Immunoaugmentative therapy (IAT)

BACKGROUND

Although this therapy has not been proven to be effective, proponents believe it helps restore the body's natural immune defenses against cancer.

IAT includes three different components taken from human blood: tumor necrosis factor, tumor complement factor, and de-blocking protein factor.

Immune cells release a chemical messenger called tumor necrosis factor (TNF) into the blood when cancer cells are detected in the body. The TNF then binds to the cancerous cell, causing changes in the cell that ultimately kill it. It has been suggested that injections containing TNF may increase the body's ability to destroy cancerous cells.

Tumor complement factor (TCF) has been shown to stimulate the production of proteins that help destroy cancer cells. Therefore, it has been suggested that injections containing TCF may help increase the immune system's response to cancerous cells.

The third component in IAT is called de-blocking protein factor (DPF). It has been suggested that these proteins remove another protein, called blocking protein factor, from the blood. It has been suggested that the blocking protein factor prevents the immune system from detecting cancer allowing the cancer to grow in the body. Therefore, proponents of IAT believe that injections containing DPF may increase the body's ability to detect cancerous cells in the body. However, there is debate over whether or not DPF and blocking protein factor even exist. Scientific studies have not proven the existence of these proteins.

It is unclear whether or not IAT is an effective treatment for cancer patients. There is currently no scientific evidence that IAT can cure cancer or prolong the lives of cancer patients. Based on anecdotal reports, proponents support the use IAT as a long-term cancer treatment of daily injections. It is not promoted as a cure for cancer. Instead, it is suggested to work the same way insulin works for diabetics. Proponents believe that patients may live longer lives if they regularly receive IAT injections.

HISTORY

1950s: A zoologist named Lawrence Burton developed the theory of immunoaugmentative therapy (IAT) in the 1950s. Burton claimed that IAT caused cancer to go into remission in mice. However, the results of his studies were questioned and other scientists were unable to produce the same results.

1973: Burton established the Immunology Research Foundation in New York and began offering IAT to cancer patients in 1973.

1974: In 1974, Burton submitted an investigation new drug (IND) application to the U.S. Food and Drug Administration (FDA) in order to start human trials with IAT. However, he withdrew his application after the FDA asked for his experimental evidence.

1977: In 1977, Burton closed the New York clinic and opened the Immunology Researching Centre (IRC) in the Bahamas.

1978: In 1978,representatives of the Bahamian Ministry of Health and the Pan American Health Organization visited Burton's clinic and reviewed the medical charts of several patients. The health officials concluded that there was no evidence that IAT was a beneficial treatment for cancer patients. The clinic remained open even though the health officials recommended that it be shut down.

Late 1970s/early 1980s: During the late 1970s and early 1980s, officials from the National Cancer Institute (NCI) in the United States asked to evaluate the safety and effectiveness of IAT. However, an agreement could not be made between Burton and the NCI. Burton never explained his technique for isolating the blood proteins, which he had patented.

1985: In 1985, Bahamian health authorities closed Burton's clinic because several of his patients developed serious infections, including hepatitis B and HIV. Health officials suspected that the infections were the result of contaminated blood used during IAT. However, the clinic re-opened in less than one year.

1986: The FDA banned the import of IAT drugs in 1986 because the agency was concerned that the products were contaminated with infectious diseases, including hepatitis B and HIV.

The U.S. Congress Office of Technology Assessment (OTA) worked with Burton to develop procedures for a study of IAT in colon cancer patients. However, the research did not produce any reliable data on the effectiveness of IAT.

2003: In April 2003, the U.S. Agency for Healthcare Research and Quality (AHRQ) issued a report on IAT. Using criteria developed by the NCI, the agency evaluated nine cancer patients that were treated with IAT. The patients had different type of cancers, which included Hodgkin's lymphoma, non-small cell carcinoma of the lung, nodular lymphoma, peritoneal mesothelioma, ovarian adenocarcinoma, squamous cell carcinoma of the vocal cords, and adenocarcinoma of the colon. The agency could not come to a clear conclusion about the effectiveness of IAT. The agency recommended further studies.

2007: There is currently no evidence on the safety or effectiveness of IAT. Proponents of IAT claim that the therapy can reduce or stop the spread of many cancers. Proponents also believe that IAT may increase life expectancy and quality of life in cancer patients.

USES

Immunoaugmentative therapy (IAT) has been used to treat various types of cancer. Treatment is only available at IAT centers, which have been established in locations including the Bahamas, Germany, and Mexico. Patients can only receive immunoaugmentative therapy (IAT) if they have been diagnosed with cancer. Then, the patient is screened to determine whether or not IAT is appropriate for his/her specific condition. Healthcare providers will take into consideration the type and severity of the cancer, as well as the patient's overall health. IAT appears to be more effective in patients who have not received chemotherapy (a cancer treatment).

During therapy, patients may receive anywhere from one to 12 injections a day. In general, treatment generally lasts about 10-12 weeks. Patients typically return to the clinic for about two weeks, every four to six months. A healthcare provider measures the patient's response to treatment throughout IAT.

SAFETY

Patients should not use immunoaugmentative therapy (IAT) in place of other, more established medical treatments for cancer.

