Christie L. Carter

When a person is first diagnosed with cancer, surveys show a common reaction is  to load up on vitamins at the health food store to help reduce the toxic effects  of chemotherapy, and perhaps even to potentially help fight the cancer.  Unfortunately, overloading on certain dietary supplements may do more harm than  good.

Maintaining a healthy diet is important during treatment. For patients unable  to do so, doctors and dieticians may recommend dietary supplements, including  antioxidants. Though available as supplements, antioxidants are found naturally  in many foods and beverages, and some data suggest they help prevent heart  disease and cancer by fighting cellular damage caused by free radicals in the  body. Free radicals are damaging substances that are produced through the body’s  normal processes. “Despite people’s belief of the benefit of antioxidant  therapy, the actual data supporting antioxidants as cancer prevention or during  cancer treatment is conflicting and sparse,” says Gabriella D’Andrea, MD, a  breast cancer medical oncologist at Memorial Sloan-Kettering Cancer Center.

With today’s $18-billion supplement industry, the Institute of Medicine  released a report in 2005 calling for regulation. Currently, dietary supplements  are not held to the same testing and approval requirements of medical drugs. As  a result of the Dietary Supplement Health and Education Act, the Food and Drug  Administration can only stop the sale of a supplement if the agency proves it is  unsafe.

Regardless of your specific situation, Dr. D’Andrea says it’s imperative for  cancer patients to remember, that contradictory data exist around this issue,  and large-scale human trials are needed to provide definitive answers. “It’s  extremely important for us to learn the effects of antioxidants in either the  positive or negative direction because the number of people affected with cancer  who are taking supplements is huge. Potentially small impacts may have large  ramifications,” she says.

While studies exist showing that vitamin C and other antioxidants can protect  cells from the detrimental effects of chemotherapy, other studies show the  possibility that the same antioxidants may also protect cancer cells from  chemotherapy. In short, dietary supplements—specifically antioxidants&mdash;may  actually work against chemotherapy’s effectiveness. For this reason, many  oncologists discourage patients from using supplements during treatment.

Cynthia Thomson, PhD, RD, assistant professor in nutritional sciences at the  University of Arizona, says patients must also consider their baseline  nutritional status going into chemotherapy when deciding whether to supplement  their diet with vitamins. “If you have low intake or serum levels, or even if  you’re just not appropriately absorbing what you’re eating, then to supplement  at levels of one to two multivitamins daily is helpful and will likely improve  your response to treatment.” Thomson says a the white blood cell count of a  patient low on antioxidants going into chemotherapy will likely have that count  drop faster than normal “potentially causing a delay in therapy because your  white count is too low.”

Under-nourished patients may also experience more side effects. “If your  micronutrient status is poor and as a result, you go into chemotherapy with some  baseline fatigue, you may become even more fatigued from treatment than the  average person,” says Thomson. However, she does caution against levels of  supplementation that exceed daily requirements.

So what’s the answer for cancer patients trying to balance their nutritional  needs during cancer treatment with any possible dangers of taking too many  dietary supplements? Drs. Thomson and D’Andrea agree that patients should  proceed with caution. “So many patients spend a lot of money on dietary  supplements thinking they’re doing themselves a service, and others seek advice  from people who aren’t particularly qualified,” D’Andrea says. “As a result,  they’re taking massive supplements of things they don’t understand.”

With no cookie-cutter approach to supplements, each situation must be  considered independently, and patients should consult their doctor before using  supplements. What’s good for one person isn’t good for everyone and what’s  appropriate during one aspect of treatment (for example, prior to surgery) isn’t  necessarily what’s right for all parts of treatment (such as during chemotherapy  and/or radiation).

Research lags behind the need for answers. “We need to define which  chemotherapeutic agents are most likely to interact with antioxidant  supplements,” says Thomson. But, D’Andrea says, “We’re just not there  yet.”

For information about a variety of dietary  supplements, visit 

. To access a list of supplements that  have had their quality verified by the United States Pharmacopeia, visit

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