Hartford Hospital

Search for

Cancer Treatment Support

En Español (Spanish Version)

Proposed Natural Treatments

Improving Survival and Quality of Life With Conventional TreatmentActive Hexose Correlated Compound (AHCC); Coriolus versicolor; Docosahexaenoic Acid; Eleutherococcus senticosus; Ginkgo biloba; Lycopene; Melatonin; Music Therapy; Mistletoe Extract, Injected; N-Acetylcysteine; Panax ginseng; Relaxation Therapies; Shark Cartilage; Shiitake; Social Support; Therapeutic Touch; Transcutaneous Electric Nerve Stimulation (TENS); Vitamin A; Vitamin C; Vitamin D

Reducing Side Effects of ChemotherapyAcetyl-L-carnitine; Acupuncture/Acupressure; Active Hexose Correlated Compound (AHCC); Aromatherapy; Beta-carotene; Chamomile Cream; Coenzyme Q10 (CoQ10); Colostrum; Creatine; Docosahexaenoic Acid; Ginger; Glutamine; Guarana; Hypnosis; Massage; Melatonin; Milk Thistle; N-Acetylcysteine; Probiotics; Relaxation Therapy; Sea Buckthorn; Traditional Chinese Herbal Medicine; Vitamin E; Yoga

Reducing Side Effects of Radiation TherapyAcupuncture; Aloe veraGel; Calendula Cream; Chamomile Cream; Multivitamin/Multimineral Supplements; Probiotics; Proteolytic Enzymes; Sea Buckthorn; Zinc

Treating Lymphedema Caused by Breast Cancer SurgeryCitrus Bioflavonoids; Oligomeric Proanthocyanidins (OPCs); Oxerutins; Traditional Chinese Herbal Medicine

Treating Weight Loss Caused by Cancer or Cancer TreatmentUndesired Weight Loss

Herbs and Supplements to Use Only With CautionAlfalfa; Androstenedione; Beta-carotene; Black Cohosh; Boron; Dong Quai; Estriol; Folate; Genistein; Hops; Licorice; Panax ginseng; Red Clover; Resveratrol; Soy; St. John’s Wort; Vitamin C; Vitamin E

Not only is cancer the second leading cause of death in the United States (after heart disease), its insidious nature gives it a special terror. Most diseases give warning in the form of escalating symptoms, while others strike so suddenly that there’s no time to brood on it. Cancer follows a different, stealthier path. A person who feels perfectly well may come back from the doctor’s office with a diagnosis of potentially fatal cancer and plenty of time to fear what comes next.

Conventional treatments for cancer also have frightening qualities to them: disfiguring surgery, arduous chemotherapy, and treatment with invisible radiation. In many cases, when cancer is found early enough, conventional treatment can lead to a permanent cure. But often the prognosis is given in statistics—a percentage chance of survival—or, worse, in months remaining to live.

No wonder, then, that people turn to alternative medicine. It would be wonderful if there were some powerful alternative approach that could rout cancer at its root. Unfortunately, the reality is that no alternative treatment offers a sure and simple route to recovery. Worse still, there are plenty of unscrupulous people who will take advantage of a cancer victim’s desperation. Even the most scrupulous providers of alternative cancer therapy mislead in one sense: they display a conviction and enthusiasm even though they do not know, in truth, whether their approach really works. It simply isn’t possible for a medical practitioner to fairly judge the effectiveness of a therapy from apparent clinical results. Only double-blind, placebo-controlled studies can do that. (For information on why this form of study is essential, see Why Does This Database Rely on Double-blind Studies?)

It is possible, of course, that some alternative therapies for cancer may truly work, even if they haven’t yet been proven. However, we may never know which ones are real and which ones offer only false promises. Proper studies require money and patience with the scientific process, and proponents of alternative cancer therapies may lack one or both of those. In addition, ethical considerations make it difficult to study an unproven therapy for a fatal disease, when therapies that provide a chance of cure are available. For this reason, most studies of alternative therapies for cancer have involved adding a natural treatment to a standard cancer regimen; alternatively, they enrolled individuals who have already failed to respond to existing methods. These latter circumstances could potentially hide the benefits of an effective natural therapy. If a treatment only worked in the absence of chemotherapy, for example (as some alternative cancer therapy proponents claim about their methods) or could only cure early cases of cancer, these ethical obstacles would prevent researchers from finding out.

This article discusses the relatively small amount of information that is known from a scientific perspective about alternative treatments for cancer. We also discuss natural options that may reduce side effects of standard cancer therapies, as well as possible interactions between herbs and supplements and drugs.

Proposed Natural Treatments for Cancer

Various natural supplements have shown some promise for improving the effectiveness of conventional cancer therapy (specifically, surgery, chemotherapy, and radiation ) or reducing its side effects. In most cases, however, the supporting evidence remains weak, and the most rigorous studies have often failed to find benefit.

Note: If you are receiving cancer treatment, do not use any herbs or supplements except under the supervision of your physician.

For information on treatments to prevent cancer, see the Cancer Prevention article.

Improving Survival and Quality of Life With Conventional Cancer Treatment

Numerous natural therapies have been proposed for enhancing the cancer-fighting effects of standard therapies. However, as noted above, most of the supporting research falls short of the necessary standard for proof: a double-blind, placebo-controlled study.

Based on the belief that sharks don't get cancer, shark cartilage has been heavily marketed as a cure for cancer. While this is a myth (sharks do get cancer), shark cartilage has, in fact, shown some promise. Shark cartilage tends to inhibit the growth of new blood vessels, a process called angiogenesis. Since cancerous tumors must build new blood vessels to feed themselves, this effect might be beneficial.

Shark cartilage also inhibits substances called matrix metalloproteases (MMPs).1 These little understood enzymes affect the extracellular matrix, the framework of substances that lie between cells in the body. MMPs are thought to play a role in diseases of the cornea, gums, skin, blood vessels, and joints, as well as in cancer and illnesses that involve excessive fibrous tissue.

A number of test tube experiments have found that shark cartilage extracts prevent new blood vessels from forming in chick embryos and other test systems.2-7 These findings have led to other test tube experiments, animal studies, and preliminary human trials to investigate the possible anticancer effects of shark cartilage. The results appeared to suggest that a particular liquid shark cartilage extract might be useful in the treatment of various cancers, including lung, prostate, and breast cancer.8-15 However, the two most recent and best designed of these studies have failed to find benefit.124,148

Cancer treatment puts tremendous stress, both physical and emotional, on those that undergo it. Several studies have examined the potential benefits of social support for women with breast cancer. According to most, but not all studies, such support improves survival and/or enhances quality of life.16-18,104 In one famous study of women with advanced breast cancer, participants who attended a support group twice weekly doubled their survival time as compared to study participants who did not attend the group.18

It is also commonly said that certain psychological coping styles (for example, fighting spirit versus helpless acceptance) can lead to longer life in people with cancer. However, a review of the evidence found that in fact there is little to no evidence that psychological attitude makes much of a difference.105 People with cancer should not feel pressured into adopting particular coping styles to improve survival or reduce the risk of recurrence, the study's authors concluded.

One study evaluated guided imagery and relaxation therapy following surgery for colon cancer.125 The results indicated no more than a short-term, mood-elevating benefit; those receiving the treatment did not recover more quickly. Another study followed 32 women who had undergone breast cancer.188 The women were randomized to receive just physical therapy or physical therapy plus a yoga program (called Yoga in Daily Life). At the end of the 3-week trial, the women in the yoga program reported less psychological distress.

In another small trial, 31 women who were still experiencing fatigue 6 months after breast cancer treatment were randomized to yoga intervention or health education.196 On average, those in the yoga group reported feeling less fatigue.

Mindfulness-based stress reduction is a technique that trains patients to become more aware of how their thoughts, feelings, and actions combine to influence their level of stress. As a result of this awareness, patients are equipped to take positive steps to reduce their stress and better cope with any challenge they may face, including a life-threatening illness. In one study, 229 women with cancer were randomized to either mindfulness training or a waitlist for 8 weeks.197 The women who participated in the training experienced an improvement in their quality of life and general well being. It is important to keep in mind that, without a control group, it is not possible to know whether the mindfulness training itself led to these favorable outcomes. A smaller study found similar results.195

A 2012 review of the literature found further evidence to support the use of mindfulness-based stress reduction in people with cancer.199 The review, which included 19 studies involving 1,118 patients, focused on techniques like yoga, relaxation exercises, and mindfulness meditation. The researchers reported that these interventions resulted in improved mood and quality life. Unfortunately, the reliability of these results is limited due to the lack of having a proper control group.

