Can cancer patients undergoing radiotherapy and chemotherapy take Chinese herbal medicine or health supplements?
Cancer patients undergoing radiation therapy or chemotherapy often ask, "Can I take Chinese herbal medicine or dietary supplements at the same time?" Both Chinese medicine practitioners and pharmacists advise that patients should first discuss this with their attending physician and then take them according to their specific condition, so they do not waste money and harm their health.
The Cancer Resource Center of Linkou Chang Gung Memorial Hospital held a "Medication Safety Lecture -- Integrated Chinese and Western Medicine Treatment for Cancer: A Discussion of Chinese Herbal Medicine and Dietary Supplements" yesterday. During the talk, many cancer patients and family members raised questions, including "Can I take Chinese herbal medicine during chemotherapy," "Which dietary supplements are better to take," and "Will taking them at the same time cause interactions," among others.
Consult a Chinese medicine practitioner to avoid interactions between Chinese and Western medicines
"In principle, it is not very advisable to use Chinese herbal medicine during standard cancer treatment, because interactions between Chinese and Western medicines are difficult to assess," said Cheng Chi-yuan, a pharmacist in the Department of Pharmacy at Linkou Chang Gung Memorial Hospital.
Cheng Chi-yuan further explained that chemotherapy courses can mainly be divided into two types: one is chemotherapy after surgery, and the other is palliative chemotherapy. Whether Chinese herbal medicine is suitable in each case must be determined according to the situation.
Chemotherapy after surgery is also called adjuvant chemotherapy. "It is a very important chemotherapy that will determine whether the cancer will recur in the future," Cheng Chi-yuan said. Postoperative chemotherapy is for patients whose cancer cells are localized and have not yet spread, and usually needs to be done for six months. "During this period, try not to take Chinese herbal medicine, follow the physician's advice for standard treatment, and supplement more protein." After chemotherapy ends, wait at least one month as a buffer, and then consult a Chinese medicine practitioner and pharmacist about whether it can be taken.
The other type, palliative chemotherapy, mainly targets patients whose cancer cells have already spread. Cheng Chi-yuan said that patients nearing the end stage of cancer may already have no ideal drugs available, but he understands the feelings of patients and family members who do not want to give up any hope, so he does not completely oppose the use of Chinese herbal medicine. Moreover, some Chinese herbal medicines can improve patients' appetite and quality of life and replenish physical strength. He suggests consulting a qualified Chinese medicine practitioner and taking them in appropriate amounts.
Some Western medicine physicians will directly tell liver cancer patients that they cannot take Chinese herbal medicine. Cheng Chi-yuan said this statement arises because the liver is the organ that detoxifies, and most foods or drugs must be metabolized by the liver. If a patient already has liver problems and then abuses drugs, it may increase the burden on the body.
Huang Chien-jung, a Chinese medicine practitioner in private practice, said whether Chinese herbal medicine harms the liver must depend on the individual's condition. The "classical formulas" recorded in the classical Chinese medicine text Shanghan Lun refer to prescriptions that have been used by people for a long time and are confirmed to have a high degree of safety. One can consult a Chinese medicine practitioner about whether they are suitable to take, but Chinese herbal medicines of unknown origin are not recommended.
"Which ones can be taken and which ones cannot? You must ask a Chinese medicine practitioner first," Cheng Chi-yuan said. Some Chinese herbal medicines can help cancer patients replenish physical strength and improve fatigue; some have blood-activating functions, such as dong quai (Angelica sinensis), and may increase angiogenesis and strengthen cancer cells, so they must be used very cautiously.
Dietary supplements can only be auxiliary and must not be treated as standard treatment
As for dietary supplements, Cheng Chi-yuan said they can only be auxiliary and must not be treated as standard treatment.
Dietary supplements that patients often ask about and that sell well include soy isoflavones, ginkgo, and red ginseng. Recently, media have also reported that brown algae can inhibit cancer recurrence and angiogenesis. However, Cheng Chi-yuan said that most dietary supplements have not yet undergone large-scale human clinical trials, and some may only remain at the stage of trials involving 20 to 30 people or animal trials. "Whether they have efficacy and side effects is still a question mark."
However, Cheng Chi-yuan said it has been confirmed that patients with endometrial cancer and breast cancer are not suitable to take dietary supplements containing red ginseng and soy isoflavones, because they contain phytoestrogens, which may interfere with human female hormones and worsen the cancer condition. In addition, ginkgo and garlic extract can inhibit platelet aggregation, and taking them in large amounts may trigger bleeding risks.
Whether taking Chinese herbal medicine or dietary supplements, there is no mandatory restriction on what can or cannot be taken. Cheng Chi-yuan reminded that patients undergoing radiotherapy and chemotherapy should grasp the following principles: do not believe folk remedies circulated in the community, do not spend all their savings to buy them, do not rely excessively on them or take only one type of drug for a period of time, and avoid taking large amounts.
Moreover, Chinese medicine treatment emphasizes that individual constitutions differ. Some cancer patients are suitable for replenishing qi, while others need to replenish blood. Huang Chien-jung said the same Chinese herbal medicine may be effective for patient A but may not be suitable for patient B. The best way is still to have a Chinese medicine practitioner diagnose the condition before taking it.