1
|
Park Y, Farhat Z, Liao LM, Inoue-Choi M, Loftfield E. Multivitamin use and all-cause and cause-specific mortality in cancer survivors. Br J Cancer 2024; 130:82-87. [PMID: 38017130 PMCID: PMC10781735 DOI: 10.1038/s41416-023-02421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Despite no sufficient evidence on benefits and harms of multivitamin use, cancer survivors use multivitamins as a self-care strategy to improve or maintain health. We examined if multivitamin use was associated with mortality in cancer survivors. METHODS 15,936 male and 7026 female cancer survivors in the NIH-AARP Diet and Health Study were included in the analysis. Types and frequency of multivitamin use at on average 4.6 years after cancer diagnosis were assessed. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression models. RESULTS Multivitamin use was not associated with lower all-cause mortality risk in all female (RR = 0.94, 95% CI:0.87-1.01 daily vs. no use) or male cancer survivors (RR = 0.96, 95% CI:0.91-1.00); however, a modest inverse association for CVD mortality was observed in female survivors of reproductive cancers (RR = 0.75, 95% CI:0.61-0.92) and male survivors of non-reproductive cancers (RR = 0.81, 95% CI:0.70-0.94). Multivitamin use was also associated with a lower risk of cancer-specific mortality in survivors of skin (RR = 0.65, 95% CI:0.48-0.88) and breast (RR = 0.79, 95% CI:0.65-0.95) cancer. DISCUSSION Multivitamin use may provide a modest survival benefit to some cancer survivors. Cancer care providers should talk with cancer survivors about potential benefits and harms of multivitamin use.
Collapse
Affiliation(s)
- Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
| | - Zeinab Farhat
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Erikka Loftfield
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
2
|
Frenkel M, Morse MB, Narayanan S. Addressing Patient Requests to Add Dietary Supplements to Their Cancer Care-A Suggested Approach. Nutrients 2023; 15:5029. [PMID: 38140288 PMCID: PMC10745580 DOI: 10.3390/nu15245029] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Dietary supplements are widely utilized by cancer patients as part of a complementary and integrative approach to their healthcare. However, a significant portion of patients refrain from discussing their supplement use with their physicians, often due to the perceived indifference or negativity of their healthcare providers. This communication gap exposes patients to unreliable information sources and potential risks associated with uninformed supplementation. As the healthcare landscape evolves, there is an increasing recognition of the pivotal role that physicians play in guiding patients' healthcare decisions. A patient-centered perspective prioritizes the provision of evidence-based information tailored to the individual's needs. It advocates for open discussions about potential risks and fosters shared decision making, respecting patient autonomy. Additionally, this approach involves offering alternative options, documenting patient preferences, and ensuring ongoing support while coordinating with the healthcare team. To address these evolving needs, healthcare providers must adopt a transformative perspective, becoming expert guides who engage with their patients as informed and empowered participants. This revised approach emphasizes an open dialogue that balances presenting facts and acknowledging uncertainties surrounding dietary supplement use. Our narrative review of the literature underscores the importance of a practical approach, centered on transparent discussions and respect for patient autonomy. By following this approach, healthcare providers can empower patients to navigate the complexities of dietary supplement use within the context of cancer care, thereby safeguarding patient safety and overall well-being. Notably, our proposed tool highlights the utilization of reliable sources, the risk stratification of supplements, specific recommendations, and subsequent monitoring, providing a structured framework for informed decision making.