Another study on relaxation therapy involved 126 hospitalized patients with cancer pain. Researchers found that the patients who listened to relaxing music for 30 minutes and received pain medication had more relief than the group who only received the medication.183 A systematic review of 30 trials and 1,891 cancer patients also supports the use of music therapy during cancer treatment.187 Based on rating scales, music interventions (eg, participating in music therapy or listening to prerecorded music) resulted in less anxiety, improved mood, and better quality of life. The patients also had small reductions in their blood pressure, heart rate, and respiratory rate. But, because of bias in these trials, the authors recommend that more studies be done to confirm the findings.

Massage therapy has been studied for its benefits in managing the symptoms associated with cancer and its treatment. In a randomized study investigating the effects of massage on 348 advanced cancer patients suffering from moderate to severe pain, the researchers found that, compared to simple touch, massage was significantly more effective at reducing pain and improving mood immediately following treatment, but the effect was not sustained.192 The authors of a review of 10 massage therapy studies were unable to draw firm conclusions about its benefits for a wide range of symptoms in patient undergoing treatment for cancer.191 A subsequent trial, however, offers tentative evidence that massage therapy may be helpful for people who have bone pain from cancer that has spread. Seventy-two people were randomized to receive massage therapy or simply attention from a therapist for about 40-45 minutes for 3 days in a row.190 Those in the massage group reported less pain.

Cancer treatment is one of the more controversial proposed uses of vitamin C. An early study tested vitamin C in 1,100 terminally ill cancer patients. One hundred patients received 10,000 mg daily of vitamin C, while the other 1,000 patients (the control group) did not receive vitamin C. Those taking the vitamin C survived more than 4 times longer on average (210 days) than those in the control group (50 days).19 A large (1,826 subjects) follow-up study by the same researchers found a nearly doubled survival rate (343 days versus 180 days) in vitamin C-treated patients whose cancers were deemed "incurable," as compared to people not treated with vitamin C.20 Benefits were also seen in a similarly designed Japanese study.21

However, while these results seem promising—almost miraculous—they, in fact, show next to nothing because they lacked a placebo group. When proper double-blind, placebo-controlled studies were performed on vitamin C for cancer, they failed to find any benefit.22,23

Vitamin C proponents have criticized these trials on various grounds, but the fact remains that there is as yet no reliable positive evidence for vitamin C in cancer.

PC-SPES is a formulation of eight natural substances: seven are plants and one is a fungus. The name is derived from the common abbreviation for prostate cancer (PC) and the Latin word spes, meaning "hope."

After its commercial launch in 1996, PC-SPES received increasing interest from the general public and prostate cancer researchers. Preliminary evidence suggested that it has significant effects on prostate cancer cells, perhaps due in part to its estrogen-like action.

However, chemical analysis reported in 2002 showed that PC-SPES is not truly a purely herbal product; samples of the product dating back to 1996 have been found to contain a form of pharmaceutical estrogen, diethylstilbestrol (DES), as well as indomethacin (an anti-inflammatory medication in the ibuprofen family), and warfarin (a strong blood thinner).51 Samples subsequent to 1999 contain less DES; but they also have shown less effectiveness in treating prostate cancer.

There is little doubt that DES is active against prostate cancer, but it presents a variety of risks, including blood clots in the legs. The other two pharmaceutical contaminants might actually reduce the risk of blood clots (which may be why they were covertly added), but present various risks all on their own. For these reasons, we strongly recommend against using PC-SPES at all.

Literally hundreds of herbs and supplements have been shown in test tube studies to fight cancer cells. However, it is a long way from a test tube to a human body, and such findings are not at all meaningful.

In this subsection we discuss several natural supplements that have received at least preliminary study in humans. Keep in mind that none of the positive studies cited below reached the level of rigor required to truly show a treatment effective. (Most lacked a control group, for example.) In contrast, several properly designed studies failed to find benefit.

A double-blind study of 53 people undergoing cancer treatment found equivocal evidence that treatment with a special form of Panax ginseng (modified to contain higher levels of certain constituents) could improve general well-being of people with cancer.137 Another study investigating the effects of Panax ginseng on survival of patients being treated for lung cancer showed no additional benefit.161

One study provides indirect, but promising evidence that a mixture of the supplements coenzyme Q10 (100mg daily), riboflavin (10 mg daily) and niacin (50 mg daily) might help reduce the chance of breast cancer metastasis, or recurrence.140

According to most but not all of the highly preliminary trials reported to date, extracts of the fungus Coriolus versicolor may enhance the effectiveness of various forms of standard cancer therapy.96-101,106 Coriolus is thought to work by stimulating the immune system. The fungi products active hexose correlated compound (AHCC) and shiitake are also advocated for this purpose.152,153

The supplement docosahexaenoic acid (DHA), a constituent of fish oil, has shown promise for enhancing the effects of the cancer chemotherapy drug doxorubicin.33

The herb ginkgo is thought to increase blood flow. An uncontrolled study evaluated combination therapy with ginkgo extract and the chemotherapy drug 5FU for the treatment of pancreatic cancer, on the theory that ginkgo might enhance blood flow to the tumor and thereby help 5FU penetrate better.35 The results were promising.

Scant preliminary evidence suggests that American ginseng may increase effectiveness of treatment for breast cancer 36 and that so-called Siberian ginseng (properly know as Eleutherococcus senticosus ) may be useful in the treatment of breast cancer 37 and other forms of cancer.38

A small unblinded study using a no-treatment control group found indications that use of a standardized tomato extract containing the supplement lycopene might slow the growth of prostate cancer.34 In a small double-blind, placebo-controlled study, a combination of soy, isoflavones, lycopene, silymarin (from milk thistle), and antioxidants showed some potential benefit for preventing recurrence of prostate cancer after prostate cancer surgery.126 Another enrolled men with rising PSA levels (a symptom of worsening cancer) and found that use of lycopene helped stabilize these levels.157 Unfortunately, because this study failed to include a placebo control group, its results fail to indicate that lycopene lowers PSA levels and therefore, by inference, slows prostate cancer. However, researchers did compare lycopene alone against lycopene plus isoflavones, and, interestingly, the combined treatment seemed to be less effective, as if the isoflavones somehow antagonized the effects of lycopene.

Preliminary studies, including unblinded controlled trials, suggest that the hormone melatonin may enhance the effectiveness of standard therapy for breast cancer, prostate cancer, brain glioblastomas, non-small-cell lung cancer, and other forms of cancer.24-29 However, no double-blind studies have been reported. Melatonin may also help decrease cancer chemotherapy side effects ( see below).30-32,107,127

Mistletoe extract (Iscador) taken by injection has been evaluated as a cancer treatment in a number of studies, including double-blind, placebo-controlled trials.39-46,108, 143,149,163,166 In general, though, these studies failed to attain adequate levels of scientific rigor or clinical relevance. The best studies found benefit; more rigorous studies found no improvement in survival time, survival rate, or quality of life. A review of 41 studies found mistletoe use was associated with improved survival in cancer patients. But, an analysis of these studies limited to randomized trials showed no effect.175

Note: The safety of mistletoe is not established, and one report suggests that it can damage the liver.47

An uncontrolled study found that use of a special spleen extract (spleen peptide preparation) somewhat reduced side effects of chemotherapy for head and neck cancer.102

In a double-blind, placebo-controlled trial, neither vitamin A nor N-acetylcysteine proved helpful for enhancing survival in head and neck cancer or lung cancer.49

Vitamin D may decrease bone pain and increase muscle strength in men with prostate cancer.48

Traditional Chinese medicine has been evaluated in a number of studies in patients being treated for cancer. In one study, acupuncture has shown a bit of promise for reducing the sense of fatigue that commonly occurs in cancer.159 Acupuncture has also been studied as a treatment for cancer-related pain. Researchers reviewed 3 small, randomized trials involving 204 people with cancer-related pain.184 The authors concluded that there wasn't enough evidence to say that acupuncture is helpful in relieving this type of pain. More high-quality studies are needed.

Similarly, medical Qigong (two 90-minute sessions weekly) was associated with improved quality of life, fatigue and mood disturbance in another study.182 A review of 15 mostly poor quality trials involving 862 patients receiving chemotherapy for non-small cell lung cancer, suggested that Chinese herbal medicine might improve quality of life.181 But, a 2010 review of 7 studies found insufficient evidence to conclude whether or not Tai Chi improves quality of life or psychological or physical outcomes in patients with breast cancer.180

Therapeutic Touch (TT) is a type of treatment that involves the "energy field" that purported surrounds and infuses the body. A TT practitioner is said to heal or otherwise correct a patient's discomposed energy field, which is thought to treat illness and lead to overall wellness. A study involving 76 breast cancer survivors found no difference between real TT and sham touch (without healing intent) in reducing cancer-related fatigue.194 However, both were more effective than no touch at all.