Proponents of IAT claim that it is safe and nontoxic. However, studied have not been performed to determine the safety of this therapy.

Some healthcare professionals are concerned that infectious diseases, such as HIV and hepatitis, may contaminate the unregulated compounds used during IAT that are derived from human blood. Although there were reports of patients who acquired infections after IAT in the 1980s, no similar reports have been made since.

There have been anecdotal reports of side effects, including fatigue, flu-like illness, pain at the injection site, generalized pain, and swelling caused by fluid accumulation.

INTEGRATIVE THERAPIES

Strong scientific evidence :

Vitamin A : Vitamin A is a fat-soluble vitamin that is derived from retinoids and carotenoids. Retinoids, such as retinal and retinoic acid, are found in animal sources (such as liver, kidney, eggs, and dairy products). Carotenoids, such as beta-carotene, are found in plants including dark or yellow vegetables and carrots. The prescription drug All-Trans-Retinoic Acid (ATRA, Vesanoid©) is a vitamin A derivative that is an established treatment for acute promyelocytic leukemia and improves median survival in this disease. Treatment should be under strict medical supervision. Vitamin A supplements should not be used simultaneously with ATRA due to a risk of increased toxicity. Patients receiving chemotherapy or radiation therapy for cancer should speak with their doctor(s) before taking antioxidants, such as vitamin A, because they may interfere with treatment. Vitamin A toxicity can occur if taken at high dosages and caution should be used with liver disease or alcoholism. Smokers who consume alcohol and beta-carotene may have an increased risk for lung cancer or heart disease. Vitamin A appears safe in pregnant women if taken at recommended doses. Use cautiously if breastfeeding because the benefits or dangers to nursing infants are not clearly established.

Good scientific evidence :

Probiotics : Probiotics are beneficial bacteria that are sometimes called friendly germs. Most probiotics come from food sources, especially cultured milk products. There is recent evidence that supplementation with Lactobacillus casei may help reduce the recurrence of colorectal tumors in patients who have previously undergone surgery for colon cancer. Long-term consumption of probiotics is considered safe and well tolerated. Diarrhea may be a sign of too many probiotics. Use cautiously if lactose intolerant.

Psychotherapy : Psychotherapy is an interactive process between a person and a qualified mental health professional (psychiatrist, psychologist, clinical social worker, licensed counselor, or other trained practitioner). There is good evidence that psychotherapy can enhance cancer patients' quality of life by reducing emotional distress and aiding in coping with the stresses and challenges of cancer. Therapy may be supportive-expressive therapy, cognitive therapy, or group therapy. Studies conflict on whether therapy improves self-esteem, death anxiety, self-satisfaction, etc. While some patients seek psychotherapy in hopes of extending survival, there is no conclusive evidence on the effects on medical prognosis.

Selenium : Selenium is a trace mineral found in soil, water, and some foods. Several studies suggest that selenium may help prevent prostate cancer. Avoid if allergic or sensitive to products containing selenium. Avoid with a history of non-melanoma skin cancer. Selenium is generally regarded as safe for pregnant or breastfeeding women. However, animal research reports that large doses of selenium may lead to birth defects.

Unclear or conflicting scientific evidence :

Acupuncture : Acupuncture, or the use of needles to manipulate the "chi" or body energy, originated in China over 5,000 years ago. There has been limited research on acupuncture for cancer pain and the research that was done had mixed results. More studies are needed to determine potential benefits. Evidence from several small studies supports the use of acupuncture at a specific point on the wrist that helps reduce the nausea and vomiting associated with chemotherapy.

Aloe : Transparent gel from the pulp of the meaty leaves of Aloe vera has been used topically for thousands of years to treat wounds, skin infections, burns, and numerous other dermatologic conditions. Dried latex from the inner lining of the leaf has traditionally been used as an oral laxative. Reports in the 1930s of topical aloe's beneficial effects on skin after radiation exposure lead to widespread use in skin products. Currently, aloe gel is sometimes recommended for cancer patients who experience radiation-induced dermatitis, although scientific evidence suggests a lack of benefit in this area. Further study is needed in this area to clarify if it is the aloe itself or other factors that may cause this benefit. Caution is advised when taking aloe supplements because numerous side effects, including a laxative effect, cramping, dehydration, and drug interactions, are possible. Aloe should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

American pawpaw : Evidence supporting the use of the American pawpaw (Asimina triloba) tree for the treatment of cancer in humans is largely anecdotal and subjective. However, use in humans has reported minimal side effects, and evidence from animal and in vitro studies suggest that American pawpaw extract does have some anticancer activity. Pawpaw standardized extract has been used for 18 months in patients with various forms of cancer. Well-designed studies on the long-term effects of pawpaw extracts have not been conducted. Pawpaw should not be used if the patient is pregnant or breastfeeding unless otherwise directed by a doctor.

Antineoplastons : Antineoplastons are a group of naturally occurring peptide fractions that were observed by Stanislaw Burzynski, MD, PhD in the late 1970s and they have been found to be absent in the urine of cancer patients. There is inconclusive scientific evidence regarding the safety and effectiveness of antineoplastons in the treatment of cancer. Several preliminary human studies (case series, phase I/II trials) have examined antineoplaston types A2, A5, A10, AS2-1, and AS2-5 for a variety of cancer types. Until better research is available, no clear conclusion can be drawn.

