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Frequently Asked Questions


Can herbs interact with any of the chemotherapy drugs?

A small study of 5 patients at the Rotterdam Cancer Institute in the Netherlands has recently been published in which it was shown that concurrent administration of a typical dose of St. John's wort (300 mg three times per day) with the chemotherapy drug Camptosar decreased the blood levels of Camptosar's active metabolite by 42%. In addition, and even more worrisome, these decreased levels were still seen as long as 3 weeks after stopping the St. John's wort. (Effects of St. John's Wort on Irinotecan Metabolism. J Natl Cancer Inst. 2002 Aug 21;94(16):1247-9. Mathijssen RH, Verweij J, De Bruijn P, Loos WJ, Sparreboom A.)

St. John's wort increases the type of enzymes in our body that metabolize many drugs, thus lowering levels of these drugs in our bloodstream. The authors of this study state that more than 50% of current anti-cancer drugs are metabolized by the same enzymes that were affected by St. John's wort in their research. Some examples would be Tamoxifen, Cytoxan, Etoposide, Vincristine, and the taxanes like Taxol and Taxotere. Thus, taking St. John's wort during chemotherapy, and also before chemotherapy begins, can have the potential to lower the level of these chemotherapy drugs, possibly reducing their effectiveness to the point of treatment failure.

This is a perfect example why a discussion about the use of all complementary therapies, which includes all herbs and other dietary supplements, with your oncologist (and also your surgeon) is critical. Don't wait for him (her) to ask, and just as importantly, if he asks you, tell the truth about what you are using. As more and more research is done, problematic herb-drug interactions that decrease the levels and potential effectiveness of chemotherapy (or also drugs used during surgery) will be determined. Speaking up could initiate a conversation that could help save your life.

The Herb-Drug Interaction Handbook by Sharon Herr, RD, is an exceptionally thorough, up-to date source of herb-drug interactions. More information about the book and ordering information is available on the author's website. In addition, The Natural Health Encyclopedia, available to subscribers at ConsumerLab.com will also provide information on drug-herb interactions.

faq posted 4/01, revised 9/02


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Nutritional Concerns during Cancer Treatment (related to side effects)

Nutritional Concerns during  Cancer Treatment 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
Nutritional Concerns during  Cancer Treatment Dear Diana, I am undergoing treatments for cancer and am not eating well. What should I do? posted 7/01
Nutritional Concerns during Treatment 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
Nutritional Concerns during Treatment Should I consume antioxidants during my cancer therapy? posted 12/01, updated 10/02
Nutritional Concerns during  Treatment Can herbs interact with any of the chemotherapy drugs? posted 4/01, updated 9/02
Nutritional Concerns during  Treatment Are there any diet changes to help relieve bloating during abdominal radiation? posted 4/03
Nutritional Concerns during  Treatment 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
Nutritional Concerns during  Treatment Is it safe to drink green tea if I have a port for administration of my chemotherapy? posted 1/04
Nutritional Concerns during  Treatment 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
Nutritional Concerns during  Treatment 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
Nutritional Concerns during  Treatment 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
Nutritional Concerns during  Treatment Is there a good web site describing the nutrition related side effects from chemo drugs? posted 10/04
Nutritional Concerns during  Treatment Should I stop drinking green tea during chemotherapy to avoid consuming too many antioxidants? posted 7/05
Nutritional Concerns during  Treatment 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
Nutritional Concerns during  Treatment What tips do you have to stay on a healthy diet during the holiday season? posted 11/06


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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
Herbs Do you know anything about the recalls of the herbal products SPES™ and PC-SPES™, both made by BotanicLabs? posted 6/02
Herbs Which herbs might cause problems with blood clotting? updated 8/03, 1/04
Herbs Can you tell me if a product called Sun Soup is useful for patients with lung cancer? posted 1/03, 4/04, 1/05
Herbs What is your opinion on IP6? I've been hearing good things about its effect on cellular health. posted 2/04
Herbs Should I drink wheatgrass juice to help fight my cancer?posted 2/04



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.

Contact Information:
Phone/Fax: 734/996-9260

P.O. Box 130221, Ann Arbor, MI  48113

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