Chemotherapy Side-Effects/Risks Last updated: May 12, 2008

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  Chemotherapy Side-Effects/Risks  
 

 
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | It can lead to... | Recommendations

 
 

Chemotherapy is used primarily to treat people with cancer, although certain chemotherapy drugs have other functions.

Many chemotherapy drugs can cause diarrhea, lack of appetite, vomiting, and damage to the gastrointestinal tract. It makes sense for people undergoing chemotherapy to take a high-potency multivitamin/mineral, to protect against deficiencies.

Often, people who undergo chemotherapy develop aversions to certain foods, sometimes making it permanently difficult to eat those foods. Exposing people to what researchers have called a “scapegoat stimulus” just before the administration of chemotherapy can direct the food aversion to the “scapegoat” food instead of more important parts of the diet. In one trial, fruit drinks administered just before chemotherapy were most effective in protecting against aversions to other foods. [Nutr Cancer 1994;21: pp.13-24]

 
 

Signs, symptoms & indicators of Chemotherapy Side-Effects/Risks:
 
 
Symptoms - Nails  Black/brown fingernails
 Black line(s) across the nails are common in dark-skinned persons but may also be the result of injury or chemotherapy.
 
 

Conditions that suggest Chemotherapy Side-Effects/Risks:
 
 
Circulation  Anemia, Megaloblastic
 Some chemotherapy agents are known inhibitors of folic acid enzymes and as such can induce a megaloblastic anemia.

Digestion

  Increased Intestinal Permeability / Leaky Gut

Immunity

  Weakened Immune System

Lab Values

  Low White Count
 Radiation therapy and chemotherapy destroy fast-growing cells such as white blood cells. Patients receiving a combination of radiation therapy and chemotherapy are at greater risk of a low white count.
 
 

Risk factors for Chemotherapy Side-Effects/Risks:
 
 
Metabolic  Problem Caused By Being Underweight
 As a general principle, when weight loss has occurred or is significant prior to the start of chemotherapy, the survival rate is reduced. The prognostic effect of weight loss prior to chemotherapy was analyzed using data from over 3000 patients enrolled in 12 chemotherapy protocols. The frequency of weight loss ranged from 31% for favorable non-Hodgkin's lymphoma to 87% for gastric cancer. Median survival was significantly shorter in 9 protocols for the patients with weight loss compared to those without weight loss.

Symptoms - Cancer

  Considering chemotherapy or considering chemo/radiation
  Recent/past chemotherapy use

Counter-indicators:
  No history of chemotherapy
 
 

Chemotherapy Side-Effects/Risks can lead to:
 
 
Circulation  Anemia, Megaloblastic
 Some chemotherapy agents are known inhibitors of folic acid enzymes and as such can induce a megaloblastic anemia.

Digestion

  Increased Intestinal Permeability / Leaky Gut

Immunity

  Weakened Immune System
 
 

Recommendations for Chemotherapy Side-Effects/Risks:
 
 
Amino Acid / Protein  Glutamine
 In high doses, glutamine helps prevent the devastating damage to the gastrointestinal tract that results from chemotherapy.

  L-Carnitine
 Treatment with L-carnitine for 7 days at 4gm per day ameliorated chemotherapy-induced fatigue until the next cycle of
chemotherapy in a study of 50 patients who received cisplatin or ifosfamide. [Br J Cancer 2002;86(12): pp.1854-1857]

Botanical

  Ginseng, Korean - Chinese / Asian (Panax ginseng)
 The use of Asian ginseng provides a protective effect from the stress of drug and radiation therapies.

  Medicinal Mushrooms
 The mushroom Coriolus versicolor contains an immune-stimulating substance called polysaccharide krestin, or PSK. PSK has been shown in several studies to help cancer patients undergoing chemotherapy. One study involved women with estrogen receptor-negative breast cancer. PSK combined with chemotherapy significantly prolonged survival time compared with chemotherapy alone. [Cancer 1992;70: pp.2475–83] Another study followed women with breast cancer who were given chemotherapy with or without PSK. The PSK-plus-chemotherapy group had a 25% better chance of survival after ten years compared with those taking chemotherapy without PSK.[Anticancer Res 1995;15: pp.2907–12] Another study looked at people who had surgically removed colon cancer. They were given chemotherapy with or without PSK. Those given PSK had a longer disease-free period and longer survival time. PSK has also been reported to prevent the toxic effects of some chemotherapy agents (vincristine, cyclophosphamide, and Adriamycin) on blood cells in patients with breast cancer. [Dis Colon Rectum 1992;35: pp.123–30] Three grams of PSK were taken orally each day in these studies.

