The number of treatment choices an individual has will depend on the type of cancer, the stage of the cancer, and other individual factors such as age, health status, and personal preferences. An individual should discuss all treatment options with their cancer team. It is important to ask questions and to understand all the cancer treatment options available.
The four major types of treatment for cancer are surgery, radiation, chemotherapy, and biologic therapies. The specific cancer treatment will be based on the individual's needs. Certain types of cancer respond very differently to different types of treatment, so determining the type of cancer is a vital step toward knowing which treatments will be most effective. The cancer's stage (how widespread it is) will also determine the best course of treatment, since early-stage cancers respond to different therapies than later-stage ones. The individual's overall health, lifestyle, and personal preferences will also play a part in deciding which treatment options will be best.
It is important for individuals to understand the goals of treatment. The treatment can either be palliative, which helps control symptoms (such as pain), or curative, which may help cure the cancer and decrease the chances of it returning. The goal of cancer treatments and therapies is to increase the quality of life for the individual suffering from this condition.
While surgery and radiation therapy are used to treat localized cancers, chemotherapy is used to treat cancer cells that have metastasized (spread) to other parts of the body. Chemotherapy is also used in combination with surgery and/or radiation or to shrink tumors, which helps surgery be easier on the patient and safer. Depending on the type of cancer and its stage of development, chemotherapy can be used to cure cancer, to keep the cancer from spreading, to slow the cancer's growth, to kill cancer cells that may have spread to other parts of the body, or to relieve symptoms caused by cancer. Not all individuals will respond the same way to chemotherapy treatments and some individual's will have more success than others.
Prior to chemotherapy: The individual undergoing chemotherapy may be asked to take some medications prior to the procedure (called pre-medications), including: steroids, such as prednisone (Deltasone®) or hydrocortisone (Solu Medrol®); antihistamines (allergy medications), such as diphenhydramine (Benadryl®); anti-nausea medications, such as ondansetron (Zofran®); sedatives, such as alprazolam (Xanax®); or antibiotics, such as levofloxacin (Levaquin®).
During chemotherapy: Individuals will be given the chemotherapy medication(s) by whichever route the doctor thinks best. Chemotherapy drugs can be given by mouth, injected through a syringe into a vein, artery, or muscle; given intravenously though an IV drip device; placed into a catheter (tube) that goes into the bladder, chest cavity, brain, spinal cord, liver, or abdomen; or, they can be applied to the skin. The decision on what route to use depends on several factors, mainly the type of tumor and the drug being used.
At the same time, individuals may be given other medications to fight the side effects of chemotherapy, including steroids, allergy medications (anti-histamines), anti-nausea medications, sedatives, and antibiotics.
Chemotherapy drugs: Almost all chemotherapy agents currently available kill cancer cells by affecting DNA synthesis or function, a process that occurs through the cell cycle. Each drug varies in the way this occurs within the cell cycle.
The major categories of chemotherapy agents are alkylating agents, antimetabolites, plant alkaloids, antitumor antibiotics, and steroid hormones. Each drug is categorized according to their effect on the cell cycle and cell chemistry.
Alkylating agents kill cells by directly attacking DNA. Alkylating agents may be used in the treatment of chronic leukemias, Hodgkin's disease, lymphomas, and certain carcinomas of the lungs, breasts, prostate, and ovaries. Cyclophosphamide (Cytoxan®) is an example of a commonly used alkylating agent.
Nitrosoureas act similarly to akylating agents and also inhibit changes necessary for DNA repair. These agents cross the blood-brain barrier and are therefore used to treat brain tumors, lymphomas, multiple myeloma, and malignant melanoma. Carmustine (BCNU or BiCNU®) and lomustine (CCNU, or CeeNU®) are the major drugs in this category.
Antimetabolites are drugs that block cell growth by interfering with certain activities, usually DNA synthesis. Once ingested into the cell, they halt normal development and reproduction. Antimetabolites may be used in the treatment of acute and chronic leukemias, choriocarcinoma, and some tumors of the gastrointestinal tract, breast, and ovary. Examples of commonly used antimetabolites are 6-mercaptopurine (Purinethol®) and 5-fluorouracil (5FU, or Leucovorin®).
Antitumor antibiotics are a diverse group of compounds. In general, they act by binding with DNA and preventing RNA synthesis. These agents are widely used in the treatment of a variety of cancers. The most commonly used drugs in this group are doxorubicin (Adriamycin®), mitomycin-C (Mutamycin®), and bleomycin (Blenoxane®).
Plant (vinca) alkaloids are anti-tumor agents derived from the periwinkle plant (Vinca sp.). These drugs act specifically by blocking cell division during mitosis (a stage of division). They are commonly used in the treatment of acute lymphoblastic leukemia, Hodgkin's and non-Hodgkin's lymphomas, neuroblastomas, Wilms' tumor, and cancers of the lungs, breasts, and testes. Vincristine (Oncovin®) and vinblastine (Velbe®) are commonly used agents in this group.
Steroid hormones are useful in treating some types of tumors. This class includes adrenocorticosteroids, estrogens, antiestrogens, progesterones, and androgens. Although their specific mechanism of action is not clear, steroid hormones modify the growth of certain hormone-dependent cancers. Tamoxifen (Nolvadex®) is an example, which is used for estrogen dependent breast cancer.
Platinum-based chemotherapy drugs contain the metal platinum. They are used to treat various types of cancers, including sarcomas, some carcinomas (e.g. small cell lung cancer and ovarian cancer), lymphomass and germ cell tumors. Examples include platinol (Cisplatin®), carboplatin (Paraplatin®), and oxaliplatin (Eloxatin®).
Often, a combination of chemotherapy is used instead of a single drug. Chemotherapy is given in cycles, each followed by a recovery period. The total course of chemotherapy is often about six months, usually ranging from three to nine months. After a cancer is removed by surgery, chemotherapy can significantly reduce the risk of cancer returning. The chances of cancer returning and the potential benefit of chemotherapy depend on the type of cancer and other individual factors.
After chemotherapy: After chemotherapy, individuals may be given any of the following medications: anti-nausea drugs, injections of immune-system boosting drugs (to increase white blood cells that fight potential infections) several days after the chemotherapy has been given, or other drugs, including steroids, antihistamines, anti-nausea medications, sedatives, and/or antibiotics.