Arabinoxylan : Arabinoxylan is made by altering the outer shell of rice bran using enzymes from Hyphomycetes mycelia mushroom extract. Arabinoxylan has been found to improve immune reactions in cancer patients. Arabinoxylan products may contain high calcium and phosphorus levels, which may be harmful for patients with compromised renal (kidney) function. Caution is advised when taking arabinoxylan supplements, as numerous side effects, including drug interactions, are possible. Arabinoxylan should not be used if the patient is pregnant or breastfeeding unless otherwise directed by a doctor.

Aromatherapy : Healing with fragrant oils has been used for thousands of years. Aromatherapy is often used in people with chronic illnesses (frequently in combination with massage) with the intention of improving quality of life or well-being. However, there is not enough scientific evidence to determine whether or not aromatherapy improves a cancer's patient's quality of life. Essential oils should not be used internally.

Art therapy : Art therapy involves the application of a variety of art modalities, including drawing, painting, clay, and sculpture. Art therapy enables the expression of inner thoughts or feelings when verbalization is difficult or not possible. Limited evidence suggests that family caregivers of cancer patients may benefit from art therapy to help them cope with the stress of care giving. Possible benefits include reduced stress, lowered anxiety, increased positive emotions, and increased positive communication with cancer patients and healthcare professionals. Art therapy may also reduce pain and other symptoms in cancer patients. More studies are needed to determine how best to use this form of intervention with this population.

Astragalus : Astragalus (Astragalus membranaceus) has been used in Chinese medicine for centuries for its immune enhancing properties. Although early laboratory and animal studies report increased immune cell function and reduced cancer cell growth associated with the use of astragalus, there is no reliable human evidence in these areas. A recent study reports that astragalus-based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. Astragalus is also sometimes used with the intention to reduce side effects of cancer treatments, such as fatigue and weight loss. Due to a lack of well-designed research, a firm conclusion cannot be drawn. Caution is advised when taking astragalus supplements, as numerous adverse effects including drug interactions are possible. Astragalus should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Bee pollen : Bee pollen is considered a highly nutritious food because it contains a balance of vitamins, minerals, proteins, carbohydrates, fats, enzymes, and essential amino acids. Research has found that bee pollen may reduce some adverse effects of cancer treatment. Additional studies are needed before a firm recommendation can be made. Caution is advised when taking bee pollen supplements as allergic reactions may occur in sensitive individuals. Bee pollen should not be used if the patient is pregnant or breastfeeding unless otherwise directed by a doctor.

Bitter melon : Bitter melon (Momordica charantia) is used in the traditional Ayurvedic form of medicine from India to lower blood sugar levels. Research has also found that bitter melon extracts may be beneficial in cancer therapies. MAP30, a protein isolated from bitter melon extract, is reported to possess anti-cancer effects in laboratory studies. Potential anti-cancer effects have not been studied appropriately in humans. Caution is advised when taking bitter melon supplements, as numerous side effects, including blood sugar lowering and drug interactions, are possible. Bitter melon should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Black tea : Black tea (Camellia sinensis) is from the same plant as green tea, but processed differently. Also, black tea usually contains more caffeine than green tea. Several studies have explored a possible association between regular consumption of black tea and rates of cancer in populations. This research has yielded conflicting results with some studies suggesting benefits and others reporting no effects. Laboratory and animal studies report that components of tea, such as polyphenols, have antioxidant properties and effects against tumors. However, effects in humans remain unclear and these components may be more common in green tea rather than in black tea. Some animal and laboratory research suggests that components of black tea may actually be carcinogenic, or cancer causing, although effects in humans are not clear. Overall, the relationship of black tea consumption and human cancer remains undetermined.

Bromelain : Bromelain is a sulfur-containing proteolytic digestive enzyme that is extracted from the stem and the fruit of the pineapple plant (Ananas comosus). There is not enough information to recommend for or against the use of bromelain in the treatment of cancer either alone or in addition to other therapies. Caution is advised when taking bromelain supplements as numerous side effects, including blood-thinning and drug interactions, are possible. Bromelain should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Cat's claw : Originally found in Peru, the use of cat's claw (Uncaria tomentosa) has been said to date back to the Inca civilization, possibly as far back as 2,000 years. Cat's claw has anti-inflammatory properties and several low-quality studies suggest that cat's claw may slow tumor growth. However, this research is early and has not identified specific types of cancer that may benefit. A few studies suggest that cat's claw may also boost the immune system. Caution is advised when taking cat's claw supplements as numerous adverse effects, including blood thinning and drug interactions, are possible. Cat's claw should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Chelation therapy : Chelation therapy involves using a chemical called ethylenediaminetetraacetic acid (EDTA) to rid the body of heavy metals that may have accumulated from environmental exposure. Preliminary data from an exploratory study suggest concurrent administration of EDTA may have myeloprotective (muscle fiber protection) ability, which allows safe intraperitoneal administration of higher doses of radiation in the treatment of ovarian cancer. Randomized controlled trials are needed before definitive recommendations can be made. Note that EDTA chelation therapy is rejected by the conventional medical community, including the American Medical Association, American Hospital Association, National Institutes of Health, and U.S. Food and Drug Administration (FDA), as a beneficial treatment due to lack of scientific evidence. Side effects include low blood sugar, headache, low calcium levels, low blood pressure, and seizures. ETDA use may result in death.