One study tested whether a diet very high in vegetables, fruit, and fiber, and low in fat could enhance survival or reduce recurrence rates in women diagnosed with breast cancer; unfortunately, no benefits were seen.150

Transcutaneous electrical nerve stimulation (TENS) is a therapeutic technique in which small voltages of electricity are transmitted across the skin via electrodes placed at specific points on the body's surface. In a review of 3 randomized trials involving 88 people, researchers did not find evidence to support the use of TENS as a treatment for cancer pain.198

Reducing Side Effects of Chemotherapy

Various herbs and supplements have shown promise for reducing the side effects of chemotherapy.

Many chemotherapy drugs work by interfering with rapidly dividing cells. Unfortunately, cancer cells aren’t the only cells that divide rapidly. The intestinal tract constantly rebuilds its lining, and chemotherapy may interfere with that process. The result: gastrointestinal side effects, such as mouth sores, nausea, loss of appetite, and diarrhea.

Several herbs and supplements have shown promise for alleviating these conditions, although none have been definitively proven effective.

A well-designed double-blind, placebo-controlled trial of 70 participants undergoing cancer chemotherapy with the drug 5-FU evaluated the potential benefits of the supplement glutamine for reducing chemotherapy-induced diarrhea.52 The results suggest that use of glutamine at a dose of 18 g daily may reduce intestinal damage and diminish symptoms of diarrhea. These promising findings indicate a need for larger trials to accurately determine the extent of benefit.

A double-blind, placebo-controlled study of 150 people undergoing chemotherapy with 5-FU found some evidence that a probiotic (friendly bacteria) called Lactobacillus rhamnosus can reduce the diarrhea that is a common complication of this treatment.156 Another, more unusual probiotic, a special, nonpathogenic form of E. coli, has also shown promise.53

Highly preliminary evidence hints that the supplement active hexose correlated compound (AHCC)151 and colostrum 59 have might help reduce chemotherapy-induced gastrointestinal side effects.59

In one study, use of the supplement creatine failed to help maintain muscle mass in people undergoing chemotherapy for colon cancer.128

In an uncontrolled study, use of the herb chamomile mouthwash appeared to help prevent mouth sores in people undergoing various forms of chemotherapy.54 However, uncontrolled studies prove nothing. A rigorous double-blind, placebo-controlled trial of 164 people did not find chamomile mouthwash effective for treating the mouth sores caused by the chemotherapy drug 5-FU.55

Beta-carotene and vitamin E have also shown some promise for preventing mouth sores (caused by various forms of cancer treatment) in preliminary studies, but rigorous studies of adequate size have not been reported.56,57

A very preliminary trial hints that ginger may reduce nausea caused by the chemotherapy drug 8-MOP.58 However, another study failed to find ginger helpful for nausea in people using the drug cisplatin.109 And a in a third trial, ginger did not add to the effectiveness of standard medications to treat chemotherapy-induced nausea and vomiting.174

Massage has shown some benefit for reducing nausea caused by chemotherapy.142 Psychological methods such as hypnosis and relaxation therapy have also shown promise for nausea.60-69,155

One study found that use of aromatherapy massage (combined massage therapy and use of fragrant essential oils) reduced symptoms of anxiety and/or depression in people undergoing treatment for cancer; at least for the short-term.141 However, the authors of a review of 10 massage therapy studies were unable to draw firm conclusions about its benefits for a wide range of symptoms in patient undergoing treatment for cancer.170

Studies of acupressure or acupuncture for reducing nausea in people undergoing chemotherapy have reached contradictory results, though on balance, there may be some benefit.110-115,129,146,156,164,172

A double-blind study performed in Hong Kong evaluated the potential benefits in cancer chemotherapy of personalized herbal formulas designed according to the principles of Traditional Chinese Herbal Medicine.139 In this study, 120 people undergoing chemotherapy for early-stage breast or colon cancer were given either a personalized formula or placebo. Researchers evaluated numerous possible effects of the treatment, but found benefits in only one: reduction of nausea. Note that even this single result is less meaningful than it may seem; it is statistically questionable to use a multiplicity of outcome measures.

In highly preliminary trials, the supplement N-acetylcysteine has shown promise for reducing various side effects of the drug ifosfamide.70-74

An animal study suggests that a constituent of fish oil called docosahexaenoic acid (DHA) might decrease side effects caused by the drug irenotecan.75

The hormone melatonin has shown some promise for reducing the side effects of various chemotherapy drugs.76,77,116

In preliminary studies, various antioxidants have shown promise for preventing heart damage and other side effects of the drug doxorubicin. See the Doxorubicin article for details.

One animal study hints that the herb milk thistle might protect against kidney damage caused by the drug cisplatin.82 In addition, there is some evidence that acetyl-L-carnitine, glutamine, and vitamin E supplementation might each reduce peripheral neuropathy symptoms in patients (painful damage to nerves outside the spinal column) receiving cisplatin or paclitaxel.130,169,179

Sea buckthorn berry has been advocated for reducing side effects of chemotherapy, but the evidence that it works is far too preliminary to be relied upon at all.

A review of 33 studies supports the view that antioxidants in general (with the exception of vitamin A) may reduce the toxic effects of chemotherapy. However, due to inconsistencies among these studies, it is unclear which antioxidants are best for this purpose.168

The herb guarana may help to improve fatigue in breast cancer patients undergoing chemotherapy.193

In a small randomized trial of 43 breast cancer patients, 6 weeks of acupuncture twice weekly reduced joint pain attributed to aromatase-inhibitor therapy.177

The Homeopathy Database also has information about this topic.

Reducing Side Effects of Radiation Therapy

Although the symptoms are generally less intense than with chemotherapy, radiation therapy can also cause problems, such as diarrhea, skin damage, and fatigue. Certain supplements and alternative therapies may offer benefit.

Two double-blind, placebo-controlled studies enrolling a total of almost 700 people undergoing radiation therapy found that use of probiotics significantly improved diarrhea.83, 145 However, of 85 women receiving pelvic radiation for cervical or uterine cancer, those who consumed a probiotic enriched yogurt had no less diarrhea than those who took a placebo drink.162

An unblinded controlled study of 75 people receiving radiation therapy for various forms of cancer found some evidence that soap enriched with Aloe vera gel can help protect the skin from radiation damage.84 However, researchers had to use questionable statistical methods to find evidence of benefit, making the results less than fully reliable. A double-blind, placebo-controlled study that evaluated the effects of aloe gel in 225 women undergoing radiation therapy for breast cancer failed to find benefit.85 Another study failed to find aloe vera beneficial for reducing side effects of radiation therapy for head and neck cancer.118

One study compared cream made from calendula flowers with the standard treatment trolamine for protecting the skin during radiation therapy and found calendula more effective.119 However, it is not known whether trolamine is beneficial, neutral, or harmful when used for this purpose, and for this reason it's not possible to draw firm conclusions from the study.

Cream made from chamomile has also been tried for protecting the skin from damage caused by radiation therapy, but the one controlled trial on the subject failed to find benefit.86

One study failed to find oligomeric proanthocyanidins (OPCs) from grape seed helpful for reducing the local side effects of radiation therapy for breast cancer.131

Radiation treatment in the vicinity of the mouth may cause alterations in taste sensation. In a small double-blind, placebo controlled trial, use of zinc supplements tended to counter this symptom.87 However, a larger follow-up study failed to find this benefit.147

One small study did find found that use of zinc could modestly decrease inflammation of the mucous membranes and skin caused by radiation therapy.138

Radiation treatment to the pelvic area can cause nausea, vomiting, and fatigue. A double-blind, placebo-controlled trial with 56 participants evaluated the potential effectiveness of proteolytic enzymes for reducing these symptoms.88 Unfortunately, no benefits were seen. Another study failed to find proteolytic enzymes helpful for reducing mouth sores or other symptoms that occur during radiation therapy of head/neck cancers.144

In a double-blind study of 40 people undergoing radiation therapy for breast cancer, use of a standard multivitamin preparation failed to reduce fatigue as compared to placebo.154 (In fact, people in the placebo group may have done somewhat better than those given the vitamin.)

A large study failed to find aromatherapy more helpful than placebo for reducing psychological distress among people undergoing radiation therapy for cancer.120 And a small randomized trial found that effleurage massage, a common massage technique, had no significant effect on anxiety, depression, or quality of life among 22 women undergoing radiation therapy for breast cancer.165

As with chemotherapy, sea buckthorn berry has been advocated for reducing side effects of radiation therapy, but again reliable evidence is lacking.

