Antioxidants, free radicals, oxidative stress
Comments
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I want to start a new thread for this topic because people frequently ask if it's ok to take antioxidants during chemo or rads. I recently read Ray Strand's book What Your Doctor Doesn't Know about Nutritional Medicine May Be Killing You. Before I return it to the libary, I want to extract some key points for my own future reference, and hopefully some helpful information for anyone trying to navigate the information overload during treatments.
In a nutshell, Dr Strand strongly recommends antioxidants to protect existing health and to combat disease. He started as a mainstream doctor and began to open his eyes after years of seeing his wife go downhill as she suffered the effects of fibromyalgia. All the treatments he provided in accordance with his training were ineffective. After years of suffering and steady decline, his wife began taking supplements. She rose from her sickbed and resumed her life.
In the cancer and chemotherapy chapter, he addresses the question asked so frequently -- should antioxidants be taken during chemo. The short answer is YES. He quotes the work of Drs Kedar Prasad and Arun Kumar at the University of Colorado Medical School Radiology Department. These two doctors reviewed more than 70 studies and concluded that high doses of multiple antioxidants used together enhanced chemotherapy treatments. The title of the report is "High Doses of Multiple Antioxidant Vitamins: Essential ingredients in improving the efficacy of standard cancer therapy" and it appeared in the Journal of the American College of Nutrition. Any negative findings were scattered and limited to one nutrient.
Strand goes on to say that normal cells take only what antioxidants they need, whereas cancer cells absorb antioxidants without knowing when to stop. This makes the cancer cells more susceptible to cell death. "Antioxidants not only aid in the battle against cancerous cells, they improve the defense of healthy cells against the damaging effects of radiation and chemotherapy." This is important, of course, because a cancerous tumor consists of rapidly dividing cells that thrive without oxygen and live long past the normal life of a cell.
Throughout the book, Strand mentions oxidative stress and the profound ill effects it can have on our health, ie, free radicals. Probably everyone has heard of free radicals by now and how antioxidants will combat them, but I didn't really grasp the magnititude of the damage free radicals can cause. Chemo can cause damage to lungs, liver, kidneys, heart and skin, and vitamin E is effective in combatting that damage. CoQ10 protects against the long-term heart damage that adriamycin causes.
I think this information is so important. This book was published in 2002. There is no good reason for doctors to continue playing dumb when people ask questions about supplements. Even more so, they are performing a huge disservice to advise against antixodants, claiming they don't know what the effects would be, therefore they advise against it.
I'll be adding some information from other chapters, but I wanted this to be at the top for those with short attention spans or information overload.
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Althea,
There's other research saying the exact opposite. They've been testing this theory on mice. Do antioxidants help or hinder, and for brain and breasts tumors its better to have a depleted antioxidant diet till the cancer cells are dead and gone:
http://jn.nutrition.org/cgi/content/full/134/5/1139
Mice are not people and in some cases, in humans, vitamin C helped in colon cancer. And it could be just the kind of antioxidants they used. Too iffy.
Does Strand point out any human studies on this?
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Before anyone gets upset over vitamin E, there is research saying the mixed kind is beneficial. I'll try posting the address to the research, it might be too long.
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Rosemary, have you read Ray Strand's book on nutritional medicine? I was hoping to keep the focus on this particular source of information mainly because there seems to be so many doctors out there advising their patients against supplements because 'they don't know' what the effects will be on treatments. Clearly, information IS available, and I was hoping to use this thread simply to put the information of this particular author in an uncomplicated thread where people might find it with the search tool.
The next tidbit from the book I want to mention here is the percentage of graduating physicians who receive any formal training in nutrition -- a measly 6%. The citation listed is page 68 of American Journal of Clinical Nutrition (1998). The main focus of physician training is detection of disease and how to treat disease with drugs.
Back in the days when infectious disease was the leading cause of death, medicine made great strides in lengthening our life spans. Nowadays, most health challenges are chronic, degenerative diseases. Dr. Strand toed the line of mainstream medicine for 23 years before he began to study potential benefits of vitamins and supplements. He devoted 7 years of study on this subject before writing the book. Of course there will be other doctors with impressive credentials arriving at different conclusions. And as always, it's up to us to decide who has information that's credible.
