Common brand names:Casodex
Summary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
Reduce Side Effects
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.1
Ginger (Zingiber officinale) can be helpful in alleviating nausea and vomiting caused by chemotherapy.2 , 3 Ginger, as tablets, capsules, or liquid herbal extracts, can be taken in 500 mg amounts every two or three hours, for a total of 1 gram per day.
In preliminary research, large amounts of melatonin were used successfully in combination with tamoxifen in a few people with breast cancer for whom tamoxifen had previously failed.4 The amounts used in this study should be taken only under the supervision of a doctor.
A liquid preparation of German chamomile (Matricaria recutita) has been shown to reduce the incidence of mouth sores in people receiving radiation and systemic chemotherapy treatment in an uncontrolled study. 5The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Russian research has looked at using eleuthero (Eleutherococcus senticosus) with chemotherapy. One study of patients with melanoma found that chemotherapy was less toxic when eleuthero was given simultaneously. Similarly, women with inoperable breast cancer given eleuthero were reported to tolerate more chemotherapy.6 Eleuthero treatment was also associated with improved immune function in women with breast cancer treated with chemotherapy and radiation.7The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
In preliminary research, large amounts of melatonin were used successfully in combination with tamoxifen in a few people with breast cancer for whom tamoxifen had previously failed.8 The amounts used in this study should be taken only under the supervision of a doctor.
Gamma Linolenic Acid
Gamma-linolenic acid (GLA), found in evening primrose and borage oils, may enhance the therapeutic effects of tamoxifen. A small group of breast cancer patients took 2.8 g of oral GLA per day in addition to tamoxifen, in a preliminary trial.9 Another group of breast cancer patients took tamoxifen alone. Those taking the GLA-tamoxifen combination appeared to have a better clinical response than did those taking tamoxifen alone. However, the results of this preliminary research are far from conclusive and need to be confirmed in a larger, more definitive trial.
Milk thistle's (Silybum marianum) major flavonoids, known collectively as silymarin, have shown synergistic actions with the chemotherapy drugs cisplatin and doxorubicin (Adriamycin) in test tubes.10 Silymarin also offsets the kidney toxicity of cisplatin in animals.11 Silymarin has not yet been studied in humans treated with cisplatin. There is some evidence that silymarin may not interfere with some chemotherapy in humans with cancer.12
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.13 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.14 Another study investigated 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.15 Three grams of PSK were taken orally each day in these studies.
Although PSK is rarely available in the United States, hot-water extract products made from Coriolus versicolor mushrooms are available. These products may have activity related to that of PSK, but their use with chemotherapy has not been studied.
Tocotrienols are compounds similar to vitamin E that are found in palm oil. Test tube studies have shown that tocotrienols enhance the effects of tamoxifen.16 Controlled studies are needed to determine whether supplementing with tocotrienols might enhance the anticancer effects of tamoxifen.
Preliminary research in animals found that the citrus flavonoid tangeretin (found primarily in the peel of citrus fruits) interferes with the ability of tamoxifen to inhibit tumor growth.17 Although the evidence is far from conclusive, people taking tamoxifen should probably avoid citrus bioflavonoid supplements, as well as beverages and foods to which citrus peel oils have been added.
Potential Negative Interaction
1. Mattes RD. Prevention of food aversions in cancer patients during treatment. Nutr Cancer 1994;21:13-24.
2. Meyer K, Schwartz J, Crater D, Keyes B. Zingiber officinale (ginger) used to prevent 8-Mop associated nausea. Dermatol Nurs 1995;7:242-4.
3. Pace JC. Oral ingestion of encapsulated ginger and reported self care actions for the relief of chemotherapy-associated nausea and vomiting. Dissertation Abstr Int 1987;8:3297.
4. Lissoni P, Barni S, Meregalli S, et al. Modulation of cancer endocrine therapy by melatonin: A phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progression under tamoxifen alone. Br J Cancer 1995;71:854-6.
5. Carl W, Emrich LS. Management of oral mucositis during local radiation and systemic chemotherapy: A study of 98 patients. J Prosthet Dent 1991;66:361-9.
6. Kupin VJ. Eleutherococcus and Other Biologically Active Modifiers in Oncology. Moscow: Medexport, 1984, 21.
7. Kupin VI, Polevaya YB, Sorokin AM. Eleutherococcus extract treatment for immunostimulation in cancer patients. Vopr Onkol 1986;32:21-6 [in Russian].
8. Lissoni P, Barni S, Meregalli S, et al. Modulation of cancer endocrine therapy by melatonin: A phase II study of tamoxifen plus melatonin in metastatic breast cancer patients progression under tamoxifen alone. Br J Cancer 1995;71:854-6.
9. Kenny FS, Pinder SE, Ellis IO, et al. Gamma linolenic acid with tamoxifen as primary therapy in breast cancer. Int J Cancer 2000;85:643-8.
10. Scambia G, De Vincenzo R, Ranelletti FO, et al. Antiproliferative effect of silybin on gynaecological malignancies: Synergism with cisplatin and doxorubicin. Eur J Cancer 1996;32A:877-82.
11. Gaedeke J, Fels LM, Bokemeyer C, et al. Cisplatin nephrotoxicity and protection by silibinin. Nephrol Dial Transplant 1996;11:55-62.
12. Invernizzi R, Bernuzzi S, Ciani D, Ascari E. Silymarine during maintenance therapy of acute promyelocytic leukemia. Haemotologia 1993;78:340-1.
13. Toi M, Hattori T, Akagi M, et al. Randomized adjuvant trial to evaluate the addition of tamoxifen and PSK to chemotherapy in patients with primary breast cancer. Cancer 1992;70:2475-83.
14. Iino Y, Yokoe T, Maemura M, et al. Immunochemotherapies versus chemotherapy as adjuvant treatment after curative resection of operable breast cancer. Anticancer Res 1995;15:2907-12.
15. Mitomi T, Tsuchiya S, Iijima N, et al. Randomized, controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum (Kanagawa). Dis Colon Rectum 1992;35:123-30.
16. Guthrie N, Gapor A, Chambers AF, Carroll KK. Inhibition of proliferation of estrogen receptor-negative MDA-MB-435 and -positive MCF-7 human breast cancer cells by palm oil tocotrienols and tamoxifen, alone and in combination. J Nutr 1997;127:544S-8S.
17. Bracke ME, Depypere HT, Boterberg T, et al. Influence of tangeretin on tamoxifen's therapeutic benefit in mammary cancer. J Natl Cancer Inst 1999;91:354-9.
Last Review: 05-01-2013
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