Collapse
Affiliation(s)
- Moshe Frenkel
- Complementary and Integrative Medicine Service, Oncology Division, Rambam Health Care Campus, Haifa 3109601, Israel
- Department of Family Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Meroe B. Morse
- Section of Integrative Medicine, Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.M.); (S.N.)
| | - Santhosshi Narayanan
- Section of Integrative Medicine, Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.M.); (S.N.)
| |
Collapse
|
3
|
Yalameha B, Nejabati HR, Nouri M. Cardioprotective potential of vanillic acid. Clin Exp Pharmacol Physiol 2023; 50:193-204. [PMID: 36370144 DOI: 10.1111/1440-1681.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/03/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
Nowadays, cardiovascular diseases (CVDs) are a global threat to public health, accounting for almost one-third of all deaths worldwide. One of the key mechanistic pathways contributing to the development of CVDs, including cardiotoxicity (CTX) and myocardial ischaemia-reperfusion injury (MIRI) is oxidative stress (OS). Increased generation of reactive oxygen species (ROS) is closely associated with decreased antioxidant capacity and mitochondrial dysfunction. Currently, despite the availability of modern pharmaceuticals, dietary-derived antioxidants are becoming more popular in developed societies to delay the progression of CVDs. One of the antioxidants derived from herbs, fruits, whole grains, juices, beers, and wines is vanillic acid (VA), which, as a phenolic compound, possesses different therapeutic properties, including cardioprotective. Based on experimental evidence, VA improves mitochondrial function as a result of the reduction in ROS production, aggravates antioxidative status, scavenges free radicals, and reduces levels of lipid peroxidation, thereby decreasing cardiac dysfunction, in particular CTX and MIRI. Considering the role of OS in the pathophysiology of CVDs, the purpose of this study is to comprehensively address recent evidence on the antioxidant importance of VA in the cardiovascular system.
Collapse
Affiliation(s)
- Banafsheh Yalameha
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Reza Nejabati
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
4
|
Dietary supplement use and recommendations for discontinuation in an integrative oncology clinic. Support Care Cancer 2023; 31:40. [DOI: 10.1007/s00520-022-07504-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
|
5
|
Liu B, Yang W, Zhang K. Role of Glucosamine and Chondroitin in the Prevention of Cancer: A Meta-Analysis. Nutr Cancer 2023; 75:785-794. [PMID: 36715012 DOI: 10.1080/01635581.2023.2173258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The anti-inflammatory properties of glucosamine and chondroitin suggest that they may have potential effects in cancer prevention. We performed this meta-analysis to assess the protective function of glucosamine and/or chondroitin intake against cancer risk. We searched the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. The odds ratio (OR), corresponding to the 95% confidence interval (95% CI), was used to assess the association between chondroitin and/or glucosamine intake and cancer risk. Thirteen studies met the inclusion criteria, with 1,690,918 participants and 55,045 cancer cases. Overall, chondroitin and/or glucosamine intake was associated with a lower risk of colorectal cancer (OR = 0.91, 95% CI, 0.87-0.94) and lung cancer (OR = 0.84, 95% CI, 0.79-0.89). Subgroup analysis supported the protective effect of different SYSADOAs (chondroitin and/or glucosamine) intake. However, the protective effect was not observed in the only chondroitin intake group and in the NSAIDs group. Our meta-analysis found that the intake of glucosamine and/or chondroitin decreased the risk of colorectal and lung cancers. Moreover, NSAIDs use may have a synergistic protective effect.
Collapse
Affiliation(s)
- Bo Liu
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Wenxing Yang
- Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Kui Zhang
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| |
Collapse
|
6
|
Johal J, Han CY, Joseph R, Munn Z, Agbejule OA, Crawford-Williams F, Wallen MP, Chan RJ, Hart NH. Dietary Supplements in People with Metastatic Cancer Who Are Experiencing Malnutrition, Cachexia, Sarcopenia, and Frailty: A Scoping Review. Nutrients 2022; 14:nu14132642. [PMID: 35807823 PMCID: PMC9268679 DOI: 10.3390/nu14132642] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023] Open
Abstract
Cancer-associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non-metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition-related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic search was conducted across databases, including MEDLINE, EMBASE, CINAHL, and clinical trial registries. Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements—vitamins, minerals, antioxidants, proteins, amino acids, fatty acids, fiber, and others. While the types of dietary supplements included varied across cancer types, omega-3 and carnitine were investigated most often. Proposed relevant attributes of dietary supplements included their antioxidant, anti-inflammatory, anti-cancer, and immunomodulatory properties. Overall, there was a paucity of interventional studies, and more randomized controlled trials are warranted.