Side effects of chemotherapy: A major concern with chemotherapy is the possibility of long-term side effects and complications, such as heart damage, lung damage, liver damage, and secondary cancers (including leukemia). Although these severe effects occur in only a small number of people, great effort is being put into finding equally effective regimens with less toxicity. Drug regimens have been developed that substantially diminish the likelihood of long-range, life-threatening complications, including acute leukemia in people who have received multiple courses of chemotherapy and radiation therapy.
Side effects of chemotherapy depend on the type of drugs, the amounts taken, and the length of treatment. The most common are nausea and vomiting, temporary hair loss, increased chance of infections, and fatigue (extreme tiredness). Many of these side effects can be uncomfortable or emotionally upsetting. However, most side effects can be controlled with medicines, supportive care measures, or by changing the treatment schedule.
Fatigue is one of the most common side effects of radiation and chemotherapy. Like most other side effects, fatigue will usually disappear once the treatment is complete. Individuals need to get plenty of rest, eat a well-balanced diet (less meats, dairy, and fats, and more vegetables), and drink plenty of water.
Hair loss may occur with some types of chemotherapy. Some individuals experience hair loss during chemotherapy treatments (and sometimes with radiation treatment to the head) while others do not, even with the same drugs. If hair loss does occur, it usually begins within two weeks of the start of therapy and gets worse one to two months after the start of therapy. Hair growth often begins even before therapy is completed. Most people are able to find suitable ways of managing the hair loss until it grows back, with specially designed hats, scarves, and wigs.
Medications for side effects of chemotherapy: Some individuals who experience certain side effects of chemotherapy may be prescribed medications to counteract these effects. Several drugs are now available for use alone or in combination to help reduce a few of the most common side effects, such as nausea, vomiting, and fatigue.
Anzemet® (dolasetron mesylate): Anzemet® helps prevent and relieve nausea and vomiting from surgery or chemotherapy. Researchers believe that nausea and vomiting during chemotherapy is associated with the release of serotonin from special cells in the small intestine. Anzemet® blocks these nerve endings in the intestine and prevents signals to the central nervous system. Anzemet® is available in tablet form and by injection.
Compazine® (prochlorperazine): Prochlorperazine helps control nausea and vomiting after surgery or chemotherapy. Prochlorperazine is available in capsule, tablet, and liquid form, and by suppository or injection. Prochlorperazine can cause drowsiness and may interact with other medications or alcohol.
Kytril® (granisetron hydrochloride): Kytril® is an anti-nausea medication FDA-approved for patients undergoing chemotherapy. Kytril® is typically given 60 minutes before chemotherapy. In some cases, a second dose is given about 12 hours after the first dose. Kytril® is available in tablet form and by injection.
Phenergan® (promethazine): Promethazine has sedative, antihistamine, and mild anti-nausea properties. It may be used to help prevent or treat nausea due to chemotherapy. Promethazine may be available in tablet form or as an oral syrup, suppository, or injection.
Procrit® (epoetin alfa): Procrit® helps the body produce more red blood cells, which help relieve fatigue due to chemotherapy. Since chemotherapy affects both normal and cancerous cells, it can decrease the number of red blood cells, which leads to anemia (lack of red blood cells to carry oxygen) and a feeling of extreme tiredness.
Neupogen® is the trade name for granulocyte colony stimulating factor (G-CSF, or filgrastim). Neupogen® is a protein-based drug that stimulates the production of white blood cells. White blood cells are important for protecting the body from infection. Neupogen® is used to increase white blood cells, and to decrease the risk of infection, in conditions such as cancer. Neupogen® can be used subcutaneously (SC) or intravenously (IV). Side effects may include nausea, bone pain, and swelling or redness at the injection site. Contacting a doctor immediately is recommended by healthcare providers if the individual develops a fever, chills, sore throat, congestion, diarrhea, or redness, pain, or swelling around a wound or sore while using Neupogen®.
Zofran® (ondansetron): Zofran® helps to relieve nausea and vomiting associated with chemotherapy. Zofran® is available in pill form, as a liquid solution, and by injection. The first dose of Zofran® (tablet form) is usually administered 30 minutes before chemotherapy and then at regular intervals for one to two days after chemotherapy.
Myelodysplastic syndrome: Myelodysplastic syndromes are diseases of the blood and bone marrow, often caused by chemotherapy. Blood cells, such as red blood cells that carry oxygen to tissues and white blood cells that help produce cells for immunity, are damaged by chemotherapy medicines. Symptoms of myelodysplastic syndrome include fatigue and chronic tiredness, shortness of breath, chilled sensation, chest pain (occasionally), an increased susceptibility to infection, and an increased susceptibility to bleeding. Patients who experience low blood cells counts during chemotherapy may also be given medications to help raise blood cell or platelet counts. For example, patients who suffer from neutropenia, a decrease in the number of neutrophils (a type of white blood cell), may be given certain growth factors, such as the granulocyte-macrophage colony stimulating factor (GM-CSF, sargramostim, or Leukine®) or Neupogen®.
Radiation therapy uses high-energy rays to kill cancer cells. It is considered a local therapy, meaning that it should be used to target areas of the body invaded by tumor masses. A radiation oncologist will plan and supervise therapy. The area to be treated will be carefully mapped out and the treatment machine will be adjusted so that only the lymphoma cells are exposed to a full dose of radiotherapy. Because of the need to target the radiation at exactly the right area of the body, a mold is sometimes made that will help to hold that part of the body still and in position during the treatment sessions.
Normal cells surrounding the lymphoma are spared the full dose, and these cells are usually able to repair themselves more easily than lymphoma cells. Therefore, radiotherapy can often control or destroy lymphoma cells, while causing only temporary damage to normal cells.
Radiotherapy is usually given on an outpatient basis, with the patient visiting the hospital up to five times a week. Before each treatment, the patient is carefully positioned, usually lying on a treatment table. Parts of the body that are not being treated may be covered. It is important to remain completely still during the treatment. Each treatment usually lasts only a few minutes and causes no discomfort. Although the patient is left alone during the actual treatment, the radiotherapy technician watches from an observation room and it is possible to talk to the individual through a microphone. A course of radiotherapy typically lasts between two and six weeks, depending on the patient's individual circumstances. The length of radiation treatment varies depending on the stage of the disease. Radiation therapy may be used alone, but is commonly used in conjunction with chemotherapy.
