Can You Take Supplements During Cancer Treatment? What Experts Say

Laura Wright, ND, an integrative oncologist at Winship Cancer Institute of Emory University, estimates that “9 out of 10” of her patients ask about supplements.

Cancer care at Emory Winship Cancer Institute starts with the foundations of health, Dr. Wright says. “Nutrition, exercise, stress management and environmental toxin avoidance, among other topics. I generally do not discuss supplements right away.”

That’s because Dr. Wright’s goal as a licensed naturopathic doctor is to ensure people with cancer have access to safe, evidence-based integrative therapies that complement and support conventional cancer treatments.

“I always begin with a discussion about safety, as supplements are not regulated,” Dr. Wright says.

Unlike prescription medications, supplements aren’t approved or regulated by the Food and Drug Administration (FDA).

Manufacturers aren’t required to prove their products are safe. Although companies can make claims if they have scientific substantiation—such as “maintains healthy joints”—the product must include a disclaimer stating that the FDA has not evaluated the claim and that the product is not intended to “diagnose, treat, cure or prevent any disease.”

When patients ask about supplements, Dr. Wright asks what they are taking and where they purchased it because sourcing is a top priority.

“Due to lack of regulation, we cannot be certain that what is listed on the label is actually in the product,” says Dr. Wright.

Other things Dr. Wright takes into consideration:

• Only purchasing supplements on reputable websites that offer physician-grade products
• Evaluating the safety of any supplement in the context of a patient’s cancer-directed treatment plan
• Assessing potential interactions with chemotherapy, immunotherapy, radiation and other targeted therapies

Diet and nutrition are important for anyone’s health, and especially important for people undergoing cancer treatment.

“We emphasize a food-first approach,” Dr. Wright says, “ensuring that the body receives the essential nutrients it needs to support healing—nutrients that cannot be adequately obtained from supplements alone. I often refer patients to our nutrition department for additional guidance tailored to their individual dietary needs.”

She explains that a variety of nutrients and minerals play key roles in the healing process. She recommends patients:

• Consume anti-inflammatory foods
• Minimize processed foods in their diets
• Incorporate healthy fats, such as omega-3s from sources like fish, avocado and walnuts

“Diet is a priority since supplements cannot compensate for poor nutritional habits.”

Winship Cancer Institute incorporates clinical dietitians as part of its clinical teams—another ancillary service like Winship’s pharmacy or social workers, for example.

Registered dietitian Rachel Keller, MS, RD, CSO, LDN, offers nutrition advice and support to patients receiving treatment at Winship at Emory Saint Joseph's Hospital.

“Every patient is different,” she says. “We don’t have a compiled list of what’s okay for patients and what’s not because certain treatment regimens require patients to be more restrictive in which supplements they can and can’t take. We always tell patients talk to your dietitian or your pharmacist. They can cross-reference.”

“When a patient asks about supplements,” Keller says, “we’ll look at their health history, treatment plan and current medication list—whether that’s for cancer treatment or other underlying health conditions.”

The first step is to see how the drugs are processed in the body. Next, the care team reviews resources like the Memorial Sloan Kettering Cancer Center herbal database or the commission on dietetic registration’s practice groups herbal database. These databases share supplement clinical details, purported uses and benefits, and any adverse reactions reported in research studies.

“We’ll look at what drugs that supplement could potentially interact with,” Keller says.

If a patient’s treatment regimen is processed in the same way in the body as the supplement, it can interfere with its effectiveness or possibly make it more toxic. Even if it doesn’t interact with the cancer treatment, it may still interact with another medication the patient is taking for something else.

Although multivitamins are the world’s most common supplements, Dr. Wright is most often asked about specific herbs and vitamins that play a role in health during cancer treatment.

“The vitamin I most commonly highlight is vitamin D, as it plays a key role in immune function, mood regulation and numerous other health benefits,” she says. “Your medical oncology team or primary care physician can assess your vitamin D levels and recommend supplementation when appropriate.”

Vitamin D can be found in the following foods:

• mushrooms
• egg yolks
• fatty fish
• vitamin D-fortified milk
• soy milk

Vitamin D is naturally produced in the body by the skin’s exposure to sunshine. “A lack of time spent outdoors is common among many people—not just patients with cancer,” Dr. Wright explains. “It’s important to remember that we all need to step away from our work and daily responsibilities from time to time and spend meaningful time outdoors.”

About Winship Cancer Institute of Emory University

Dedicated to discovering cures for cancer and inspiring hope, Winship Cancer Institute of Emory University is Georgia’s only National Cancer Institute-designated Comprehensive Cancer Center, a prestigious distinction given to the top tier of cancer centers nationwide for making breakthroughs against cancer. Winship is researching, developing, teaching and providing patients novel and highly effective ways to prevent, detect, diagnose, treat and survive cancer. Cancer care at Winship includes leading cancer specialists collaborating across disciplines to tailor treatment plans to each patient’s needs; innovative therapies and clinical trials; comprehensive patient and family support services; and a care experience aimed at easing the burden of cancer. For more information, visit winshipcancer.emory.edu.