The next post I add to this thread will come from the heart disease chapter where the story of a doctor's career literally goes into the basement when his research focused on something besides cholesterol as the major risk factor in heart disease.
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Did you know that sudden death by heart attack is frequently the first detected sign of heart trouble?
Did you know that roughly half the heart attacks each year happen in people with normal cholesterol levels?
Did you know that high cholesterol used to be anything under 320?
I doubt if anyone who reads the news or watches tv can go an entire day without hearing some cautionary statement about high cholesterol. Yet, studies from decades ago show heart disease is the result of inflammation of the blood vessels. Further studies revealed that inflammation of the blood vessels can be controlled by adequate levels of antioxidants.
Cholesterol levels are important, of course, but so are homocysteine levels. Chances are, the latter is something unfamiliar. A young Harvard-trained pathologist, Dr McCully, in the 1960s took an interest in the cases of two young boys who died of heart attacks. They appeared to have hardening of the arteries, something more common in much older people. Apparently, when our bodies are presented with methionine, an amino acid found abundantly in the standard american diet, a byproduct called homocysteine is produced. When we have an overabundance of homocysteine, our bodies convert it back to methioinine or cysteine.
Both cysteine and methionine are benign, but in order for the conversion from homocysteine to take place, our bodies need folic acid, B6 and B12. Should our bodies be deficient in these three B vitamins, the levels of homocysteine start to rise.
Dr McCully's reports on homocysteine appeared in medical journals in the 60s and 70s. At that time he was an assistant pathologist at Massachusetts General Hospital and an assistant professor at Harvard Medical School. The chief of the department at Harvard was supportive of this work, but then a new department head arrived. Dr McCully was told to seek his own research funding. His lab was moved to a basement. In 1979 Dr McCully was terminated because his theory linking elevated homocysteine levels to heart disease had not been proven (cite referenced is a New York Times article published August 1997). He subsequently lost his other job at the hospital and a former Harvard classmate labelled McCully's work as "errant nonsense" and a "hoax being perpetrated on the public." Coincidentally, research that WAS being funded at that time focused on the theory of heart attacks being connected with high cholesterol levels.
In 1990 the homocysteine theory received new interest. Dr Stampfer of Harvard School of Health looked at these levels in 15,000 physicians who participated in a study. "Dr Stampfer reported that even mildly elevated levels were directly related to an increased risk of developing heart disease." In 1995 Dr Selhub arrived at similar conclusions, coupled with an observation that "most patients with high homocysteine levels also had low levels of folic acid and vitamins B12 and B6 in their bodies."
These findings are corroborated by a large case-control study, The European Concerted Action Project. Further conclusions indicate that risk of vascular disease is dramatically increased when combined with other risk factors of hypertension, high cholesterol, or smoking. More simply stated, the lower the homocysteine, the better.
Have your homocysteine levels ever been checked? I'd never heard of it until I read this book. I seriously doubt mine have ever been checked, even though chemo, esp adriamycin, is notorious for causing heart damage. Should you have the good fortune of having a doctor who actually checks this particular item, it's best to have a homocysteine level less than seven (micromols per liter of blood) and anything over 12 is troublesome. So get your actual number because the 'normal' range is defined as anything between 5 and 15.
In summary of this chapter, Dr McCully attended a reunion at Mass General where he encountered someone who said "Well, it looks like you were right after all." Some consolation, 20 years later. Not!
There's a lot of great information throughout this book. My copy is due today so this will be my last 'book report' entry on this thread. I know at least one or two people from the natural girls thread own a copy of this book, so if there's any questions, maybe someone can look up an answer. As for the quality of information in this book, all I can say is it resonates with me. I can only hope that my inner voice guides me well as I try to discern what information is pertinent and accurate. I think the story of Dr McCully is relevant to us as cancer patients because it illustrates how the very careers of researchers is directed by the influence of money. Research has to be funded in order for it to happen. It sure seems to me that vitamins are a good source of income for somebody, but I guess in comparison, supplements pale in comparison to the profits made by pharmaceuticals. Now I'll have to go squint at all the labels of my supplements to see if I'm getting enough folic acid, B6 and B12.
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Oh, one more item really must be mentioned here. The RDA (recommended daily allowance) numbers are minimums. Optimal levels are nearly always higher, frequently MUCH higher than the RDA.