Depending on how and where the radiation is administered, it may cause certain side effects such as fatigue (extreme tiredness), loss of appetite, nausea, diarrhea, and skin problems. Radiation of lymph node areas may result in suppression of the immune system to varying degrees. Irradiation of the underlying bone and the marrow within the bone may result in suppression of the blood counts.
Surgery is the treatment of choice for many types of cancer, such as colon or breast. Treatment depends on the stage of the disease and the overall health of the patient. Chemotherapy and radiation therapy may be used as adjuvant treatment or in addition to surgery.
Cryosurgery: During cryosurgery, a doctor uses very cold material, such as liquid nitrogen spray, or a cold robe to freeze and destroy cancer cells or cells that may become cancerous (such as irregular cells in the cervix that could become cervical cancer).
Electrosurgery: Electrosurgery is the application of high-frequency electrical currents by a doctor. These currents can kill cancer cells, such as in the mouth or on the skin.
Laser surgery: Laser surgery is used to treat many types of cancer. Laser therapy uses high-intensity light to treat cancer and other illnesses. Lasers can be used to shrink or destroy tumors. Lasers are most commonly used to treat superficial cancers (cancers on the surface of the body or the lining of internal organs) such as basal cell skin cancer and the very early stages of some cancers, such as cervical, penile, vaginal, vulvar, and non-small cell lung cancer.
Mohs' surgery: Mohs' surgery is useful for removing cancer from sensitive areas such as near the eye. Mohs' surgery is also useful for assessing how deep a cancer is growing. Mohs' surgery is performed by carefully removing cancer layer by layer with a scalpel or knife. After removing a layer, the doctor will evaluate the cells under a microscope until all the abnormal cells have been removed and the surrounding tissue shows no evidence of cancer.
Laparoscopic surgery: In laparoscopic surgery (or minimally invasive surgery), a surgeon uses a laparoscope to see inside the body without making large incisions. A laparoscope is a telescopic rod lens system that is usually connected to a video camera. Several small incisions are made and a tiny camera and surgical tools are inserted into the body. The surgeon watches a monitor that projects what the camera sees inside the body. The smaller incisions mean faster recovery and a reduced risk of complications. Laparoscopic surgery is used in cancer diagnosis, staging, treatment, and symptom relief.
Robotic surgery: In robotic surgery, the surgeon sits away from the operating table and watches a screen that projects a three-dimensional image of the area being operated on. The surgeon uses hand controls that tell a robot how to maneuver surgical tools to perform the operation. Robotic surgery helps the surgeon operate in hard-to-reach areas. But robotic surgical systems are expensive and require specialized training, so robotic surgery is only available in specialized medical centers.
Human studies of promising new or experimental treatments are known as clinical trials. A clinical trial is only done when there is some reason to believe that the treatment being studied may be valuable to the patient. Treatments used in clinical trials are often found to have real benefits. Clinical trials are not commonly used as treatments for cancer, but are an option. A doctor will help get information on various clinical trials available for certain types of cancer. There is no guarantee of success in clinical trials for the patients, and some individuals will actually not receive medication (the placebo).
Types of clinical trials: There are three phases of clinical trials in which a treatment is studied before it can be approved by the U.S. Food and Drug Administration (FDA).
Phase I clinical trials: The purpose of a phase I study is to find the best way to give a new treatment and find out how much of it can be given safely. Doctors watch patients carefully for any harmful side effects. The treatment has been well tested in lab and animal studies, but the side effects in patients are not completely known. Doctors running the clinical trial start by giving very low doses of the drug to the first patients and increasing the dose for later groups of patients until side effects appear. Although doctors are hoping to help patients, the main purpose of a phase I study is to test the safety of the drug.
Phase II clinical trials: These studies are designed to see if the drug works. Patients are given the best dose of the drug (based on the results of the phase I study) and closely observed for an effect on the cancer. The doctors will also look for side effects.
Phase III clinical trials: Phase III studies are done to see if the new treatment is better than what is already available. They involve large numbers of patients. One group (the control group) receives the standard (most accepted) treatment. The other group receives the new treatment. All patients in phase III studies are closely watched. The study will be stopped if the side effects of the new treatment are too severe or if one group has had much better results than the others.
If an individual enrolls in a clinical trial, a team of experts will monitor their progress very carefully. The study is especially designed to pay close attention to the individual with cancer. However, there may be risks. Even with animal testing and laboratory studies, it is difficult to determine what side effects may occur in individuals undergoing clinical trials for cancer. It is important to discuss all potential risks and benefits carefully with a healthcare provider before making a decision to enroll in a clinical trial.
Photodynamic therapy: Photodynamic therapy (PDT) is another type of cancer treatment that uses lasers. In PDT, a drug called a photosensitizer or photosensitizing agent is injected into a patient and absorbed by cells all over the individual's body. After a couple of days, the agent is found mostly in cancer cells. Laser light is then used to activate the agent and destroy cancer cells. Because the photosensitizer makes the skin and eyes sensitive to light for approximately six weeks, individuals undergoing PDT are advised to avoid direct sunlight and bright indoor light during that time.
Perillyl alcohol is a naturally occurring chemical with anticancer activity. Perillyl alcohol is found in lavender, cherries, and mint. The use of perillyl alcohol for cancer treatments is in phase I clinical trials.
Laetrile: Laetrile is a substance derived from a chemical called amygdalin, which is found in the seeds of apricots, plums, and bitter almonds. Laetrile is publicized as an antineoplastic (prevents the development of a tumor or neoplasm) drug, although there is no supporting evidence.
Pain may be acute or chronic. Acute pain is severe and lasts a relatively short time. It is usually a signal that body tissue is being injured in some way, and the pain generally disappears when the injury heals. Chronic or persistent pain may range from mild to severe, and it is present to some degree for long periods of time. Some individuals with chronic pain that is controlled by medicine can have breakthroughpain. This occurs when moderate to severe pain "breaks through" or is felt for a short time. Breakthrough pain may occur several times a day, even when the proper dose of medicine is given for chronic and persistent pain.
Pain may be caused by the cancer itself. Whether the individual has pain and the amount of pain they have may depend on the type of cancer, the stage (extent) of the disease, and the individual's pain threshold (tolerance for pain). Most of the pain comes when a tumor presses on bones, nerves, or body organs. Pain can also be caused by the treatment or procedures for diagnosing cancer.
Cancer pain is usually treated with analgesic (pain relieving) drugs, both prescription and non-prescription, and with non-drug treatments such as relaxation techniques, biofeedback, imagery, and others. Healthcare providers recommend asking a doctor or pharmacist for advice before taking any medicine for pain.
