Dietary supplement use in cancer care: help or harm.
Conventional wisdom generally recommends complete avoidance of all dietary supplements, especially during chemotherapy and radiation. This interdiction persists, in spite of high rates of dietary supplement use by patients throughout all phases of cancer care, and can result in patients' perceptions of physicians as negative, thus leading to widespread nondisclosure of use. A review of the clinical literature shows that some evidence for harm does exist; however, data also exist that show benefit from using certain well-qualified supplements. Physicians should increase their knowledge base about dietary supplement use in cancer and consider all of the data when advising patients. Strategies that are patient-centered and reflect the complete array of available evidence lead to more nuanced messages about dietary supplement use in cancer. This should encourage greater disclosure of use by patients and ultimately increase safety and efficacy for patients choosing to use dietary supplements during cancer care.
Hardy
Mary L
ML
Simms/Mann-UCLA Center for Integrative Oncology, University of California at Los Angeles, 200 UCLA Medical Plaza, Suite 502 Los Angeles, CA 90095-9615, USA. mhardy@mednet.ucla.edu
D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use; D002100:Cachexia / Q000628:therapy; D000529:Complementary Therapies; D019587:Dietary Supplements / Q000009:adverse effects / Q000706:statistics & numerical data; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000628:therapy; D041743:Herb-Drug Interactions; D019584:Hot Flashes / Q000628:therapy; D006801:Humans; D008209:Lymphedema / Q000628:therapy; D009369:Neoplasms / Q000178:diet therapy / Q000188:drug therapy / Q000517:prevention & control / Q000532:radiotherapy / Q000628:therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy; D008517:Phytotherapy; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use; D011832:Radiation Injuries / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012306:Risk; D013280:Stomatitis / Q000628:therapy
D000975:Antioxidants; D028321:Plant Preparations