The use of antioxidants during radiation therapy is controversial. One study found that use of antioxidants decreased radiation therapy side effects, but may have decreased radiation therapy effectiveness as well.132

In a small trial, patients who wore acupressure bands for up to 7 days following radiation therapy reported less nausea than patients who received only usual care.176

A systematic review of 3 randomized trials involving 123 people with head and neck cancer found that real acupuncture was more effective than sham (fake) acupuncture in reducing the risk of dry mouth (xerostomia) due to radiation therapy.186 A subsequent study also supports the use of acupuncture in reducing dry mouth in such patients. But, unlike the previous trial, this one compared acupuncture to standard care (rather than to sham treatment).189

This topic is also discussed in the Homeopathy Database, in the radiation therapy support chapter.

Treating Side Effects Caused by Breast Cancer Surgery

Many women experience lymphedema (chronic arm swelling caused by damage to the lymph drainage system) following breast cancer surgery. Natural treatments for this condition include oxerutins, citrus bioflavonoids, and OPCs. For more information see the Surgery Support article.

Another small randomized trial of 70 patients found that acupuncture may decrease dry mouth and pain after removing lymph nodes in the neck for cancer treatment.178

Women who have had breast cancer surgery frequently experience annoying hot flashes. Estrogen treatment is not an option, as it might increase the risk of cancer recurrence.

In a 2-month, double-blind trial, 85 women who had undergone treatment for breast cancer received either the herb black cohosh or placebo.89 The results were not encouraging: black cohosh did not reduce overall hot-flash symptoms.

Four double-blind, placebo-controlled trials evaluated soy isoflavones as a treatment for hot flashes, but again failed to find benefit.90,91,121,133

A trial involving 72 breast cancer patients failed to find real acupuncture significantly more effective than sham acupuncture for treatment of hot flashes.160 And, a 2008 review of all existing studies on the subject concluded that the evidence does not support a beneficial effect for acupuncture in breast cancer patients suffering from hot flashes.173

In a small randomized trial, hypnosis appeared to reduce hot flashes as well as improve mood and sleep among 51 breast cancer survivors compared no hypnosis.171

After a mastectomy, some women develop wound complications. Ninety women who had undergone a mastectomy were randomized to receive 1 of 3 treatments: routine wound care, the Chinese herbSalvia miltiorrhiza (given intravenously for 3 days), or another Chinese herb called anisodamine (also given intravenously for 3 days).185 The women who received the herbal treatments had fewer wound complications compared to those in the routine wound care group. But, the women who took anisodamine had more adverse effects related to the treatment, like painful urination.

Treating Weight Loss Caused by Cancer or Cancer Treatment

Cancer can cause a condition called tumor-induced weight loss (TIWL), in which symptoms of starvation occur despite apparently adequate nutrition. The cause is thought to be a particular form of inflammation caused by the cancer. Cancer chemotherapy can also cause weight loss. For information on natural treatments that may be helpful, see the Undesired Weight Loss article.

Cancer Cures

Numerous herbs have been claimed effective for treatment of cancer, including:

However, there is no reliable evidence to indicate that they actually help, and one pokeroot, is actively toxic.

Various herbal combinations have also been promoted for the treatment of cancer, including the Hoxsey cancer cure, Essiac, and Jason Winter's cancer-cure tea. Again, however, there is no reliable evidence that they really work.

Similarly, various dietary approaches claimed to help treat cancer, such as macrobiotics and raw foods, lack meaningful supporting evidence.103

Herbs and Supplements to Use Only With Caution

Various herbs and supplements may interact adversely with drugs used to treat cancer. We strongly recommend that individuals under treatment for cancer do not use any herb or supplement except under physician’s supervision. A few important categories of potential interactions are described here. Follow the links to the indicated article for detailed information.

The herb St. John’s wort interacts with many medications, including various chemotherapy drugs.

The drug methotrexate causes the body to become deficient in folate. For this reason, people who take methotrexate for rheumatoid arthritis, juvenile rheumatoid arthritis, or psoriasis are sometimes advised to take folate supplements. Studies indicate that in those conditions, use of folate does not impair the action of the drug. However, no studies have as yet established that folate supplements are safe to take with methotrexate when it is used to treat cancer.

The citrus bioflavonoid tangeretin may interact with the breast cancer drug tamoxifen.

One highly preliminary study found that black cohosh might interfere with the action of the chemotherapy drug cisplatin.134

Heated disagreement exists regarding whether it is safe or appropriate to combine antioxidants (eg, vitamin E, vitamin C, and beta-carotene) with standard chemotherapy drugs. The reasoning behind the concern is that some chemotherapy drugs may work in part by creating free radicals that destroy cancer cells, and antioxidants might interfere with this beneficial effect.94

There is little reliable evidence, though, that antioxidants interfere with chemotherapy drugs. Additionally, there is growing evidence that antioxidants may not cause harm and, in certain cases, may offer benefits.95,104,122,135 However, the effects are likely to vary with the specific situation (for example, type and stage of cancer, and kind of treatment used), and there is far more research to be done.123 Therefore, we strongly recommend that you do not take antioxidants (or any other supplements) while undergoing cancer chemotherapy except on the advice of a physician.

A similar situation exists regarding radiation therapy. One study found that use of antioxidants decreased radiation therapy side effects, but may have decreased radiation therapy effectiveness as well.136 Another study found some evidence that people who both smoked cigarettes and used antioxidants while undergoing radiation therapy for head and neck cancer had increased risk of treatment failure as compared to smokers who did not use antioxidants.158

After reviewing much of the research on this controversial topic, one group of researchers published an article in the Journal of National Cancer Institute, in which they conclude that antioxidants should be discouraged during either chemotherapy or radiation therapy because of their potential to reduce the effectiveness of these treatments.167

Women who have had breast cancer are at high risk for a recurrence. As noted above, use of estrogen promotes the development of breast cancer, and for this reason it is off limits. However, certain natural products may present a similar risk. Numerous herbs and supplements have estrogen-like properties, including the following:

Contrary to popular belief, black cohosh is probably not estrogenic.

Other supplements, such as androstenedione and boron, may raise estrogen levels in the body. Finally, although the herbs dong quai and Panax ginseng do not appear to act in an estrogen-like manner, they may nonetheless stimulate growth of breast cancer cells.92 Women who have undergone breast cancer surgery should use these herbs and supplements only under the advice of a physician.

The weak estrogen, estriol, is sometimes advocated by alternative practitioners as a safer choice than standard estrogen. However, test tube studies suggest that estriol is just as likely to cause breast cancer as any other form of estrogen.93

References

Wojtowicz-Praga S. Clinical potential of matrix metalloprotease inhibitors. Drugs R D (New Zealand). 1999;1:117-129.

Dupont E, Savard PE, Jourdain C, et al. Antiangiogenic properties of a novel shark cartilage extract: potential role in the treatment of psoriasis. J Cutan Med Surg. 1998;2:146-152.

Sheu JR, Fu CC, Tsai ML, et al. Effect of U-995, a potent shark cartilage-derived angiogenesis inhibitor, on anti-angiogenesis and anti-tumor activities. Anticancer Res. 1998;18:4435-4441.

Davis PF, He Y, Furneaux RH, et al. Inhibition of angiogenesis by oral ingestion of powdered shark cartilage in a rat model. Microvasc Res. 1997;54:178-182.

Oikawa T, Ashino-Fuse H, Shimamura M, et al. A novel angiogenic inhibitor derived from Japanese shark cartilage (I). Extraction and estimation of inhibitory activities toward tumor and embryonic angiogenesis. Cancer Lett. 1990;51:181-186.

McGuire TR, Kazakoff PW, Hoie EB, et al. Antiproliferative activity of shark cartilage with and without tumor necrosis factor-alpha in human umbilical vein endothelium. Pharmacotherapy. 1996;16:237-244.

Lee A, Langer R. Shark cartilage contains inhibitors of tumor angiogenesis. Science. 1983;221:1185-1187.

Riviere M, Latreille J, Falardeau P, et al. AE-941 (Neovastat), an inhibitor of angiogenesis: phase I/II cancer clinical trial results. Cancer Invest. 1999;17(suppl 1):16-17.

Jamali M-A, Riviere M, Falardeau P, et al. Effect of AE-941 (Neovastat), an angiogenesis inhibitor, in the Lewis lung carcinoma metastatic model, efficacy, toxicity prevention, and survival. Clin Invest Med. 1998;(suppl):S16.

Riviere M, Falardeau P, Latreille J, et al. Phase I/II lung cancer clinical trial results with AE-941 (Neovastat), an inhibitor of angiogenesis. Clin Invest Med. 1998;(suppl):S14.

