Interactions between Gefitinib & other Nauturopathic Therapies - 1257435

Hi William,

I'm sorry about your mom's diagnosis, but it's good that she has an EGFR mutation and I hope that Gefitinib proves to be very effective for her and that she tolerates it well.

Regarding your question, Dr. Weiss said the following in the discussing the very similar drug Tarceva (erlotinib): "I am aware of no data showing harm with the combination of tarceva and small doses of melatonin, fish oil, probiotics, or multivitamin." - http://cancergrace.org/forums/index.php?topic=9503.msg75315#msg75315

When my wife was taking Tarceva, her integrative medicine doctor, with the approval of her oncologist, had her taking vitamin D, fish oil, turmeric (curcumin) and a couple of other supplements, and she responded well to Tarceva.

The problem is that there are so many potential supplements out there that they can't all be tested with Tarceva or Gefitinib to authoritatively determine whether they lessen the effectiveness of either. There is a list of known interactions at: http://www.drugs.com/monograph/tarceva.html

JimC
Forum moderator

That's exactly right. I'm pretty sure that there's no evidence to say there's an interaction with Iressa (gefitinib) or Tarceva (erlotinib) with any of the supplements you mention, but there's also no evidence at all on them... It's just an unknown, though I wouldn't presume there to be a problem with anything on that list.

-Dr. West

GRACE needs to avoid making recommendations, so while we can share information when it's available, we can't offer medical advice. I'm afraid it's illegal for us to say what someone who isn't our patient should do.

I'll confess that findings in a mouse usually have no remote bearing on the unfathomably more complex situation of a cancer patient. It's like doing an experiment with a paper airplane and then going directly from that to changing the structure of a 747 flying that day. It's simply my opinion, but my perspective is that in the absence of actual substantial evidence in patients, mistletoe injections and curcumin are simply voodoo, "woo woo" science...and there just isn't anything to say about them helping any more than a walk in the sun. I try to convey the evidence to support different interventions I recommend to patients, and I would consider it unethical to recommend treatments that are essentially devoid of any reasonable quality evidence that they help actual humans with cancer.

-Dr. West

Hi William,

In answer to your question, I can't really say that we did anything all that unusual. We tried to eat better just to help minimize the side effects of treatment, but we didn't do any of the more specific techniques such as avoiding sugar or red meat entirely. Although I have no way of knowing, I don't really believe that her supplements had much to do with how well she did; I simply think that the biology of her cancer was simpler and less aggressive than others and that her EGFR mutation resulted in a good response to Tarceva.

JimC
Forum moderator

I appreciate that, and I understand that we don't know everything about cancer or cancer treatments. I certainly don't have an expertise in mistletoe, and I think that the less concern we have about side effects and the less we have to offer in terms of other alternatives, the less we should care about whether the evidence is extremely strong or not.

I also completely agree that survival benefit isn't the only yardstick by which we should measure the benefit of a treatment. If something offers palliative benefit/symptom relief/improvement of quality of life, that's the other critical side of the coin, along with duration of survival.

I truly look forward to studies with mistletoe being completed, as I would welcome any new effective treatments to help here.

-Dr. West

Hain, there are no trials being conducted in the US using mistletoe. There are two listed in clinicaltrials.gov and their both in Switzerland. From everything I've read up on mistletoe, it can help with side effects from both chemo and radiation. And doing alternative treatment is a personal choice and oncologists are not in their speciality to offer alternative treatments. Take care, Judy
http://clinicaltrials.gov/ct2/results?term=mistletoe+and+cancer

I think the operative word is evidence. If there are relevant complementary or competing anti-cancer treatments with evidence, it it incumbent on an oncologist to become knowledgeable enough to discuss how they might fit into a treatment plan. But thus far, actual evidence in human cancer patients for alternative medicines has been very sparse, often non-existent.

There are innumerable interventions being recommended by various naturopaths based on scant evidence from early animal models, or less evidence than that, and oncologists can't be held accountable for declaring these untested interventions as safe or unsafe, valuable or not valuable. The true answer in the absence of evidence is going to be "we don't know", and this leads many oncologists to be disinclined to favor something that has no good evidence to support it and may be harmful -- that should be the case whether it's a new chemo agent or naturopath-prescribed agent.

-Dr. West