become prevalent today in America. Complementary and Alternative Medicine (CAM) has been defined by the National Center for Complementary and Alternative Medicine as “a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine.” Some of these include implementing vitamins and minerals into the diet, yoga, acupuncture, and use of teas and plants (anything of nature) to gain healing benefits. Complementary medicine, means to incorporate and add to the conventional treatment to help ease the harsh side effects of chemotherapy. Examples of this are yoga, a healthy diet, teas, and certain vitamins to soothe
nausea and upset stomach. Ginger, a natural root, is proven to ease headaches, nausea, and calm the digestive tract. Similarly, peppermint, has a natural calming and soothing effect on both the stomach and the nasal passages. It can be placed externally on the body to help aches and pains because it is a natural anti inflammatory.
As promising as these practices seem in theory, the ways and to the extent they are being used are dangerous with conventional treatment. The main reason why a good thing can be bad in this case is that most medical doctors who went to school to be oncologists will be against self treatment. When a patient goes in to get conventional treatment for their cancer, such as chemotherapy, radiation, and bone marrow transplants along with the treatment for side effects; the doctor is responsible for the care of this patient until the treatment is finished. They will track the progress and do everything they can to ensure their patient is receiving the best care and has the best chance of remission. Because of this, most doctors will not believe in opting for Complementary care because they are educated to treat pharmaceutically, this is a controversial debate. But either way it is viewed: a patient must choose who they are going to receive advice from: their doctor or information on the internet, friends, family, articles etc. The problem that is going on today is that cancer patients will begin a conventional treatment (chemo), while also trying on their own to self medicate, often using the internet as their doctor. According to The Oncologist, Complementary and Alternative Medicine is a “booming business” with “billions of dollars spent.” (Tascilar. The Oncologist) The study “Dangerous Combinations: Ingestible CAM supplements Use during Chemotherapy in patients with ovarian cancer” posted on The Journal of Alternative and Complementary Medicine states, “Herbs, vitamins, and some foods have
biological activities that could interact with the activities or metabolism of conventional pharmaceuticals. Reviewed articles have highlighted these potential
interactions and suggested that some supplements should be considered contraindicated for use by patients with cancer undergoing surgery or those receiving active treatment with conventional chemotherapeutic agents.” The study followed women diagnosed with ovarian cancer, before, during, and after treatment who were also taking alternative medicines of their choice. “For each CAM substance included in our survey, drug–CAM combinations that have the potential to affect the therapeutic efficacy of chemotherapy through modification of the activity of enzyme pathways that influence drug clearance were considered on a drug-by-drug basis.” (Anderson. al el 2017)
In another study by Annuals of Oncology, “Drug-Drug Interactions in patients treated for cancer: a prospective study on clinical interventions,” the problem is further examined. This article highlights the importance of screening for cancer patients before starting a chemotherapy or other treatment. DDIs, or drug-drug interactions, are “a major concern in oncology.” Using a
clinical study of 302 people, 120 out of 603 DDIs were considered “clinically relevant.” The article concludes that screening for drug interactions should be done before starting a anticancer treatment because of the possible dangerous interactions. The study concluded that in the world of oncology, drug-drug interactions are a real problem. The combinations analyzed were a cause of three different complications: central nervous system interactions such as drowsiness and risk of falling, gastrointestinal interactions such as GI bleeding, and prolongation (concentration of medicine in the system). (Annals of Oncology volume 26, issue 5)
Not only is this trend of self treating cancer with “natural” remedies inconclusive and dangerous when unmonitored, but unlike treatment you receive from a certified practitioner with a degree, a hospital and a pharmacy; many CAM substances are unregulated. Since most vitamins, teas, supplements etc. that are not provided by a pharmacy aren’t regulated by the FDA, many substances aren’t useful or safe. “In addition, pollution with pathogenic micro-organisms, pesticides, heavy metals, etc., is no exception, which makes health risks even higher . For example, for cannabis, which can be used for palliative purposes by cancer patients , it was recently demonstrated that cannabis bought in Dutch “coffee shops” can be contaminated by bacteria and fungi that may harm seriously ill patients.” (Complementary and Alternative Medicine During Cancer Treatment: Beyond innocence. The Oncologist ) Many marketed vitamins and supplements are allowed to be sold with claims that have not been proven, as long as there are no clear diseases that are caused by them. The article mentioned, “The FDA has no authority to approve or analyze these products before they are brought to the market.” Patients are shopping for their own, “lifesaving” treatments on the internet, by the claims that these companies are making. There are endless scams being marketed to the public, and the “medicines” that go along with them are sold without being regulated for safety, potency, and pureness. In a study done by Schmidt and Ernst, posted on The Oncologist, it was found that, “Five of the 32 investigated Web sites gave information biased in favor of its own products or services, and only 10 gave references to scientific literature. Some Websites even promoted and discussed CAM treatments for which no compelling safety and efficacy data could be found in regular medical databases. A few sites were outright dangerous, as they advised patients against
using conventional therapies” (Hyodo, Ichinosuke. “Nationwide Survey on Complementary and Alternative Medicine in Cancer Patients in Japan.” Journal of Clinical Oncology) Not only this, but when a cancer patient is also being treated with chemotherapy, it leaves their immune system weak and subject to other diseases and pathogens. A compromised immune system combined with unknown chemicals and substances is a dangerous combination.
