Drug nutrient interaction in cancer patients

Introduction

Drug-nutrient interactions are defined as physical, chemical, physiologic, or

pathophysiologic relationships between a drug and a nutrient. The causes of most
clinically significant drug-nutrient interactions are usually multifactorial.
When dietary supplements /herbs and cancer drugs are taken together, there is
always a risk of the supplement having an impact on the pharmacokinetics (PK) or
pharmacodynamics (PD) of the drug

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The cancer information summary gives an overview of cancer therapy

interactions with various foods and dietary supplements and includes the following
critical facts are

1,The combination of cancer drugs taken by patients and the complementary and

alternative medicine / CAM/  A term used to describe a medical product or practice
that is used together with (complementary) or instead of (alternative) standard
medical care. Usually, less is known about most types of complementary and
alternative medicine than about standard treatments, which go through a long and
careful research process to prove they are safe and effective
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• Complementary and alternative medicine may include dietary supplements, vitamins,

herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual
healing, and meditation.

Over one-third of adults with cancer in the United States use some form of complementary
and alternative medicine (CAM). Taking anticancer drugs and CAM together may cause
adverse outcomes.
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2,For many specific antioxidant supplements, A substance that protects cells from the

damage caused by free radicals (unstable molecules made by the process of oxidation

during normal metabolism). Free radicals may play a part in cancer, heart disease,

stroke, and other diseases of aging. Antioxidants include beta-carotene, lycopene,

vitamins A, C, and E, and other natural and manufactured substances.

In laboratory and animal studies, the presence of increased levels of

exogenous antioxidants has been shown to prevent the types of free radical damage that

have been associated with cancer development.

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Therefore, researchers have investigated whether taking dietary

antioxidant supplements can help lower the risk of developing or dying from cancer in

humans.

3,Certain constituents of foods and dietary supplements Anticancer drug interactions

with dietary supplements, including CAM, may alter drug absorption, distribution, and

excretion, potentially causing unexpected effects. (e.g., St. John’s wort, grapefruit

juice, and epigallocatechin gallate from green tea) can alter the PK of specific types of

drugs.
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• 4, Specific enzymes and factors help drugs work in the body. The cytochrome P450

superfamily of enzymes play a major role in the metabolism of many cancer drugs, The
transport protein, P-glycoprotein, is another factor involved in how cancer drugs work in
the body. If a dietary supplement impacts a cytochrome P450 enzyme or P-glycoprotein,
the cancer drug will not work like it should and the patient will not receive the full
benefits of the drug.

• Cancer has one of the highest incidences of protein-calorie malnutrition among

hospitalized patients. The protein calorie malnutrition is often related to the underlying
disease itself, treatments related to the cancer, or a combination of the two
Reference
• PDQ Integrative, Alternative, and Complementary Therapies Editorial Board. Cancer Therapy Interactions
With Foods and Dietary Supplements (PDQ®): Health Professional Version. 2022 May 26. In: PDQ Cancer
Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK563071 /