Coenzyme Q10 : CoQ10 is produced by the human body and is necessary for the basic functioning of cells. Age and diseases, such as cancer, may cause decreases in this important cofactor. Although supplementation of CoQ10 has been reported to improve general health, it has not been proven to reduce cancer and it has not been compared to other forms of breast cancer treatment. Although its use is not clearly defined, CoQ10 levels are generally decreased in breast cancer patients. Therefore, further testing needs to be done.

Copper : Copper is a mineral that occurs naturally in many foods including vegetables, legumes, nuts, grains, and fruits as well as shellfish, avocado, and beef (organs such as liver). Preliminary research reports that lowering copper levels may arrest the progression of cancer by inhibiting blood vessel growth. Copper intake has not been identified as a risk factor for the development or progression of cancer. Copper is potentially unsafe when used orally in higher doses than the recommended daily allowance (RDA). Copper supplements should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

DHEA : DHEA (dehydroepiandrosterone) is a hormone produced by the adrenal glands. DHEA serves as precursor to male and female sex hormones (androgens and estrogens). Initial research reports that the use of intravaginal DHEA may be safe, promoting the regression of low-grade cervical lesions (damaged tissue). However, further study is necessary in this area before a firm conclusion can be drawn. Patients should not substitute the use of DHEA for more established therapies and should discuss management options and follow-up with a primary healthcare professional or gynecologist. Caution is advised when taking DHEA supplements due to side effects and possible drug interactions. DHEA should not be used in pregnancy or breastfeeding, unless otherwise directed by a doctor.

Echinacea : The evidence from a small number of randomized trials evaluating the efficacy of Echinacea in the treatment of radiation-induced leukopenia (decrease in white blood cells) is equivocal. Studies have used the combination product Esberitox©, which includes extracts of echinacea (Echinacea purpurea and pallida) root, white cedar(Thuja occidentalis) leaf, and wild indigo (Baptisia tinctoria) root. Caution is advised when taking Echinacea supplements, as numerous adverse effects including drug interactions are possible. Echinacea should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Essiac© : Essiac© contains a combination of herbs, including burdock root (Arctium lappa), sheep sorrel (Rumex acetosella), slippery elm inner bark (Ulmus fulva), and Turkish rhubarb (Rheum palmatum). There are no properly conducted published human studies of Essiac© for the treatment of cancer. A laboratory at Memorial Sloan-Kettering Cancer Center tested Essiac© on mice during the 1970s, although results were never formally published and remain controversial. Questions were raised of improper preparation of the formula. A human study was started in Canada in the late 1970s, but it was stopped early due to concerns about inconsistent preparation of the formula and inadequate study design. In the 1980s, the Canadian Department of National Health and Welfare collected information about 86 cancer patients treated with Essiac©. Results were inconclusive (17 patients had died at the time of the study, inadequate information was available for eight patients, "no benefits" were found in 47 patients, five reported reduced need for pain medications, and one noted subjective improvement). Most individuals also received other cancer treatments such as chemotherapy, making the effects of Essiac© impossible to isolate.

Currently, there is not enough evidence to recommend for or against the use of this herbal mixture as a therapy for any type of cancer. Different brands may contain variable ingredients, and the comparative effectiveness of these formulas is not known. None of the individual herbs used in Essiac© has been tested in rigorous human cancer trials (rhubarb has shown some anti-tumor properties in animal experiments; slippery elm inner bark has not; sheep sorrel and burdock have been used traditionally in cancer remedies). Numerous individual patient testimonials and reports from manufacturers are available on the Internet, although these cannot be considered scientifically viable as evidence. Individuals with cancer are advised not to delay treatment with more proven therapies.

Caution is advised when taking Essiac© because numerous side effects and interactions have been reported. Essiac© should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.

Focusing : Focusing (experiential therapy) is a method of psychotherapy that involves being aware of one's feelings surrounding a particular issue and understanding the meaning behind words or images conveyed by those feelings. Early evidence suggests that focusing may improve the mood and body attitude in cancer patients. Firm recommendations cannot be made until well-designed clinical trials are available.

Folic acid : Folic acid or folate is a water-soluble B vitamin needed for human health. Preliminary evidence surrounding the use of folate seems promising for decreasing the risk of breast, cervical, pancreatic, and gastrointestinal cancer. Currently, there is insufficient evidence available to recommend folate supplementation for any type of cancer prevention or treatment. Please follow the advice of a qualified healthcare provider in this area. Folic acid may mask the symptoms of pernicious, aplastic, or normocytic anemias caused by vitamin B12 deficiency and may lead to neurological damage.

Gamma linolenic acid (GLA) : GLA is an omega-6 essential fatty acid. Some laboratory and human studies indicate that GLA may have anti-tumor activity and may be used as an adjunct agent to a chemotherapy regimen. Although not studied directly for brain tumors, clinical trials have been conducted in the treatment of breast, colorectal, and liver cancer. Caution is advised when taking GLA supplements as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible. GLA should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.

