Phytoestrogens and Antioxidants -- Bits of Experimental Evidence

Highlights of the Society for Integrative Oncology 1st International Conference; November 17-19, 2004; New York, NY

Sara M. Mariani, MD, PhD

Disclosures
In This Article

Introduction

Healthcare professionals are estimating that more than 80% of cancer patients are taking some form of supplement or receiving some form of complementary/alternative treatment. Approximately 60% would be using nutritional supplements and vitamins, about 40% herbal medications. In many cases, it seems that such use is not part of the patients' records, whether by omission or a specific desire of the patients themselves.

In the uncertainty surrounding the benefits associated with these alternative treatments, voices of caution are being heard saying that the word natural or complementary does not necessarily imply safety for the patient, although this is often the general, but potentially erroneous, perception. After all, they argue, Socrates committed suicide by drinking a potion of cicuta (water hemlock), one of the most potent natural compounds known to humans. And healthcare professionals of the older generation have not forgotten how difficult it was to achieve an accurate titration of another, most powerful herbal remedy, digitalis (derived from the foxglove plant), that's widely used in clinical practice, "cloaked" as a drug.

Some physicians, who have vowed "primum non nuocere," are wary of this turn of events and say that fads are often not of benefit to patients. Yet, they have to treat patients who are taking them, without a clear understanding of what these complementary or alternative treatments may do to their patients or to the treatment regimes selected. This is surely a situation that fosters more confusion and potential risks than needed.

Many of the experts convened at the Society for Integrative Oncology 1st International Conference, recently held in New York, NY, although at times of different "persuasion" as to which treatment is best, and seemed to agree on 1 point: New treatments may complement old ones for a comprehensive treatment of patients with cancer, but implementation of such treatments can proceed only if suitable clinical evidence of efficacy, safety, and tolerability is provided to the medical community and to the patients. At the same time, an unbiased evaluation of objective, appropriately powered, and reproducible data can only be of benefit to the oncology community at large.

Whether conventional or alternative, medicine is supposed to have the same aim: curing a patient, with the least toxicity. If a cure cannot be achieved, then the priority is for each patient to receive the best possible treatment. And because many believe that we are only now, in these past few years, beginning to achieve control of some cancers, and many more are still challenging our best medical resources, then we can only infer that there is plenty of work for all.

We provide an overview of some of the hotly debated issues in a comprehensive approach to the management of cancer patients: For example, can phytoestrogens be of benefit to patients with pancreatic cancer (PC)? Does a new study support the use of phytoestrogens in breast cancer survivors? Then there's the quandary: to allow or not the use of protective antioxidants in cancer patients undergoing radiation treatment?

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