In the article “The danger of alternative therapies and why Steve Jobs was wrong” by Sandra Ryan posted on The Journal, the story of Steve Jobs and his cancer story is discussed. The main idea of the story is that some cancers, such as pancreatic or esophageal cancers are extremely aggressive and move quickly. Patients don’t have time to research, buy, and experiment with different alternative options. They must begin treatment immediately, there is no time to waste exploring. Ryan said,“Shortly after Jobs’ death, one cancer specialist from Harvard University, Ramzi Amri, wrote: “Mr Jobs allegedly chose to undergo all sorts of alternative treatment options before opting for conventional medicine…given the circumstances, it seems sound to assume that Mr Jobs’ choice for alternative medicine has eventually led to an unnecessarily early death.” ( Alternative Therapies. 2012) Jobs opted to go vegetarian, hoping to cure his cancer through diet. Although nutrition is key to a healthy, functioning body and especially important during recovery from chemotherapy, and as prevention for diseases and cancer, once a person is diagnosed with cancer it is important to start treatment right away.
Brian Tracy, a recognized author of more than 60 books and speaker on self improvement and development shared his personal cancer story on his website, Briantracy.com. He gives credit to cancer doctors, research and treatment today and their success. He was diagnosed with a
large tumor in his throat, and shares how he was guided by a “team of specialists who worked together to get him through the process.” (Brian Tracy. My Own Story) His emotional story is raw and real, sharing his fears and feelings throughout the process. His overall outlook was positive and encouraging, he shared the quote “This too shall pass” as his motivation. On August 31st, he had his voice again as he spoke in front of thousands of people at a seminar. In the blog he said, “Follow the advice of your doctors. The quality of cancer treatment in the United States is the best in the world, and the survivorship rates are the highest. The doctors who specialize in cancer have committed their lives to helping people survive cancer, no matter what they have.”
His story is inspirational to cancer fighters because it shows that there is hope, and that you will have doctors by your side who have devoted their lives to finding a cure. Another important note Tracy made is that he had the option to do alternative medicine, but chose instead to listen to the advice of his doctors and came through alive. He stated, “As I did more research, I found that every single alternative to the “standards of care” had been exhaustively tested in multiple universities and clinics and found to be ineffective. Once I realized that, I resigned myself to standard treatment, with all the pain and side effects, and simply trusted my doctors to take the best care of me, which they did.” (Tracy. My Own Story)
My personal story relates to Brian Tracy’s in way. When I was diagnosed with Chronic Myeloid Leukemia in November, I was immediately taken into the caring hands of the doctors at Presbyterian and St. Luke’s Hospital in Denver. I have never received such amazing, comprehensive care before. The staff at Colorado Blood Cancer Institution are some of the most supportive, kind and caring people I have ever met. Because of this, I might be biased to be
drawn to the world of Pharm and oncologists, but I truly believe that they devote their lives and careers to caring for people with cancer, making it the least scary, and unknown experience as they can. They work day in day out to make sure their patients are comfortable- physically and emotionally. Like Tracy mentioned in his blog, I agree that the doctors took the best care of me they possibly could and that the world of cancer treatment and research is a remarkable and growing one.
Integrative Medicine and practices to help ease side effects of cancer treatment such as yoga, massage, a healthy diet, music and art therapy, and vitamins (monitored or prescribed by an oncologist) are necessary and extremely helpful in the treatment process. However, there is a difference between alternative and complementary medicine that is helpful and that is hurtful. The internet, unmonitored supplements, and advice from non doctors are not that answer to a newly diagnosed cancer patient, no matter how good the idea may sound. Concluding by adding a statement from an article on Journal of Clinical Oncology, “These results indicate that better patient-physician communication and more reliable information on CAM products are needed... More research is urgently needed. Oncologists should be aware of these facts, and the use of CAM products should be determined before initiating chemotherapy, especially when using new investigational drugs.”
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Grapefruit Juice and St John's Wort Are Just the Tip of the Iceberg - Cutting-Edge -
July-August-2010 Issue 37 - Cancer World - Shaping the Future of Cancer Care,
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