Also, there is a problem with quality since standards for supplements are not the greatest. How are we to know if we're getting what the package says on the label? Fortunately, there's an answer! What we need to look for is GMP -- Good Manufacturing Practices. Companies that follow these practices produce "pharmaceutical-grade supplements." US government does not require these practices to be followed, but some companies choose to follow them in order to assure customers of quality.
Another standard to look for is USP (US Pharmacopoeia) standards . "These are government guidelines that assure you and me that medications and supplement tablets will be absorbed by our bodies." I can't remember if it was in this book or elsewhere that recommends you place a supplement in warm water and observe it 30 minutes later. If the tablet or capsule hasn't dissolved, it may indicate a poor rate of absorption. ...I have to wonder about this one, now that I've typed it out. After all, our stomachs contain some pretty powerful acids for breaking down whatever passes through.
Anyway, hope this thread is helpful to lots of people who are trying to make heads or tails out of the mountains of information we encounter in breastcancerland.
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Althea, thanks for the wonderful info! My naturopathic MD tested my homocysteine level it was at 11, she put me on prescription B's plus folic acid its called Metanx, as she wanted to see the level at 7, I will have it retested in a few months.
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I had to ask my Cardio to do a homocysteine test. He didn't offer. But I knew about having the test done, and sure enough it came in high. I asked him what I should do about it to fix it, he wanted to up my statin dosage. I happened to have to go to my Onc that same week, I asked him what I should do about fixing it, he wrote me a prescription for 5000 mgs of folic acid to take for 3 months. I had it re-tested and it was down to normal range. Statin or folic acid? It was an easy choice for me to make. I don't see that cardio anymore.
Good info Althea.
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How great both of you have already had your homocysteine levels tested! Except, why do we have to ask for these tests?? Rosemary, how did your cardiologist react when you asked for the test?
Can you explain why your doctors are writing prescriptions for B vitamins? Is it a cost savings issue? Aren't all the B vitamins available over the counter?
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Althea, the naturopathic MD that I see, offered the Metanx, its high dose B6, B12 and Folic, I guess its the combo that works to lower the homocysteine level, for me personally it was easier than trying to figure it out myself.
L
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Althea,
They write prescriptions because of the high dosage needed for the repair. My cardio gave me a blank look when I asked for the test. Said nothing. Yes, why do we have to ask for it?
B6 in high doses can cause neuropathy in some people. It really needs to be no higher than 25 mgs - 50 mgs...a good B complex will take this into consideration. You'll see dosages all over the place in a good one. That's the way they should be, not one set dosage for all the B's.
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Thank goodness my PCP checked both my homocysteine and cholesterol levels (along with many other things) when I saw her at the end of my tx. Both were shockingly high for the first time ever, which she and I both attributed to chemo and rads. Like Lorraine, I'm on Metanx for the homocysteines, and will have bloodwork done again this month. I would not take no for an answer if a doc won't order these. Deanna
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Rosemary, at least your dr agreed to do the test. I asked for a specific test last year for my thyroid levels and my internist refused to even authorize the dern thing. I''m looking at my multivitamin label and there's only 400 MICROgrams of folic acid (100% RDA). That's oceans apart from 5000 MILLIgrams.
I also looked at the website for metanx and it looks like something just for diabetics. fairy and dlb, are you diabetic? Seems to me like there's a lot of people besides diabetics that could benefit from metanx. In any case, this metanx sure backs up Strand's assertion that the RDA is woefully inadequate if we have some damage that needs to be reversed.
Deanna, have you actually had a doctor say no when you request a test? I'm wondering how you get a yes in that situation or if you find another doctor at that point. I tried to get my estrogen levels tested at the oncologist's office and got nowhere. That's one of many reasons why I don't go back there anymore. I probably wouldn't get anywhere with asking for homocysteine testing either, even though I received adriamycin which is notorious for causing heart damage.
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althea ~ No, I'm not diabetic, and I don't know exactly why Metanx is also RX'd for high homocysteine levels. Since it's a vitamin supplement, I didn't worry about taking it, and was just relieved that it, and not a drug, was my PCP's treatment of choice. I just hope it works!