Collapse
Affiliation(s)
- Jolyn Johal
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
| | - Chad Yixian Han
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
| | - Ria Joseph
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
| | - Zachary Munn
- Joanna Briggs Institute (JBI), The University of Adelaide, Adelaide, SA 5001, Australia;
| | - Oluwaseyifunmi Andi Agbejule
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Matthew P. Wallen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
- School of Science, Psychology and Sport, Federation University, Mount Helen, VIC 3350, Australia
| | - Raymond J. Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Nicolas H. Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; (J.J.); (C.Y.H.); (R.J.); (O.A.A.); (F.C.-W.); (M.P.W.); (R.J.C.)
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Precision Medicine (Cancer), South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
- Correspondence:
| |
Collapse
|
7
|
Conway RE, Rigler FV, Croker HA, Lally PJ, Beeken RJ, Fisher A. Dietary supplement use by individuals living with and beyond breast, prostate, and colorectal cancer: A cross-sectional survey. Cancer 2022; 128:1331-1338. [PMID: 34927236 DOI: 10.1002/cncr.34055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/08/2021] [Accepted: 11/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Dietary supplements (DSs) are not recommended for the prevention of cancer recurrence. Although DS use is common in individuals living with and beyond cancer, its associations with beliefs about reduced cancer recurrence risk and demographic and health behaviors are unclear. METHODS Adults (18 years old or older) who had been diagnosed with breast, prostate, or colorectal cancer were recruited through National Health Service sites in Essex and London. Participants completed a mailed survey and telephone or online 24-hour dietary recalls (MyFood24). Supplement use was collected during the dietary recalls. Associations between DS use and demographics, health behaviors, and beliefs about DSs and cancer were explored. RESULTS Nineteen percent of 1049 individuals believed that DSs were important for the reduction of cancer recurrence risk, and 40% of individuals reported DS use. DS use was positively associated with being female (odds ratio [OR], 2.48; confidence interval [CI], 1.72-3.56), meeting 5-a-day fruit and vegetable recommendations (OR, 1.36; CI, 1.02-1.82), and believing that DSs were important for reducing cancer recurrence risk (OR, 3.13; CI, 2.35-4.18). DS use was negatively associated with having obesity (OR, 0.58; CI, 0.38-0.87). The most commonly taken DSs overall were fish oils (taken by 13%). Calcium with or without vitamin D was the most common DS taken by individuals with breast cancer (15%). CONCLUSIONS DS use by individuals living with and beyond cancer is associated with demographic factors and health behaviors. A belief that DSs reduce the risk of cancer recurrence is common and positively associated with DS use. There is a need for health care professionals to provide advice about DS use and cancer recurrence risk.
Collapse
Affiliation(s)
- Rana E Conway
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Freyja V Rigler
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Helen A Croker
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Phillippa J Lally
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | | | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| |
Collapse
|
8
|
Tank M, Franz K, Cereda E, Norman K. Dietary supplement use in ambulatory cancer patients: a survey on prevalence, motivation and attitudes. J Cancer Res Clin Oncol 2021; 147:1917-1925. [PMID: 33825025 PMCID: PMC8164602 DOI: 10.1007/s00432-021-03594-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/10/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Patients with cancer often believe dietary supplements (DS) such as micronutrients and botanical products to be health supporting and non-toxic despite growing concerns regarding potential pharmacological interactions. Studies on the prevalence of DS use among patients with cancer are heterogeneous and mainly conducted at university-based cancer centers. This survey focused on a particular cancer patient group treated in an ambulatory setting without regular access to professional nutritional counselling. METHODS Patients with a history of cancer or hematological malignancy were included in this survey. A self-reported questionnaire was used to evaluate the different aspects of DS use, changes in dietary habits and patients' demographic characteristics. RESULTS Almost every second patient reported using DS (47.2%). Women (56.3%), patients with an academic degree (56.0%) and non-smokers (84.8%) were more inclined to use DS. Along with magnesium (16.6%), calcium (14.3%), multivitamins (12.0%) and vitamin C (9.4%), use of herbal supplements (12.6%) was common. Women (84.8% vs. 74.9% of men, p = < 0.001) and patients younger than 65 years (84.4% vs. 77.2% of patients > 65 y, p = 0.002) sought dietary advice more often. Support of the immune system was the main reason for DS use (26.4%) and a relevant number of patients (49.6%) reported to have changed their dietary habits following cancer diagnosis. CONCLUSION DS use is common among patients with cancer treated in an ambulatory setting. This finding should encourage oncologists to implement detailed questioning about DS use and dietary habits to prevent potential interactions and offer substantial advice.
