As an oncologist, I have seen many patients who are looking for ways to support their cancer treatment with the use of supplements. While some supplements may provide benefits, it’s crucial to understand that not all supplements are created equal, and some may even interfere with your cancer treatment. In this article, I will discuss the importance of appropriate cancer supplements and provide some resources to help you make informed decisions.

Firstly, it’s essential to understand that supplements are not a substitute for cancer treatment. While some supplements may provide benefits, they cannot replace standard cancer treatments such as chemotherapy, radiation therapy, and surgery. It’s also important to be aware that newer treatments carry a lot less toxicity by targeting cancer rather than the individual or focus on the immune system, relying on an individual to kill the cancer instead of drugs.  Regardless, it’s important to discuss any supplements you are taking or considering with your healthcare provider before incorporating them into your treatment plan.

Secondly, it’s crucial to understand that not all supplements are safe for cancer patients. Some supplements may interact with cancer treatments and cause adverse effects. For example, some supplements may interfere with the effectiveness of chemotherapy, while others may increase the risk of bleeding during surgery. Again, please discuss any supplements you are taking or considering with your healthcare provider.

Thirdly, it’s essential to choose supplements that are backed by research and have been shown to provide benefits for cancer patients. Some supplements may provide benefits such as reducing inflammation, supporting immune function, and improving quality of life. However, it’s important to choose supplements that have been studied in clinical trials and have been shown to be safe and effective.

Here are some resources to help you make informed decisions about cancer supplements:

1) The National Cancer Institute‘s Office of Cancer Complementary and Alternative Medicine (OCCAM) provides information and resources about complementary and alternative medicine (CAM) for cancer patients, including information about supplements.

2) The American Cancer Society provides information about CAM and cancer, including information about supplements and how they may interact with cancer treatment.

3) The Memorial Sloan Kettering Cancer Center’s About Herbs database provides evidence-based information about herbs, botanicals, and supplements commonly used by cancer patients.

4) The National Center for Complementary and Integrative Health (NCCIH) provides information about CAM and cancer, including information about supplements and how they may interact with cancer treatment.

5) The Cancer Treatment Centers of America provides information about supplements commonly used by cancer patients, including potential benefits, risks, and interactions with cancer treatment.

6) The American Society of Clinical Oncology (ASCO) offers information about complementary and alternative medicine (CAM) for cancer patients, including information about supplements.

7) The National Institute of Health’s Office of Dietary Supplements provides information about dietary supplements, including potential benefits, risks, and interactions with cancer treatment.

8) The Society for Integrative Oncology offers resources and information about integrative oncology, including the use of supplements and other complementary therapies.

9) The Oncology Association of Naturopathic Physicians offers information about naturopathic medicine and cancer, including information about supplements commonly used by cancer patients.

10) The Integrative Medicine Program at the University of Michigan offers information about integrative medicine and cancer, including information about supplements and other complementary therapies.

 

It’s important to note that these concerns are not exhaustive, and each patient may have unique questions and needs. Therefore, it’s essential to have open and honest communication with healthcare professionals to address specific concerns and develop a personalized care plan.

By consulting reliable resources and discussing any supplements you are taking or considering with your healthcare provider, you can make informed decisions about how to support your cancer treatment and improve your quality of life. Remember that supplements are not a substitute for cancer treatment, and it’s essential to work with your healthcare team to develop a personalized treatment plan that meets your unique needs and circumstances.

– Dr. John Haluschak, Oncologist & 4CancerWellness Founder

4CancerWellness recognizes breast cancer is multifaceted and when addressing the latest advances, requires understanding the different types of breast cancer, which makes this information a lot more straightforward. Below is an overview of the 3 basic types of breast cancer:

1️⃣ The first type is low grade (not aggressive), grows slowly over months or even years, is strongly hormone/estrogen-dependent, and if recurring or advanced, spreads mainly to bones. This type is referred to as Luminal A.

2️⃣ The second type is generally a higher grade, sometimes occurring in younger people and can spread anywhere. If an important gene called HER2 is expressed, it is typically in this type of breast cancer. It’s referred to as Luminal B.

3️⃣ The third and last basic type is Triple Negative Breast Cancer (TNBC), occurring often in young people, spread anywhere like the second type and referred to as Basal.

For further information on understanding the types of breast cancer, read our previous blog ‘3 Basic Types of Breast Cancer’.