Garlic : Preliminary human studies suggest that regular consumption of garlic (Allium sativum, particularly aged garlic) may reduce the risk of developing several types of cancer. Some studies use multi-ingredient products making it difficult to determine if garlic alone may play a beneficial role. Further well-designed human clinical trials are needed to conclude whether eating garlic or taking garlic supplements may prevent or treat cancer. Caution is advised when taking garlic supplements as numerous side effects, including an increased risk of bleeding and drug interactions, are possible. Avoid if pregnant or breastfeeding, unless otherwise directed by a doctor.

Ginseng : Several human studies suggest that Asian ginseng (Panax ginseng) may reduce the risk and progression of various organ cancers, especially if ginseng powder or extract is used. Results may have been affected by other lifestyle choices in people who use ginseng, such as exercise or dietary habits. Asian ginseng is also reported to help protect against radiation damage, increase immunity and well-being, and decrease fatigue. Additional trials are necessary before a clear conclusion can be reached. Caution is advised when taking ginseng supplements as numerous adverse effects, including an increased risk of drug interactions, are possible. Ginseng should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Healing touch : Preliminary data suggest that healing touch (HT) may be of benefit in cancer patients for inducing relaxation and improving quality of life. However, due to weaknesses in design and the small number of studies, data is insufficient to make definitive recommendations. Stronger study designs are needed.

Hoxsey formula : "Hoxsey formula" is a misleading name because it is not a single formula, but rather it is a therapeutic regimen consisting of an oral tonic and topical (on the skin) preparations. The tonic is individualized for cancer patients based on general condition, location of cancer, and previous history of treatment. An ingredient that usually remains constant for every patient is potassium iodide. Other ingredients are then added and may include licorice, red clover, burdock, stillingia root, berberis root, pokeroot, cascara, Aromatic USP 14, prickly ash bark, and buckthorn bark. A red paste may be used, which tends to be caustic (irritating), containing antimony trisulfide, zinc chloride, and bloodroot. A topical yellow powder may be used and contains arsenic sulfide, talc, sulfur, and a "yellow precipitate." A clear solution may also be administered and contains trichloroacetic acid. There are no well-designed human studies available evaluating the safety or effectiveness of Hoxsey formula. Caution is advised when taking the Hoxsey formula supplements as numerous adverse effects, including an increased risk of drug interactions, are possible. Hoxsey formula should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Hydrazine sulfate : Hydrazine is an industrial chemical marketed as having the potential to repress weight loss and cachexia (muscle wasting) associated with cancer and to improve general appetite status. A large randomized controlled trial of hydrazine has not proven it effective for improving appetite, reducing weight loss, or improving survival in adults. The National Cancer Institute (NCI) sponsored studies of hydrazine sulfate that claimed efficacy in improving survival for some patients with advanced cancer. However, trial results found that hydrazine sulfate did not prolong survival for cancer patients. The U.S. Food and Drug Administration (FDA) has received requests from individual physicians for approval to use hydrazine sulfate on a case-by-case "compassionate use" basis on the chance that patients with no other available effective therapy might benefit. The overall controversy in the use of hydrazine sulfate is ongoing and the relevance to clinical practice is unknown. The use of hydrazine sulfate needs to be evaluated further before any recommendations can be made. Side effects have been reported including nausea, vomiting, diarrhea, dizziness, and low blood sugar (hypoglycemia).

Iodine : Iodine is an element (atomic number 53) that is required by humans for the synthesis of thyroid hormones (triiodothyronine/T3 and thyroxine/T4). The potential role of non-radioactive iodine in cancer care remains unknown. Antioxidant and anti-tumor effects have been proposed based on laboratory research. In contrast, some scientists have asserted that tumors may uptake more iodine than normal tissues. Overall, no clear conclusion can be drawn based on the currently available evidence. Iodine should not be used if the patient is pregnant or breastfeeding unless otherwise directed by a doctor.

Lavender : Perillyl alcohol (POH), derived from lavender (Lavendula officinalis), might be beneficial in the treatment of some types of cancer. This research has focused on cancers of the pancreas, breast, and intestine. Preliminary small studies in humans suggest safety and tolerability of POH, but effectiveness has not been established.

Lycopene : High levels of lycopene are found in tomatoes and in tomato-based products. Tomatoes are also sources of other nutrients such as vitamin C, folate, and potassium. Several laboratory and human studies examining tomato-based products and blood lycopene levels suggest that lycopene may be associated with a lower risk of developing cancer and may help stimulate the immune system. Due to a lack of well-designed human research using lycopene supplements, this issue remains unclear.

Maitake : Maitake is the Japanese name for the edible fungus Grifola frondosa. Maitake has been used traditionally both as a food and for medicinal purposes. Early laboratory and human studies suggest that beta-glucan extracts from maitake may increase the body's ability to fight cancer. These studies have not been well designed and better research is needed before the use of maitake for cancer can be recommended. Caution is advised when taking maitake supplements as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible. Avoid if pregnant or breastfeeding, unless otherwise directed by a doctor.