Pain will generally be graded on a Pain Intensity Scale. Using a pain scale is helpful in describing how much pain a patient is feeling. Using the Pain Intensity Scale, individuals answer questions and assign a number from zero to 10 according to their pain level. No pain gets a zero, while a 10 is the highest level of pain imaginable. Questions can include the severity of pain, how pain changes with medication, and how bad the pain is during the day and night. If one medicine or treatment does not work for the pain, there is almost always another one that can be tried. Changes may also be made in the frequency and dosages to help increase the pain relief.
Medications for pain: The type of medicine and the method by which the medicine is given depend on the type and cause of pain. Non-opiate (non-narcotic) pain medications are given for mild to moderate pain. These drugs can generally be purchased over-the-counter (OTC) and may include acetaminophen, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin®). It is best to check with a healthcare professional before taking any OTC medication. NSAIDs can slow blood clotting, especially if the individual is on chemotherapy due to drug interactions.
For moderate to severe pain, opiate (narcotic) medications may be given. These drugs include morphine (MS Contin®), fentanyl (Duragesic®), hydromorphone (Dilaudid®), and oxycodone (Percocet®, Oxycontin®). Individuals must have a prescription for these medications, and the medications are generally time released, meaning their effects last more than a few hours. Nonopiods may be used along with opioids for moderate to severe pain. Opiate medications may cause side effects such as drowsiness and constipation. Their use may also cause addiction, both physical and psychological, in a short length of time. For breakthrough pain, immediate-release opiates may be given, such as oral morphine (Oramorph®) or oxycodone (Roxicodone®). A prescription is required for these medicines. A short-acting opioid, which relieves breakthrough pain quickly, needs to be used with a long-acting opioid for persistent pain. It is important to tell a doctor or pharmacist if taking any OTC medication, as some OTC medicines may contain acetaminophen (Tylenol®). Some prescription pain medications, such as oxycodone/acetaminophen combination (Percocet®) or hydrocodone/acetaminophen (Lortab®, Vicodin®) may also contain acetaminophen, thereby increasing the potential for acetaminophen induced liver toxicity.
Individuals who take opiates for pain sometimes find that over time they need to take larger doses. This may be due to an increase in the pain or the development of drug tolerance. Drug tolerance occurs when the body gets used to the medicine and does not relieve the pain as well as it once did. Many individuals do not develop a tolerance to opiates. If tolerance does develop, usually small increases in the dose or a change in the kind of medicine will help relieve the pain. Increasing the doses of opiates to relieve increasing pain or to overcome drug tolerance does not always lead to addiction. Alcohol should be avoided when taking medications for pain due to a potential for interactions. Using alcohol in combination with pain medications can lead to overdose symptoms such as weakness, difficulty in breathing, confusion, anxiety, or more severe drowsiness or dizziness. It is recommended to use caution when driving automobiles or operating heavy machinery when taking opiate pain medications. Medications for pain may also cause nausea and vomiting in sensitive individuals.
For tingling and burning pain associated with some cancers, antidepressant medications (such as amitriptyline or Elavil®) or anticonvulsant medications (such as gabapentin or Neurontin®) may be used. Both these medications may cause drowsiness and sedation.
For pain caused by swelling, steroid medications, including prednisone (Deltasone®), may be used. Side effects of steroid medications include edema (swelling) and a decline in immune system function.
Pain medications may be given by several different routes, including orally (by mouth), topically (on the skin), and rectally (into the anus as a suppository). Pain medications may also be given by injection, including: subcutaneous (SC) injection or injected just under the skin using a small needle), intravenous (IV) or injected directly into the vein through a needle, and intrathecal and epidural injections that are placed directly into the fluid around the spinal cord (intrathecal) or into the space around the spinal cord (epidural). Patient-controlled analgesia (PCA) pumps may also be used. PCA pumps help control the amount of pain medicine an individual takes. When pain relief is needed, the individual can receive a preset dose of pain medicine by pressing a button on a computerized pump that is connected to a small tube placed in the body using a minor surgical technique.
Non-drug treatments for pain: Non-drug treatments are now widely used to help manage cancer pain. There are many techniques that are used alone or along with medicine. Some individuals find they can take a lower dose of medicine with such techniques. These methods include: acupuncture, art therapy, focusing, healing touch, prayer, psychotherapy, transcutaneous electrical nerve stimulation (TENS), and yoga. See the "Integrative Therapies" section of this monograph for more information on these techniques.
Resources exist that provide cancer patients and their loved ones with an opportunity to learn ways of coping with the uncertainty that cancer brings and links to support groups that give them a chance to meet others who face similar issues. Support groups offer patients and loved ones emotional support, an opportunity to learn ways of coping with the uncertainty and changes in their lives, a chance to meet others who face similar issues, and a time to explore issues faced by all cancer survivors. Support groups for cancer patients can be located by asking a healthcare provider, such as a doctor or social worker, for more information.
Strong scientific evidence
Vitamin A: Vitamin A is a fat-soluble vitamin that is derived from two sources: preformed retinoids and provitamin carotenoids. Retinoids, such as retinal and retinoic acid, are found in animal sources such as livers, kidneys, eggs, and dairy produce. Carotenoids, like beta-carotene (which has the highest vitamin A activity), are found in plants such as dark or yellow vegetables and carrots.
The prescription drug All-Trans-Retinoic Acid (ATRA, Vesanoid®) is a vitamin A derivative that is an established treatment for acute promyelocytic leukemia and improves median survival in this disease. Treatment should be under strict medical supervision. Vitamin A supplements should not be used simultaneously with ATRA due to a risk of increased toxicity.
Good scientific evidence
Psychotherapy: Psychotherapy is an interactive process between a person and a qualified mental health professional (psychiatrist, psychologist, clinical social worker, licensed counselor, or other trained practitioner). There is good evidence that psychotherapy can enhance cancer patients' quality of life by reducing emotional distress and aiding in coping with the stresses and challenges of cancer. Therapy may be supportive-expressive therapy, cognitive therapy, or group therapy. Studies conflict on whether therapy improves self-esteem, death anxiety, self-satisfaction, etc. While some patients seek psychotherapy in hopes of extending survival, there is no conclusive evidence of effects on medical prognosis.