As far as onc's not testing us for collateral damage, I think that's just how they operate. They focus on getting us through chemo, and let our PCP or specialists pick up the pieces and undo the damage. I had a similar experience to yours when I asked my onc's nurse if she could add a cholesterol test to the CBC my onc had ordered. She said, no, my insurance wouldn't cover it. When I offered to pay for it out of pocket, she just rolled her eyes and shook her head and never did go and ask my onc, as I asked her to. This was only because she had commented that she could see fat globules in my blood and asked me if I'd ever had high cholesterol, which alarmed me because I never have. Luckily, my PCP is an internest, and very thorough about bloodwork. If she wasn't, I think I would go to a naturapathic doctor -- which I may still do for some other areas of concern, especially progesterone. My insurance won't cover a naturapath, but I believe they'll pay for the bloodwork. (Not sure -- still want to check on that if it's not ordered by an M.D.)
Anyway, have you asked your PCP to check your homocysteine levels? I think that's something that falls into their overall scope of interest, because I think it's a key, heart disease prognosticator. Deanna
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Althea,
You normally wouldn't want to take a high dose of folic acid on a daily basis. The high dose is just for special circumstances and only taken for 3 months. First you have to find out if you have a high homocysteine level.
I'm due to see my Cardio and I was thinking of asking him to check for my vitamin levels. To me, all these things are connected. If they don't do the research how do they know if low vitamin levels have anything to do with heart disease? We have to be our own advocates, and Drs. shouldn't say no to normal testing procedures.
Your gyno would do the hormone levels. They do them all the time.
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Nope not diabetic either, the doc explained to me that Metanx is just vitamins, so did the pharmacist when I asked them. When I asked my Onc AND my gyno to do my hormone levels they both said no, go figure!
L
ox
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Tell the gyno your growing hair in strange places, do a hormone check. That usually works. I can't believe these Dr's would turn down doing a hormone test. I can believe it but I have to wonder why. I guess I'll never find out.
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These quotes are taken from a couple of different sites on the topic of antioxidants and their benefits for treating cancer - intravenous vitamin c in particular. Rosemary, I'm not sure if you are a family practitioner or oncologist, or just skeptical, but I encourage you to do the research for your own benefit. I have first hand witnessed the benefits of antioxidant therapies to treat cancer. Through a very dear loved one and several acquaintances and friends of mine. Please read the following - for your own benefit...
Conventional medicine is in an alternate universe on this subject because they are too busy protecting the drug industry's profits in treating cancer.
No non-toxic, readily available agent has ever been approved by the Food and Drug Administration for the treatment of cancer. Intravenous Vitamin C for the treatment of cancer, is highly effective and readily available. It is also an inexpensive alternative to chemotherapy and therefore you will not find many drug companies lining up to test and market such a readily available agent. And so the question of what vitamin C can do for patients, has inexcusably remained in limbo.
Thirty years ago, Nobel laureate Linus Pauling advocated HIGH-DOSE VITAMIN C as part of the treatment of cancer. His recommendations were based on a small number of patients who had been given either oral or intravenous (IV) vitamin C. Subsequent clinical trials at the Mayo Clinic failed to demonstrate any benefits from oral vitamin C, and the therapy was rejected by conventional medicine.
Recent experimental studies, however, have found that IV VITAMIN C can raise blood levels of vitamin C 25 to 70 times higher than those achievable through oral supplements. That’s significant because such high doses are toxic to cancer cells, but not normal cells.
To explain, large amounts of oral vitamin C increase blood levels up to 70 to 220 μmol/L – far less than the 1,000 μmol/L needed to destroy many types of cancer cells. With IV vitamin C, blood concentrations can be increased up to 14,000 μmol/L of blood. In a report in the Canadian Medical Association Journal, Mark Levine, MD, PhD, of the U.S. National Institutes of Health, and his colleagues described three people treated with IV vitamin C and other supplements. Two of the patients are still alive, and the third (a long-standing cigarette smoker) lived much longer than expected.
One of the cases was a 49-year-old man diagnosed in 1996 with a primary bladder cancer that was starting to metastasize. The tumors were removed surgically, and the patient declined chemo and radiation therapy. The patient decided to receive IV vitamin C at the Bright Spot for Health, a nutritional medicine clinic in Wichita, Kansas. He received two 30-gram IVs weekly for three months, followed by 30 grams once every month or so for four years. “Now, nine years after diagnosis, the patient is in good health with no symptoms of recurrence or metastasis,” wrote Levine and his coauthors.
