AntiOxidants: Good or Bad? So confused now.

Spoonie77

Ok, so in general I had the thinking that vitamins and antioxidants were helpful for people (managing side effects, pain, symptoms, etc), especially for people with life-long chronic illnesses (such as myself) and/or various cancers BUT then I found this tonight from the NCI and other sites, basically saying that some of them INCREASE cancer growth!!!

Antioxidants Accelerate the Growth and Invasiveness of Tumors in Mice

https://www.cancer.gov/news-events/cancer-currents-blog/2015/antioxidants-metastasis



Oxidative stress inhibits distant metastasis by human melanoma cells.

https://www.ncbi.nlm.nih.gov/pubmed/26466563

Antioxidants and Cancer – Should I take them?

https://careoncology.com/antioxidants-and-cancer-should-i-take-them/

Is this real? Is this a thing? If so, why is no one telling me about this?

These are on my medication lists, I have taken them for years. Am I speeding up any tumor cells right now????

Uggggh. Very confusing to say the least.

ShetlandPony

Food good. Supplements bad.

(Generally. Some exclusions apply. For example, vitamin D capsules to achieve a normal level is most likely good. Vitamin D is not an antioxidant.).

Spoonie77

Thanks SPony. So getting minerals/vitamins/antioxidants is better/more useable for our bodies. Check.

The problem is for me, I need to be taking 4,000mg of Vitamin C, 500 mg Magnesium, 1,000 mg Aceytl L Carnitine, 1,200 mg Fish Oil, and many other supplements daily to help manage my chronic illness/disability symptoms. Many of which have huge antioxidant properties/reactivity. I cannot eat that much veggies/fruit in a day, even if I tried. Ugggggh.

I will definitely be putting this on the list for the next MO message I send. Color me concerned.

Why do they not tell us this??????

ksusan

Because there isn't firm evidence one way or the other. Do talk with your MO, but don't let Dr. Google freak you out.

Spoonie77

Thanks KSusan. Appreciated. Some of that info is coming directly from NCBI, which I trust. It's not random Dr. Google in otherwords, but you are right not going to freak out. Will definitely be asking my MO about my specific supplements needed to maintain my QOL.

gb2115

The issue with antioxidants from food via from supplements is in the dosage. It's not necessarily that the same nutrient in food is safer in the same dose. However, you're never going to get 4000 mg of vitamin C from food. There's concern that high levels of antioxidants "feed" tumor cells...the amount you'd naturally get in food is way lower than a mega-supplement. That's why no radiation oncologist is telling people to avoid fruit---it's not necessary because normal amounts of these things are low in food (but sufficient assuming normal food intake). Eating 4000 mg of vitamin C through food could potentially cause the same issues regarding feeding a tumor through antioxidants.

I would discuss with your MO and make sure they know you are taking mega doses, not the amounts in a weak multivitamin. It's all a risk vs benefit, and your MO is there to help you sort it out.

Spoonie77

Thanks GB. They do know, but I will refresh their memories because dang it if I wanna go through all I"m going through only to "help" the caner come back! Eeeek.

ShetlandPony

The difference in food vs. supplement may not only be dosage, but that other substances, micronutrients, phytochemicals etc. may be present in the food and affect how the vitamin etc. works in the body. In the book I mention below, Block suggests that the closer supplements are to whole natural foods, the more likely they are to be safe and healthful (page 290).

Spoonie, I see your dilemma, as you need to consider your other health issues as well. As you know, with almost any approach we take to dealing with illness, there is a risk-benefit calculation to be done, and quality of life is part of the calculation. In your situation I would do the following: Take copies of the articles to each of your physicians, your oncologist and the one who helps you manage your other chronic condition, so they can see that your concern is not some vague internet-fueled panic but based on some research. Better yet, also ask the nurse to give them the papers to read before you appointment. Also I would continue to follow the research on this topic. Third, I would look for someone to help me balance everything and make an individualized plan. Specifically, I might try to get a consultation at the Block Center for Integrative Treatment in Illinois. I have read Keith Block's book Life Over Cancer, and they seem to understand a lot about integrative treatment, including nutrition, and are grounded in science.