Although PSK is available without prescription in the United States, it is usually not found in health food stores. Through special suppliers to the medical profession, however, PSK can be obtained from doctors of natural medicine. Most but not all Coriolus versicolor extracts contain less than the high level of active ingredient (at least 30% protein-bound polysaccharides) found in PSK.

  Ganoderma Lucidum
  Astragalus Root (Astragalus membrinaceus)
 Astragalus reduces bone marrow supression and gastrointestinal toxicity caused by chemotherapy and radiation. Research has also shown that subjects with advanced cancer showed a two to three fold increase in the strength of their immune response after being given astragalus. A second study showed that astragalus boosted immune response, even in animals that were treated with an immunosuppressive drug, cyclophosphamide. Astragalus is taken in China by cancer patients to boost immunity after drug or radiation treatment.

  Coneflower (Echinacea purpura)
 Echinacea is a popular immune-boosting herb that has been investigated for use with chemotherapy. One study looked at the effects of cyclophosphamide, echinacea, and thymus gland extracts to treat advanced cancer patients. Although small and uncontrolled, this trial suggested that the combination modestly extended the life span of some patients with inoperable cancers. Signs of restoration of immune function were seen in these patients. [Cancer Invest 1992;10: pp.343-48]

Nutrient

  Beta-Carotene
 Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks. Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

Vitamins

  Antioxidants
 A number of people have been concerned about the possible interference of antioxidants with chemotherapy and radiation effectiveness. A large formal review of the medical literature was done by Drs Lamson and Brignall, both Naturopathic Doctors and published in Alternative Medicine Reviews, 1999;4(5): pp.304-329. The results showed that there were actually only 3 specific chemotherpy treatments that interfered with the conventional chemotherapy, usually they actually helped. Their conclusion follows.

"Frequently, the effects of using antioxidants concurrent with chemotherapy and radiation are synergistic. Except for three specific interactions outlined above (flavonoids with tamoxifen, NAC with doxorubicin, and beta-carotene with 5-fluorouracil), there is no evidence to date showing that natural antioxidants interfere with conventional cancer therapeutics in vivo. Studies have shown patients treated with antioxidants, with or without chemotherapy and radiation, have many benefits. Patients have been noted to tolerate standard treatment better, experience less weight loss, have a better quality of life, and most importantly, live longer than patients receiving no supplements. It is time to research the role of these agents in conventional oncologic treatment, rather than dismiss them as a class based on theoretical concerns."

Taking ACES (Vitamin A, Vitamin C, Vitamin E and selenium) before and during therapy has been helpful in decreasing the toxicity of chemotherapy, while increasing its effectiveness.

Applying vitamin E topically to mouth sores twice per day leads to complete healing in six out of nine people, compared with only one of nine taking placebo. Applying vitamin E only once per day was helpful to only some groups of patients in another trial, but not all studies have found vitamin E to be effective.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Very strongly or absolutely counter-indicative
May do some good
Likely to help

Take a look at America over a century ago (1904):
Only 14 percent of the homes in the U.S. had a bathtub.
Only 8 percent of the homes had a telephone.
A three-minute call from Denver to New York City cost only $11.
There were only 8,000 cars in the U.S. and only 144 miles of paved roads.
The maximum speed limit in most cities was 10 mph.





GLOSSARY

Anemia:  A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Chemotherapy:  A treatment of disease by any chemicals. Used most often to refer to the chemical treatments used to combat cancer cells.

Diarrhea:  Excessive discharge of contents of bowel.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Folic Acid:  A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.

Gastrointestinal:  Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.

Lymphoma:  Any tumor of the lymphatic tissues.

Mineral:  Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.

White Blood Cell:  (WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.