In a separate report published in the Puerto Rico Health Sciences Journal, doctors described the safety of high-dose IV vitamin C in 24 late-stage terminal cancer patients. The patients were given 10,000 to 50,000 mg of IV vitamin C daily. Most had been deficient in vitamin C before treatment, and side effects were infrequent and mild.
Levine and his colleagues believe that vitamin C produces large amounts of hydrogen peroxide, a potent generator of free radicals, inside tumors. The mechanism is similar to conventional chemotherapy, but without the side effects.
However, a recent report in the journal Nature suggests another mechanism to vitamin C’s benefits. Cancer cells produce large amounts of the enzyme lysyl oxidase, which promotes metastasis. However, an earlier study found that vitamin C inhibited the activity of lysyl oxidase.
(OMNS) National Institutes of Health scientists have confirmed the concepts that vitamin C is selectively toxic to cancer cells and that tumor-toxic levels of vitamin C can be attained using intravenous administration. -
Rosemary44, this is in response to a previous response you had regarding antioxidants. These quotes are taken from a couple of different sites on the topic of antioxidants and their benefits for treating cancer - intravenous vitamin c in particular. I have first hand witnessed the benefits of antioxidant therapies to treat cancer. Through a very dear loved one and several acquaintances and friends of mine. Please read the following... Conventional medicine is in an alternate universe on this subject because they are too busy protecting the drug industry's profits in treating cancer.
No non-toxic, readily available agent has ever been approved by the Food and Drug Administration for the treatment of cancer. Intravenous Vitamin C for the treatment of cancer, is highly effective and readily available. It is also an inexpensive alternative to chemotherapy and therefore you will not find many drug companies lining up to test and market such a readily available agent. And so the question of what vitamin C can do for patients, has inexcusably remained in limbo.
Thirty years ago, Nobel laureate Linus Pauling advocated HIGH-DOSE VITAMIN C as part of the treatment of cancer. His recommendations were based on a small number of patients who had been given either oral or intravenous (IV) vitamin C. Subsequent clinical trials at the Mayo Clinic failed to demonstrate any benefits from oral vitamin C, and the therapy was rejected by conventional medicine.
Recent experimental studies, however, have found that IV VITAMIN C can raise blood levels of vitamin C 25 to 70 times higher than those achievable through oral supplements. That’s significant because such high doses are toxic to cancer cells, but not normal cells.
To explain, large amounts of oral vitamin C increase blood levels up to 70 to 220 μmol/L – far less than the 1,000 μmol/L needed to destroy many types of cancer cells. With IV vitamin C, blood concentrations can be increased up to 14,000 μmol/L of blood. In a report in the Canadian Medical Association Journal, Mark Levine, MD, PhD, of the U.S. National Institutes of Health, and his colleagues described three people treated with IV vitamin C and other supplements. Two of the patients are still alive, and the third (a long-standing cigarette smoker) lived much longer than expected.
One of the cases was a 49-year-old man diagnosed in 1996 with a primary bladder cancer that was starting to metastasize. The tumors were removed surgically, and the patient declined chemo and radiation therapy. The patient decided to receive IV vitamin C at the Bright Spot for Health, a nutritional medicine clinic in Wichita, Kansas. He received two 30-gram IVs weekly for three months, followed by 30 grams once every month or so for four years. “Now, nine years after diagnosis, the patient is in good health with no symptoms of recurrence or metastasis,” wrote Levine and his coauthors.
In a separate report published in the Puerto Rico Health Sciences Journal, doctors described the safety of high-dose IV vitamin C in 24 late-stage terminal cancer patients. The patients were given 10,000 to 50,000 mg of IV vitamin C daily. Most had been deficient in vitamin C before treatment, and side effects were infrequent and mild.
Levine and his colleagues believe that vitamin C produces large amounts of hydrogen peroxide, a potent generator of free radicals, inside tumors. The mechanism is similar to conventional chemotherapy, but without the side effects.
However, a recent report in the journal Nature suggests another mechanism to vitamin C’s benefits. Cancer cells produce large amounts of the enzyme lysyl oxidase, which promotes metastasis. However, an earlier study found that vitamin C inhibited the activity of lysyl oxidase.