Riviere M, Alaoui-Jamali M, Falardeau P, et al. Neovastat: an inhibitor of angiogenesis with anti-cancer activity. Presented at: American Association for Cancer Research Annual Meeting 39; March 28-April 1, 1998; New Orleans, LA.

Blasecki J, Alaoui-Jamali M, Wang T, et al. Oral administration of Neovastat inhibits tumor progression in animal models of progressive tumor growth and metastasis. Int J Oncol. 1997;11(suppl):934.

Dupont E, Alaoui-Jamali M, Wang T, et al. Angiostatic and antitumoral activity of AE-941 (Neovastat), a molecular fraction derived from shark cartilage. Presented at: American Association for Cancer Research Annual Meeting 38; April 12-16, 1997; San Diego, CA.

Horsman MR, Alsner J, Overgaard J. The effect of shark cartilage extracts on the growth and metastatic spread of the SCCVII carcinoma. Acta Oncol. 1998;37:441-445.

Miller DR, Anderson GT, Stark JJ, et al. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol. 1998;16:3649-3655.

Gellert GA, Maxwell RM, Siegel BS. Survival of breast cancer patients receiving adjunctive psychosocial support therapy: a 10-year follow-up study. J Clin Oncol. 1993;11:66-69.

Mausell E, Brisson J, Deschênes L. Social support and survival among women with breast cancer. Cancer. 1995;76:631-637.

Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2:888-891.

Cameron E, Pauling L. Supplemental ascorbate in the supportive treatment of cancer: prolongation of survival times in terminal human cancer. Proc Natl Acad Sci USA. 1976;73:3685-3689.

Cameron E, Campbell A. Innovation vs. quality control: an "unpublishable" clinical trial of supplemental ascorbate in incurable cancer. Med Hypotheses. 1991;36:185-189.

Murata A, Morishige F, Yamaguchi H. Prolongation of survival times of terminal cancer patients by administration of large doses of ascorbate. Int J Vit Nutr Res Suppl. 1982;23:103-113.

Creagan ET, Moertel CG, O'Fallon JR, et al. Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer. A controlled trial. N Engl J Med. 1979;301:687-690.

Moertel CG, Fleming TR, Creagan ET, et al. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. A randomized double-blind comparison. N Engl J Med. 1985;312:137-141.

Lissoni P, Meregalli S, Nosetto L, et al. Increased survival time in brain glioblastomas by a radioneuroendocrine strategy with radiotherapy plus melatonin compared to radiotherapy alone. Oncology. 1996;53:43-46.

Lissoni P, Paolorossi F, Ardizzoia A, et al. A randomized study of chemotherapy with cisplatin plus etoposide versus chemoendocrine therapy with cisplatin, etoposide and the pineal hormone melatonin as a first-line treatment of advanced non-small cell lung cancer patients in a poor clinical state. J Pineal Res. 1997;23:15-19.

Neri B, de Leonardis V, Gemelli MT, et al. Melatonin as biological response modifier in cancer patients. Anticancer Res. 1998;18:1329-1332.

Cos S, Fernández R, Güézmes A, Sánchez-Barceló EJ. Influence of melatonin on invasive and metastatic properties of MCF-7 human breast cancer cells. Cancer Res. 1998;58:4383-4390.

Lissoni P, Barmo 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 progressing under tamoxifen alone. Br J Cancer. 1995;71:854-856.

Lissoni P, Cazzanga M, Tancini G, et al. Reversal of clinical resistance to LHRH analogue in metastatic prostate cancer by the pineal hormone melatonin: efficacy of LHRH analogue plus melatonin in patients progressing on LHRH analogue alone. Eur Urol. 1997;31:178-181.

Lockwood K, Moesgaard S, Hanioka T, Folkers K. Apparent partial remission of breast cancer in "high risk" patients supplemented with nutritional antioxidants, essential fatty acids and coenzyme Q 10. Molec Aspects Med Suppl. 1994;5:S231-S240.

Lockwood K, Moesgaard S, Folkers K. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q 10. Biochem Biophys Res Comm. 1994;199:1504-1508.

Lockwood K, Moesgaard S, Yamamoto T, Folkers K. Progress on therapy of breast cancer with vitamin Q 10 and the regression of metastases. Biochem Biophys Res Comm. 1995;212:172-177.

Rudra PK, Krokan HE. Cell-specific enhancement of doxorubicin toxicity in human tumour cells by docosahexaenoic acid. Anticancer Res. 2001;21:29-38.

Kucuk O, Sarkar FH, Sakr W, et al. Phase II randomized clinical trial of lycopene supplementation before radical prostatectomy. Cancer Epidemiol Biomarkers Prev. 2001;10:861-868.

Hauns B, Haring B, Kohler S, et al. Phase II study with 5-fluorouracil and Ginkgo biloba extract (GBE 761 ONC) in patients with pancreatic cancer. Arzneimittelforschung. 1999;49:1030-1034.

Duda RB, Zhong Y, Navas V, et al. American ginseng and breast cancer therapeutic agents synergistically inhibit MCF-7 breast cancer cell growth. J Surg Oncol. 1999;72:230-239.

Gvamichava AR, Khatiashvili TM, Khudzhadze RG, et al. First results of the use of Eleutherococcus in the combined treatment of breast carcinoma. Lek Sredestva Dal’nego Vostoka. 1966;7:231-235.

Kupin VI, Polevaia YeB, Sorokin AM. Stimulation of the immunological reactivity of cancer patients by Eleutherococcus extract. Vopr Onkol. 1986;32:21-26.

Kiene H, Buschel G, Hornebar M, et al. Mistletoe or not mistletoe is still the question. Forsch Komplementarmed Klass Naturheilkd. 2001;8:309-312.

Goebell PJ, Otto T, Suhr J, Rubben H. Evaluation of an unconventional treatment modality with mistletoe lectin to prevent recurrence of superficial bladder cancer: a randomized phase II trial. J Urol. 2002;168:72-75.

Kleijnen J, Knipschild P. Mistletoe treatment for cancer. Review of controlled trials in humans. Phytomedicine. 1994;1:255-260.

McNamee D. Mistletoe extract ineffective in melanoma. Lancet. 1999;354:1101.

Lenartz D, Dott U, Menzel J, Schierholz JM, Beuth J. Survival of glioma patients after complementary treatment with galactoside-specific lectin from mistletoe. Anticancer Res. 2000;20:2073-2076.

Stauder H, Kreuser ED. Mistletoe extracts standardised in terms of mistletoe lectins (ML I) in oncology: current state of clinical research. Onkologie. 2002;25:374-380.

Steuer-Vogt MK, Bonkowsky V, Ambrosch P, et al. The effect of an adjuvant mistletoe treatment programme in resected head and neck cancer patients: a randomised controlled clinical trial. Eur J Cancer. 2001;37:23-31.

Heiny BM. Adjuvant treatment with standardized mistletoe extract reduces leukopenia and improves the quality of life of patients with advanced carcinoma of the breast receiving palliative chemotherapy (VEC regimen). Krebsmedizin. 1991;12:3-14.

Harvey J, Colin-Jones DG. Mistletoe hepatitis. Br Med J (Clin Res Ed). 1981;282:186-187.

Van Veldhuizen PJ, Taylor SA, Williamson S, Drees BM. Treatment of vitamin D deficiency in patients with metastatic prostate cancer may improve bone pain and muscle strength. J Urol. 2000;163:187-190.

van Zandwijk N, Dalesio O, Pastorino U, et al. EUROSCAN, a randomized trial of vitamin A and N-acetylcysteine in patients with head and neck cancer or lung cancer. J Natl Cancer Inst. 2000;92:977-986.

Bruera E, Strasser F, Palmer JL, et al. Effect of fish oil on appetite and other symptoms in patients with advanced cancer and anorexia/cachexia: a double-blind, placebo-controlled study. J Clin Oncol. 2003;21:129-134.

Sovak M, Seligson AL, Konas M, et al. PC-SPES in prostate cancer: an herbal mixture currently containing warfarin and previously diethylstilbestrol and indomethacin. Presented at: 93rd Annual Meeting of the American Association for Cancer Research; April 6-10, 2002; San Francisco, CA.

Daniele B, Perrone F, Gallo C, et al. Oral glutamine in the prevention of fluorouracil induced intestinal toxicity: a double blind, placebo controlled, randomised trial. Gut. 2001;48:28-33.

Unger C, Haring B, Kruse A, et al. Double-blind randomised placebo-controlled phase III study of an E. coli extract plus 5-fluorouracil versus 5-fluorouracil in patients with advanced colorectal cancer. Arzneimittelforschung. 2001;51:332-338.