Melatonin : There are several early-phase and controlled human trials of melatonin in patients with various advanced stage malignancies, including brain, breast, colorectal, gastric, liver, lung, pancreatic, and testicular cancer as well as lymphoma, melanoma, renal cell carcinoma, and soft-tissue sarcoma. Currently, no clear conclusion can be drawn in this area. There is not enough definitive scientific evidence to discern if melatonin is beneficial against any type of cancer, whether it increases (or decreases) the effectiveness of other cancer therapies or if it safely reduces chemotherapy side effects. Melatonin is not to be used for extended periods of time. Caution is advised when taking melatonin supplements as numerous adverse effects, including drug interactions, are possible. Melatonin is not recommended during pregnancy or breastfeeding unless otherwise advised by a doctor.

Milk thistle : Milk thistle (Silybum marianum) has been used medicinally for over 2,000 years, most commonly for the treatment of liver and gallbladder disorders. There are early reports from laboratory experiments that the components silymarin and silibinin found in milk thistle may reduce the growth of human breast, cervical, and prostate cancer cells. There is also one report of a patient with liver cancer who improved following treatment with milk thistle. This research is too early to determine firm conclusions and the effects have not been shown in high-quality human trials. Caution is advised when taking milk thistle supplements as numerous side effects, including an increased risk of bleeding and drug interactions, are possible. Milk thistle should not be used in pregnancy or breastfeeding, unless otherwise directed by a doctor.

Mistletoe : Mistletoe is one of the most widely used unconventional cancer treatments in Europe. Extracts have been studied for a variety of human cancers including bladder, breast, cervical, CNS (central nervous system), colorectal, head and neck, liver, lung, lymphatic, ovarian, and renal (kidney) cancers as well as melanoma and leukemia. However, efficacy has not been conclusively proven for any one condition. In fact, some studies have shown lack of efficacy of certain preparations for a variety of cancers. Larger, well-designed clinical trials are needed. Caution is advised when taking mistletoe supplements as numerous adverse effects, including nausea, vomiting, and drug interactions, are possible. Avoid if pregnant or breastfeeding, unless otherwise directed by a doctor.

Moxibustion : Moxibustion is a healing technique employed across the diverse traditions of acupuncture and oriental medicine for over 2,000 years. Moxibustion uses the principle of heat to stimulate circulation and break up congestion or stagnation of blood and chi. Moxibustion is more closely related to acupuncture as it is applied to specific acupuncture points. Preliminary evidence from one study of patients with nasopharyngeal cancer suggests that moxibustion (without needles) may reduce the side effects of chemotherapy or radiation therapy. More studies are needed.

Oleander : Laboratory studies of oleander (Nerium oleander) suggest possible anti-cancer effects, although reliable research in humans is not currently available. There are reports that long-term use of oleander may have positive effects in patients with leiomyosarcoma, Ewing's sarcoma, prostate, or breast cancer. More research is needed. Caution is advised when taking oleander supplements as numerous adverse effects, including drug interactions, are possible. Avoid if pregnant or breastfeeding, unless otherwise directed by a doctor.

Omega-3 fatty acid : Omega-3 fatty acids are essential fatty acids found in some plants and fish. There should be a balance of omega-6 and omega-3 fatty acids for health. Randomized controlled trials are necessary before a clear conclusion can be drawn. Caution is advised when taking omega-3 supplements as numerous adverse effects, including an increase in bleeding and drug interactions, are possible.

Physical therapy : Physical therapy was first documented in China around 3,000 BC with the use of joint manipulation and massage to relieve pain. The goal of physical therapy, or physiotherapy, is to improve mobility, restore function, reduce pain, and prevent further injury. Many techniques, including exercises, stretches, traction, electrical stimulation, and massage, have been used. Physical therapy programs are often used following a surgical removal of the breast, which may include arm mobilization, shoulder strengthening, prevention and treatment of upper extremity edema (swelling), and education about arm function. One study suggested that immediate postoperative physical therapy may increase shoulder range of motion, but more high quality trials are needed.

Prayer, distant healing : Initial studies in patients with cancer (such as leukemia) report variable effects on disease progression or death rates when intercessory prayer is used. Better quality research is necessary before a firm conclusion can be drawn.

PSK : Protein-bound polysaccharide (PSK) has been used in traditional Chinese medicine (TCM) since the Ming Dynasty of China. PSK is obtained from cultured mycelia of the Coriolus versicolor, a mushroom thought to have antimicrobial, antiviral, anti-tumor, and immune stimulating properties. PSK, in addition to chemotherapy and surgery, has been associated with n increased disease-free survival rate for patients with colorectal cancer in various clinical trials as opposed to pharmaceutical drugs alone. Well-designed clinical trials are needed to confirm these results along with optimal dosing regimens and optimal pharmaceutical combinations. PSK does not seem to affect the cure rate of colon cancer. Caution is advised when taking PSK supplements as numerous adverse effects, including drug interactions, are possible. Avoid if pregnant or breastfeeding, unless otherwise by a doctor.