santabarbarian

Spoonie,

Just a FYI... I had a consult with an integrative Oncologist in Chicago called Dr Keith Block (The Block Center) who is very well regarded, and he has had me on a huge number of supplements including antioxidants (C, selenium, magnesium, omega 3 fish oil, curcumin, quercetin, ubiquinol, alpha lipoic acid, etc....) during my chemo and continuing still. I do high doses of curcumin and fish oil and pretty standard doses of the others. There is not a lot of definitive evidence for or against these supplements, but his personal practice has been giving patients a lot of supplements for about 30 years and his patient outcomes are great. (That is not a double blind trial, but it is reassuring.)

My MO in my town looked up everything I was recommended to take by Dr Block. and the only adjustment I needed was to back off curcumin and fish oil for a few weeks before my surgery, as those two are blood thinners.

I had a great outcome from chemo (taxotere/ carboplatin) and have recovered rapidly and well. I am still on the supplements and plan to stay on them through my window of recurrence -- and maybe forever.

LeesaD

My MO and RO both told me to avoid antioxidant supplements during treatment. They explained to me in simplest terms that antioxidants protect your cells..not just the good ones but the bad ones too so during treatment you don’t want to protect the bad cells. They never said anything about post treatment but I don’t take antioxidants anyway. I just take Vitamin D which isn’t considered an antioxidant.

Staceybee

Spoonie – thank you for starting this discussion on antioxidants and the potential for their use to accelerate cancer cell growth as I have also been reading about this, which has decreased my enjoyment of the blueberries and green tea I have every morning.

As noted in the article in the links below, a study way back in 1994 of smokers without diagnosed cancer resulted in those taking the antioxidant betacarotene developing cancer at higher rates than the control group. The hypothesis is that many of the smokers already had undiagnosed microtumors and the antioxidant accelerated the growth of the microtumors in those who took it. The logic is that the antioxidant protected the cancer cells from apoptosis. Another study of smokers and those exposed to asbestos had a similar outcome and the study had to be stopped early because of the higher rates of cancer development. Other studies with other antioxidants, vitamin E and NAC, raise the same concern. So then I think about my case: I had ILC removed in a lumpectomy – but ILC can be multifocal and contralateral. What if I have undetected microtumors in my other breast – and even though I am on an AI to starve cancer cells of estrogen – can antioxidants provide a benefit to the cancer cells?

I am pretty confused. Should I even be drinking green tea? I had been taking melatonin to help me sleep, but that is an antioxidant, so I've stopped that for now.

I saw an interview with the breast surgeon Dr. Kristi Funk on Good Morning America and among the 10 things she recommended was amla powder, called the world's "most powerful antioxidant." So I started taking it – I didn't even ask my oncologist, who is very "medical" and I expected would be dismissive, but I thought, "How could it hurt?" Dr. Funk is a renowned doctor, she would not be recommending anything that could be harmful. But after I started learning about the potential negative effects with Then I re-read the interview and it is titled the "Top 10 breast cancer prevention tips." Is there a distinction – antioxidants can be helpful in preventing cancer, but harmful if you have it? In his 2012 paper, James Watson, the former head of the National Cancer Institute (and Nobel Prize Winner) suggests that antioxidants could be causing more cancer than they prevent.

Needless to stay, I have stopped taking amla as well.

I am going to make an appointment with the head of the Integrative Medicine at the cancer hospital where I am treated to ask him his views on all of this. (When I saw him last year after I finished radiation and tried to ask about complementary supplements he evaded the topic and directed me to their exercise, acupuncture and meditation programs - but I think I am better informed now so will ask some more direct and specific questions.)

marijen

Here’s a better study Spoonie, I’ll go with this one!

Antioxidants (Basel). 2019 May 18;8(5). pii: E137. doi: 10.3390/antiox8050137.

Dietary Flavonoids as Cancer Chemopreventive Agents: An Updated Review of Human Studies.

Rodríguez-García C1,2, Sánchez-Quesada C3,4,5, J Gaforio J6,7,8,9.