Collapse
Affiliation(s)
- Maja Tank
- Medizinisches Versorgungszentrum Tempelhof Oncology, Berlin, Germany.,Department of Geriatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany
| | - Kristina Franz
- Department of Geriatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany.,Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Kristina Norman
- Department of Geriatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany. .,Institute of Nutritional Science, University of Potsdam, Potsdam, Germany. .,Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
| |
Collapse
|
9
|
Ferdous UT, Yusof ZNB. Medicinal Prospects of Antioxidants From Algal Sources in Cancer Therapy. Front Pharmacol 2021; 12:593116. [PMID: 33746748 PMCID: PMC7973026 DOI: 10.3389/fphar.2021.593116] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 01/19/2021] [Indexed: 12/20/2022] Open
Abstract
Though cancer therapeutics can successfully eradicate cancerous cells, the effectiveness of these medications is mostly restricted to several deleterious side effects. Therefore, to alleviate these side effects, antioxidant supplementation is often warranted, reducing reactive species levels and mitigating persistent oxidative damage. Thus, it can impede the growth of cancer cells while protecting the normal cells simultaneously. Moreover, antioxidant supplementation alone or in combination with chemotherapeutics hinders further tumor development, prevents chemoresistance by improving the response to chemotherapy drugs, and enhances cancer patients' quality of life by alleviating side effects. Preclinical and clinical studies have been revealed the efficacy of using phytochemical and dietary antioxidants from different sources in treating chemo and radiation therapy-induced toxicities and enhancing treatment effectiveness. In this context, algae, both micro and macro, can be considered as alternative natural sources of antioxidants. Algae possess antioxidants from diverse groups, which can be exploited in the pharmaceutical industry. Despite having nutritional benefits, investigation and utilization of algal antioxidants are still in their infancy. This review article summarizes the prospective anticancer effect of twenty-three antioxidants from microalgae and their potential mechanism of action in cancer cells, as well as usage in cancer therapy. In addition, antioxidants from seaweeds, especially from edible species, are outlined, as well.