Unclear or conflicting scientific evidence
Acupuncture: Acupuncture, or the use of needles to manipulate the "chi" or body energy, originated in China over 5,000 years ago. There has been limited research on acupuncture for cancer pain, and the research that was done was shown to have mixed results. More studies are needed to determine potential benefits. Evidence from several small studies supports the use of acupuncture at a specific point on the wrist (P6), which helps reduce the nausea and vomiting associated with chemotherapy.
Aloe: Transparent gel from the pulp of the meaty leaves of Aloe vera has been used topically for thousands of years to treat wounds, skin infections, burns, and numerous other dermatologic conditions. Preliminary research suggests that aloe may help prevent or aid in the regression of cancerous tumors. Additional research is needed in this area. Caution is advised when taking aloe supplements, as numerous adverse effects including a laxative effect, cramping, dehydration, and drug interactions, are possible. Aloe should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
American pawpaw: Evidence supporting the use of the American pawpaw (Asimina triloba) tree for the treatment of cancer in humans is largely anecdotal and subjective. Use in humans has reported minimal side effects, and evidence from animal and in vitro studies suggests that American pawpaw extract does have some anticancer activity. Pawpaw standardized extract has been used for 18 months in patients with various forms of cancer. No well-designed studies on the long-term effects of pawpaw extracts have been conducted. Pawpaw should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Antineoplastons: Antineoplastons are a group of naturally occurring peptide fractions isolated from human blood and urine. Antineoplastonswere observed by Stanislaw Burzynski, MD, PhD in the late 1970s and found to be absent in the urine of cancer patients. There is inconclusive scientific evidence regarding the effectiveness of antineoplastons in the treatment of cancer. Several preliminary human studies (case series, phase I/II trials) have examined antineoplaston types A2, A5, A10, AS2-1, and AS2-5 for a variety of cancer types. It remains unclear if antineoplastons are effective, or what doses may be safe. Until better research is available, no clear conclusion can be drawn.
Arabinoxylan: Arabinoxylan is made by altering the outer shell of rice bran using enzymes from Hyphomycetes mycelia mushroom extract. Arabinoxylan has been found to improve immune reactions in diabetes and cancer patients. Arabinoxylan products may contain high calcium and phosphorus levels, which may be harmful for patients with compromised renal (kidney) function.
Aromatherapy: Healing with fragrant oils has been used for thousands of years. Aromatherapy is often used in people with chronic illnesses (frequently in combination with massage), with the intention to improve quality of life or well-being. There is not enough scientific evidence in this area to form a firm conclusion about the effectiveness of aromatherapy. Essential oils are not for internal use.
Art therapy: Art therapy involves the application of a variety of art modalities including drawing, painting, clay, and sculpture. Art therapy enables the expression of inner thoughts or feelings when verbalization is difficult or not possible. Limited evidence suggests that family caregivers of cancer patients may benefit from art therapy to help them cope with the stress of care giving. Possible benefits include reduced stress, lowered anxiety, increased positive emotions, and increased positive communication with cancer patients and healthcare professionals. Art therapy may also reduce pain and other symptoms in cancer patients. More studies are needed to determine how best to use this form of intervention with this population.
Astragalus: Astragalus (Astragalus membranaceus) has been used in Chinese medicine for centuries for its immune enhancing properties. Although early laboratory and animal studies report increased immune cell function and reduced cancer cell growth associated with the use of astragalus, there is no reliable human evidence in these areas. A recent study reports that astragalus-based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy (such as platinol or Cisplatin®) when combined with chemotherapy. Astragalus is also sometimes used with the intention to reduce side effects of cancer treatments, such as fatigue and weight loss. Due to a lack of well-designed research, a firm conclusion cannot be drawn.
Bee pollen: Bee pollen is considered a highly nutritious food because it contains a balance of vitamins, minerals, proteins, carbohydrates, fats, enzymes, and essential amino acids. Research has found that bee pollen may reduce some adverse effects of cancer treatment, but additional studies are needed before a firm recommendation can be made. Caution is advised when taking bee pollen supplements as allergic reactions may occur in sensitive individuals. Bee pollen should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Bitter melon: Bitter melon (Momordica charantia) is used in the traditional Ayurvedic form of medicine from India for lowering blood sugar levels. Research has also found that bitter melon extracts may be beneficial in cancer therapies. MAP30, a protein isolated from bitter melon extract, is reported to possess anti-cancer effects in laboratory studies. Potential anti-cancer effects have not been studied appropriately in humans. Caution is advised when taking bitter melon supplements, as numerous adverse effects including blood sugar lowering and drug interactions are possible. Bitter melon should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Black tea: Black tea (Camellia sinensis) is from the same plant as green tea, but processed differently and contains more caffeine than green tea. Several studies have explored a possible association between regular consumption of black tea and rates of cancer in populations. This research has yielded conflicting results, with some studies suggesting benefits and others reporting no effects. Laboratory and animal studies report that components of tea, such as polyphenols, have antioxidant properties and effects against tumors. Effects in humans remain unclear, and these components may be more common in green tea rather than in black tea. Some animal and laboratory research suggests that components of black tea may actually be carcinogenic, or cancer causing although effects in humans are not clear. Overall, the relationship of black tea consumption and human cancer remains undetermined.
Bromelain: Bromelain is a sulfur-containing proteolytic digestive enzyme that is extracted from the stem and the fruit of the pineapple plant (Ananas comosus). There is not enough information to recommend for or against the use of bromelain in the treatment of cancer, either alone or in addition to other therapies. Caution is advised when taking bromelain supplements, as numerous adverse effects including blood thinning and drug interactions are possible.
Cat's claw: Originally used in Peru, the use of cat's claw (Uncaria tomentosa) has been said to date back to the Inca civilization, possibly as far back as 2,000 years. Cat's claw has anti-inflammatory properties, and several low-quality studies suggest it may slow tumor growth; however, this research is early and has not identified specific types of cancer that may benefit. A few studies suggest that cat's claw may also boost the immune system. Caution is advised when taking cat's claw supplements, as numerous adverse effects including blood thinning and drug interactions are possible. Cat's claw should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Copper: Copper is a mineral that occurs naturally in many foods, including vegetables, legumes, nuts, grains and fruits, as well as shellfish, avocado, and beef (organs such as liver). Preliminary research reports that lowering copper levels theoretically may arrest the progression of cancer by inhibiting blood vessel growth (angiogenesis). Copper intake has not been identified as a risk factor for the development or progression of cancer. Copper is potentially unsafe when used orally in higher doses than the recommended dietary allowance (RDA). Copper supplements should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Cranberry: Several laboratory studies have reported positive effects of proanthocyanidins, flavonoid components of cranberry (Vaccinium macrocarpon) and other fruits such as blueberries, grape seed, and pomegranate, on health. Based on a small amount of laboratory research, cranberry has been proposed for cancer prevention, but studies are needed in humans before a recommendation can be made.
