The Use of Dietary Supplements in Oncology
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The use of dietary supplements among patients affected by cancer is extensive, with an estimated 20-90 % of patients using these products. Their use of these products is often not shared with the treating physician. This is because patients perceive or believe that their physicians are indifferent or negative toward the use of dietary supplements. As a result, patients may obtain information about dietary supplements from unreliable sources, exposing themselves to unnecessary risks. Since there are limited scientific data on the efficacy and safety of many dietary supplements, advising patients about when to use them during the course of illness is a clinical challenge. Improving the communication process between the health care team and their patients in this area is critical. We describe a practical patient-centered approach to managing dietary supplement use in cancer care. This approach makes use of all available scientific data relating to the safety and efficacy of these supplements combined with how to have an open, patient-centered discussion with patients about their needs and expectations.
KeywordsComplementary medicine Alternative medicine Cancer care Nutritional supplements Dietary supplements Patient–physician communication
Compliance with Ethics Guidelines
Conflict of Interest
Moshe Frenkel and Victor Sierpina declare that they have no conflict of interest
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as:• Of importance
- 1.US Food and Drug Administration. Q&A on dietary supplements. http://www.fda.gov/Food/DietarySupplements/QADietarySupplements/default.htm#what_is. Accessed 8 Mar 2014.
- 2.NewHope360. 2014 global supplement and nutrition industry report. http://newhope360.com/2014-global-supplement-and-nutrition-industry-report. Accessed 15 Feb 2014.
- 4.Gahche J, Bailey R, Burt V, et al. Dietary supplement use among U.S. adults has increased since NHANES III (1988–1994). NCHS data brief, no 61. Hyattsville: National Center for Health Statistics; 2011.Google Scholar
- 6.Sparber A, Bauer L, Curt G, et al. Use of complementary medicine by adult patients participating in cancer clinical trials. Oncol Nurs Forum. 2000;17:623–30.Google Scholar
- 7.•Ben-Arye E, Polliack A, Schiff E, Tadmor T, Samuels N. Advising patients on the use of non-herbal nutritional supplements during cancer therapy: a need for doctor-patient communication. J Pain Symptom Manage. 2013;46(6):887–96. The very high use of CIM treatments during cancer therapy makes it essential that treating physicians have the communication skills to understand and address their patients’ preferences and uses in these areas. This is critical as such use, especially the use of certain dietary supplements, may interact with cancer therapy.PubMedCrossRefGoogle Scholar
- 20.•Frenkel M, Abrams D, Ladas E, et al. Integrating dietary supplements into cancer care. Integr Cancer Ther. 2013;12:369–84. This is a landmark article that assesses the real-world practice of integrative oncologists and their patients’ choices of dietary supplements. It summarizes existing data on safety and efficacy and gives practical prescribing information useful to both clinicians and patients.PubMedCrossRefGoogle Scholar
- 27.•Frenkel M, Cohen L. Effective communication about the use of complementary and integrative medicine in cancer care. J Altern Complement Med. 2014;20(1):12–8. Understanding how to communicate with patients about dietary supplements and other complementary and integrative therapies during cancer care is a complex yet critical skill. This article explores key issues in this process, and illustrates that effective communication is vital to clinicians treating patients with cancer who have questions about integrative therapies.PubMedCrossRefGoogle Scholar
- 28.Frenkel M, Ben AE. Communicating with patients about the use of complementary and integrative medicine in cancer care. In: Cohen L, Markman M, editors. Integrative oncology: incorporating complementary medicine into conventional care. Totowa: Humana; 2008.Google Scholar