Collapse
Affiliation(s)
- Umme Tamanna Ferdous
- Aquatic Animal Health and Therapeutics Laboratory (AquaHealth), Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia
| | - Zetty Norhana Balia Yusof
- Aquatic Animal Health and Therapeutics Laboratory (AquaHealth), Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia
- Faculty of Biotechnology and Biomolecular Sciences, Department of Biochemistry, Universiti Putra Malaysia, Selangor, Malaysia
- Bioprocessing and Biomanufacturing Research Center, Universiti Putra Malaysia, Selangor, Malaysia
| |
Collapse
|
10
|
Levit R, Savoy de Giori G, de Moreno de LeBlanc A, LeBlanc JG. Evaluation of vitamin-producing and immunomodulatory lactic acid bacteria as a potential co-adjuvant for cancer therapy in a mouse model. J Appl Microbiol 2020; 130:2063-2074. [PMID: 33128836 DOI: 10.1111/jam.14918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022]
Abstract
AIMS To evaluate a mixture of selected lactic acid bacteria (LAB) (a riboflavin-producer, a folate-producer and an immunomodulatory strain) as co-adjuvant for 5-fluorouracil (5-FU) chemotherapy in cell culture and using a 4T1 cell animal model of breast cancer. METHODS AND RESULTS The viability of Caco-2 cells exposed to 5-FU and/or LAB was analysed. Mice bearing breast tumour were treated with 5-FU and/or LAB. Tumour growth was measured. Intestinal mucositis (IM) was evaluated in small intestine; haematological parameters and plasma cytokines were determined. The bacterial mixture did not negatively affect the cytotoxic activity of 5-FU on Caco-2 cells. The LAB mixture attenuated the IM and prevented blood cell decreases associated with 5-FU treatment. Mice that received 5-FU and LAB mixture decreased tumour growth and showed modulation of systemic cytokines modified by both tumour growth and 5-FU treatment. The LAB mixture by itself delayed tumour growth. CONCLUSIONS The mixture of selected LAB was able to reduce the side-effects associated with chemotherapy without affecting its primary anti-tumour activity. SIGNIFICANCE AND IMPACT OF THE STUDY This bacterial mixture could prevent the interruption of conventional oncologic therapies by reducing undesirable side-effects. In addition, this blend would provide essential nutrients (vitamins) to oncology patients.
Collapse
Affiliation(s)
- R Levit
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Tucumán, Argentina
| | - G Savoy de Giori
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Tucumán, Argentina.,Cátedra de Microbiología Superior, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Tucumán, Argentina
| | - A de Moreno de LeBlanc
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Tucumán, Argentina
| | - J G LeBlanc
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Tucumán, Argentina
| |
Collapse
|
11
|
Roeland EJ, Bohlke K, Baracos VE, Bruera E, del Fabbro E, Dixon S, Fallon M, Herrstedt J, Lau H, Platek M, Rugo HS, Schnipper HH, Smith TJ, Tan W, Loprinzi CL. Management of Cancer Cachexia: ASCO Guideline. J Clin Oncol 2020; 38:2438-2453. [DOI: 10.1200/jco.20.00611] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To provide evidence-based guidance on the clinical management of cancer cachexia in adult patients with advanced cancer. METHODS A systematic review of the literature collected evidence regarding nutritional, pharmacologic, and other interventions, such as exercise, for cancer cachexia. PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and systematic reviews of RCTs published from 1966 through October 17, 2019. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The review included 20 systematic reviews and 13 additional RCTs. Dietary counseling, with or without oral nutritional supplements, was reported to increase body weight in some trials, but evidence remains limited. Pharmacologic interventions associated with improvements in appetite and/or body weight include progesterone analogs and corticosteroids. The other evaluated interventions either had no benefit or insufficient evidence of benefit to draw conclusions on efficacy. Limitations of the evidence include high drop-out rates, consistent with advanced cancer, as well as variability across studies in outcomes of interest and methods for outcome assessment. RECOMMENDATIONS Dietary counseling may be offered with the goals of providing patients and caregivers with advice for the management of cachexia. Enteral feeding tubes and parenteral nutrition should not be used routinely. In the absence of more robust evidence, no specific pharmacological intervention can be recommended as the standard of care; therefore, clinicians may choose not to prescribe medications specifically for the treatment of cancer cachexia. Nonetheless, when it is decided to trial a drug to improve appetite and/or improve weight gain, currently available pharmacologic interventions that may be used include progesterone analogs and short-term (weeks) corticosteroids.