Author information

Abstract

Over the past few years, interest in health research has increased, making improved health a global goal for 2030. The purpose of such research is to ensure healthy lives and promote wellbeing across individuals of all ages. It has been shown that nutrition plays a key role in the prevention of some chronic diseases such as obesity, cardiovascular disease, diabetes, and cancer. One of the aspects that characterises a healthy diet is a high intake of vegetables and fruits, as both are flavonoid-rich foods. Flavonoids are one of the main subclasses of dietary polyphenols and possess strong antioxidant activity and anti-carcinogenic properties. Moreover, some population-based studies have described a relationship between cancer risk and dietary flavonoid intake. In this context, the goal of this review was to provide an updated evaluation of the association between the risk of different types of cancers and dietary flavonoid intake. We analysed all relevant epidemiological studies from January 2008 to March 2019 using the PUBMED and Web of Science databases. In summary, this review concludes that dietary flavonoid intake is associated with a reduced risk of different types of cancer, such as gastric, breast, prostate, and colorectal cancers.

KEYWORDS:

antioxidants; cancer; diet; flavonoids

PMID:

31109072

PMCID:

PMC6562590

DOI:

10.3390/antiox8050137

Peregrinelady

When I was first diagnosed, I researched quite a bit and did find some info about antioxidants that suggested that mega doses could encourage cancer growth. I was concerned because as a teacher, I used to take Emergen-C on a daily basis. It has an amount of vitamin C many times the daily requirement. I immediately quit taking it and even returned the tea I had ordered from John Hopkins. I now only take Vitamin D. It just kind of makes sense with the whole "do things in moderation" theme.

marijen

Peregrinelady, Wow, you had your surgery a year after your dx? We were dx’d the same time.

Peregrinelady

Hi Marijen, actually I had my left mastectomy in May 2015, then the right mastectomy and reconstruction at the same time in April 2016. I just didn't know how to separate them on my profile.

godisone

Spoonie77 you have raised a really important issue. When i come across any such articles or when i am just double mind about the nutrition i am currently on, i prefer taking everything which nature provides us in its simplest form like i would never mind fruits as a way to derive sugars but would definitely not go for complex and processed sugar loaded in a brownie or muffin, to me home cooked food is better any day as compared to the low fat and low carb brunch at a famous restaurant. Cooked over uncooked and natural over processed is my mantra. Supplements are not really required if you are taking a balanced diet with all the essential nutrients, minerals and vitamins. Do not follow fad diets and just stick to the traditional way of consuming the locally grown food that has been consumed by generations. Stay clear of alcohol and smoking as it deprives the body of many essential minerals and vitamins, add a little work out to your everyday regime and you are good to go towards a healthy, happy life.

SandiBeach57

I guess I need to reevaluate my vitamins and supplements. Not sure if MO is the best resource and will try to find a nutritionist for cancer patients.

Any input would be appreciative with respect to anti-oxidants..

I am in treatment for Stage IV diagnosed with liver mets.

I take Calcium (1200mg), D3 (2000iu), Magnesium (250mg), Vitamin K2 (100mcg) for osteoporosis. I also take Vitamin C (1000mg), Vitamin E (180mg), Fish oil (2400 mg), Vitamin B complex, Milk Thistle (175 mg) for liver, Glucosamine (1500 mg) and Chondroitin (1100mg) for joint pain.

I also drink an elixor of lemons, garlic and ginger..not daily, just when I feel up to making it!

S

santabarbarian

The advice we get is all over the map because of the lack of double blind studies in this area. Also, there are several distinctly different kinds of breast cancer and some of them will be different in their responses to various foods and supplements. One size does not fit all.

There are some very good sources of info though... 1. MDs who have long experience w patients on these supplements, 2. anecdotal evidence like large population studies. In the case of large population studies, who gets cancer and who does not, or who recurs and who does not. For example, metformin emerged as protective against recurrence in a population study when those taking it showed much lower recurrence. Walnut eaters did better. Those with low animal fat diets did better. Etc.

The Moss Reports are a great source of info. These are cancer specific reports assembled by a scientist about all the things show to reduce recurrences and lower risks.

MOs are, sadly, NOT the best source of nutritional info unless they are integrative-medicine-aware. Naturopathic physicians with cancer subspecialty or integrative MOs would be a better bet.

