Complementary Alternative Therapies
Vitamin and mineral supplementation is associated with longer survival and quality of life in NSCLC patients. Median survival is 4.3 years for NSCLC patients who supplement with vitamins and minerals versus 2.0 years for those who do not use such supplements (Jatoi A et al 2005a). As the statistics on conventional treatment outcomes for lung cancer remain disappointing, vitamin and mineral supplementation combined with complementary alternative therapies should be considered to help control lung cancer, maintain quality of life, and prolong survival (van Zandwijk N et al 2000). It is particularly important for advanced lung cancer patients to incorporate novel and integrative nutritional supplementation into their treatment regimens.
Apigenin, a flavone (ie, a class of flavonoids) that is present in fruits and vegetables (eg, onions, oranges, tea, celery, artichoke, and parsley), has been shown to possess anti-inflammatory, antioxidant, and anticancer properties. Many studies have confirmed the cancer chemopreventive effects of apigenin (Patel 2007).
Apigenin inhibits expression of vascular endothelial growth factor (VEGF) and angiogenesis in lung cancer cells (Liu 2005). It was observed in a study that apigenin suppressed the proliferation of lung cancer cells and increased their susceptibility to antitumor drugs (Ren 2011).
Astragalus. Astragalus, an herb used for centuries in Asia, has exhibited immune-stimulatory effects. Astragalus potentiates lymphokine-activated killer cells (Chu 1988). One study found that astragalus could partially restore depressed immune function in tumor-bearing mice (Cho 2007a), while another concluded that “…astragalus could exhibit anti-tumor effects, which might be achieved through activating the…anti-tumor immune mechanism of the host” (Cho 2007b).
In a 2003 study, individuals with advanced lung cancer received injectable astragalus. The 1-year survival rate was 46.8% in the astragalus group compared to 30% in the control group (Zou 2003). In 2006, researchers conducted a review to evaluate evidence from trials using Astragalus-based herbal medicine combined with platinum-based chemotherapy in patients with advanced non-small cell lung cancer. The researchers identified 12 studies with a total of 940 subjects that reported a 33% decreased risk of death at 1 year in those receiving astragalus-based Chinese herbal combinations compared to chemotherapy alone. Additionally, 9 studies were identified with a total of 768 subjects that reported a 27% decreased risk of death at 2 years in favor of those receiving astragalus-based Chinese herbal combinations compared to chemotherapy alone (McCulloch 2006).
Vitamin D. As previously outlined in the “Surgery” section, vitamin D improves survival in early-stage NSCLC patients (Zhou W et al 2005). Therefore, vitamin D supplementation is recommended for lung cancer patients planning to undergo surgery, particularly during the winter season, and especially for those with darker skin, and for vegans who have limited sun exposure. Experimental studies show that vitamin D protects against lung cancer progression by preventing cancer spread (metastases) (Wiers KM et al 2000). Sources of vitamin D include sunlight, milk, and darkly colored fish.
Adenosine triphosphate. Adenosine triphosphate (ATP) is produced in the body and provides energy to cells. In nonrandomized studies involving advanced NSCLC patients, ATP infusions slowed weight loss and deterioration of quality of life (Haskell CM et al 1998). A randomized trial showed that ATP infusions (20–75 mg/kg per minute for 30 hours at two- to four-week intervals) have beneficial effects on weight, muscle strength, energy levels, and quality of life in patients with advanced NSCLC (Agteresch HJ et al 2003).
Intravenous ATP infusions work by restoring liver energy levels in patients with advanced lung cancer (Leij-Halfwerk S et al 2002) and by counteracting tissue loss (Agteresch HJ et al 2002). ATP is taken up by red blood cells and reaches levels 50 to 70 percent above baseline concentrations at approximately 24 hours (Agteresch HJ et al 2000). In addition, preclinical studies showed that ATP administration may improve the anticancer effects of chemotherapy (Maymon R et al 1994) and radiotherapy (Estrela JM et al 1995) and may also have protective effects against tissue damage caused by radiation (Senagore AJ et al 1992).
Green tea. A phase I clinical trial in advanced NSCLC patients determined that high doses of green tea extract (3 g/m2 daily) are well tolerated and stabilize cancer in some patients (Laurie SA et al 2005). Based on their results, the researchers proposed that green tea extract might be useful in preventing cancer progression in those at high risk for lung cancer relapse (following completion of treatment for early-stage lung cancer) or in those at high risk of developing a second cancer. In addition, green tea extract could be considered in combination with standard chemotherapy agents in advanced lung cancer (Laurie SA et al 2005).
Green tea extract can be taken safely for at least six months at an oral dose of seven to eight Japanese cups (120 mL) three times daily (Pisters KM et al 2001). The side effects of green tea extract are caffeine related. However, preclinical studies found that caffeine contributes to the prevention of tumor growth (Lu YP et al 2000; Xu Y et al 1992). Therefore, decaffeinated green tea extract may be less effective.