Collapse
Affiliation(s)
| | - Kari Bohlke
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | | | - Marie Fallon
- Edinburgh Oncology Centre, University of Edinburgh, UK
| | - Jørn Herrstedt
- Zealand University Hospital Roskilde and University of Copenhagen, Denmark
| | - Harold Lau
- University of Calgary, Calgary, Alberta, Canada
| | - Mary Platek
- Roswell Park Comprehensive Cancer Center and D’Youville College, Buffalo, NY
| | - Hope S. Rugo
- University of California San Francisco, San Francisco, CA
| | | | | | | | | |
Collapse
|
12
|
Roeland EJ, Bohlke K, Baracos VE, Bruera E, del Fabbro E, Dixon S, Fallon M, Herrstedt J, Lau H, Platek M, Rugo HS, Schnipper HH, Smith TJ, Tan W, Loprinzi CL. Management of Cancer Cachexia: ASCO Guideline. J Clin Oncol 2020. [DOI: 10.1200/jco.20.00611 10.1200/jco.20.00611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To provide evidence-based guidance on the clinical management of cancer cachexia in adult patients with advanced cancer. METHODS A systematic review of the literature collected evidence regarding nutritional, pharmacologic, and other interventions, such as exercise, for cancer cachexia. PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and systematic reviews of RCTs published from 1966 through October 17, 2019. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The review included 20 systematic reviews and 13 additional RCTs. Dietary counseling, with or without oral nutritional supplements, was reported to increase body weight in some trials, but evidence remains limited. Pharmacologic interventions associated with improvements in appetite and/or body weight include progesterone analogs and corticosteroids. The other evaluated interventions either had no benefit or insufficient evidence of benefit to draw conclusions on efficacy. Limitations of the evidence include high drop-out rates, consistent with advanced cancer, as well as variability across studies in outcomes of interest and methods for outcome assessment. RECOMMENDATIONS Dietary counseling may be offered with the goals of providing patients and caregivers with advice for the management of cachexia. Enteral feeding tubes and parenteral nutrition should not be used routinely. In the absence of more robust evidence, no specific pharmacological intervention can be recommended as the standard of care; therefore, clinicians may choose not to prescribe medications specifically for the treatment of cancer cachexia. Nonetheless, when it is decided to trial a drug to improve appetite and/or improve weight gain, currently available pharmacologic interventions that may be used include progesterone analogs and short-term (weeks) corticosteroids.
Collapse
Affiliation(s)
| | - Kari Bohlke
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | | | - Marie Fallon
- Edinburgh Oncology Centre, University of Edinburgh, UK
| | - Jørn Herrstedt
- Zealand University Hospital Roskilde and University of Copenhagen, Denmark
| | - Harold Lau
- University of Calgary, Calgary, Alberta, Canada
| | - Mary Platek
- Roswell Park Comprehensive Cancer Center and D’Youville College, Buffalo, NY
| | - Hope S. Rugo
- University of California San Francisco, San Francisco, CA
| | | | | | | | | |
Collapse
|
13
|
de Lima FD, Battaglini CL, Chaves SN, Ugliara L, Sarandy J, Lima RM, Bottaro M. Effect of strength training and antioxidant supplementation on perceived and performance fatigability in breast cancer survivors: a randomized, double-blinded, placebo-controlled study. Appl Physiol Nutr Metab 2020; 45:1165-1173. [PMID: 32348688 DOI: 10.1139/apnm-2020-0166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This randomized, double-blinded, placebo-controlled study aimed to investigate the effect of strength training (ST) combined with vitamin C and E supplementation on perceived and performance fatigability in breast cancer survivors (BCS). Twenty-five BCS were randomly assigned to 1 of 2 groups: vitamins (VIT; n = 12; 51.0 ± 9.0 years) or placebo (PLA; n = 13; 48.2 ± 8.3 years). Both groups performed a 10-week ST protocol, twice a week. The VIT group was supplemented with vitamins C (500 mg/day) and E (180 mg/day) and the PLA group with polydextrose (1 g/day), once a day after breakfast. At the beginning and at the end of the training period, perceived fatigability was assessed using Multidimensional Fatigue Inventory (MFI)-20 (general fatigue and physical fatigue). Performance fatigability was assessed during 30 maximal isokinetic knee extensions at 120°/s. General fatigue decreased similarly in the VIT (p = 0.004) and PLA (p = 0.011) groups. Physical fatigue decreased similarly in the VIT (p = 0.011) and PLA (p = 0.001) groups. Performance fatigability also decreased similarly in the VIT (p = 0.026) and PLA (p < 0.001) groups. There was no difference between groups at any moment (p > 0.05). In summary, antioxidant supplementation does not add any positive synergistic effect to ST in terms of improving perceived or performance fatigability in BCS. This clinical trial is registered in the Brazilian Clinical Trials Registry, number RBR-843pth (UTN no.: U1111-1222-6511). Novelty ST with maximal repetitions reduces perceived and performance fatigability of BCS. Vitamins C and E supplementation does not add any positive synergistic effect to ST in terms of reducing fatigability in BCS.