Though he cited lack of double blind clinical trials re supplements, my hometown MO looked up every single thing that Dr Block recommended for me in my consult, and was comfortable with all of it in the end. (When my tumor rapidly shrank his tune changed from a bit dubious to very supportive.) I think I may have been one of his first patients to do High Dose C IVs, etc.

Granted I am a data point of one but I think my supplement use was key to how well I knocked out the cancer, withstood chemo and bounced back. I feel incredible. Even in between my early chemos I felt much better than I had pre-diagnosis, once I had a super-nourished diet. I am continuing on my supplements and very comfortable with this choice.

Dr Block's book "Life Over Cancer" talks about the evidence in support of antioxidants.

Spoonie77

Thanks everyone for the comments.

I wish I could just go it natural and derive from foods, but like a few others here on the thread I also am treating for other conditions which require supplementation. I see my MOs PA tomorrow for my first Lupron injection, I"m going to ask her, but I'm guessing I will get the standard response of "Eat what you need" which is impossible for people like myself and SandiBeach. If I find out anything of interest, I'll be sure to pass it along.

Beesie

Dark chocolate is an antioxidant. Therefore it is obvious to me that antioxidants are good for us. In moderation, of course.

Spoonie77

Lol Beesie - wholeheartedly agree with that one! Nommmm nommmm nommm

SandiBeach57

I will add dark chocolate to my supplement list...

marijen

Here's another study Spoonie

Cell Cycle. 2012 Apr 1; 11(7): 1445–1454.

Published online 2012 Apr 1. doi: 10.4161/cc.19841

PMCID: PMC3350881

PMID: 22395432

Mitochondrial metabolism in cancer metastasis

Visualizing tumor cell mitochondria and the "reverse Warburg effect" in positive lymph node tissue

Excerpt:

Most cancer patients die from tumor recurrence and metastasis, not from primary tumors. Thus, great reductions in cancer-associated mortality could be achieved by the prevention of tumor recurrence and metastasis. Several groups have directly implicated the production of hydrogen peroxide in tumor recurrence and metastasis, using mouse animal models. In this context, treatment with catalase (a powerful catalytic antioxidant that detoxifies hydrogen peroxide) is sufficient to almost completely block tumor recurrence and metastasis.^{27,31–37,51–53}

So, what is the role of hydrogen peroxide in cancer cell metastasis? We have previously shown that cancer cells secrete hydrogen peroxide to induce oxidative stress in neighboring normal cells, such as stromal fibroblasts.^27,37 Oxidative stress in cancer-associated fibroblasts, in turn, provides high-energy fuels for cancer cells to burn via oxidative mitochondrial metabolism.^16,17 Thus, cancer cells that produce hydrogen peroxide can leave the primary tumor site, as they will extract nutrients from any adjacent cell, wherever they go, via oxidative stress and stromal autophagy. Here, we have directly visualized this metabolic coupling in both primary and metastastic breast cancers using markers of mitochondrial function, oxidative stress and glycolysis.

These findings have important clinical implications for anticancer therapy, especially using antioxidants. Consistent with this notion, breast cancer patients treated with simple antioxidants (Vitamin C and E) after conventional therapy showed dramatic reductions in both recurrence and mortality (>20%).⁵⁴ If breast cancer patients that had undergone radio-therapy (a treatment that generates and enhances oxidative stress) were excluded, the antioxidant-induced reductions in both recurrence and mortality approached nearly 40–50%.⁵⁴ Thus, we should reconsider the use of antioxidants as a critical component of anticancer therapy.⁵⁴

Conversely, most conventional therapies (chemo ± radiation) kill cancer cells via increased oxidative stress.²⁰ However, sub-lethal doses of conventional therapy, which fail to kill all the cancer cells, may be inducing systemic oxidative stress and the "reverse Warburg effect," leading to tumor recurrence and/or metastasis, or even secondary malignancies, such as leukemias and lymphomas.^20,55,56 This may explain why combining antioxidants with conventional therapy effectively reduces mortality and recurrence by preventing the local and systemic induction of the "reverse Warburg effect."^55,56

Anonymous

I would like to chime in and suggest that whole foods are good sources of nutrients, but pesticide-free, hormone free foods are even a bit better for our health. The problem with just eating food, according to my naturopathic oncologist, is that we usually can't even get RDAs in simply eating food because our soils are so depleted of nutrients in the first place. I take Vit D, liver support, and some misc. amino acids for hair and nails and mood, my MO checks my Vit D levels, and I leave it at that, mostly. Supplements are incredibly costly, and I eat pretty well organically and feel pretty good overall.