Psyllium : Psyllium, also referred to as ispaghula, is derived from the husks of the seeds of Plantago ovata. Psyllium contains a high level of soluble dietary fiber and is the chief ingredient in many commonly used bulk laxatives. Results from animal studies indicate that diets including psyllium could be an effective means of reducing colon cancer risk. One preliminary human study reports the effects of psyllium in colorectal cancer. Healthcare professionals recommend not taking medications and dietary supplements (including herbs and vitamins) within one hour before taking psyllium and two hours after. Psyllium may interfere with the absorption of medications and dietary supplements.

Reishi mushroom : Reishi (Ganoderma lucidum) has been shown to have antineoplastic and immunomodulatory effects in animal studies. One clinical trial and two case reports exist on advanced cancer patients using Ganopoly©, a Ganoderma lucidum polysaccharide extract. Results show improved quality of life and enhanced immune responses, which are typically reduced or damaged in cancer patients receiving chemotherapy and/or radiation therapy. Well-designed long-term studies are needed to confirm these results and potential side effects. Caution is advised when taking reishi supplements as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible. Reishi should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Resveratrol : Resveratrol is an antioxidant found in over 70 plant species including nuts, grapes, pine trees, certain vines, and red wine. It has been reported effective in stopping the growth of breast cancer cells in laboratory studies. The effects of resveratrol on breast cancer in humans cannot be adequately assessed from trials using food, wine, or combination products containing resveratrol and other substances. Well-designed clinical trials of resveratrol alone are needed. Caution is advised when taking resveratrol supplements as numerous adverse effects, including an increase in bleeding and drug interactions, are possible. Resveratrol should not be used if the patient is pregnant or breastfeeding unless otherwise directed by a doctor.

Seaweed, kelp, bladderwrack : Bladderwrack (Fucus vesiculosus) is a brown seaweed that grows on the northern coasts of the Atlantic and Pacific oceans and the North and Baltic seas. Bladderwrack appears to suppress the growth of various cancer cells in animal and laboratory studies. Currently there are no reliable human studies available to support a recommendation for use in cancer. Caution is advised when taking bladderwrack supplements as numerous adverse effects, including an increased risk of drug interactions, are possible. Bladderwrack should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Selenium : Selenium is a trace mineral found in soil, water, and some foods. It is an essential element in several metabolic pathways. Several studies suggest that low levels of selenium (measured in the blood or in tissues such as toenail clippings) may be a risk factor for developing cancer. Population studies suggest that people with cancer are more likely to have low selenium levels than healthy matched individuals, but in most cases it is not clear if the low selenium levels are a cause or merely a consequence of disease. It remains unclear if selenium is beneficial in the treatment of any type of cancer.

Shark cartilage : For several decades, shark cartilage has been proposed as a cancer treatment. Studies have shown shark cartilage or the shark cartilage product AE-941 (Neovastat©) to block the growth of new blood vessels, a process called "anti-angiogenesis," which is believed to play a role in controlling the growth of some tumors. There have also been several reports of successful treatments of end-stage cancer patients with shark cartilage, but these have not been well-designed or included reliable comparisons to accepted treatments.

Many studies have been supported by shark cartilage product manufacturers, which may influence the results. In the United States, shark cartilage products cannot claim to cure cancer and the U.S. Food and Drug Administration (FDA) has sent warning letters to companies that promote their products in this way. Without further evidence from well-designed human trials, it remains unclear if shark cartilage is of any benefit in cancer and patients are advised to check with their doctor and pharmacist before taking shark cartilage. Caution is advised when taking shark cartilage supplements as numerous adverse effects, including an increased risk of drug interactions, are possible. Shark cartilage should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Shiitake : Shiitake (Lentinus edodes) has been taken by mouth to boost the immune system, decrease cholesterol levels, and to slow the aging process. Lentinan, derived from shiitake, has been injected as an adjunct treatment for cancer and HIV infection. Laboratory, animal, and human studies of lentinan have shown positive results in cancer patients when used in addition to chemotherapy drugs. Further well-designed clinical trials on all types of cancer are required to confirm these results. Caution is advised when taking shiitake supplements as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible. Shiitake should not be used if the patient is pregnant or breastfeeding unless otherwise directed by a doctor.

Soy : Soy (Glycine max) contains compounds that have been reported effective against tumors. Genistein, an isoflavone found in soy, has been found in laboratory and animal studies to possess anti-cancer effects, such as blocking new blood vessel growth, acting as a tyrosine kinase inhibitor (a mechanism of many new cancer treatments), or causing cancer cell death (apoptosis). In contrast, genistein has also been reported to increase the growth of pancreas tumor cells in laboratory research. Until reliable human research is available, it remains unclear if dietary soy or soy isoflavone supplements are beneficial, harmful, or neutral in people with various types of cancer. Caution is advised when taking soy supplements as numerous adverse effects, including an increased risk of drug interactions, are possible. Soy should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Tai chi : Tai chi is a system of movements and positions believed to have developed in 12th century China. Tai chi techniques aim to address the body and mind as an interconnected system and are traditionally believed to have mental and physical health benefits to improve posture, balance, flexibility, and strength. Tai chi chuan has been studied in breast cancer patients to improve functional capacity (specifically aerobic capacity, muscular strength, and flexibility). Larger studies are needed to make a firm recommendation.