Collapse
Affiliation(s)
- Filipe Dinato de Lima
- College of Health Sciences, University of Brasília, Brasília, DF 70910-900, Brazil.,College of Health and Education Sciences, University Center of Brasília, Brasília, DF 70790-075, Brazil
| | - Cláudio L Battaglini
- Department of Exercise and Sport Science and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8700, USA
| | - Sandro Nobre Chaves
- College of Physical Education, University of Brasília, Brasília, DF 70910-900, Brazil
| | - Lucas Ugliara
- College of Physical Education, University of Brasília, Brasília, DF 70910-900, Brazil
| | - Jonathan Sarandy
- College of Physical Education, University of Brasília, Brasília, DF 70910-900, Brazil
| | - Ricardo Moreno Lima
- College of Physical Education, University of Brasília, Brasília, DF 70910-900, Brazil
| | - Martim Bottaro
- College of Physical Education, University of Brasília, Brasília, DF 70910-900, Brazil
| |
Collapse
|
14
|
Outcome Expectancies, Health Information Seeking, and Cancer Beliefs Associated with Multivitamin/Mineral Use in a National Sample, HINTS-FDA 2015. J Acad Nutr Diet 2020; 120:1368-1376. [PMID: 32061553 DOI: 10.1016/j.jand.2019.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/07/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Dietary supplements, including multivitamins/minerals, are commonly reported by adults, yet little is known about multivitamin/mineral use in relation to information seeking, cancer-specific outcome expectancies, and cancer beliefs. OBJECTIVE To examine the relationship of heath information seeking, beliefs about cancer, and outcome expectancies with multivitamin/mineral use within a national sample. DESIGN A secondary analysis of data collected by The Health Information National Trends Survey (HINTS) and the US Food and Drug Administration (FDA) (HINTS-FDA 2015) was conducted. HINTS-FDA 2015 evaluated information seeking, beliefs about cancer, and health behaviors and was a self-administered, two-stage mail survey sent to a random sample of US postal addresses stratified by county smoking rates. PARTICIPANTS Adult household residents were invited to participate, resulting in a 33% response rate (n=3,738). MAIN OUTCOME MEASURES Participants self-reported use of multivitamin/mineral products. STATISTICAL ANALYSES Adjusting for covariates (demographics, single-ingredient and herbal supplement use) weighted stepwise binary logistic regression was used to examine correlates of self-reported multivitamin/mineral use. RESULTS Intake was associated with less than a high school education, having health insurance, and single-ingredient and herbal supplement use. Trust in health organizations (odds ratio [OR]=1.67, P<0.001) and the expectancy that cancer could be avoided with dietary supplements (OR=1.76, P<0.001) correlated with use. Agreement that supplements labeled as "anticarcinogenic" could treat (OR=3.07, P<0.001) or prevent cancer (OR=6.06, P<0.001) correlated with multivitamin/mineral use. Fatalistic beliefs (P<0.001) and negative information-seeking experiences (P<0.001) were associated with slightly lower odds of use. CONCLUSIONS Despite leading health organizations' discouragement of dietary supplements for cancer prevention, this study found that trust in health organizations and outcome expectancies were associated with multivitamin/mineral use. This divergence presents a need to explore how dietary supplement evidence based recommendations can be translated and disseminated for the public.