Echinacea: The evidence from a small number of randomized trials evaluating efficacy of Echinacea in the treatment of radiation-induced leukopenia (decrease in white blood cells) is equivocal. Studies have used the combination product Esberitox®, which includes extracts of Echinacea (Echinacea purpurea and pallida) root, white cedar (Thuja occidentalis) leaf, and wild indigo (Baptisia tinctoria)root.
Essiac®: Essiac® contains a combination of herbs, including burdock root (Arctium lappa), sheep sorrel (Rumex acetosella), slippery elm inner bark (Ulmus fulva), and Turkish rhubarb (Rheum palmatum). The original formula was developed by the Canadian nurse Rene Caisse (1888-1978) and is thought to be effective in cancer therapies, although there is currently no evidence for any type of cancer. Different brands may contain variable ingredients, and the comparative effectiveness of these formulas is not known. None of the individual herbs used in Essiac® have been tested in rigorous human cancer trials, although some components have anti-tumor activity in laboratory studies. Caution is advised when taking Essiac® supplements, as numerous adverse effects, including drug interactions, are possible. Essiac® should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Focusing: Focusing (experiential therapy) is a method of psychotherapy that involves being aware of one's feelings surrounding a particular issue and understanding the meaning behind words or images conveyed by those feelings. Early evidence suggests that focusing may improve the mood and body attitude of cancer patients. Firm recommendations cannot be made until well-designed clinical trials are available.
Garlic: Preliminary human studies suggest that regular consumption of garlic (Allium sativum, particularly aged garlic) may reduce the risk of developing several types of cancer. Some studies use multi-ingredient products so it is difficult to determine if garlic alone may play a beneficial role. Further well-designed human clinical trials are needed to conclude whether eating garlic or taking garlic supplements may prevent or treat cancer. Caution is advised when taking garlic supplements, as numerous adverse effects, including an increased risk of bleeding and drug interactions, are possible.
Ginseng: Several human studies suggest that Asian ginseng (Panax ginseng) may reduce the risk and progression of various organ cancers, especially if ginseng powder or extract is used. Results may have been affected by other lifestyle choices in people who use ginseng, such as exercise or dietary habits. Asian ginseng is also reported to help protect against radiation damage, increase immunity and well-being, and decrease fatigue. Additional trials are necessary before a clear conclusion can be reached. Caution is advised when taking ginseng supplements, as numerous adverse effects including an increased risk of drug interactions are possible. Ginseng should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Green tea: Green tea is made from the dried leaves of Camellia sinensis, a perennial evergreen shrub. Green tea has a long history of use in health and longevity, dating back to China approximately 5,000 years ago. Although used for centuries to help prevent diseases, the relationship of green tea consumption and human cancer remains inconclusive. Evidence from well-designed clinical trials is needed before a firm recommendation can be made in this area.
Healing touch (HT): Preliminary data suggests HT may be of benefit in cancer patients for inducing relaxation and improving quality of life. However, due to weaknesses in design and the small number of studies, data are insufficient to make definitive recommendations. Studies with stronger designs are needed.
Hoxsey formula: "Hoxsey formula" is a misleading name, because it is not a single formula, but rather it is a therapeutic regimen consisting of an oral tonic and topical (on the skin) preparations. The tonic is individualized for cancer patients based on general condition, location of cancer, and previous history of treatment. An ingredient that usually remains constant for every patient is potassium iodide. Other ingredients are then added and may include licorice, red clover, burdock, stillingia root, berberis root, pokeroot, cascara, Aromatic USP 14, prickly ash bark, and buckthorn bark. A red paste may be used, which tends to be caustic (irritating), and contains antimony trisulfide, zinc chloride, and bloodroot. A topical yellow powder may be used, and contains arsenic sulfide, talc, sulfur, and a "yellow precipitate." A clear solution may also be administered, and contains trichloroacetic acid. There are no well-designed human studies available evaluating the safety or effectiveness of Hoxsey formula. Caution is advised when taking the Hoxsey formula supplements, as numerous adverse effects including an increased risk of drug interactions are possible. Hoxsey formula should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Hydrazine sulfate: Hydrazine is an industrial chemical marketed as having the potential to repress weight loss and cachexia (muscle wasting) associated with cancer, and to improve general appetite status. In large randomized controlled trials, hydrazine has not been found effective for improving appetite, reducing weight loss, or improving survival in adults. The National Cancer Institute (NCI) sponsored studies of hydrazine sulfate that claimed efficacy in improving survival for some patients with advanced cancer. Trial results found that hydrazine sulfate did not prolong survival for cancer patients. The U.S. Food and Drug Administration (FDA) has received requests from individual physicians for approval to use hydrazine sulfate on a case-by-case "compassionate use" basis on the chance that patients with no other available effective therapy might benefit. The overall controversy in the use of hydrazine sulfate is ongoing, and relevance to clinical practice is unknown. The use of hydrazine sulfate needs to be evaluated further before any recommendations can be made. Side effects have been reported, including nausea, vomiting, stomach cramping, and diarrhea.
Lycopene: High levels of lycopene are found in tomatoes and in tomato-based products. Tomatoes are also sources of other nutrients such as vitamin C, folate, and potassium. Several laboratory and human studies examining tomato-based products and blood lycopene levels suggest that lycopene may be associated with a lower risk of developing cancer and may help stimulate the immune system. However, due to a lack of well-designed human research using lycopene supplements, this issue remains unclear.
Maitake mushroom: Maitake is the Japanese name for the edible fungus Grifola frondosa. Maitake has been used traditionally both as a food and for medicinal purposes. Early studies in the laboratory as well as in humans suggest that beta-glucan extracts from maitake may increase the body's ability to fight cancer. These studies have not been well designed, and better research is needed before the use of maitake for cancer can be recommended.