(OMNS) National Institutes of Health scientists have confirmed the concepts that vitamin C is selectively toxic to cancer cells and that tumor-toxic levels of vitamin C can be attained using intravenous administration. -
Niss,
These are the key words, a potent generator of free radicals that's why high doses of C are beneficial.
"Levine and his colleagues believe that vitamin C produces large amounts of hydrogen peroxide, a potent generator of free radicals, inside tumors".
Some think we don't want to be taking a potent generator of antioxidents that might hinder the work of free radicals. Some antioxidants seem to do just that, as in the research I posted at the beginning of this thread. It could be more beneficial to starve a tumor of some antioxidants, and let the chemo produced free radicals do their job. And others say not.
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^bump^
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I've also been curious about this subject. I looked into what 'chemo' is. It's an oxidant. If we are putting anti-oxidants in our bodies it is countering the effectiveness of the oxidant/chemo. I am focusing on providing an oxidative state for my body. I am drinking alkaline water with a pH of 8.5-9.0. I am taking TwinLab Gentle-C 500 and will be ordering Jarrow Formula's Beta Glucan Immune Activator, Garden Of Life RM-10 Ultra, Now Foods vit D3, Source Natuals Tumeric, Jarrow Formula's Toco-Sorb vit E tocotrienol complex, Metagenics I 3 C (indole-3-carbinol), and Nature's Answer Barley Grass. I am laying off the high anti-oxidants I was taking i.e., alpha lipoic acid. I was taking that with CoQ10. I was also taking a veggie carotenoid that had 20,000 IU in it. I read not to excced 6,000 IU of vit A a day because it utilizes the same receptors that vit D does. I had my D level checked and it was 26, which is insufficient. The range to have is 40-60 nanograms per milliliter.
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^bump^
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althea, you wrote: "Back in the days when infectious disease was the leading cause of death, medicine made great strides in lengthening our life spans. Nowadays, most health challenges are chronic, degenerative diseases."
Indeed, that's one of the main problems with conventional medicine: the most effective medical system in the world with regards to infectious diseases and trauma. But now stumped where chronic illnesses are concerned. And absolutely refusing to ackinowlege that they are stumped.
The debate about antioxidants during chemo versus no antioxidants will probably continue. I, personally, lean towards thinking that antioxidants during chemo is the best way to go, because this theory makes sense to me.....The other debates that will continue for sure are Bioidentical Hormones or no Bioidentical Hormones? And of course, mammo as a screening tool, or not?
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So glad this topic came up...I have been reading everything I can on anti-cancer vitamins, foods and supplements....I truly believe I know more at this time than my doctors...When I asked my Rad doctor if I should be taking extra during my rad treatments, she just answered to stay away from antioxidants..When I pursued the conversation and asked why she said that they would lesson the effect of radiation during the treatment that after the treatment it would have no effect, she said the antioxidants stay in our bodies about 24 hrs...So the way I see it is to take these right after rads treatment so when I go again, I will have had the benefit of them and they will be at thier weakest (24 hrs after last treatment) I also plan on giving myself extra on Saturdays...Now this is only my plan and I am not a doctor...I do a lot of research and ask a lot of questions...I agree that most doctors do not know the benefits of these tested anti -cancer nutrition/supplements studies and they just stick to the old ways...Some of these old ways make no common sense to me....We all just have to make our own choices of the information we are provided and also that we pursue outside as althea has mentioned,,,,I will be looking for that book, it is right up my alley...I just finished David Shreiber, MD, PHD..book called "Anticancer ..A new way of life"......
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I find that the Life Extension foundation has many answers to many questions, (not all), and when I joined I received this huge book titled Disease Prevention and Treatment. It just so happens that I was reading the section on antioxidants, and came upon this link.
http://www.lef.org/protocols/prtcls-txt/t-prtcl-153.html
somanywomen....
BTW....the book Anticancer is one fantastic book, and my daughter Lori, (dx with TNBC in June of 2007) and I have recommended this book to everyone.
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Nan, I had already put the Life Extension membership on my Christmas list....I also want gift cards to vitamin/health/organic shops..A little different from the diamonds of past...Boy have my priorities changed!!!!..Thanks for link, I just printed the info to read, find it very imformative.....
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