Written By: Dr. Adam McLeod, ND, BSc (Hons)
Everyone has seen a cancer patient who has lost a significant amount of weight as the disease progressed. It is a scary experience to see someone that you love waste away as the cancer deprives their body of the nutrients that they so desperately need. In the chaos of going from one appointment to the next, patients often do not realize how malnourished they have become.
The significant wasting that late stage cancer patients experience is known as cachexia. To understand why this happens it is helpful to look at the molecular pathways relevant to cachexia. The exact mechanism is not well defined but inflammatory cytokines are thought to play a major role. Cancer is a condition that creates significant systemic inflammation and this dramatically increases the concentration of inflammatory cytokines through out the body. The most prominent inflammatory cytokines during cachexia are often TNF-a and IL6 5.
The good news is that there are a number of natural tools which can help to significantly reduce these inflammatory cytokines. Of course there are cases where the disease has progressed to the point where it is not possible to reverse the effects of cachexia. However, in my clinical practice I have seen many patients reverse the effects of cachexia rather quickly when the correct natural supports are used. When we take the time to look at how these natural supports work it is immediately obvious why they can be so effective.
Omega-3’s are potent natural anti-inflammatories and specifically they reduce TNF-a and IL6 levels in the body1,2,3. In order to have the desired therapeutic effect from supplementation with omega-3’s it is critical that the proper dose is used. Many supplements (especially pill forms) containing omega-3’s do not have the appropriate dose of eicosapentaenoic acid(EPA) and this will not have any impact on an extreme case such as cachexia. When the appropriate dosing is used sometimes patients can see significant improvements in cachexia from supplementing with omega-3’s 4.
Cancer loves L-glutamine and it uses it in high amounts to support its metabolic needs. Some patients upon hearing this falsely assume that removing glutamine from the diet would then starve cancer cells. This is the wrong approach to take. Cancer cells will get glutamine whether you have it in your diet or not. If it is not in your diet then the cancer cells will cause the muscles to break down so that the glutamine can be extracted from the muscles. This will rapidly worsen the cachexia. The simplistic view that if cancer uses a substance then it should be avoided is not always correct in these complex clinical cases. When patients are supported with adequate amounts of glutamine this can help to slow down muscle breakdown and give healthy cells the glutamine that they also need to function6. The glutamine is also necessary for your immune system to function properly and this need far outweighs any concerns of “feeding” cancer cells glutamine in cases of cachexia.
In my experience the combination of L-glutamine and omega-3’s can help to heal the gut and this allows cancer patients to absorb nutrients more effectively from their food. A major challenge for advanced cancer patients is that even if they eat enough food, they struggle to adequately absorb nutrients from their food. By supporting gut health with adequate amounts of these simple remedies, this can help to enhance the absorption of nutrients at a time when patients are extremely malnourished.
There are many other natural therapies which can also be applied in cachexia to help improve the patients quality of life. For example, cannabinoids can be used to help stimulate appetite while reducing the sensation of nausea that many of these patients have. In other cases, the use of a Myers IV is indicated to bypass any concerns with absorption and get nutrients directly into the blood. Patients generally feel better when the inflammation is reduced following the application of these various naturopathic supports. It is critical that patients have professional guidance from a qualified naturopathic physician when utilizing these supports. Cachexia is a unique metabolic circumstance that requires the appropriate doses if you expect to see any benefit.
Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology. http://www.yaletownnaturopathic.com
1) Kang, Jing X., and Karsten H. Weylandt. “Modulation of inflammatory cytokines by omega-3 fatty acids.” Lipids in Health and Disease. Springer Netherlands, 2008. 133-143.
2) De Caterina, Raffaele, et al. “The omega-3 fatty acid docosahexaenoate reduces cytokine-induced expression of proatherogenic and proinflammatory proteins in human endothelial cells.” Arteriosclerosis, Thrombosis, and Vascular Biology 14.11 (1994): 1829-1836.
3) Nelson, Tracy L., and Matthew S. Hickey. “Acute changes in dietary omega-3 fatty acid intake lowers soluble interleukin-6 receptor in healthy adult normal weight and overweight males.” Cytokine 26.5 (2004): 195-201.
4) Radbruch, L., F. Elsner, and P. Trottenberg. “Clinical practice guidelines on cancer cachexia in advanced cancer patients. European Palliative Care Research Collaborative.” (2011).
5) Yeh, Shing-Shing, Kimathi Blackwood, and Michael W. Schuster. “The cytokine basis of cachexia and its treatment: are they ready for prime time?.” Journal of the American Medical Directors Association 9.4 (2008): 219-236.
6) May, Patricia Eubanks, et al. “Reversal of cancer-related wasting using oral supplementation with a combination of β-hydroxy-β-methylbutyrate, arginine, and glutamine.” The American journal of surgery 183.4 (2002): 471-479.