Melatonin: There are several early-phase and controlled human trials of melatonin in patients with various advanced stage malignancies, including brain, breast, colorectal, gastric, liver, lung, pancreatic, and testicular cancer, as well as lymphoma, melanoma, renal cell carcinoma, and soft-tissue sarcoma. Currently, no clear conclusion can be drawn in this area. There is not enough definitive scientific evidence to discern if melatonin is beneficial against any type of cancer, whether it increases (or decreases) the effectiveness of other cancer therapies, or if it safely reduces chemotherapy side effects. Melatonin is not to be used for extended periods of time. Caution is advised when taking melatonin supplements, as numerous adverse effects including drug interactions are possible.
Mistletoe: Mistletoe is one of the most widely used unconventional cancer treatments in Europe. Extracts have been studied for a variety of human cancers including bladder, breast, cervical, CNS, colorectal, head and neck, liver, lung, lymphatic, ovarian, and renal (kidney) cancers as well as melanoma and leukemia. Efficacy has not been conclusively proven for any one condition, and in fact some studies have shown a lack of efficacy in certain preparations for a variety of cancers. Larger, well-designed clinical trials are needed. Caution is advised when taking mistletoe supplements, as numerous adverse effects including nausea, vomiting, and drug interactions are possible. Mistletoe should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Moxibustion: Moxibustion is a healing technique employed across the diverse traditions of acupuncture and oriental medicine for over 2,000 years. Moxibustion uses the principle of heat to stimulate circulation and break up congestion or stagnation of blood and chi. Moxibustion is more closely related to acupuncture as it is applied to specific acupuncture points. More studies are needed.
Oleander: Laboratory studies of oleander (Nerium oleander) suggest possible anti-cancer effects, although reliable research in humans is not currently available. There are reports that long-term use of oleander may have positive effects in patients with leiomyosarcoma, Ewing's sarcoma, prostate, or breast cancer. More research is needed.
Omega: Omega-3 fatty acids are essential fatty acids found in some plants and fish. There should be a balance of omega-6 and omega-3 fatty acids for health. Randomized controlled trials are necessary before a clear conclusion can be drawn. Caution is advised when taking omega-3 supplements, as numerous adverse effects including an increase in bleeding and drug interactions are possible. Omega-3 supplements should not be used if the patient is pregnant or breastfeeding, unless otherwise directed by a doctor.
Prayer: Initial studies in patients with cancer (such as leukemia) report variable effects on disease progression or death rates when intercessory prayer is used. Better quality research is necessary before a firm conclusion can be drawn. Prayer helps give individuals suffering from cancer a sense of hope.
Reishi mushroom: Reishi (Ganoderma lucidum) has been shown to have antineoplastic and immunomodulatory effects in animal studies. One clinical trial and two case reports exist on advanced cancer patients using Ganopoly®, a Ganoderma lucidum polysaccharide extract. Results show improved quality of life and enhanced immune responses, which are typically reduced or damaged in cancer patients receiving chemotherapy and/or radiation therapy. Well-designed long-term studies are needed to confirm these results and potential side effects.
Seaweed: Bladderwrack (Fucus vesiculosus) is a brown seaweed that grows on the northern coasts of the Atlantic and Pacific oceans, and the North and Baltic seas. Bladderwrack appears to suppress the growth of various cancer cells in animal and laboratory studies. Currently, there are no reliable human studies available to support a recommendation for use in cancer. Bladderwrack should not be used if the patient is pregnant or breastfeeding, or has hyperthyroidism (increased thyroid hormone), unless otherwise directed by a doctor.
Selenium: Selenium is a trace mineral found in soil, water, and some foods, and it is an essential element in several metabolic pathways. Several studies suggest that low levels of selenium (measured in the blood or in tissues such as toenail clippings), may be a risk factor for developing cancer, particularly prostate cancer. Population studies suggest that people with cancer are more likely to have low selenium levels than healthy matched individuals, but in most cases it is not clear if the low selenium levels are a cause or merely a consequence of disease. It remains unclear if selenium is beneficial in the treatment of any type of cancer.
Shark cartilage: For several decades, shark cartilage has been proposed as a cancer treatment. Studies have shown shark cartilage or the shark cartilage product AE-941 (Neovastat®) to block the growth of new blood vessels, a process called "anti-angiogenesis," which is believed to play a role in controlling growth of some tumors. There have also been several reports of successful treatments of end-stage cancer patients with shark cartilage, but these have not been well-designed or included reliable comparisons to accepted treatments.
Many studies have been supported by shark cartilage product manufacturers, which may influence the results. In the United States, shark cartilage products cannot claim to cure cancer, and the U.S. Food and Drug Administration (FDA) has sent warning letters to companies that promote products in this way. Without further evidence from well-designed human trials, it remains unclear if shark cartilage is of any benefit in cancer and patients are advised to check with their doctor and pharmacist before taking shark cartilage.
Shiitake mushroom: Shiitake (Lentinus edodes) has been taken by mouth for boosting the immune system, decreasing cholesterol levels, and for anti-aging. Lentinan, derived from shiitake, has been injected as an adjunct treatment for cancer and HIV infection. Laboratory, animal, and human studies of lentinan have shown positive results in cancer patients when used in addition to chemotherapy drugs. Further well-designed clinical trials on all types of cancer are required to confirm these results.
Soy: Soy (Glycine max) contains compounds that have been effective against tumors. Genistein, an isoflavone found in soy, has been found in laboratory and animal studies to possess anti-cancer effects, such as blocking new blood vessel growth (anti-angiogenesis), acting as a tyrosine kinase inhibitor (a mechanism of many new cancer treatments), or causing cancer cell death (apoptosis). Until reliable human research is available, it remains unclear if dietary soy or soy isoflavone supplements are beneficial, harmful, or neutral in people with various types of cancer. Caution is advised when taking soy supplements, as numerous adverse effects including an increased risk of drug interactions are possible.
Transcutaneous electrical nerve stimulation (TENS): Transcutaneous electrical nerve stimulation (TENS) is a non-invasive technique in which a low-voltage electrical current is delivered through wires from a small power unit to electrodes located on the skin. Although TENS has been used with some success in pain associated with cancer, there is not enough reliable evidence to draw a firm conclusion in this area.
Thiamin (Vitamin B1): Thiamin deficiency has been observed in some cancer patients, possibly due to increased metabolic needs. It is not clear if lowered levels of thiamin in such patients may actually be beneficial. Currently, it remains unclear if thiamin supplementation plays a role in the management of any particular type(s) of cancer.
