Dr. Howard Jack West: Vitamins and Supplements for Mesothelioma Patients

Hi I’m Jack West, medical oncologist at Swedish Cancer Institute in Seattle, Washington One of the more common questions that I get asked in my clinic by patients with mesothelioma or many other types of cancer is — what vitamins and supplements can or should I take to do better against my cancer I will say that there is not evidence that supplements or specific vitamins lead to better outcomes with a couple of key exceptions One is that one of the main chemotherapies used for mesothelioma is called alimta or pemetrexed and it has been shown that patients receiving this medication
do better when they receive B12 and ffolate starting a week or two before the actual chemo is administered and continue on it regularly the whole time that they are receiving alimta, typically with another drug called cisplatin, or sometimes carboplatin instead The B12 is given by an injection in the arm in the deltoid muscle every two months or nine weeks Folate or folic acid is another vitamin that is taken orally at a low dose and importantly these drugs help to rescue the normal cells of the body and minimize side effects from the alimta But if they’re taken in too high dose they can help rescue the cancer cells and this is a theme that I’d like to cover and that is that sometimes more is not better, specifically with vitamins There are a lot of claims and it might be intuitive to think that more vitamins must be better than less but in fact there is a real risk that if it is not well studied taking a lot of any supplement or vitamin could backfire and lead to worse outcomes. There is certainly good reason to suspect that with B12 and folate given before starting alimta but there’s also some evidence that anti oxidants vitamins like A, C and E can potentially undermine the efficacy of conventional chemotherapies in various settings I’ll say the evidence on this is not that strong but it’s certainly a very real concern and there are some very responsible naturopathic physicians who do think about and offer many supplements who are extremely cautious and conservative about giving medications, giving vitamins and supplements that can potentially interfere with the better established treatments that we would want to give, namely something like chemotherapy in the setting of mesothelioma or other cancers particularly in a setting where where we don’t have a lot to offer choosing something as an alternative therapy might be an extremely appropriate choice because at
least it might do some good and the less evidence we have that a conventional therapy is going to be beneficial, the less you have to lose by trying any unknown but particularly in settings where we have some established treatments, keeping on untested treatments is not a good idea. Take care I hope that helps

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