Carl W, Emrich LS. Management of oral mucositis during local radiation and systemic chemotherapy: A study of 98 patients. J Prosthet Dent. 1991;66:361-369.

Fidler P, Loprinzi CL, O'Fallon JR, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer. 1996;77:522-525.

Mills EED. The modifying effect of beta-carotene on radiation and chemotherapy induced oral mucositis. Brit J Cancer. 1988;57:416-417.

Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med. 1992;92:481-484.

Meyer K, Schwartz J, Crater D, et al. Zingiber officinale (ginger) used to prevent 8-Mop associated nausea. Dermatol Nurs. 1995;7:242-244.

Playford RJ, Macdonald CE, Johnson WS. Colostrum and milk-derived peptide growth factors for the treatment of gastrointestinal disorders. Am J Clin Nutr. 2000;72:5-14.

Zeltzer LK, Dolgin MJ, LeBaron S, et al. A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer. Pediatrics. 1991;88:34-42.

Syrjala KL, Cummings C, Donaldson GW. Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial. Pain. 1992;48:137-146.

Lyles JN, Burish TG, Krozely MG, et al. Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy. J Consult Clin Psychol. 1982;50:509-524.

Troesch LM, Rodehaver CB, Delaney EA, Yanes B. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Nurs Forum. 1993;20:1179-1185.

Syrjala KL, Donaldson GW, Davis MW, et al. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 1995;63:189-198.

Troesch LM, Rodehaver CB, Delaney EA, Yanes B. The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Nurs Forum. 1993;20:1179-1185.

Speca M, Carlson LE, Goodey E, et al. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 2000;62:613-622.

Zeltzer L, LeBaron S. Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. J Pediatr. 1982;101:1032-1035.

Walker LG, Walker MB, Ogston K, et al. Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy. Br J Cancer. 1999;80:262-268.

Baider L, Peretz T, Hadani PE, Koch U. Psychological intervention in cancer patients: a randomized study. Gen Hosp Psychiatry. 2001;23:272-277.

Holoya PY, Duelge J, Hansen RM,. Prophylaxis of ifosfamide toxicity with oral acetylcysteine. Sem Oncol. 1983;10(suppl 1):66-71.

Slavik M, Saiers JH. Phase I clinical study of acetylcysteine’s preventing ifosfamide-induced hematuria. Sem Oncol. 1983;10(suppl 1):62-65.

Loehrer PJ, Williams SD, Einhorn LH. N-Acetylcysteine and ifosfamide in the treatment of unresectable pancreatic adenocarcinoma and refractory testicular cancer. Sem Oncol. 1983;10(suppl 1):72-75.

Morgan LR, Donley PJ, Harrison EF. The control of ifosfamide induced hematuria with N-acetylcysteine. Proc Am Assoc Cancer Res. 1981;22:190.

De Blasio F, et al. N-acetyl cysteine (NAC) in preventing nausea and vomiting induced by chemotherapy in patients suffering from inoperable non small cell lung cancer (NSCLC). Chest. 1996;110(suppl 4):103S.

Hardman WE, Moyer MP, Cameron IL. Consumption of an omega-3 fatty acids product, INCELL AAFA, reduced side-effects of CPT-11 (irinotecan) in mice. Br J Cancer. 2002;86:983-989.

Lissoni P, Tancini G, Barni S, et al. Treatment of cancer chemotherapy-induced toxicity with the pineal hormone melatonin. Support Care Cancer. 1997;5:126-129.

Lissoni P, Barni S, Mandalà, et al. Decreased toxicity and increased efficacy of cancer chemotherapy using the pineal hormone melatonin in metastatic solid tumour patients with poor clinical status. Eur J Cancer. 1999;35:1688-1692.

Combs AB, Choe JY, Truong DH, et al. Reduction by coenzyme Q 10 of the acute toxicity of adriamycin in mice. Res Commun Chem Pathol Pharmacol. 1977;18:565-568.

Judy WV, Hall JH, Dugan W, et al. Coenzyme Q 10 reduction of Adriamycin cardiotoxicity. Biomed Clin Aspects Coenzyme Q. 1984;4:231-241.

Sugiyama S, Yamada K, Hayakawa M, et al. Approaches that mitigate doxorubicin-induced delayed adverse effects on mitochondrial functions in rat hearts; Liposome-encapsulated doxorubicin or combination therapy with antioxidant. Biochem Mol Biol Int. 1995;36:1001-1007.

Legha SS, Wang YM, Mackay B, et al. Clinical and pharmacologic investigation of the effects of alpha-tocopherol on Adriamycin cardiotoxicity. Ann NY Acad Sci. 1982;393:411-418.

Gaedeke J, Fels LM, Bokemeyer C, et al. Cisplatin nephrotoxicity and protection by silibinin. Nephrol Dial Transplant. 1996;11:55-62.

Urbancsek H, Kazar T, Mezes I, et al. Results of a double-blind, randomized study to evaluate the efficacy and safety of Antibiophilus in patients with radiation-induced diarrhoea. Eur J Gastroenterol Hepatol. 2001;13:391-396.

Olsen DL, Raub W Jr, Bradley C, et al. The effect of aloe vera gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapy. Oncol Nurs Forum. 2001;28:543-547.

Heggie S, Bryant GP, Tripcony L, et al. A phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue. Cancer Nurs. 2002;25:442-451.

Maiche AG, Grohn P, Maki-Hokkonen H. Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncol. 1991;30:395-396.

Ripamonti C, Zecca E, Brunelli C, et al. A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation. Cancer. 1998;82:1938-1945.

Martin T, Uhder K, Kurek R, et al. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial. Radiother Oncol. 2002;65:17-22.

Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol. 2001;19:2739-2745.

Van Patten CL, Olivotto IA, Chambers GK, et al. Effect of soy phytoestrogens on hot flashes in postmenopausal women with breast cancer: a randomized, controlled clinical trial. J Clin Oncol. 2002;20:1449-1455.

Quella SK, Loprinzi CL, Barton DL. Evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors: A North Central Cancer Treatment Group Trial. J Clin Oncol. 2000;18:1068-1074.

Amato P, Christophe S, Mellon P. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause. 2002;9:145-150.

Lippman M, Monaco ME, Bolan G. Effects of estrone, estradiol and estriol on hormone-responsive human breast cancer in long-term tissue culture. Cancer Res. 1977;37:1901-1907.

Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology. 1999;13:1003-1012.

Weijl NI, Cleton FJ, Osanto S. Free radicals and antioxidants in chemotherapy-induced toxicity. Cancer Treat Res. 1997;23:209-240.

Morimoto T, Ogawa M, Orita K, et al. Postoperative adjuvant randomised trial comparing chemo-endocrine therapy, chemotherapy and immunotherapy for patients with stage II breast cancer: 5-year results from the Nishinihon Cooperative Study Group of Adjuvant Chemo-endocrine Therapy for Breast Cancer (ACETBC) of Japan. Eur J Cancer. 1996;32A:235-242.

Nakazato H, Koike A, Saji S, et al. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Study Group of Immunochemotherapy with PSK for Gastric Cancer. Lancet. 1994;343:1122-1126.

Torisu M, Hayashi Y, Ishimitsu T, et al. Significant prolongation of disease-free period gained by oral polysaccharide K (PSK) administration after curative surgical operation of colorectal cancer. Cancer Immunol Immunother. 1990;31:261-268.

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. 5-year results from the Nishi-Nippon Group of the Adjuvant Chemoendocrine Therapy for Breast Cancer Organization. Cancer. 1992;70:2475-2483.

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;35:123-130.

Iino Y, Yokoe T, Maemura M, et al. Immunochemotherapies versus chemotherapy as adjuvant treatment after curative resection of operable breast cancer. Anticancer Res. 1995;15:2907-2912.

Borghardt J, Rosien B, Gortelmeyer R, et al. Effects of a spleen peptide preparation as supportive therapy in inoperable head and neck cancer patients. Arzneimittelforschung. 2000;50:178-184.

Weitzman S. Alternative nutritional cancer therapies. Int J Cancer Suppl. 1998;11:69-72. 104. Drisko JA, Chapman J, Hunter VJ. The use of antioxidant therapies during chemotherapy. Gynecol Oncol. 2003;88:434-439.

Bordeleau L, Szalai JP, Ennis M, et al. Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: overall effects of the intervention and an exploration of missing data. J Clin Oncol. 2003;21:1944-1951.

Petticrew M, Bell R, Hunter D. Influence of psychological coping on survival and recurrence in people with cancer: systematic review. BMJ. 2002;325:1066.

