Warning: Consult an Oncologist Before Self-Medicating with Complementary & Alternative Medicines

Herbs, Special Diets, & Vitamin Supplements May Interfere with Chemotherapy

Consult a physician before using complementary and alternative medical treatments.

Evelyn E. Smith

M.S. in Library Science, University of North Texas (2012)

Cancer patients are increasingly turning to complementary and alternative medical (CAM) treatments, such as diet and vitamins, to augment their cancer treatments. Even if patients fear that their physician might try to persuade them not to use CAM, patients need to tell their oncologist about the non-prescription supplements they are taking and the diets they are following since these may interact adversely with chemotherapy. Conversely, all their physicians also need to ask them  if they are taking supplements and herbs or engaging in any complementary or alternative treatments. Indeed, anytime any patient takes herbal supplements, vitamins, or follows a special diet whatever his or her medical condition, he or she needs to check with a physician since these may interfere with a prescribed medication.


Different studies give contradictory evidence as to whether treatments like acupuncture and yoga helped relieve fatigue in cancer patients following chemotherapy treatments. Moderate to vigorous exercise might also help alleviate fatigue, depression, or anxiety. Almost all studies point out, however, that cancer patients with a university education are more likely to use CAM perhaps because this treatment helps them feel more in control of their well-being. Since most oncologists now accept that their well-educated patients are open to trying CAM, they usually work with them to integrate complimentary diet and exercise regimes with surgical, radiation, or chemotherapy treatments.

Alsanad, S. M., Williamson E. M., and Howard, R. L. (2014, August 26). Cancer patients at risk of herb/food supplement-drug interactions: A systematic review. Phytotherapy Research: PTR. doi: 10:1002/PTR.5213. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25158128

A survey of 818 articles using key words as well as a questionnaire submitted to 806 cancer patients determined that 53.7 percent were take some combination of supplements and drugs and that 167 incidents of risk had affected 13.9 percent of those surveyed.

Anderson, M.R., Sweet, E., and Lowe, K. A., et al. (2013, August). Dangerous combinations: ingestible CAM supplement use during chemotherapy in patients with ovarian cancer. Journal of Alternative and Complementary Medicine (New York, New York), 19(8) 714-20. doi: 10.1089/acm.2012.0295. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23445210

Of 200 women in this study who reported using chemotherapy to treat ovarian cancer, 40 percent reported using one or more complementary or alternative medicine (CAM) supplements that could adversely interact with one or more of the chemotherapy medications they were also taking. Those who took multiple CAM supplements were of particular concern since these might cause adverse side effects, increase the toxicity of chemotherapy, or reduce its effectiveness.

Ernst, Edward. (2013, April 18). Cancer patients who use alternative medicines die sooner. Retrieved from http://edzardernst.com/2013/04/cancer-patients-who-use-alternative-medicine-die-sooner/

Studies show that cancer patients who use complementary and alternative (CAM) treatments to supplement traditional cancer therapies don't have [necessarily] higher survival rates than those who only follow regimes prescribed by their physicians. Instead a Korean study of 481 terminal cancer patients between July 2005 to October 2006 found that those who sought out CAM reported “worse cognitive functioning and fatigue (Ernst, 2013, April 18, para. 1 & 2). A Norwegian study of 515 terminal cancer patients over a five-year-period published in 2003 similarly found a higher death rate of 79 percent in patients who supplemented their treatments with CAM compared with a 65 percent death rate for those who didn't use CAM (Ernst, 2013, April 18, para. 3). Several reasons might account for these results: 1) Patients might ineffectively self-medicate with CAM; 2) some treatments [interacting with chemotherapy] might cause direct harm, and 3) those patients who use CAM “might, on average, suffer from more advanced cancers (Ernst, 2013, April 18, para. 4).

Finnegan, John J., Molassiotis, A., & Richardson, A., et al. (2013, July). A systematic review of complementary and alternative interventions for the management of cancer related fatigue. Integrative Cancer Therapies, 12(4): 276-90. doi: 10.1177/1534735413485816. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23632236

A systematic review of CAM interventions to relieve cancer-related fatigue after examining acupuncture, massage, yoga, and relaxation training offers limited evidence that hypnosis and ginseng might prevent the rise of cancer-related fatigue while acupuncture and bio-field healing may possibly reduced fatigue in the aftermath of cancer treatments. Taking multivitamins, however, has proved ineffective in relieving fatigue.

Fouladbakhsh, Judith M., Balneaves, Lynda, and Jenuwine, Elizabeth. (2013, September 1). Understanding CAM natural health products: Implications of use among cancer patients and survivors. Journal of the Advanced Practitioner in Oncology, 4(5): 289-306. [full text Online]. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093439/

Cancer patients are increasingly turning to herbs, vitamins, and natural health products to ease pain, fatigue, insomnia, anxiety, and depression while not necessarily informing health care providers, thus leaving them prey to adverse interactions between complementary and alternative medications (CAM) and prescribed medication. Accordingly, the RN's authoring this informative article furnish an overview of alternative medications and their potential interactions (Abstract).

Garland,S. N., Valentine, D., and Desai, K;, et al. (2013, November). Complementary and alternative medicine use and benefit among cancer patients. Journal of Alternative and Complementary Medicine (New York, New York), 19(11): 876-81. doi: 10.1089/acm.2012.0964. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23777242

A cross-sectional survey of 316 oncology patients indicates that 61.3 percent used complementary and/or alternative medications following their diagnosis. Factors most associated with CAM use were a college education, a breast cancer diagnosis, and being 12 to 36 months past the initial diagnosis. According to those surveyed, “energy healing” and “the healing arts” were the most beneficial treatments while special diets, herbal remedies, vitamins, and massage yielded fewer benefits. Acupuncture, chiropractic treatment, homeopathy, relaxation techniques, yoga, and ta chi didn't contribute to the patients' well being (Abstract).