TENS (transcutaneous electrical nerve stimulation) : Transcutaneous electrical nerve stimulation (TENS) is a non-invasive technique in which a low-voltage electrical current is delivered through wires from a small power unit to electrodes located on the skin. Although TENS has been used with some success in pain associated with cancer, there is not enough reliable evidence to draw a firm conclusion in this area.

Thiamin (vitamin B1) : Thiamin deficiency has been observed in some cancer patients, possibly due to increased metabolic needs. It is not clear if lowered levels of thiamin in such patients may actually be beneficial. Currently, it remains unclear if thiamin supplementation plays a role in the management of any particular type(s) of cancer.

Traditional Chinese medicine (TCM) : The ancient Chinese philosophy of Taoism provided the basis for the development of Chinese medical theory. TCM uses over 120 different herbs in cancer treatment, depending on the type and cause of the cancer. Studies have reported significant benefits including reducing tumors, reducing treatment side effects, and improving response to treatment. More studies of stronger design are needed before TCM can be recommended with confidence as an adjunct to cancer treatment, although centuries of traditional use in cancer cannot be discounted.

Turmeric : Turmeric (Curcuma longa) is commonly used for its anti-inflammatory properties. Several early animal and laboratory studies report anti-cancer (colon, skin, breast) properties of curcumin. Many mechanisms have been considered, including antioxidant activity, anti-angiogenesis (prevention of new blood vessel growth), and direct effects on cancer cells. Currently, it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area. Caution is advised when taking turmeric supplements as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible. Turmeric should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.

Vitamin A : Vitamin A is a fat-soluble vitamin that is derived from retinoids and carotenoids. Retinoids, such as retinal and retinoic acid, are found in animal sources (such as liver, kidney, eggs, and dairy products). Carotenoids, such as beta-carotene, are found in plants including dark or yellow vegetables and carrots. Research results are not clear as to whether vitamin A is beneficial in the treatment or prevention of breast cancer. Patients receiving chemotherapy or radiation therapy for cancer should speak with their doctor(s) before taking antioxidants, such as vitamin A, because they may interact with treatment. Vitamin A toxicity can occur if taken at high dosages and caution should be used with liver disease or alcoholism. Smokers who consume alcohol and beta-carotene may have an increased risk for lung cancer or heart disease. Vitamin A appears safe in pregnant women if taken at recommended doses. Use cautiously if breastfeeding because the benefits or dangers to nursing infants are not clearly established.

Vitamin B6 : Epidemiological research suggests that male smokers with higher serum levels of pyridoxine may have a lower risk of lung cancer. Well-designed clinical trails of pyridoxine supplementation are needed to confirm these results and supplementation is not standard therapy at this time.

Vitamin B12 : Vitamin B12 (or cyanocobalamin) is an essential water-soluble vitamin that is commonly found in a variety of foods such as fish, shellfish, meats, and dairy products. Researchers at Johns Hopkins University report that women with breast cancer tend to have lower vitamin B12 levels in their blood serum than do women without breast cancer. In a subsequent review of these findings, it was hypothesized that vitamin B12 deficiency may lead to breast cancer because it could result in less folate being available to ensure proper DNA replication and repair. Higher dietary folate intake is associated with a reduced risk of breast cancer. The risk may be further reduced in women who also consume high amounts of dietary vitamin B12 in combination with dietary pyridoxine (vitamin B6) and methionine. However, there is no evidence that dietary vitamin B12 alone reduces the risk of breast cancer.

Vitamin C (ascorbic acid) : Dietary intake of fruits and vegetables high in vitamin C has been associated with a reduced risk of various types of cancer; however, it is not clear that it is specifically the vitamin C in these foods that is beneficial and vitamin C supplements have not been found to be associated with this protective effect. Experts have recommended increasing dietary consumption of fruits and vegetables high in vitamin C, such as apples, asparagus, berries, broccoli, cabbage, melon (cantaloupe, honeydew, watermelon), cauliflower, citrus fruits (lemons, oranges), fortified breads/grains/cereal, kale, kiwi, potatoes, spinach, and tomatoes. Vitamin C has a long history of adjunctive use in cancer therapy and although there have not been any definitive studies using intravenous (or oral) vitamin C, there is evidence that it has benefit in some cases. Better-designed studies are needed. Large doses (greater than two grams) may cause diarrhea and gastrointestinal upset.

Vitamin E : There is no reliable scientific evidence that vitamin E is effective as a treatment for any specific type of cancer. Caution is merited in people undergoing treatment with chemotherapy or radiation because it has been proposed that the use of high-dose antioxidants may actually reduce the anti-cancer effects of these therapies. This remains an area of controversy and studies have produced variable results. Patients interested in using high-dose antioxidants, such as vitamin E, during chemotherapy or radiation should discuss this decision with their medical oncologist or radiation oncologist. Caution is advised when taking vitamin E supplements as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible.

Yoga : Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Several studies in cancer patients report enhanced quality of life, lower sleep disturbance, decreased stress symptoms, and changes in cancer-related immune cells after patients received relaxation, meditation, and gentle yoga therapy. Yoga is not recommended as a sole treatment for cancer, but it may be helpful as an adjunctive therapy.

AUTHOR INFORMATION

This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

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