Transcript Name of presentation

Practical Oncology
Nutritional Alternatives
for Cancer
Wendy Blount, DVM
Nutraceutical
NAVNA - North American Veterinary Nutraceutical
Association
•Non-drug substance
•Purified and extracted
•Administered orally
•Provides nutritional building blocks for normal body
structure and function
•Intent is to improve health and well being
NOT Nutraceuticals
•Whole herbs
•Unprocessed (raw) natural products
•Cartilage powders
•Applied topically or injected
Quality Control
Governmental regulation
•Dietary Supplement Health and Education Act of
1994 - gives FDA power of enforcement over all
dietary supplements
•Nutrition Labeling and Education Act of 1990 FTC enforces label claims on all products sold in US
Quality Control
•NASC Membership
•NADA Number if claims on the label
•Third Party Evaluation
•www.consumerlab.com
•Veterinary literature - clinical studies in the
target species, not in vitro studies or lab
animal studies
•USP
Quality Control
Other things to look for
•Ingredient List - Beware “proprietary blends”
•Nature of the claims
•Good instructions for use
•Studies provided by manufacturer are on their
actual product, not ingredients
National Animal Supplement Council
•www.nasc.cc
•Member companies submit themselves to
rigorous independent inspections
•Work directly with FDA to improve best
manufacturing processes and adverse event
reporting
•Work closely with AAFCO
•Encourage research on animal supplements
NADA - New Animal Drug Application
•Required by law if medical claims are on the
label
•Often ignored
•NADA number means the manufacturer has
bothered to abide by FDA regulations for drug
manufacture
ConsumerLabs
•www.consumerlabs.com
•Purchases and tests dietary supplements for
potency and purity - published reports
•Compiles information on dietary supplements
•Compiles a list of recalls and FDA warning
letters pertaining to dietary supplement
manufacturers
•Look for the ConsumerLabs Seal on the label
USP - United States Pharmacopeia
•Compiles a list of suppliers that have voluntarily
submitted their products for USP verification and
approval
Diet and Cancer
•With the exception of lymphoma and some nasal and
oral tumors, there is no scientifically proven dietary
recommendation for cancer patients
•RULE #1: KEEP THEM EATING!!
Carbohydrates
•Cancer patients often have increased lactate , which can
cause muscle soreness and poor energy
•Simple carbohydrates contribute to lactate production
•Tumors preferentially use carbohydrates rather than
proteins and fats as nutrition for growth
•Pets with cancer have increased protein requirements
•low carb diet is preferred for cancer patients
•Feed proteins & fats to feed the patient & starve the tumor
Arginine & Glutamine
•Cancer patients often have low blood arginine
•Supplementation of arginine may improve immune
function
•Supplementation of glutamine may slow cancer cachexia
and protect against GI toxicity of chemotherapy
•Glutamine supplementation can cause diarrhea
•Hill’s n/d has increased arginine
Cancer Diet (as calories)
•Dogs – 35-45% protein 30-35% fat, 20% carbs
•Cats – 50-60% protein, 35-40% fat, <15% carbs
•http://binkyspage.tripod.com/canfood.html
•Pet Food Percent Calories Calculator
•Home made diet in Client Handout – Nutritional
Alternatives for Cancer (use fish as protein source)
•When choosing vegetables, choose those with color and
low in starch
•Have a nutritionist balance the diet if used long term
Raw Diets
•Raw meat ever recommended for animals undergoing
chemotherapy
•Probably not recommended for any immunosuppressed
pet
Cooking Spices with Anticancer Activity
•Garlic may induce apoptosis ad differentiation in some
tumor lines
•in moderation to prevent oxidative injury to RBC
•1 clove per 40 lbs per day is good
•Turmeric has preventative antineoplastic and antioxidant
effects
•1 tsp per 50 lbs is good
Fatty Acids – Omega-3
•DHA - docosahexaenoic acid (22:6n-3)
•EPA- eicosapentaenoic acid (20:5n-3)
•EPA and DHA in fish oil
•DHA also in blue-green algae
