Children receiving cancer treatment (chemotherapy and/or radiation) can experience side effects caused by their treatment. Many patients and families may consider using complementary and alternative medicines, such as natural health products, to help with these symptoms.
While some of these therapies might seem helpful, they could also seriously harm your child, may be expensive, and may not help at all. Unless a treatment has been tested scientifically, we cannot say with certainty that it helps to control or cure a disease.
Also be aware that some people who practise alternative medicine discourage the use of conventional medicine. As a result, some doctors or hospitals may have policies to protect children from potentially dangerous alternative treatments.
As a caregiver, the best thing you can do for your child when you are faced with many options is to educate yourself. Before giving anything to your child, talk to your child’s doctor, nurse, or treatment team to make sure it is not harmful.
What is conventional medicine?
Conventional medicine refers to the health practices that are widely used by health professionals to diagnose and treat disease. They are treatments that have been proven to work based on scientific research on large numbers of people. The potential side effects are well known and strategies are in place to monitor and manage the side effects over time.
What are complementary and alternative therapies/medicines?
Complementary therapy refers to products, techniques, or practices that fall outside conventional medicine. Used together with conventional medicine, complementary therapies may relieve symptoms or stresses. Some complementary approaches are being studied in the same way as conventional treatments. Examples of complementary therapies include the use of massage therapy or acupuncture to manage the side effects of chemotherapy.
Alternative medicine refers to products, techniques, or practices that fall outside conventional medicine. Alternative medicine is used instead of conventional medicine, and has not been proven to work through scientific research. Some alternative approaches are being studied in the same way as conventional treatments. In some cases, research has shown that they do not work or are unsafe.
What are natural health products?
Natural health product is a term used to refer to a group of health products including:
- vitamins and minerals
- herbal remedies
- homeopathic medicines
- traditional Chinese medicines or Ayurvedic medicines
- probiotics
- other products like amino acids and essential fatty acids
These products may be natural but they can cause side effects. They may also interact with chemotherapy, radiation therapy or other conventional medicines.
Most natural health products have not been studied together with chemotherapy and their safety is unclear. Before you give a natural health product to your child, talk to your child's health-care provider to review its safety. Also review with your child's health-care provider the chance that a natural health product may interact with your child's other treatments.
Not all natural health products that you can buy have been assessed by Health Canada. Products that have been assessed by Health Canada may have a Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) on the label. Ask your pharmacist to show you if the product you are considering buying has one of these numbers. You do not need a prescription to buy natural health products.
Talking to the treatment team
Your child’s treatment team will not be surprised if you ask them about complementary or alternative therapies. In fact, they will want to know if you are considering the use of complementary or alternative therapies and can answer any questions you may have. Many people are using such therapies for themselves and for their children.
The treatment team can help you understand the potential risks and benefits of the supplements you might be considering.
It is important to let your child’s health-care team know if you are considering alternatives. Some therapies interfere with your child’s conventional therapy because they can cause more side effects or make the treatment less effective. Your child’s doctor or nurse may be willing to talk to the person recommending the alternative therapy.
The best way to tell if a complementary or alternative therapy is safe for your child is to ask your child’s treatment team. Below are questions you may wish to discuss with the treatment team about a complementary or alternative therapy.
What is known about the therapy? What does it claim to do?
Unless a treatment has been tested scientifically in large numbers of children, we cannot say with certainty that it helps to control or cure a disease. Case studies or anecdotes are not scientific proof. There are many stories that sound convincing about people who have been cured from cancer through alternative treatments. But consider the following questions:
- Has this treatment been tested in children who have the same tumour as your child?
- How many children were treated?
- What were the results for all of the children treated, not just the success stories?
- What were the side effects?
Is the therapy harmful or does it create problems with conventional treatment?
Some therapies can interact negatively with conventional treatment, causing the conventional treatment to be less effective or causing negative side effects. For example, high-dose antioxidants, such as vitamins C and E, can make radiation therapy or chemotherapy less effective. Herbs such as essiac and yew needle have been associated with heart and kidney problems when taken with certain chemotherapy drugs.