Breast Cancer Treatment by Type

The latest and newest treatments for breast cancer are dependent on the type.

The first type is almost always very estrogen-dependent (in basic terms, needs estrogen to survive). 

The second type benefits from treatments directed to:

• Estrogen with Anti-estrogen treatments
• Her2 with Anti-HER2 treatments
• Less specific or quite toxic drugs are historically referred to as chemotherapy.

Note: Clarifying “Chemotherapy”

Unfortunately, the topic of chemotherapy can be confusing or misleading… 

Historically, we called drugs that killed cells ‘chemotherapy’, hoping to kill cancer cells more than your own cells. This comes with side effects. 

In actuality, any medication taken for any disease (ex. diabetes, heart disease, migraines) is considered ‘chemotherapy’. 

Now, when your healthcare provider refers to ‘chemotherapy’ they may be referring to any drug that is relevant to your cancer treatment. It’s important to ask your provider for clarification. 

TNBC or the last type of breast cancer benefits from the addition of immunotherapy to classic chemotherapy. 

Importantly, with advances in diagnosis, understanding risks, and newer treatments, we continue to have higher cure rates and continue to improve life expectancy.

Breast Cancer Treatment Explained

First a couple of observations. We never use placebos for breast cancer drug studies when there are proven treatments that exist. 

Second, in advanced cancers, including breast cancer, we now recognize that cancer cells are driven by newly acquired mutations in specific genes. We are also able to identify these mutations from a simple blood test. This type of testing is called Next Generation Sequencing and currently plays a role in advanced cancers that have failed the commonly used treatments. This is very different from tests that look for inherited genetic information called germline testing where we can simply get this from saliva. This is a whole different assessment that instead looks to predict risk of breast cancer before it happens. 

Yes, it can seem confusing as we try to explain the role of genetics regarding both cancer risks but also cancer treatment. 

Lastly, when addressing breast cancer treatments, it gets confusing, because all cancer drugs are now called chemotherapy even though that is not what people were referring to with the toxic chemotherapies of the late 1900s and early 2000s. 

What about drugs that target estrogen, or a gene like HER2, or for that matter immunotherapy? These are clearly not toxic in the same way as historical chemotherapy.  Instead, they work by targeting specific genes or helping our own immune system which results in us getting rid of a cancer cell.  That is not to say they do not have risks, but clearly, they are very different from historical chemotherapy.

Newer Advances Based on the 3 Types of Breast Cancer…

Type 1 Breast Cancer Treatment Advances

The mainstay of treatment for this very estrogen-dependent slow-growing cancer was a SERM (selective estrogen receptor modulators) but increasingly we now see the widespread use of aromatase inhibitors (AI) given a better safety profile. The latter only works if a woman is in menopause – when you only make estrogen because of a protein called aromatase (we sometimes elect to induce menopause at an early age for these very estrogen-dependent cancers). 

Other hormone approaches have been used if failing an AI, such as pure estrogen receptors down-regulator. A more recent advance is the concurrent use of kinase inhibitors called CDK4/6 that improve outcomes in this type of breast cancer and are now being studied when the cancer is found in its earliest stages

Another very early advance is a newer type of PET scan based on trying estrogen  for one day (an estradiol challenge) that basically informs if the cancer is still sensitive to Endocrine based treatments. This PET scan uses the isotope, FFNP, and is 100% sensitive and specific (meaning accurately identifies if an anti-estrogen approach would still work).  

Another significant area is avoiding the development of anti-estrogen resistance by improved antagonism and degradation of estrogen receptors. We are identifying molecules that more effectively inhibit the degradation of the receptor (we want estrogen receptor to stay expressed: retain estrogen dependence). We are also finding molecules that more effectively travel to the tumor, thus allowing the drug to reach the sensitive tumor cell in higher concentrations. 

Finally, an area of research in this type of breast cancer is also understanding the significance of the ESR1 mutation that also leads to AI resistance. Clearly, the future is much brighter for this type of breast cancer and we are focusing on something other than classic chemotherapy.

Type 2 Breast Cancer Treatment Advances

The second type of breast cancer is often higher grade, hormone expressed to some degree and often HER2 expressed. It is also the most varied and evolving type of breast cancer. The major advances in this type of breast cancer are when the cancer over-expresses the gene HER2.  We now use commonly a combined HER2 approach with two agents addressing this pathway, but chemotherapy is often still needed to maximize response.

