Leukemia-3

Tracking your progress

Because all leukemia therapies produce individual responses based on factors such as the type of leukemia, patient's age, nutritional status, and the presence of other diseases, monthly blood testing to monitor progress is recommended. Patients treated for leukemia should work closely with their physician to follow the results of blood and other tests to determine the best treatment course.

The following tests are valuable:

1)Cholesterol levels: low cholesterol return to normal physiological levels with response to treatment in AML and CML (Baroni S et al 1994; Baroni S et al 1996; Moschovi M et al 2004).

2)Total lipid profiles: monitoring of lipids such as serum albumin and body mass index can play a role in assessing response to treatment as these lipids are low at leukemia diagnosis (Fiorenza AM et al 2000; Moschovi M et al 2004).

3)Cortisol levels: increased levels in AML, CML, and CLL are associated with immune dysfunction (Everaus H 1992; Everaus H et al 1997; Singh JN et al 1989). Monitoring cortisol levels in cancer patients may be useful in observing the psychological impact of the disease and associated treatment on the individual (Cohen L et al 2001).

4)DHEA levels: abnormal levels may be associated with immune cell dysfunction (Uozumi K et al 1996). Baseline levels can be determined by radioimmunoassay before DHEA supplementation, shown to correct impaired immune function in animal models (Catalina F et al 2003; Inserra P et al 1998).

5)Coagulation profile: blood-clotting parameters are usually abnormal in leukemia. Tests may show low levels of platelets, increased prothrombin time (PT), partial thromboplastin time (PTT), and/or decreased fibrinogen (Barton JC et al 1986). Response to therapy is often accompanied by normalization of these blood tests with increased fibrinogen and decreased PTT (Anders O et al 1988; Higuchi T et al 1997).

6)Hemoglobin levels: anemia is common in patients with leukemia, and this can be monitored by periodically measuring hemoglobin status. Hemoglobin levels less than 11g/dL are typically seen with leukemia (Quirt I et al 2001b).

7)Cytokine panel: tests in patients with leukemia typically reveal that blood levels of pro-inflammatory cytokines, such as interkeukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1 beta (IL-1ß), and tumor necrosis factor-alpha (TNF-a) are elevated.

8)Genetic profile: p53 (Lian F et al 1999; Melo MB et al 2002; Nakano Y et al 2000) and Bcr-Abl tyrosine kinase (Patlak M 2002).

9)Blood smears: assessments of blood cell shape and size show the presence of leukemia cells by highlighting irregularities in cell shape and structure.

10)Bone marrow tests: samples taken by aspiration can detect leukemic cells in bone marrow and monitor treatment effectiveness.

11)X-rays: leukemia progression can be monitored by X-rays to detect disease spread to the lymph nodes, lungs, bone, and joints. Magnetic resonance imaging (MRI) can detect brain metastases (Vera P et al 1999).

12)Abdominal sonography: this is a diagnostic imaging method used to monitor the effect of treatment through detection of enlarged spleen (splenomegaly) and abdominal lymph nodes (Bessmel'tsev SS et al 1991).

13)Physical examinations play a very important role in monitoring the response to treatment and checking for relapse following leukemia remission, including the presence of enlarged lymph nodes or an enlarged spleen (Saven A et al 1998).

For More Information…

Leukemia patients may wish to read these chapters and design a program that will address the full range of their cancer problems:

- Cancer Chemotherapy

- Cancer Radiation

- Complementary Adjuvant Cancer Therapies

- Blood Disorders

For general information on all aspects of leukemia:
The American Cancer Society, (800) ACS-2345
The Leukemia & Lymphoma Society, (800) 955-4572 http://www.leukemia-lymphoma.org/hm_lls

Life Extension Foundation Recommendations

Leukemia patients should consult their physicians before starting to use any nutritional supplements while receiving conventional medical treatment. In addition, leukemia patients using nutritional supplements should enlist the assistance of their physicians to ensure the implementation of blood tests and diagnostic procedures that are essential for monitoring the effectiveness of any adjuvant therapy for leukemia.

The Life Extension Foundation suggests:


1)Vitamin A— 40,000 to 50,000 IU daily (Kakizoe T 2003; Meyskens FL, Jr. et al 1995)

2)Vitamin D3— 16,000 IU three times per week (Mellibovsky L et al 1993)

3)Curcumin— three 800 mg capsules up to three times daily, 2 hours apart from all medications (Gescher A 2004)

4)Green tea— 725 mg of green tea extract (containing 93% polyphenols, 34% epigallocatechin gallate) three times daily, or 10 cups of Japanese green tea (Laurie SA et al 2005; Pisters KM et al 2001)

5)Soy extract— containing 50 mg of isoflavones twice daily (Anderson GD et al 2003b)

6)Lipoic acid— 600 mg orally three times daily (Rock E et al 2003)

7)Vitamin E— 400 IU daily (Kakizoe T 2003)

8)Vitamin B12— 1 mg daily (Gonin JM et al 2003)

9)L-Ascorbic acid— 2000 mg daily (Kakizoe T 2003)

10)Shark liver oil— 1500-3000mg [containing 20% alkylgycerols (300-600mg)] a day in divided dosages (Pugliese PT et al 1998)

11)Essential fatty acids— 700 mg GLA daily; 4.8 grams EPA daily; 4.9 grams DHA daily (Buckley R et al 2004; Johnson CD et al 2001)

12)DHEA— 50 mg daily for men; 25 mg daily for women (Huppert FA et al 2001)

13)Resveratrol— 25 mg daily (Walle T et al 2004)

14)Folic acid— up to 1 mg daily (Scagliotti GV et al 2003)

15)Melatonin— 20 mg before bedtime (Lissoni P et al 2000)

16)Panax ginseng— 100 mg standardized to contain 4% gensenosides twice daily (Anderson GD et al 2003a)

17)Garlic— 600 mg of aged garlic extract twice daily (Hassan HT 2004)


Leukemia Safety Caveats

An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Curcumin
Do not take curcumin if you have a bile duct obstruction or a history of gallstones. Taking curcumin can stimulate bile production.
Consult your doctor before taking curcumin if you have gastroesophageal reflux disease (GERD) or a history of peptic ulcer disease.
Consult your doctor before taking curcumin if you take warfarin or antiplatelet drugs. Curcumin can have antithrombotic activity.
Always take curcumin with food. Curcumin may cause gastric irritation, ulceration, gastritis, and peptic ulcer disease if taken on an empty stomach.
Curcumin can cause gastrointestinal symptoms such as nausea and diarrhea.