•ALA - Alpha linolenic acid (18:3n-3)
•precursor to EPA & DHA
•Present in flax seed (linseed) oil
Fatty Acids – Omega-3
•ALA Not well converted to DHA and EPA in dogs and
cats
•due to lack of delta-6-dehydrogenase
•Need fish oil for EPA and DHA benefits
•Doses vary
•250-300mg EPA/DHA per 10 lb
Fatty Acids – Omega-3
•Powerful antiinflammatory effects
•decrease synovial IL-1 production, which
contributes to pathogenesis of arthritis
•Necessary for mitochondrial function
•Residual effects for several weeks after
discontinuing therapy
Fatty Acids – Omega-3
•Antineoplastic effects
•Both fish oil and arginine increased survival time
and disease free interval in dogs with LSA
•Decrease production of cytokines that mediate
cancer cachexia
•Antinflammatory effects are accompanied by
immunostimulant properties
•Slow tumor growth in vitro
Fatty Acids – Omega-3
Quality Control
•Contamination with heavy metals, dioxins and
PCBs is a concern
•More of a problem with eating fish than fish oil
supplements (stored in tissues)
•No fish oil products tested by ConsumerLab have
ever been contaminated
Fatty Acids – Omega-3
Quality Control
•Beware of rancidity of refrigerated, pressed oils
•3-6 and 3-6-9 products not recommended for
cancer patients
•Cod Liver Oil is not always the best source
•High in Vitamins A & D
Fatty Acids – Omega-3
Side Effects
•Inhibit platelet function at very high doses
•Give with food to avoid GI upset
•Very high doses without antioxidant support can
result in lipid peroxidation
•Most commercial products are preserved with
antioxidants
•Anecdotal reports of pancreatitis and steatitis in cats
Fatty Acids – Omega-6:Omega-3 Ratio
•Response to omega-3 therapy is due to both
omega-3 dose and omega 6:ratio in the diet
•Ideal ratio is probably between 3:1 and 9:1
•Many diets >30:1; some >50:1
•The more omega-6’s in the diet, the more omega3’s needed for therapeutic effect
•Presence of excessive omega-3’s can suppress
omega-6 production and vice versa
Antioxidants
•Cancers produce an oxidative state, resulting in
free radicals and peroxides that injure tissues
•Antioxidants can improve the oxidative state, and
may slow neoplastic proliferation and reduce
adverse effects of chemotherapy in people
•Many oncologists recommend against antioxidant
supplementation, for fear of decreasing efficacy of
oxidative chemotherapy agents
•Most human studies show that cancer patients
that take antioxidants do better
Antioxidants
•Antioxidants such as vitamins A, E, C, zinc,
selenium, coQ10, etc., are dependent on one
another
•Studies that show negative effects of antioxidants
are often single agent studies
•Though controversial, my personal
recommendation for cancer patients is to use a
broad spectrum antioxidant supplement such as
Cell Advance by VetriScience
Flavonoids
•Resveratrol from red grapes and red wine
Green tea polyphenols
•Phytoestrogens from soy
•Curcumin in turmeric
•Anthocyanadins from berries
•Quercetin
•Citrus bioflavonoids
Flavonoids
•Antioxidant effects may help prevent cancer
•Promote differentiation and apoptosis
•antiangiogenic
•Enhanced immune function
•Inhibition of local invasion and distant metastasis
Hill’s n/d
•Restricted carbohydrates
•Increased arginine
•Increased protein and fat
•Increased omega-3’s from fish oil
•Dogs undergoing chemotherapy for lymphoma
have increased survival time and longer disease
free interval after chemo when fed n/d
•Similar findings for dogs undergoing radiation
therapy for nasal and oral tumors
Many, Many Others
•Nutritional Alternatives for Cancer – handout
•Neoplasene – Buck Mountain Botanicals
•Sell only through veterinarians
•Bloodroot, halogens and water
•Wound balm topical product
•Oral product
•Injectable product
Many, Many Others
•Tumexal – CanineCare.us
• Some cancer cells have inactivated p53
tumor suppressor gene
•Tumexal claims to duplicate the essential
functions of p53
•No side effects, per the website
•No information on ingredients
•Illegally labeled unapproved drug
•Dr. John Nice is really Dr. John Nyce