Tsang KW, Lam CL, Yan C, et al. Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer. Respir Med. 2003;97:618-624.

Reiter RJ, Tan DX, Sainz RM, et al. Melatonin: reducing the toxicity and increasing the efficacy of drugs. J Pharm Pharmacol. 2002;54:1299-321.

Ernst E, Schmidt K, Steuer-Vogt MK. Mistletoe for cancer? A systematic review of randomised clinical trials. Int J Cancer. 2003;107:262-267.

Manusirivithaya S, Sripramote M, Tangjitgamol S, et al. Antiemetic effect of ginger in gynecologic oncology patients receiving cisplatin. Int J Gynecol Cancer. 2004;14:1063-1069.

Shen J, Wenger N, Glaspy J, et al. Electroacupuncture for control of myeloablative chemotherapy-induced emesis: a randomized controlled trial. JAMA. 2000;284:2755-2761.

Dundee JW, Ghaly RG, Fitzpatrick KTJ, et al. Acupuncture prophylaxis of cancer chemotherapy-induced sickness. J R Soc Med. 1988;82:268-271.

Roscoe JA, Morrow GR, Hickok JT, et al. The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. J Pain Symptom Manage. 2003;26:731-42.

Treish I, Shord S, Valgus J, et al. Randomized double-blind study of the Reliefband as an adjunct to standard antiemetics in patients receiving moderately-high to highly emetogenic chemotherapy. Support Care Cancer. June 27, 2003. [Epub ahead of print]

Streitberger K, Friedrich-Rust M, Bardenheuer H, et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Clin Cancer Res. 2003;9:2538-2544.

Klein J, Griffiths P. Acupressure for nausea and vomiting in cancer patients receiving chemotherapy. Br J Community Nurs. 2004;9:383-388.

Reiter RJ, Tan DX, Sainz RM, et al. Melatonin: reducing the toxicity and increasing the efficacy of drugs. J Pharm Pharmacol. 2002;54:1299-321.

Roffe L, Schmidt K, Ernst E, et al. Efficacy of coenzyme Q 10 for improved tolerability of cancer treatments: a systematic review. J Clin Oncol. 2004;22:4418-24.

Su CK, Mehta V, Ravikumar L, et al. Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms. Int J Radiat Oncol Biol Phys. 2004;60:171-177.

Pommier P, Gomez F, Sunyach MP, et al. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol. 2004;22:1447-1453.

Graham PH, Browne L, Cox H, et al. Inhalation aromatherapy during radiotherapy: results of a placebo-controlled double-blind randomized trial. J Clin Oncol. 2003;21:2372-2376.

Nikander E, Kilkkinen A, Metsa-Heikkila M, et al. A randomized placebo-controlled crossover trial with phytoestrogens in treatment of menopause in breast cancer patients. Obstet Gynecol. 2003;101:1213-1220.

Weijl NI, Elsendoorn TJ, Lentjes EG, et al. Supplementation with antioxidant micronutrients and chemotherapy-induced toxicity in cancer patients treated with cisplatin-based chemotherapy: a randomised, double-blind, placebo-controlled study. Eur J Cancer. 2004;40:1713-1723.

Seifried HE, McDonald SS, Anderson DE, et al. The antioxidant conundrum in cancer. Cancer Res. 2003;63:4295-1298.

Loprinzi C, Levitt R, Barton DL, et al. Evaluation of shark cartilage in patients with advanced cancer. Cancer. 2005 May 23. [Epub]

Haase O, Schwenk W, Hermann C, et al. Guided Imagery and Relaxation in Conventional Colorectal Resections: A Randomized, Controlled, Partially Blinded Trial. Dis Colon Rectum. 2005 Jun 27. [Epub ahead of print]

Schroder FH, Roobol MJ, Boeve ER, et al. Randomized, double-blind, placebo-controlled crossover study in men with prostate cancer and rising PSA: effectiveness of a dietary supplement. Eur Urol. 2005 Oct 17. [Epub ahead of print]

Mills E, Wu P, Seely D, et al. Melatonin in the treatment of cancer: a systematic review of randomized controlled trials and meta-analysis. J Pineal Res. 2005;39:360-366.

Norman K, Stubler D, Baier P, et al. Effects of creatine supplementation on nutritional status, muscle function and quality of life in patients with colorectal cancer-A double blind randomised controlled trial. Clin Nutr. 2006 May 12. [Epub ahead of print]

Roscoe JA, Matteson SE, Morrow GR, et al. Acustimulation wrist bands are not effective for the control of chemotherapy-induced nausea in women with breast cancer. J Pain Symptom Manage. 2005;29:376-384.

Maestri A, De Pasquale Ceratti A, Cundari S, et al. A pilot study on the effect of acetyl-L-carnitine in paclitaxel- and cisplatin-induced peripheral neuropathy. Tumori. 2005;91:135-138.

Brooker S, Martin S, Pearson A, et al. Double-blind, placebo-controlled, randomised phase II trial of IH636 grape seed proanthocyanidin extract (GSPE) in patients with radiation-induced breast induration. Radiother Oncol. 2006 Mar 16. [Epub ahead of print]

Bairati I, Meyer F, Gelinas M, et al. A Randomized Trial of Antioxidant Vitamins to Prevent Acute Adverse Effects of Radiation Therapy in Head and Neck Cancer Patients. J Clin Oncol. 2005 Jul 18. [Epub ahead of print]

Macgregor CA, Canney PA, Patterson G, et al. A randomised double-blind controlled trial of oral soy supplements versus placebo for treatment of menopausal symptoms in patients with early breast cancer. Eur J Cancer. 2005;41:708-714.

Rockwell S, Liu Y, Higgins S. Alteration of the effects of cancer therapy agents on breast cancer cells by the herbal medicine black cohosh. Breast Cancer Res Treat. 2005;90:233-239.

Nicolson GL. Lipid replacement/antioxidant therapy as an adjunct supplement to reduce the adverse effects of cancer therapy and restore mitochondrial function. Pathol Oncol Res. 2005;11:139-144.

Bairati I, Meyer F, Gelinas M, et al. A randomized trial of antioxidant vitamins to prevent acute adverse effects of radiation therapy in head and neck cancer patients. J Clin Oncol. 2005 Jul 18. [Epub ahead of print]

Kim JH, Park CY, Lee SJ. Effects of sun ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot trial. J Clin Pharm Ther. 2006;31:331-334.

Lin LC, Que J, Lin LK, et al. Zinc supplementation to improve mucositis and dermatitis in patients after radiotherapy for head-and-neck cancers: a double-blind, randomized study. Int J Radiat Oncol Biol Phys. 2006;65:745-750.

Mok T, Yeo W, Johnson P, et al. A double-blind placebo-controlled randomized study of Chinese herbal medicine as complementary therapy for reduction of chemotherapy-induced toxicity. Ann Oncol. 2007 Jan 17. [Epub ahead of print]

Premkumar VG, Yuvaraj S, Vijayasarathy K, et al. Effect of coenzyme Q 10, riboflavin, and niacin on serum CEA and CA 15-3 levels in breast cancer patients undergoing tamoxifen therapy. Biol Pharm Bull. 2007;30:367-370.

Wilkinson SM, Love SB, Westcombe AM, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:532-539.

Billhult A, Bergbom I, Stener-Victorin E. Massage relieves nausea in women with breast cancer who are undergoing chemotherapy. J Altern Complement Med. 2007;13:53-58.

Schink M, Troger W, Dabidian A, et al. Mistletoe extract reduces the surgical suppression of natural killer cell activity in cancer patients: a randomized phase III trial. Forsch Komplementarmed. 2007;14:9-17.

Dorr W, Herrmann T. Efficacy of Wobe-Mugos® E for reduction of oral mucositis after radiotherapy: results of a prospective, randomized, placebo-controlled, triple-blind phase III multicenter study. Strahlenther Onkol. 2007;183:121-127.

Delia P, Sansotta G, Donato V, et al. Use of probiotics for prevention of radiation-induced diarrhea. World J Gastroenterol. 2007;13:912-5.

Molassiotis A, Helin AM, Dabbour R, et al. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complement Ther Med. 2007;15:3-12.

Halyard MY, Jatoi A, Sloan JA, et al. Does zinc sulfate prevent therapy-induced taste alterations in head and neck cancer patients? Results of phase III double-blind, placebo-controlled trial from the North Central Cancer Treatment Group (N01C4). Int J Radiat Oncol Biol Phys. 2007;67:1318-22.

Sussman L. Shark cartilage shows no benefit as a therapeutic agent for lung cancer. EurekAlert! website. Available at: http://www.eurekalert.org/pub_releases/2007-06...tm-scs060107.php. Accessed 6/19/07.