DHEA

Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss

EPA/DHA

Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.

Folic acid

- Consult your doctor before taking folic acid if you have a vitamin B12 deficiency.

- Daily doses of more than 1 milligram of folic acid can precipitate or exacerbate the neurological damage caused by a vitamin B12 deficiency.

Garlic

- Garlic has blood-thinning, anticlotting properties.

- Discontinue using garlic before any surgical procedure.

- Garlic can cause headache, muscle pain, fatigue, vertigo, watery eyes, asthma, and gastrointestinal symptoms such as nausea and diarrhea.

- Ingesting large amounts of garlic can cause bad breath and body odor.

Genistein

- Consult your doctor before taking genistein/genistin if you have prostate cancer.

- Do not take genistein/genistin if you have estrogen receptor–positive tumors.
Genistein/genistin can cause hypothyroidism in some people.

Ginseng

- Consult your doctor before taking ginseng if you have high blood pressure. Overuse of ginseng can increase blood pressure.

- Consult your doctor before taking ginseng if you take nonsteroidal anti-inflammatory drugs (NSAIDs) and/or warfarin (Coumadin). Taking NSAIDs or warfarin with ginseng can increase the risk of bleeding.

- Consult your doctor before taking ginseng if you have diabetes. Taking ginseng can cause an extreme drop in your blood glucose level.

- Ginseng can cause breast pain, vaginal bleeding after menopause, insomnia, headaches, and nosebleeds.

GLA

- Consult your doctor before taking GLA if you take warfarin (Coumadin). Taking GLA with warfarin may increase the risk of bleeding.

- Discontinue using GLA 2 weeks before any surgical procedure.

- GLA can cause gastrointestinal symptoms such as nausea and diarrhea.

Green Tea

Consult your doctor before taking green tea extract if you take aspirin or warfarin (Coumadin). Taking green tea extract and aspirin or warfarin can increase the risk of bleeding.
Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea extract may decrease platelet aggregation.
Green tea extract contains caffeine, which may produce a variety of symptoms including restlessness, nausea, headache, muscle tension, sleep disturbances, and rapid heartbeat.

Melatonin

Do not take melatonin if you are depressed.
Do not take high doses of melatonin if you are trying to conceive. High doses of melatonin have been shown to inhibit ovulation.
Melatonin can cause morning grogginess, a feeling of having a hangover or a “heavy head,” or gastrointestinal symptoms such as nausea

Shark Liver Oil

- Do not exceed the maximum recommended dose.

- Prolonged use (more than 30 days in a row) causes a rare side effect known as thrombocythemia (excess platelets), which can cause the blood to clot.

- Shark liver oil can cause rash, breath that smells like garlic, fatigue, irritability, and gastrointestinal symptoms such as nausea and diarrhea.

Vitamin A

- Do not take vitamin A if you have hypervitaminosis A.

- Do not take vitamin A if you take retinoids or retinoid analogues (such as acitretin, all-trans-retinoic acid, bexarotene, etretinate, and isotretinoin). Vitamin A can add to the toxicity of these drugs.

- Do not take large amounts of vitamin A. Taking large amounts of vitamin A may cause acute or chronic toxicity. Early signs and symptoms of chronic toxicity include dry, rough skin; cracked lips; sparse, coarse hair; and loss of hair from the eyebrows. Later signs and symptoms of toxicity include irritability, headache, pseudotumor cerebri (benign intracranial hypertension), elevated serum liver enzymes, reversible noncirrhotic portal high blood pressure, fibrosis and cirrhosis of the liver, and death from liver failure.

Vitamin B12 (cyanocobalamin)

Do not take cyanocobalamin if you have Leber's optic atrophy.

Vitamin C

- Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.

- Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.

Vitamin D

- Do not take vitamin D if you have hypercalcemia.

- Consult your doctor before taking vitamin D if you are taking digoxin or any cardiac glycoside.

- Only take large doses of vitamin D (2000 international units or 50 micrograms or more daily) if prescribed by your doctor.

- See your doctor frequently if you take vitamin D and thiazides or if you take large doses of vitamin D. You may develop hypercalcemia.

- Chronic large doses (95 micrograms or 3800 international units or more daily) of vitamin D can cause hypercalcemia.

- Chronic large dosages of 95 micrograms or 3,800 IU/day or greater may cause hypercalcemia in healthy individuals.

Vitamin E

- Individuals taking warfarin/coumadin should be cautious in using high doses of vitamin E and should do so only under a physician’s supervision.

- Individuals with vitamin K deficiencies, such as those with liver failure, should be cautious in using high doses of vitamin E.

- Individuals with any lesions that have a propensity to bleed (e.g., bleeding peptic ulcers), those with a history of hemorrhagic stroke and those with inherited bleeding disorders (e.g., hemophilia) should use Vitamin E with extreme caution.

- Vitamin E supplementation should be discontinued one month prior to any surgical procedure.