One of the more important advances in this type of breast cancer are the new antibody-drug conjugates as a mechanism of delivering more effective cancer-killing with less toxicity than classic chemotherapy.

Type 3 Breast Cancer Treatment Advances 

The third type of breast cancer is often called triple-negative breast cancer (TNBC). One of the most important advances in this type of breast cancer is the understanding that immune-based mechanisms are very helpful, often with less toxicity. Advances in understanding immune-related toxicities and mitigating these toxicities have played an important role.

In November 2020, the FDA approved pembrolizumab for advanced triple-negative breast cancer in combination with chemotherapy. The same goes for atezolizumab and chemotherapy. Immunotherapy has been FDA approved for early-stage TNBC as a neoadjuvant treatment (prior to surgery).  This treatment along with chemotherapy resulted in a higher complete remission rate though too early to say, hopefully, better outcomes.

So whichever type of breast cancer you need addressed, advances specific to your type of breast cancer will result in higher cure rates, longer control of recurrent or advanced cancer, and most importantly, less treatment-related toxicity. 

We realize you may have other great questions and direct you to some of the most helpful information sites, like Cancer.net, Cancer.gov, NCCN.com or ACS.org.

Over the years, patients have frequently asked, “what vitamins should I take?” As cancer doctors, our first priority is to cure cancer and help patients understand their prognosis and treatment. But even if less critical, they should still have an answer to the vitamin question. As we looked into it further we just couldn’t find an appropriate answer or product, so we formed the SafeVite Research Team and got to work. 

Over the last 4 years our findings have surprised us in that, although there is a tremendous body of evidence and prior studies regarding vitamins and cancer, it just hadn’t been put together in one logical product… until now. SafeVite has been formulated by our Research Team of Cancer Doctors, carefully considering which vitamins to include and in what doses, in an effort to maximize the benefit to patients in and after cancer treatment.

Some of the questions our Research Team has answered in formulating SafeVite:

• There are certain vitamins to avoid during curative treatment
• Treatment can lead to specific long-term vitamin deficiencies
• Cancer patients run the risk of dangerously elevated vitamin levels
• Cancer treatment can lead to long-term toxicities like hair thinning and nerve damage

And these are just a few examples.

We know the answer is not ‘more vitamins are better’ or just buying a multivitamin off the shelf, as they do not address the specific deficiencies, toxicities and conditions caused by cancer and/or cancer treatment as found in our research. The answer is SafeVite and it’s our goal that SafeVite supports your body’s vitamin needs as you continue your fight against cancer.

What does SafeVite contain and why?

Using the most current references and studies, our research team has focused on vitamins that can be safely recommended for all cancer patients.

Examples are:

• D deficiency is widespread and frequently seen in patients receiving cancer treatments including colon and breast cancer patients.
• B6 (pyridoxine) — Likely protects or mitigates the nerve damage by chemotherapeutic agents and possibly targeted agents that are often used to treat lymphoma, breast, colon, lung, sarcoma and myeloma (and other cancers). B6 is associated with lower risk of hormone positive breast cancer and likely helpful in colon and pancreatic cancer.
• B12 is deficient in many types of cancer including breast cancer and multiple myeloma. B12 deficiency often results from deficiency of the protein intrinsic factor produced by the parietal cell in the stomach and thus frequently present in cancer patients and likely requires a very high dose in order to be absorbed by passive diffusion. B12 based on homocysteine alterations likely mitigates bone turnover and bone fracture risk.

What does SafeVite avoid and why?

Based on the most credible research available, SafeVite’s Cancer specialists have concluded that it is appropriate to avoid some vitamins from use in order to maximize your body’s fight against Cancer.

• Calcium – One out of every four cancer patients will have significantly elevated calcium levels at some time in their life. Although calcium may be necessary for certain patients (like those on bone strengthening agents) it is best to avoid added calcium until confirmed with your doctor what amounts are appropriate.
• Zinc – Though Zinc can specifically help with taste alterations due to radiation damage in oral cavity; it could mitigate the curative effects of this treatment. This is currently still being studied. For now likely best to avoid since its known benefits are limited to this specific situation and it definitely leads to copper deficiency.
• E & A – Vitamins E and A, beta-carotene and selenium definitely interfere with potentially curative chemotherapy and radiation treatments while surprisingly seem to not be helpful in cancer prevention or possibly harmful in the development of cancers like lung cancer or prostate cancer.