Huebner, J., Prott, F. J.,and Micke, O., et al. (2014, May 12). Online survey of cancer patients on complementary and alternative medicine. Oncology Research and Treatment, 37(6), 304-308. doi: 10.1159/000362616. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24903760

An Online survey of German cancer patients found that 77 percent of those surveyed were using complementary and alternative medicine (CAM) with 63 percent of them informing their oncologist of this use. However, in 74 percent of these cases, the oncologist didn't take the time to discuss the use of these non-prescribed treatments. The patients most commonly used biologically-based therapies (supplements, herbs, and special diets), relaxation techniques, prayer, and medication to complement cancer treatment, seeking to reduce side effects of chemo- or radiation-therapy, “boost the immune system”, or “get active” (Abstract).

Kabel, A (2014, November 14). Fighting for wellness: Strategies of mid-to-older women living with cancer. Journal of Cross-culture Gerontology. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25391218

A significant percentage of older adult cancer patients rely of complementary and alternative (CAM) treatments particularly as they transition to a post-[chemotherapy and/or surgical] treatment phase of their cancer.

Mishra, Si, Scherer, R. W., and Snyder C., et al. (2012, August) Exercise interventions on health-related quality of life for people with cancer during active treatment. The Cochrane Database of Systematic Reviews, 15(8): CDD08465. doi: 10.1002/14651858.CD008465.pub 2. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23632236

Searching citations through the Cochrane Central Register of Controlled Trials, as well as publication like Pub Med/ MEDLINE as well as the Web of Science and Scopus, from their inception to November 2011, researchers determined that moderate and/or vigorous exercise was most likely to relieve anxiety in breast cancer survivors, although depression, fatigue, and sleep disturbances were more likely to decrease in cancers other than breast cancer.

Nissen, N. , Lunde, A., Pedersen, C. G., et al. (2014, October 10). The use of complementary and alternative medicine after the completion of hospital treatment for colorectal cancer: Findings from a questionnaire in Denmark. BMC Complementary and Alternative Medicine, 14 (388). doi: 10.1186/1472-6882-14-388. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25304122

A Danish study of patients who had completed hospital treatment for colorectal cancer found that of the 247 patients questioned, 49.4 percent had used some form of complimentary and alternative medicine (CAM) in the past month; and of these, 49.2 percent had used natural medications or dietary supplements only while 32 percent had also consulted an alternative therapist, and 18.9 percent had sought both treatments. Users of CAM were more likely to be women with high education levels who used these alternative treatments without the prompting of a physician. Indeed, 51 percent didn't disclose the use of CAM to their physicians while a physician only asked the patient about whether he or she was using CAM in only 8.5 percent of the cases (Nissen, 2014, October 10, Abstract).

Patel, V. H. (2014, November 14). Nutrition and prostate cancer: An overview. Expert Review of Anti-cancer Therapy, 14(11), 1295-304. doi: 10.1586/14737140.2014.972946. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25367323

Physicians have discovered a link between nutrition, lifestyle, and the development and progression of prostate cancer; for example, obesity and metabolic syndrome are key risk factors for prostate cancer as are the consumption of saturated and trans fats. At the same time, prostate patients are increasingly turning to complementary and alternative (CAM) treatments like vitamins and special diets. Thus, nutraceuticals and supplements have proved beneficial in the prevention and the recovery from prostate cancer (Patel, 2014, November 14, Abstract).

Smith, P. J., Clavarino, A., and Long, J. et al. (2014, March). Why do some cancer patients receiving chemotherapy choose to take complementary and alternative medicines and what are the risks? Asia-Pacific Journal of Clinical Oncology, 10 (1), 1-10. doi: 10.1111/ajco.12115. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23910177

Complementary and alternative medicine (CAM), such as herbs, vitamins, and special diets, that the body systematically absorbs are most likely to interfere with chemotherapy and potentially harm cancer patients. Cancer patients are most likely to ingest CAM to lessen chemotherapy's side effects, manage symptoms, or treat medical conditions unrelated to the diagnosis of cancer while a small percentage of patients decide to use CAM instead of chemotherapy, thus delaying conventional treatment. Family, friends, casual acquaintances, and even practitioners all may encourage the use of CAM. However, when researchers tested their use of these complementary or alternative treatments in rigorous chemical trials, no CAM alone showed any benefit beyond the use of a placebo, and with the exception of the use of ginger to treat chemotherapy-induced nausea, no compelling reason exists to override the risk of using CAM while undergoing chemotherapy, However, evidence exists that complementary mind-body therapies provide supportive care during chemotherapy.

Templeton,, A. J., Thurlmann, B., and Bauman, M., et al. (2013, March). Cross-sectional study of self-reported physical activity, eating habits and use of complementary medicine in breast cancer survivors. BMC Cancer, 13, 153. doi: 10.1186/1471-2407-13-153. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23530694

A cross-sectional study of Swiss breast cancer survivors whose breast cancer was caught early indicated that 69 percent reported the were physically active more than once weekly, taking a brisk 30-minute walk; 87 percent paid special attention to nutrition and were following a low-fat diet, and 46 percent had adopted complementary and alternative medicine (CAM) treatments. Factors influencing regularly taking part in physical exercise included using CAM, an older age, and fewer worries about the future whereas regular physical activity along with a university-level education were indicative of special attention to diet and routine brisk exercise. A university education and a lower age also pointed to the use of CAM. About half the patients questions were interested in learning more about complementary and alternative medical treatments and were also willing to take part in institutionally-sponsored, wellness programs.

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