Claire in AZ

santabarbarian

claire, my integrative MO said the same. A vegetable grown in depleted soil is not the same as one grown in healthy soil.

wallycat

Here's my take. Pro-oxidants are as important as antioxidants. Our bodies fight diseases and help our immune system via pro-oxidants but too much is bad. Antioxidants help modify some of the pro-oxidants but too many antioxidants begin to act (or change to) pro-oxidants. So the problem isn't that either is bad, it is how to figure out what each of our bodies requires and stay in that homeostasis range. Genetics is just one component. Our past lifestyles seem to also affect various antioxidants/vitamins/supplements.
For example, former and/or current smokers increased risk of cancer with vitamin A supplements, but not beta-carotene supplements. And the dose had to be above a certain threshold. There are other studies that show Vitamin E might also play a part with smokers. Are there other habits? Some runners log so many miles that their body has too many pro-oxidants, even though exercise is good for us, there is a threshold.

The old saying everything in moderation, including moderation ...

I agree that in a perfect world, nutrition should come from food but there (to my mind) is so little advancement in nutrition information. If you're looking at studies that are older, we have to accept that some plants/veggies have become hybridized (some for better, some not), the soils are depleted, the growing season has changed and the trucking/shipping has increased.

I found this article that does a very good summary to explain some of what I wrote: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC39209...

Anonymous

Thank you Wallycat!

ShetlandPony

A good place to find links to scientific papers about food and supplements is

Foodforbreastcancer.com

santabarbarian

One of the best resources I have seen is The Moss Report on Breast Cancer. The report is assembled by a scientist named Moss who culls through all the medical literature out there and presents the complimentary and conventional practices with the most well-validated evidence supporting them. (One of my friends bought the BC one for me.) Much evidence supports specific supplements and foods, and some of them are specific to certain kinds of BC.

Staceybee

I wanted to report back about my meeting with the head of integrative medicine for a major cancer hospital re: the discussion about anti-oxidant use. When I walked to into the appointment he introduced me to a doctor of Chinese medicine and a pharmacist specializing in cancer, who would join us. I thought, great - two additional experts.

I asked the lead doctor about the studies and views that anti-oxidant supplement use could actually protect cancer cells and promote proliferation. He said, yes, that is a possibility and that they recommend no supplementation of any kind. I mentioned I was using amla (gooseberry powder), he said don't take it. I asked about melatonin to help me sleep, he said don't take it. I asked if I could take turmeric supplements for joint pain, he said don't take it. Nada, nothing, no supplements. All the center recommends is a plant-based diet, lots of cruciferous vegetables, wild caught fish, minimal sugar and alcohol, limited soy and flax - the commonsense basics. The doctor of Chinese medicine and pharmacist did not say a word during the meeting. What was the point of them being there?

I asked about drinking green tea - if it is an anti-oxidant should I drink it? He said, oh, green tea is very good for you - you should drink it. How that makes sense, I don't know, but did not push it.

Instead of melatonin, he sent me to someone to teach me cognitive behavioral therapy to sleep better. This was my second time meeting with him - the first time a year ago, he put me in an acupuncture study and signed me up for an exercise class. They also keep sending me emails about meditation classes.

I have to admit that I found the meeting frustrating and deflating. There must be hundreds of papers and studies on nutritional and supplemental strategies in addition to the medication, but according to this center, it doesn't boil down to anything.

santabarbarian

Not all Integrative Oncologists agree with that advice, as you know. The diet advice I got was identical to yours. But I was told to do a lot of supplements + melatonin + metformin by my integrative MO.

Its ANNOYING that there is not a general agreement!