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Do Antioxidants Interfere w/ Myeloma ?

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Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival…

Hi David- I am on multiple myeloma treatment. Do antioxidants interfere with my treatment? Can I undergo whole body hyperthermia aka sauna? JJ

Hi JJ-
Regarding whole body hyperthermia, check with your GP first, but according to the research I have found, WBH is good for your heart, brain and detoxifies. I have a sauna several times a week so I am biased. I find saunas to be very relaxing.
Your question about antioxidants raises several different issues regarding MM treatment. I am assuming that you are asking about FDA approved chemotherapy regimens such as Revlimid, Velcade and Dexamethasone- RVD is the standard-of-care induction triplet.
Antioxidants in general- I think most oncologists are fine with you eating nutritiously and therefore increasing your daily intake of antioxidants. Antioxidants from food is okay based on what I have read. I know of no studies that prove nutritional antioxidants pro or con.
As for supplements such as vitamins, studies are available only for specific antioxidants. I will list several studies below.
The issue of antioxidants interfering with chemotherapy is controversial. I can think of no other debate in oncology that is more argued about- pro and con. Personally, just me, just my opinion, is reflected in the top study linked below. Generally speaking, according to the study, antioxidants do not interfere with chemo. However there are lots of studies that say the opposite- that antioxidant supplementation does interfere with chemo.
Keep in mind that I look at the issue as a multiple myeloma survivor. I look at the fact that conventional oncology can’t cure MM with chemo and that all MM patients will eventually hit multi-drug resistance (MDR), end-stage MM and death. So I take this issue personally…
  1. The only antioxidant that is specifically contraindicated or shown to interfere with a specific chemotherapy drug is vitamin C and Velcade. See the study linked below.
  2. Vitamin D3 has been shown to be associated with multiple myeloma. Low blood levels of vitamin D3 increase risk of MM and vitamin D3 supplementation is good for bone health. See the study linked below.
  3. Antioxidant supplementation of a specific type such as curcumin has been shown to be cytotoxic to MM, as well as be integrative meaning curcumin has been shown to enhance the efficacy of velcade (bortezomib) and revlimid (lenalidomide). Study below-
What I am saying JJ, is that the issue depends on the specific antioxidant and also that the issues is heatedly debated.
I am sorry I can’t provide a yes or no answer.
David Emerson
  • MM Survivor
  • MM Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Hyperthermia in Cancer Treatment

“Hyperthermia (also called thermal therapy or thermotherapy) is a type of cancer treatment in which body tissue is exposed to high temperatures (up to 113°F). Research has shown that high temperatures can damage and kill cancer cells, usually with minimal injury to normal tissues (1). By killing cancer cells and damaging proteins and structures within cells (2), hyperthermia may shrink tumors…”

Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 1.

Fifty human clinical randomized or observational trials have been conducted, involving 8,521 patients using beta-carotene; vitamins A, C, and E; selenium; cysteine; B vitamins; vitamin D3; vitamin K3; and glutathione as single agents or in combination.
CONCLUSIONS: Since the 1970s, 280 peer-reviewed in vitro and in vivo studies, including 50 human studies involving 8,521 patients, 5,081 of whom were given nutrients, have consistently shown that non-prescription antioxidants and other nutrients do not interfere with therapeutic modalities for cancer. 
Furthermore, they enhance the killing of therapeutic modalities for cancer, decrease their side effects, and protect normal tissue. In 15 human studies, 3,738 patients who took non-prescription antioxidants and other nutrients actually had increased survival.”

Ascorbic acid inhibits antitumor activity of bortezomib in vivo.

Earlier studies have shown that ascorbic acid (vitamin C) inhibits bortezomib-induced cytotoxicity against cancer cells in vitro. However, the clinical significance of vitamin C on bortezomib treatment is unclear. In this study, we examined whether daily oral intake of vitamin C inhibits antimultiple myeloma (MM) activities of bortezomib. Vitamin C, at orally achievable concentrations, inhibited in vitro MM cell cytotoxicity of bortezomib and blocked its inhibitory effect on 20S proteasome activity. Specifically, plasma collected from healthy volunteers taking 1 g/day vitamin C reduced bortezomib-induced MM cell death in vitro. This antagonistic effect of vitamin C against proteasome inhibitors is limited to the boronate class of inhibitors (bortezomib and MG262). In vivo activity of this combination treatment was then evaluated using our xenograft model of human MM in SCID (severe combined immune-deficient) mice. Bortezomib (0.1 mg/kg twice a week for 4 weeks) significantly inhibits in vivo MM cell growth, which was blocked by oral vitamin C (40 mg/kg/day). Therefore, our results for the first time show that vitamin C can significantly reduce the activity of bortezomib treatment in vivo; and importantly, suggest that patients receiving treatment with bortezomib should avoid taking vitamin C dietary supplements.
Here, we studied 83 unselected multiple myeloma patients from December 2007 through December 2014. Lower 25(OH) D levels (<10 ng/mL) were associated with higher number of plasma cells in the bone marrow. Supplementation of vitamin D was accompanied with a significant increase in hemoglobin (11.8 to 12.3 p = .039), leukocyte (4.9 to 5.8 p = .011), and erythrocyte (3.8 to 4.0 p = .004) levels, while thrombocytes (200.5 to 175.2 p = .036) decreased. In conclusion, the present study found a high incidence of vitamin D deficiency and insufficiency in MM patients. In myeloma patients, vitamin D levels and supplementation should be more widely taken into account.

Synergistic effects of curcumin and bortezomib on multiple myeloma cells

“To investigate the effects of curcumin and/or bortezomib on the proliferation of MM1.R cells, MTT assay was performed. Our results showed that, curcumin treatment alone significantly inhibited the proliferation of MM1.R cells (P < 0.05), in a dose-dependent manner. On the other hand, the monotherapy of 0.01 mmol/L bortezomib did not significantly alter the prolif– eration of MM1.R cells (P > 0.05). However, when the cells were treated with curcumin and bortezomib combination, the cell proliferation was further significantly declined compared with the curcumin treatment alone at corre- sponding concentrations (P < 0.05 for 20 and 40 μg/mL)


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