Traditional Chinese medicine (TCM): The ancient Chinese philosophy of Taoism provided the basis for the development of Chinese medical theory. TCM uses over 120 different herbs in cancer treatment, dependent upon the type and cause of the cancer. Studies have reported significant benefits include reducing tumors, reducing treatment side effects, and improved response to treatment. More studies of stronger design are needed before TCM can be recommended with confidence as an adjunct to cancer treatment, although centuries of traditional use in cancer cannot be discounted.
Turmeric: Turmeric (Curcuma longa) is commonly used for its anti-inflammatory properties. Several early animal and laboratory studies report anti-cancer (colon, skin, breast) properties of curcumin. Many mechanisms have been considered, including antioxidant activity, anti-angiogenesis (prevention of new blood vessel growth), and direct effects on cancer cells. Currently, it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area. Caution is advised when taking turmeric supplements, as numerous adverse effects including an increased risk of bleeding and drug interactions are possible.
Vitamin C (ascorbic acid): Dietary intake of fruits and vegetables high in vitamin C has been associated with a reduced risk of various types of cancer in population studies (particularly cancers of the mouth, esophagus, stomach, colon, or lung). However, it is not clear that it is specifically the vitamin C in these foods that is beneficial, and vitamin C supplements have not been found to be associated with this protective effect. Experts have recommended increasing dietary consumption of fruits and vegetables high in vitamin C, such as apples, asparagus, berries, broccoli, cabbage, melon (cantaloupe, honeydew, watermelon), cauliflower, citrus fruits (lemons, oranges), fortified breads/grains/cereal, kale, kiwi, potatoes, spinach, and tomatoes. Vitamin C has a long history of adjunctive use in cancer therapy, and although there have not been any definitive studies using intravenous (or oral) vitamin C, there is evidence that it has benefit in some cases. Better-designed studies are needed. Large doses (greater than 2 grams) may cause diarrhea and gastrointestinal upset.
Vitamin E: There is no reliable scientific evidence that vitamin E is effective as a treatment for any specific type of cancer. Caution is merited in people undergoing treatment with chemotherapy or radiation, because it has been proposed that the use of high-dose antioxidants may actually reduce the anti-cancer effects of these therapies. This remains an area of controversy and studies have produced variable results. Patients interested in using high-dose antioxidants such as vitamin E during chemotherapy or radiation should discuss this decision with their medical oncologist or radiation oncologist. Caution is advised when taking vitamin E supplements, as numerous adverse effects including an increased risk of bleeding and drug interactions are possible.
Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Several studies in cancer patients report enhanced quality of life, lower sleep disturbance, decreased stress symptoms, and changes in cancer-related immune cells after patients received relaxation, meditation, and gentle yoga therapy. Yoga is not recommended as a sole treatment for cancer, but may be helpful as an adjunct therapy.
Fair negative scientific evidence
Integrative therapies used in cancer therapies that have fair negative scientific evidence include: apricot (Prunus armeniaca), beta-carotene, flaxseed and flaxseed oil (Linum usitatissimum), hypnotherapy, and iridology.
Traditional or theoretical uses which lack scientific evidence
Integrative therapies with historical or theoretical uses in cancer but lack sufficient clinical evidence include: acerola (Malpighia glabra, Malpighia punicifolia), aconite (Aconitum napellus), African wild potato (Hypoxis hemerocallidea), alfalfa (Medicago sativa), andrographis (Andrographis paniculata Nees, Kan Jang®, SHA-10), l-arginine, ashwagandha (Withania somnifera), asparagus (Asparagus officinalis), barley (Hordeum vulgare), bilberry (Vaccinium myrtillus), boron, bupleurum (Bupleurum falcatum), chicory (Cichorium intybus), DHEA, feverfew (Tanacetum parthenium), garcinia (Garcinia cambogia), hydroxycitric acid, holy basil (Ocimum sanctum), kava kava (Piper methysticum), licorice (Glycyrrhiza glabra), neem (Azadirachta indica), ozone therapy, PC-SPES, podophyllum (Podophyllum peltatum), pycnogenol (Pinus pinaster), rehmannia (Rehmannia glutinosa), spiritual healing, sweet almond (Prunus amygdulus dulcis), thymus extract, watercress (Nasturtium officinale), and yew (Taxus sp.).
Chemical exposure reduction: If the individual works with chemicals, such as is the case with hairdressers, printers, and painters, they should follow all safety instructions to avoid exposure. If an individual has their own well for water, they may wish to have it tested for contaminants such as lead and arsenic. Local health departments can be a source of water testing.
Exercise and weight control: Controlling weight and exercising regularly can reduce the risk of developing cancer. The American Cancer Society recommends at least 30 minutes of physical activityfive or more days a week if the individual can tolerate it.
Fruits, vegetables and whole grains: Fruits, vegetables, and whole grains contain vitamins, minerals, fiber, and antioxidants, which may help protect from developing various types of cancer. Eating five or more servings of fresh fruits and vegetables every day is important for health. A variety of produce should be included in the individual's diet such as kale, chard, spinach, dark green lettuce, peppers, and squashes.
Limit alcohol consumption: Consuming moderate to heavy amounts of alcohol, such as more than one drink a day for women and two for men, may increase the risk of developing certain cancers, such as colon and breast cancer. This is particularly true if the individual has a close relative, such as a parent, child, or sibling with cancer.
Limit fat, especially saturated fat: People who eat high-fat diets may have a higher rate of cancer, such as colon cancer. It is important to limit saturated fats from animal sources such as red meat. Other foods that contain saturated fat include milk, cheese, ice cream, coconut and palm oils. It is best to restrict the total fat intake to about 30% of the daily calories, with no more than 10% coming from saturated fats.
Screening tests: It is best to follow the early detection screening guidelines to help find colon, breast, prostate, and other cancers.
Smoking cessation: Smoking can increase the risk of cancers such as lung and bladder.
Vitamins and minerals: Calcium, magnesium, pyridoxine (vitamin B6), and folic acid may help reduce the risk of colorectal cancer. Good food sources of calcium include skim or low-fat milk and other dairy products, shrimp, and soy products such as tofu and soy milk. Magnesium is found in leafy greens, nuts, peas, and beans. Food sources of vitamin B6 include grains, legumes, peas, spinach, carrots, potatoes, dairy foods, and meat. Folic acid is found in dark leafy greens such as spinach and lettuce, and in legumes, melons, bananas, broccoli, and orange juice.