Lung Cancer Supplement Recommendations

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

  • Lower levels of vitamin D have been associated with an increased risk for developing lung cancer as well as lung cancer death.
  • 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]

Omega-3 fatty acids

  • Clinical trials with the omega-3 fatty acids, EPA and DHA, have shown improved nutritional status, better functional status, reduced inflammation, and improved effectiveness of chemotherapeutic agents.[2],[3],[4] Additionally, GLA, another omega-3 found in Evening Primrose oil, helps to maintain balance in the fatty acids and enhances the anti-inflammatory effect.[5],[6]
  • Suggested dose: 2-3 grams combined EPA & DHA per day, with at least 1-2 grams of a GLA source.

Alpha Lipoic Acid

  • Shown to protect healthy cells from oxidative stress and induce apoptosis (programmed cell death) in cancer cells, and when combined with N-acetylcysteine was found to restore function to the immune cells of cancer patients.[7],[8]
  • Suggested dose: 300mg, 1-2 times per day.

N-acetylcysteine (NAC)

  • An important antioxidant and building block for glutathione, NAC inhibits cancer growth by multiple mechanisms, and may have synergistic effect when used with alpha lipoic acid, EGCG, and isothiocyanates.[9],[10] It may be most indicated for those with genetic variants impairing glutathione production.
  • Suggested dose: 600mg, 2-3 times per day.

Isothiocyanates

  • Isothiocyanates occur in many commonly consumed cruciferous vegetables (broccoli, cauliflower, kale, etc.) and have numerous anti-cancer properties. They have recently been shown to reduce drug-resistance of some lung cancer cells.[11],[12]
  • Suggested dose: 600mcg per day.

Green tea extract

  • Catechins, antioxidants found in green tea, particularly ECEG (epigallocatechin-3-gallate), have been shown to have numerous anti-cancer effects, and may enhance chemotherapy effectiveness.[13]
  • Suggested dose: 1g EGCG and mixed catechins.

Curcumin

  • The pharmacologically active component of the spice turmeric, curcumin inhibits tumor growth by multiple mechanisms, and has shown synergistic function with several chemotherapeutic agents.[14]
  • Suggested dose: 1-2g per day of Meriva® or Longvida® curcumin.[15],[16]

Resveratrol

  • Found in red wine and grapes, this antioxidant inhibits the invasion and metastasis of lung cancer cells.[17]
  • Suggested dose: 100-200mg per day.

Quercetin

  • A high intake of this antioxidant has been associated with a reduced risk of developing lung cancer, as it appears to influence several anti-proliferative pathways.[18],[19]
  • 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.[20],[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] Finocchiaro C, Segre O, Fadda M, et al. Effect of n-3 fatty acids on patients with advanced lung cancer: a double-blind, placebo-controlled study. Br J Nutr. 2012 Jul;108(2):327-33.

[3] van der Meij BS, Langius JA, et al. Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT. Eur J Clin Nutr. 2012 Mar;66(3):399-404.

[4] Murphy RA, Mourtzakis M, Chu QS, et al. Supplementation with fish oil increases first-line chemotherapy efficacy in patients with advanced nonsmall cell lung cancer. Cancer. 2011 Aug 15;117(16):3774-80.

[5] Xu Y, Qian SY1. Anti-cancer activities of ω-6 polyunsaturated fatty acids. Biomed J. 2014 May-Jun;37(3):112-9.

[6] 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.

[7] Choi SY, Yu JH, Kim H. Mechanism of alpha-lipoic acid-induced apoptosis of lung cancer cells. Ann N Y Acad Sci. 2009 Aug;1171:149-55.

[8] Mantovani G, Macciò A, Melis G, et al. Restoration of functional defects in peripheral blood mononuclear cells isolated from cancer patients by thiol antioxidants alpha-lipoic acid and N-acetyl cysteine. Int J Cancer. 2000 Jun 15;86(6):842-7.

[9] Lambert JD, Sang S, Yang CS. N-Acetylcysteine enhances the lung cancer inhibitory effect of epigallocatechin-3-gallate and forms a new adduct. Free Radic Biol Med. 2008 Mar 15;44(6):1069-74.

[10] De Flora S, Izzotti A, D’Agostini F, et al. Mechanisms of N-acetylcysteine in the prevention of DNA damage and cancer, with special reference to smoking-related end-points. Carcinogenesis. 2001 Jul;22(7):999-1013.

[11] Wu X, Zhu Y, Yan H, Isothiocyanates induce oxidative stress and suppress the metastasis potential of human non-small cell lung cancer cells. BMC Cancer. 2010 Jun 9;10:269.

[12] Wu WJ, Zhang Y, Zeng ZL, et al. β-phenylethyl isothiocyanate reverses platinum resistance by a GSH-dependent mechanism in cancer cells with epithelial-mesenchymal transition phenotype. Biochem Pharmacol. 2013 Feb 15;85(4):486-96.

[13] Suganuma M, Saha A, Fujiki H. New cancer treatment strategy using combination of green tea catechins and anticancer drugs. Cancer Sci. 2011 Feb;102(2):317-23.

[14] Yin H, Guo R, Xu Y, et al. Synergistic antitumor efficiency of docetaxel and curcumin against lung cancer. Acta Biochim Biophys Sin (Shanghai). 2012 Feb;44(2):147-53.

[15] 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

[16] 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.

[17] Kim YS, Sull JW, Sung HJ, et al. Suppressing effect of resveratrol on the migration and invasion of human metastatic lung and cervical cancer cells. Mol Biol Rep. 2012 Sep;39(9):8709-16.

[18] Lam TK, Rotunno M, Lubin JH, et al. Dietary quercetin, quercetin-gene interaction, metabolic gene expression in lung tissue and lung cancer risk. Carcinogenesis. 2010 Apr;31(4):634-42.

[19] Zheng SY, Li Y, et al. Anticancer effect and apoptosis induction by quercetin in the human lung cancer cell line A-549. Mol Med Rep. 2012 Mar;5(3):822-6.

[20] Cutando A, López-Valverde A, et al. Role of melatonin in cancer treatment. Anticancer Res. 2012 Jul;32(7):2747-53.

[21] Lissoni P, Chilelli M, Villa S, et al. Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial. J Pineal Res. 2003 Aug;35(1):12-5.

[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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