Multiple nutritional supplements have been associated with reduced cancer occurrence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.
- Vitamin D levels have been associated with both the incidence of colorectal cancer as well as overall mortality.
- Suggested dose is that sufficient to raise vitamin D blood levels to >40 ng/mL, which may require 5000 IU per day or more.[1]
Curcumin
- Extracted from the spice turmeric, curcumin has been shown to arrest cancer cell growth, induce programmed cell-death (apoptosis), and increase the efficacy of chemotherapy for treatment resistant colorectal cancer cells.[2] While trials of curcumin suggest at least 4g per day may be more beneficial than lower doses,[3]
- Suggested dose: 1-2g per day of Meriva® or Longvida® curcumin.[4],[5]
Green tea extract
- ECEG (Epigallocatechin-3-gallate) from green tea has multiple anti-cancer mechanisms of action, is associated with a reduced incidence of colorectal cancer, and has been shown to reduce the incidence of adenoma formation in patients that have had them previously removed.[6],[7]
- Suggested dose: 1g EGCG and mixed catechins.
Resveratrol
- This antioxidant interferes with all stages of cancer development, and its low bioavailability may make it more suitable for colorectal cancer.[8] When given to patients with colorectal cancer at a dose of 500-1000mg per day, it reduced tumor proliferation.[9]
- Suggested dose: 500-100 mg per day.
Grape seed extract and/or pycnogenol
- Grape seed extract inhibits the growth of cancer cells through several mechanisms, and may have synergistic benefit when used with resveratrol.[10],[11]
- Suggested dose: 100-200mg per day
Probiotics
- While probiotic therapy for colorectal cancer treatment is not well-established, microbiota are thought to influence multiple pathways by which cancer develops and progresses. Additionally, pre-surgery supplementation has been shown to improve outcomes and reduce treatment side effects.
- Suggested dose: 1 capsule 2x per day, at least 25 billion CFU/capsule.[12].
Omega-3 fatty acids
- The omega-3 fatty acids DHA and EPA have broad health benefits, such as reducing the oxidative stress and inflammation thought to influence colorectal cancer progression and recurrence.[13] Current evidence suggests several grams of these fatty acids improve nutritional status and potentially the effectiveness of other cancer therapies.[14] Additionally, GLA, another omega-3, helps to maintain balance in the fatty acids and enhances the anti-inflammatory effect.[15],[16]
- Suggested dose: 1-2 grams combined EPA & DHA per day, with at least 1-2 grams of a GLA source.
Diindolylmethane (DIM)
- Extracted from cruciferous vegetables, such as broccoli, cauliflower, cabbage, etc., DIM has been shown to target several mechanism by which colorectal cancer cells are resistant to apoptosis (programmed cell death) .[17],[18]
- Suggested dose: 250mg per day.
Quercetin
- Dietary consumption of this flavonoid is associated with a reduced risk of colorectal cancer, as well as in vitro induction of apoptosis in colorectal cancer cells, and improved efficacy of 5-fluorouracil, the most commonly used chemotherapy for colorectal cancer.[19],[20]
- Suggested dose: 200-400mg, three times per day.
Melatonin
- A hormone, supplemental melatonin intake has improved survival in a number of cancers, and may enhance conventional therapy effectiveness.[21]
- Suggested dose: At least 3mg at night, preferably time-released.
Vitamin E
- Various components of vitamin E have shown anti-cancer properties. Although alpha-tocopherol is often used in clinical trials, when given alone it may deplete other important components of vitamin E.[22],[23]
- Suggested dose: 200-400 IU per day of mixed tocopherols and tocotrienols.
Vitamin K2
- Vitamin K-2 (MK-7) has the longest half-life, meaning it is the most stable, of all forms of vitamin K. Shown to improve bone and cardiovascular health, higher intakes of this form have also been associated with reduced cancer incidence & fatality, and may improve effectiveness of other therapies.[24],[25],[26]
- Suggested dose: 100 mcg vitamin K-2 (MK-7).
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[1] Garland CF, French CB, Baggerly LL, et al. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.
[2] Shakibaei M, Mobasheri A, Lueders C, et al. Curcumin Enhances the Effect of Chemotherapy against Colorectal Cancer Cells by Inhibition of NF-κB and Src Protein Kinase Signaling Pathways. PLoS One. 2013;8(2):e57218.
[3] Carroll RE, Benya RV, et al. Phase IIa clinical trial of curcumin for the prevention of colorectal neoplasia. Cancer Prev Res (Phila). 2011 Mar;4(3):354-64.