Collapse
|
15
|
Fasinu PS, Rapp GK. Herbal Interaction With Chemotherapeutic Drugs-A Focus on Clinically Significant Findings. Front Oncol 2019; 9:1356. [PMID: 31850232 PMCID: PMC6901834 DOI: 10.3389/fonc.2019.01356] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/18/2019] [Indexed: 11/30/2022] Open
Abstract
One of the most consequential risks associated with the concomitant use of herbal products and chemotherapeutic agents is herb-drug interactions. The risk is higher in patients with chronic conditions taking multiple medications. Herb-drug interaction is particularly undesirable in cancer management because of the precipitous dose-effect relationship and toxicity of chemotherapeutic agents. The most common mechanism of herb-drug interaction is the herbal-mediated inhibition and/or induction of drug-metabolizing enzymes (DME) and/or transport proteins leading to the alteration in the pharmacokinetic disposition of the victim drug. Most mechanistic research has focused on laboratory-based studies, determining the effects of herbal products on DMEs and extrapolating findings to predict clinical relevance; however, not all DME/transporter protein inhibition/induction results in clinical herb-drug interaction. This study reviews relevant literature and identified six herbal products namely echinacea, garlic, ginseng, grapefruit juice, milk thistle, and St John's wort, which have shown interactions with chemotherapeutic agents in humans. This focus on clinically significant herb-drug interaction, should be of interest to the public including practitioners, researchers, and consumers of cancer chemotherapy.
Collapse
Affiliation(s)
- Pius S Fasinu
- Department of Pharmaceutical Sciences, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, United States
| | - Gloria K Rapp
- Department of Pharmaceutical Sciences, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, United States
| |
Collapse
|
16
|
Borre M, Dam GA, Grønbaek H. Use of biologically based complementary medicines in patients with neuroendocrine tumors. Scand J Gastroenterol 2019; 54:998-1002. [PMID: 31368373 DOI: 10.1080/00365521.2019.1646799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Biologically based complementary medicines (BB-CMs) are popular in patients with cancer. However, there are only limited data for BB-CMs in patients with neuroendocrine tumors (NET). We aimed to identify the prevalence and type of BB-CM use and the association to the nutritional risk score (NRS-2002) in NET patients. Methods: We performed a cross-sectional questionnaire study in NET outpatients at the Department of Hepatology and Gastroenterology at Aarhus University Hospital. The nutritional risk was determined by the NRS-2002. Results: We included 186 patients (51% women, median age 66 years). Sixty-six percent were regular BB-CM users. Forty-two percent used at least two supplements. The most popular BB-CMs were vitamin and mineral supplements (47%), calcium and vitamin D (34%). One-third used non-vitamin non-mineral supplements such as fish oil, herbs, Ginger, Q-10, garlic and probiotics. The use of BB-CMs was associated with female gender (48% vs. 37%, p < .05). Intake was significantly more frequent among patients with an NRS score ≥ 3, (60% vs. 76%) and in patients with change in performance status (58% vs. 76%), (p < .05, all). Patients reporting dietary changes used BB-CMs more frequently than patients without dietary changes (61% vs. 77%) (p < .05). Conclusions: In our study, 66% percent of NET patients use BB-CM and 42% used two or more supplements. Vitamins with and without herbal ingredients, minerals, calcium, vitamin D, and fish oil were the most popular supplements. The use of BB-CMs was associated with an NRS score ≥ 3, change in dietary intake, female gender, and change in ECOG performance status.
Collapse
Affiliation(s)
- Mette Borre
- Department of Hepatology and Gastroenterology, Aarhus University Hospital ENETS Centre of Excellence, Aarhus University Hospital , Aarhus , Denmark
| | - Gitte Aarøe Dam
- Department of Hepatology and Gastroenterology, Aarhus University Hospital ENETS Centre of Excellence, Aarhus University Hospital , Aarhus , Denmark
| | - Henning Grønbaek
- Department of Hepatology and Gastroenterology, Aarhus University Hospital ENETS Centre of Excellence, Aarhus University Hospital , Aarhus , Denmark
| |
Collapse
|