Grossarth-Maticek R, Ziegler R. Prospective controlled cohort studies on long-term therapy of cervical cancer patients with a mistletoe preparation (iscador®). Forsch Komplementarmed. 2007;14:140-147.

Pierce JP, Natarajan L, Caan BJ, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women's Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007;298:289-298.

Hirose A, Sato E, Fujii H, et al. The influence of active hexose correlated compound (AHCC) on cisplatin-evoked chemotherapeutic and side effects in tumor-bearing mice. Toxicol Appl Pharmacol. 2007 Apr 20. [Epub ahead of print]

Cowawintaweewat S, Manoromana S, Sriplung H, et al. Prognostic improvement of patients with advanced liver cancer after active hexose correlated compound (AHCC) treatment. Asian Pac J Allergy Immunol. 2006;24:33-45.

deVere White RW, Hackman RM, Soares SE, et al. Effects of a mushroom mycelium extract on the treatment of prostate cancer. Urology. 2002;60:640-644.

de Souza Fede AB, Bensi CG, Trufelli DC, et al. Multivitamins do not improve radiation therapy-related fatigue: results of a double-blind randomized crossover trial. Am J Clin Oncol. 2007;30:432-436.

Richardson J, Smith JE, McCall G, et al. Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence. Eur J Cancer Care (Engl). 2007;16:402-412.

Osterlund P, Ruotsalainen T, Korpela R, et al. Lactobacillus supplementation for diarrhea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer. 2007 Sep 25. [Epub ahead of print]

Vaishampayan U, Hussain M, Banerjee M, et al. Lycopene and soy isoflavones in the treatment of prostate cancer. Nutr Cancer. 2007;59:1-7.

Meyer F, Bairati I, Fortin A, et al. Interaction between antioxidant vitamin supplementation and cigarette smoking during radiation therapy in relation to long-term effects on recurrence and mortality: A randomized trial among head and neck cancer patients. Int J Cancer. 2007 Dec 4. [Epub ahead of print]

Molassiotis A, Sylt P, Diggins H. The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: A randomised controlled trial. Complement Ther Med. 2007;15:228-237.

Deng G, Vickers A, Yeung S, et al. Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol. 2007;25:5584-5590.

Lu P, Su W, Miao ZH, et al. Effect and mechanism of ginsenoside Rg3 on postoperative life span of patients with non-small cell lung cancer. Chin J Integr Med. 2008 Jan 25.

Giralt J, Regadera JP, Verges R, et al. Effects of probiotic Lactobacillus casei DN-114 001 in prevention of radiation-induced diarrhea: results from multicenter, randomized,placebo-controlled nutritional trial. Int J Radiat Oncol Biol Phys. 2008 Feb 1.

Horneber MA, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews. 2008;(2): CD003297.

Lee J, Dodd M, Dibble S, et al. Review of acupressure studies for chemotherapy-induced nausea and vomiting control. J Pain Symptom Manage. 2008 Apr 25.

Billhult A, Lindholm C, Gunnarsson R, et al. The effect of massage on cellular immunity, endocrine and psychological factors in women with breast cancer—a randomized controlled clinical trial. Auton Neurosci. 2008 May 10.

Grossarth-Maticek R, Ziegler R. Randomized and non-randomized prospective controlled cohort studies in matched pair design for the long-term therapy of corpus uteri cancer patients with a mistletoe preparation (Iscador). Eur J Med Res. 2008;13:107-120.

Lawenda BD, Kelly KM, Ladas EJ, et al. Should supplemental antioxidants administration be avoided during chemotherapy and radiation therapy? J Natl Cancer Inst. 2008 May 27.

Block KI, Koch AC, Mead MN, et al. Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomized controlled trials. Int J Cancer. 2008;123:1227-1239.

Amara S. Oral glutamine for the prevention of chemotherapy-induced peripheral neuropathy. Ann Pharmacother. 2008 Aug 12.

Wilkinson S, Barnes K, Storey L. Massage for symptom relief in patients with cancer: systematic review. J Adv Nurs. 2008;63:430-439.

Elkins G, Marcus J, Stearns V, et al. Randomized trial of a hypnosis intervention for treatment of hot flashes among breast cancer survivors. J Clin Oncol. 2008 Sep 22.

Gottschling S, Reindl TK, Meyer S, et al. Acupuncture to alleviate chemotherapy-induced nausea and vomiting in pediatric oncology—a randomized multicenter crossover pilot trial. Klin Padiatr. 2008;220:365-370.

Lee MS, Kim KH, Choi SM et al. Acupuncture for treating hot flashes in breast cancer patients: a systematic review. Breast Cancer Res Treat. 2008 Nov 4.

Zick SM, Ruffin MT, Lee J, et al. Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomiting. Support Care Cancer. 2008 Nov 13.

Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer. 2009;9:451.

Roscoe JA, Bushunow P, Jean-Pierre P, et al. Acupressure bands are effective in reducing radiation therapy-related nausea. J Pain Symptom Manage. 2009;38:381.

Crew KD, Capodice JL, Greenlee H, et al. Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. J Clin Oncol. 2010;28:1154.

Pfister DG, Cassileth BR, Deng GE, et al. Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol. 2010;28(15):2565.

Pace A, Giannarelli D, Galiè E, et al. Vitamin E neuroprotection for cisplatin neuropathy: a randomized, placebo-controlled trial. Neurology. 2010;74(9):762.

Lee MS, Choi TY, Ernst E. Tai chi for breast cancer patients: a systematic review. Breast Cancer Res Treat. 2010 ;120(2):309.

Chen S, Flower A, Ritchie A, et al. Oral Chinese herbal medicine (CHM) as an adjuvant treatment during chemotherapy for non-small cell lung cancer: A systematic review. Lung Cancer. 2010;68(2):137.

Oh B, Butow P, Mullan B, et al. Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol. 2010;21(3):608.

Huang ST, Good M, Zauszniewski JA. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud. 2010;47(11):1354-1362.

Paley C, Johnson M, Tashani O, Bagnall A. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2011;(1):CD007753.

Chen J, Lv Q, Yu M, Zhang X, Gou J. Randomized clinical trial of Chinese herbal medications to reduce wound complications after mastectomy for breast carcinoma. Br J Surg. 2010;97(12):1798-804.

O'Sullivan EM, Higginson IJ. Clinical effectiveness and safety of acupuncture in the treatment of irradiation-induced xerostomia in patients with head and neck cancer: a systematic review. Acupunct Med. 2010;28(4):191-199.

Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2011;(8):CD006911.

Kovačič T, Kovačič M. Impact of relaxation training according to Yoga In Daily Life system on perceived stress after breast cancer surgery. Integr Cancer Ther. 2011;10(1):16-26.

Meng Z, Garcia MK, Hu C, et al. Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Cancer. 2011 Nov 9.

Jane SW, Chen SL, Wilkie DJ, et al. Effects of massage on pain, mood status, relaxation, and sleep in Taiwanese patients with metastatic bone pain: a randomized clinical trial. Pain. 2011;152(10):2432-2442.

Wilkinson S, Barnes K, Storey L. Massage for symptom relief in patients with cancer: systematic review. J Adv Nurs. 2008;63:430-439.

Kutner JS, Smith MC, Corbin L, et al. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med. 2008;149:369-379.

de Oliveira Campos MP, Riechelmann R, Martins LC, Hassan BJ, Casa FB, Del Giglio A. Guarana (Paullinia cupana) improves fatigue in breast cancer patients undergoing systemic chemotherapy. J Altern Complement Med. 2011;17(6):505-512.

Jain S, Pavlik D, Distefan J, et al. Complementary medicine for fatigue and cortisol variability in breast cancer survivors: a randomized controlled trial. Cancer. 2012;118(3):777-787.

Lerman R, Jarski R, Rea H, Gellish R, Vicini F. Improving symptoms and quality of life of female cancer survivors: a randomized controlled study. Ann Surg Oncol. 2012;19(2):373-378.

Ganz PA, Irwin MR, Olmstead R, Greendale G, et al. Yoga for persistent fatigue in breast cancer survivors: A randomized controlled trial. Cancer. 2011 Dec 16. [Epub ahead of print]

Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012 Apr 20;30(12):1335-1342.

Hurlow A, Bennett MI, Robb KA, et al. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database Syst Rev. 2012;3:CD006276.

Musial F, Büssing A, Heusser P, Choi KE, Ostermann T. Mindfulness-based stress reduction for integrative cancer care: a summary of evidence. Forsch Komplementmed. 2011;18(4):192-202.

Last reviewed July 2012 by EBSCO CAM Review Board

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.