Natural health products can interact with chemotherapy drugs in different ways. For example, they can change how much chemotherapy is absorbed into the bloodstream, where the chemotherapy acts in the body and how quickly the body breaks it down. Using a natural health product at the same time as chemotherapy or radiation therapy may:
- Decrease the amount of chemotherapy in the bloodstream. This may decrease how well the chemotherapy works.
- Block the action of chemotherapy or radiation therapy. This may decrease how well the therapy works.
- Increase the amount of chemotherapy in the bloodstream. This may cause more side effects of chemotherapy.
Has the therapy been studied? Are the results published in journals that are independently reviewed by other experts? What do the results show?
If a complementary therapy seems promising, researchers may try to study the therapy in a scientific manner and will determine ways to implement the therapy if it shows effectiveness.
What are the credentials of the person who does or is recommending the complementary/alternative treatment? How do you know that the medication is pure?
Some practitioners of complementary or alternative therapies may take a few weekend courses, set up a business, and present themselves as experts. Others, such as chiropractors or naturopaths, may have years of standardized training, and may belong to colleges that regulate their practice. This depends on the country and on the type of complementary or alternative treatment.
To show how important proper training is, consider the following study. As part of the study, a U.S. researcher from the Cancer Research Center of Hawaii posed as the daughter of a patient with advanced breast cancer. The researcher visited 40 health food stores and asked staff to recommend a product for her mother. In total, 36 retailers made a recommendation, either directly or by showing products that other customers had bought. Shark cartilage was recommended most often, by 17 retailers, but the research to date has not shown that it is effective. In addition, almost 20 different herbs, nearly a dozen different vitamin supplements, and nine biological agents such as fish oils were recommended. There was no consistent answer or explanation why the product was recommended. Many did not ask the researcher more detailed questions about her "mother." This study was published in the Archives of Family Medicine in 2000.
Another concern is that natural health products or supplements might not be pure. Unlike conventional drugs, which are strictly regulated by governing bodies, different brands of non-conventional pills or supplements may have different amounts of their active ingredient. A person may pay a lot for a product that has little or no therapeutic benefit and which may be potentially harmful.
Is it true that some natural health products can be used to treat side effects of chemotherapy or radiation therapy?
There are some natural health products which have been studied in humans and have been shown to help reduce some of the side effects caused by cancer treatment. However, some of these natural health products may also decrease how well the chemotherapy works. The use of any natural health products should be discussed with your child’s health-care provider.
How do I know if a natural health product can interact with chemotherapy drugs or other prescription drugs?
It is important to talk to the health-care providers that your child sees at the hospital or cancer clinic before giving your child any natural health product.
Can I give my child antioxidants to prevent the side effects of chemotherapy or radiation therapy?
Some people think that antioxidants, such as vitamin C, might protect normal cells from cancer therapy. However, vitamin C and other antioxidants may reduce the effectiveness of cancer therapy. It is recommended that antioxidants like vitamin C not be given as a supplement during radiation or chemotherapy that relies on oxidation to work properly. Please discuss with your child's health-care provider whether it is safe to give an antioxidant to your child during their cancer therapy.
Can I give my child a multivitamin during their chemotherapy or radiation therapy?
Various ingredients in multivitamin products may interact with cancer therapy or may be unsafe during cancer treatment (for example, vitamin C, vitamin E, folic acid, iron). Before giving your child a multivitamin, ask your health-care provider to review if a multivitamin is safe and beneficial for your child during cancer therapy.
While my child receives cancer therapy, should I avoid spices and herbs in cooking?
No. Spices that are used in normal amounts in cooking do not pose a risk for an interaction with chemotherapy.
While my child receives cancer therapy, can I give my child a probiotic supplement?
No. Probiotic supplements are natural health products which contain purified bacteria in large quantities and may not be safe for children during cancer therapy.
While my child receives cancer therapy, can I give my child foods that contain probiotics such as yogurt, infant formula and cereals?
Yes. The amounts of probiotics found in foods supplemented with probiotics should not pose a risk to your child.