Frequently Asked Questions

My oncologist recently told me not to take any extra vitamin E (besides what is in my multi). He cited recent studies - including the now-famous Johns Hopkins study - and said it causes "excess death".

I had heard recently that large doses of E are contraindicated for breast cancer patients but I don’t know the source of this information. Have you heard anything new about women with breast cancer taking vitamin E supplements either during or after treatments are complete to reduce risk of recurrence?

Thanks for visiting my web site. The Johns Hopkins study probably has value for direct comparison only if you are over age 60 and already have heart disease (their study population). I don’t think those results are particularly useful for people without pre-existing heart disease.

Regarding cancer survivors, particularly breast cancer, the following
article (which is only an observational study, not an intervention
study, so subject to many biases) offers some clue that antioxidant
supplementation for extended periods of time after treatment offer
some modest protection against recurrence.

Nutr Cancer. 2003;46(1):15-22.
Antioxidant supplements and risk of breast cancer recurrence and
breast cancer-related mortality among postmenopausal women.
Fleischauer AT, Simonsen N, Arab L.

However, much is not known regarding how helpful or harmful
supplements may be, which ones for which cancer, which stage, which
treatment, how much, what form, what combinations, when to begin, etc.

Here are two research studies showing the complexity of making helpful recommendations:

(1) As one example of how outcomes may differ by cancer type, another
observational study has shown modest benefit to breast cancer
survivors but harm to those with ALL (a type of leukemia) who
supplemented with antioxidants prior to a stem cell transplant.

J Am Diet Assoc. 2003 Aug;103(8):982-9.
The association between vitamin C and vitamin E supplement use before hematopoietic stem cell transplant and outcomes to two years.
Bruemmer B, Patterson RE, Cheney C, Aker SN, Witherspoon RP.

(2) Another recent study using rats showed that supplementing the rats that developed breast cancer with vitamin E during their chemotherapy treatment resulted in larger tumors than those rats that did not receive the additional vitamin E.

Nutr Cancer 2005;51(2):178-83.
Alpha-tocopherol suppresses mammary tumor sensitivity to anthracyclines in fish oil-fed rats.
Colas S, Germain E, Arab K, Maheo K, Goupille C, Bougnoux P.

All of these studies together demonstrate how little science is known underlying the appropriate recommendation in each person’s unique situation. My best advice is for each person to seek the professional expertise of a Registered Dietitian (RD) at your own cancer treatment facility in order to have all the recent research reviewed and assessed for both safety and effectiveness of the dietary supplements of interest in relation to your particular cancer, stage, treatments, and recovery goals.

Finally, I highly recommend visiting the web site of Suzanne Dixon, MPH, MS, RD. She is a highly regarded nutrition and cancer expert and covers some of these confusing situations and topics in depth on her web site www.cancernutritioninfo.com. A modest annual fee is required (well worth it!) but a free trial subscription is available.

posted 3/06

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Back to Main QandA Page Vitamins I have recently seen a lot of news articles about the relationship between vitamin D and cancer prevention. Should we all run out and get more Vitamin D supplements? posted 2/06 I am being treated for bladder cancer. I have heard that vitamins that might help me reduce my risk of recurrence. Do you know anything about this? posted 8/02 , updated 11/05 Do you have recommendations for herbs and vitamins that children should use to recover from a bone marrow transplant? posted 3/05 Can you provide a list of all chemotherapy drugs called alkylating agents that may potentially have interactions with antioxidant supplements during chemotherapy? posted 10/02 Should I consume antioxidants during my cancer therapy? posted 12/01, updated 10/02 Should I stop drinking green tea during chemotherapy to avoid consuming too many antioxidants? posted 7/05 I have recently heard that Vitamin A may be linked to osteoporosis. I see Vitamin A in nearly everything on food labels, even my soymilk. What is the connection and how much should I be consuming? posted 5/02, updated 2/03   Back to Main QandA Page Breast Cancer Is soy safe to consume for women with ER+ breast cancer? posted 4/01, updated 1/05 Is there any new information for breast cancer patients who have ER+ tumors regarding the safety of eating soy foods? posted 2/02 I am currently taking Tamoxifen. My daughter heard on TV that I should be eating soy to make it work more efficiently. Do you know of any studies verifying this information? posted 5/01, updated 1/05 I have read conflicting reports on the benefits vs. the dangers of Tamoxifen for breast cancer treatment. Have you found better nutritional alternatives? Should women with ER+ breast cancer avoid flaxseeds and flax oil that contain the phytoestrogens called lignans? Is weight gain common during breast cancer treatments? posted 8/00 What are some good breast cancer web sites? posted 4/04 Are there any foods I should avoid while taking Tamoxifen? posted 6/04 Does moderate alcohol consumption have a harmful effect on persons who have had breast cancer? posted 11/04 Should I be avoiding all caffeine to help fight my breast cancer? posted 11/04  Back to Main QandA Page Herbs and other Dietary Supplements Can herbs interact with any of the chemotherapy drugs? posted 4/01, updated 9/02 Is the herbal product Amrit® safe to take during chemotherapy? posted 9/02 Did you use Essiac tea? There seems to be so much confusing and conflicting information available about this. Can you steer me to some reliable information? posted 8/02, updated 1/05 Do you know anything about the recalls of the herbal products SPES™ and PC-SPES™, both made by BotanicLabs? posted 6/02 Which herbs might cause problems with blood clotting? updated 8/03, 1/04 Can you tell me if a product called Sun Soup is useful for patients with lung cancer? posted 1/03, 4/04, 1/05 What is your opinion on IP6? I've been hearing good things about its effect on cellular health. posted 2/04 Should I drink wheatgrass juice to help fight my cancer?posted 2/04   Back to Main QandA Page Nutritional Concerns during Cancer Treatment (related to side effects) Can you provide a list of all chemotherapy drugs called alkylating agents that may potentially have interactions with antioxidant supplements during chemotherapy? posted 10/02 Dear Diana, I am undergoing treatments for cancer and am not eating well. What should I do? posted 7/01 Can I drink your soy shake recipes if my oncologist or dietitian has recommended that I follow a neutropenic diet due to my low white blood cell counts? posted 5/00, updated 7/01, updated 11/02, updated 8/03 Should I consume antioxidants during my cancer therapy? posted 12/01, updated 10/02 Can herbs interact with any of the chemotherapy drugs? posted 4/01, updated 9/02 Are there any diet changes to help relieve bloating during abdominal radiation? posted 4/03 Do you have diet suggestions for someone who has diarrhea after radiation therapy for rectal cancer? posted 1/04, updated 4/04, 11/04, 1/05 Is it safe to drink green tea if I have a port for administration of my chemotherapy? posted 1/04 Can you tell me foods to eat to reduce the acid in my urine and pain in my bladder and ureters? posted 2/04, updated 5/05 How can I eat a diet as healthy as you suggest if I need to be hospitalized for more than a day or two? posted 3/04 My husband is having chemotherapy treatments and has lost his sense of taste after one treatment. Are there any foods I can prepare that will give him some relief? posted 9/04 Is there a good web site describing the nutrition related side effects from chemo drugs? posted 10/04 Should I stop drinking green tea during chemotherapy to avoid consuming too many antioxidants? posted 7/05 How can I use the diet recommendations on your web site and in your book to both increase my intake of cancer fighting foods for optimizing my cancer recovery and lose weight at the same time? posted 3/06 What tips do you have to stay on a healthy diet during the holiday season? posted 11/06

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These questions and answers are intended to be of a general informative nature. Please consult with the Registered Dietitian in your cancer center or your health care provider for nutritional advice that can be individualized to your specific medical condition.