Alpha-tocopherol. High levels of alpha-tocopherol (50 mg), if taken during the early critical stages of lung cancer initiation, may prevent lung cancer development (Woodson K et al 1999). Alpha-tocopheryl succinate hinders the initiation and progression of lung cancer by preventing COX activity and by blocking inflammatory responses mediated by prostaglandin E2 (Lee E et al 2006).
Pomegranate. Pomegranate, which is rich in antioxidants, has gained widespread popularity as a functional food (ie, has health benefits). The health benefits of the fruit, juice(s), and extract(s) have been studied in realtion to a variety of chornic diseases, including cancer (Syed 2012; Johanningsmeier 2011). Pomegranate extract provides significant protection against experimentally induced lung cancer. Researchers observed that 8 months of pomegranate supplementation reduced lung tumor formation by 66% in mice exposed to lung carcinogens (Khan 2007a). Another study found that pomegranate fruit extract inhibited the formation of tumor growth in mice implanted with lung cancer cells, leading the authors to conclude that “…pomegranate fruit extract can be a useful chemopreventive/chemotherapeutic agent against human lung cancer” (Khan 2007b).
PSK. PSK, which is a specially prepared polysaccharide extract from the mushroom Coriolus versicolor, has been studied extensively in Japan where it is used as a non-specific biological response modifier to enhance the immune system in cancer patients (Koda 2003; Noguchi 1995; Yokoe 1997). PSK suppresses tumor cell invasiveness by down-regulating several invasion-related factors (Zhang 2000). PSK has been shown to enhance NK cell activity in multiple studies (Ohwada 2006; Fisher 2002; Garcia-Lora 2001; Pedrinaci 1999).
In a clinical trial, individuals with Stages 1-3 lung cancer received radiation therapy with or without PSK. Researchers observed that the 5-year survival was 39% in the PSK group compared to 17% in the control (Stages 1 and 2) and 26% in the PSK group compared to 8% in the control (Stage 3) (Hayakawa 1997). Similar results were obtained by these same researchers in a previous study (Hayakawa 1993).
Quercetin. Quercetin is a flavonoid found in a broad range of foods, from grape skins and red onions to green tea and tomatoes. Quercetin’s antioxidant and anti-inflammatory properties protect cellular DNA from cancer-inducing mutations (Aherne 1999). Quercetin traps developing cancer cells in the early phases of their replicative cycle, effectively preventing further malignant development and promoting cancer cell death (Yang 2006). Furthermore, quercetin favorably modulates chemical signaling pathways that are abnormal in cancer cells (Morrow 2001; Bach 2010).
Quercetin inhibits the growth of lung cancer cells (Yang 2006; Zheng 2012). In one experiment, laboratory rats were treated with quercetin (25mg/kg body weight) before exposure to benzo(a)pyrene, a powerful environmental carcinogen found in cigarette smoke, charbroiled foods, and automobile (particularly diesel) exhaust, making it among the most common pollutants in the environment. While untreated rats developed lung cancers, those supplemented first with quercetin showed no such findings (Kamaraj 2007).
Selenium. Selenium protects against lung cancer, especially in populations in which average selenium intakes are low (Rayman MP 2005; Zhuo H et al 2004; Reid ME et al 2002;). Family members of lung cancer patients were found to have selenium levels significantly lower than those of healthy controls (Miyamoto H et al 1987). At pharmacological doses, selenium may act as an adjuvant treatment for lung cancer (Neve J 2002). A phase III multicenter clinical trial is investigating whether daily selenium supplementation is effective in preventing the growth of new tumors in NSCLC patients whose tumors were surgically removed; details are available at www.clinicaltrials.gov.
Novel nutritional supplements. The following nutritional supplements have been investigated in lung cancer patients and found to be without adverse effects; however, optimum doses have not yet been established:
- N-acetylcysteine (Maasilta P et al 1992; Jepsen S et al 1989)
- R-lipoic acid (Mantovani G et al 2003)
- Zinc (Evans WK et al 1987)
- Magnesium (Takeda Y et al 2005)
- Scutellaria baicalensis (Udut EV et al 2005; Gol’dberg VE et al 1997)
The following nutritional supplements have shown promising affects against lung cancer in experimental studies, although clinical studies have not yet been carried out:
- Curcumin (Lee J et al 2005)
- Ginseng (Panwar M et al 2005)
- Garlic (Wu XJ et al 2005)
- Lycopene (Arab L et al 2002)
- GLA (de Bravo MG et al 1995)
- Silibinin (Chen PN et al 2005)
- Grape seed proanthocyanidins (Bagchi D et al 2002)
- Black tea polyphenols (Lin JK 2002)
- Genistein from soy (Lei W et al 1998, 1999)
Lung cancer patients may want to call Life Extension at 1-800-544-4440 for updated information on optimal dosages of the above nutrients.