[4] Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Cancer Chemother Pharmacol. 2007 Jul;60(2):171-7.
[5] DiSilvestro RA1, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79. doi: 10.1186/1475-2891-11-79.
[6] Yang G, Shu XO, Li H, et al. Prospective cohort study of green tea consumption and colorectal cancer risk in women. Cancer Epidemiol Biomarkers Prev. 2007 Jun;16(6):1219-23.
[7] Shimizu M, Fukutomi Y et al. Green tea extracts for the prevention of metachronous colorectal adenomas: a pilot study. Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3020-5.
[8] Juan ME, Alfaras I, Planas JM. Colorectal cancer chemoprevention by trans-resveratrol. Pharmacol Res. 2012 Jun;65(6):584-91.
[9] Patel KR, Brown VA, Jones DJ, et al. Clinical pharmacology of resveratrol and its metabolites in colorectal cancer patients. Cancer Res. 2010 Oct 1;70(19):7392-9.
[10] Radhakrishnan S, Reddivari L, et al. Resveratrol potentiates grape seed extract induced human colon cancer cell apoptosis. Front Biosci (Elite Ed). 2011 Jun 1;3:1509-23.
[11] Kaur M, Tyagi A, Singh RP, et al. Grape seed extract upregulates p21 (Cip1) through redox-mediated activation of ERK1/2 and posttranscriptional regulation leading to cell cycle arrest in colon carcinoma HT29 cells. Mol Carcinog. 2011 Jul;50(7):553-62.
[12] Azcárate-Peril MA, Sikes M, Bruno-Bárcena JM. The intestinal microbiota, gastrointestinal environment and colorectal cancer: a putative role for probiotics in prevention of colorectal cancer? Am J Physiol Gastrointest Liver Physiol. 2011 Sep;301(3):G401-24.
[13] Cockbain AJ, Toogood GJ, Hull MA. Omega-3 polyunsaturated fatty acids for the treatment and prevention of colorectal cancer. Gut. 2012 Jan;61(1):135-49.
[14] Read JA, Beale PJ, Volker DH, et al. Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial. Support Care Cancer. 2007 Mar;15(3):301-7.
[15] Xu Y, Qian SY1. Anti-cancer activities of ω-6 polyunsaturated fatty acids. Biomed J. 2014 May-Jun;37(3):112-9.
[16] Biomed J. 2014 May-Jun;37(3):112-9. Gamma linolenic acid with tamoxifen as primary therapy in breast cancer. Int J Cancer. 2000 Mar 1;85(5):643-8.
[17] Bhatnagar N, Li X, Chen Y, et al. 3,3′-diindolylmethane enhances the efficacy of butyrate in colon cancer prevention through down-regulation of survivin. Cancer Prev Res (Phila). 2009 Jun;2(6):581-9.
[18] Lerner A, Grafi-Cohen M, Napso T, et al. The indolic diet-derivative, 3,3′-diindolylmethane, induced apoptosis in human colon cancer cells through upregulation of NDRG1. J Biomed Biotechnol. 2012;2012:256178
[19] Zhang H, Zhang M, Yu L, et al. Antitumor activities of quercetin and quercetin-5′,8-disulfonate in human colon and breast canicer cell lines. Food Chem Toxicol. 2012 May;50(5):1589-99.
[20] Xavier CP, Lima CF, Rohde M, et al. Quercetin enhances 5-fluorouracil-induced apoptosis in MSI colorectal cancer cells through p53 modulation. Cancer Chemother Pharmacol. 2011 Dec;68(6):1449-57.
[21] Cutando A, López-Valverde A, et al. Role of melatonin in cancer treatment. Anticancer Res. 2012 Jul;32(7):2747-53.
[22] Ju J, Picinich SC, Yang Z, et al. Cancer-preventive activities of tocopherols and tocotrienols. Carcinogenesis. 2010 Apr;31(4):533-42.
[23] Yang CS, Suh N, Kong AN. Does vitamin E prevent or promote cancer? Cancer Prev Res (Phila). 2012 May;5(5):701-5.
[24] Nimptsch K, Rohrmann S, Kaaks R, et al. Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2010 May;91(5):1348-58.
[25] Nimptsch K, Rohrmann S, Linseisen J. Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2008 Apr;87(4):985-92.
[26] Zhang H, Ozaki I, Hamajima H, et al. Vitamin K2 augments 5-fluorouracil-induced growth inhibition of human hepatocellular carcinoma cells by inhibiting NF-κB activation. Oncol Rep. 2011 Jan;25(1):159-66.
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