Cancer and the Immune System: The Role of Natural Medicine

Overview

Optimal immune function is essential in both fighting cancer among patients who have active cancer, as well as for the prevention of cancer in patients at high risk. Natural therapies that enhance immune function include medicinal mushrooms, Astragalus, probiotics, vitamin D, intravenous vitamin C, and mistletoe therapy.

Article

Cancer is thought to affect approximately 2 in 5 Canadians at some point during their lifetime (1). While cancer can be an intimidating diagnosis, it is important for individuals to be aware of adjunctive strategies at their disposal to help fight this diagnosis. One of the key avenues is strengthening immune function so the body can target cancer cells more effectively.

Effective immune function is essential in both fighting cancer among patients who actively have cancer, as well as for the prevention of cancer in patients at high risk. It is the role of specialized immune cells such as lymphocytes, T-helper cells, and natural killer (NK) cells to carry on ongoing immune surveillance. In other words, these cells “seek out and destroy” cancer cells as they arise in the body (2,3). Cancer, being an ever-adapting disease, survives in part by suppressing this ability (3). Inhibitory immune cells such as regulatory T-cells (Tregs) may infiltrate the tumour and suppress the ability of other effector immune cells to kill cancer cells.3 In addition, one of the most common and problematic side effects of chemotherapy also involves immune suppression.

On the other hand, among patients with cancer, it has been shown that those with relatively higher counts of lymphocytes fare better in terms of cancer treatment outcomes and survival (4.5). Clearly the immune system is the key to optimizing cancer treatments, and conventional medicine recognizes this as well, as may be seen in the development of new immunotherapeutic drugs that target various aspects of the immune system (3).

Naturopathic cancer care utilizes several types of therapies that enhance immune function, both in the aims of treating and/ or preventing cancer. Some of these include:

Medicinal mushrooms such as Coriolus versicolor (turkey tail) and Ganoderma lucidum (reishi mushroom) have been shown to help offset the immune suppressing effects of chemotherapy, and improve survival among patients with lung cancer, breast cancer, gastric cancer and colorectal cancer (6,7,8). It is important that a good quality mushroom extract is used, and should be hot water extracted. This process liberates the polysaccharides that are responsible for mushrooms’ therapeutic effects, and is the form used traditionally in Asia as well as in clinical trials (6).

Astragalus membranaceous is an herb used extensively in Chinese medicine as well as Western herbalism that has been shown to boost immune function. In patients with non-small cell lung cancer (NSCLC), astragalus lowered the toxic effect of radiation therapy on white blood cell counts and improved survival (9).

Probiotics are important gut-based immune modulators. One study of patients with colorectal cancer found that supplementation probiotics beginning one day before surgery and continuing for 15 days afterward, resulted in an overall decrease in all major post-operative complications, including infection, compared to placebo (10). Patients receiving probiotics had shorter hospital stays and lower levels of inflammatory cytokines, such as TNF and IL-6 (10).

Probiotics also help improve the eradication rates of infectious agents associated with cancer risk, such as human papilloma virus (HPV) and Helicobacter pylori (H. pylori) bacteria (11,12). HPV infection is associated with cervical dysplasia (a precursor to cervical cancer), as well as oral cancers, while H. pylori is associated with gastric cancers.

Vitamin D is an important immune modulating nutrient in which many Canadians are deficient (13). Vitamin D is also important in regulating healthy cell division (14). It is generally accepted that blood levels of the marker 25(OH)D should be equal to or above 75nmol/L. Studies have shown that being low in vitamin D elevates risk of several types of cancers, while being sufficient in vitamin D is associated with better treatment outcomes (15, 16, 17).

Finally, two more advanced, injectable therapies that stimulate immune function are intravenous vitamin C therapy and mistletoe therapy (18, 19, 20). These may be used as adjuncts to chemotherapy and/ or radiation in patients with active cancer, or to prevent recurrence in patients who have completed treatment. IV vitamin C has been shown to reduce side effects of chemotherapy, reduce tumor markers such as prostate specific antigen (PSA) and inflammatory cytokines, and may improve survival in patients with cancer (18). Mistletoe therapy has been shown to reduce immune suppression associated with chemotherapy, improve quality of life, and extend survival in patients with breast and gynecological cancers (19, 20).

Please note that individuals with cancer should consult a knowledgeable, licensed naturopathic doctor to determine what treatments may be most appropriate for them, and to minimize risk of interactions with standard treatments.

References

  1. Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2016. Toronto, ON: Canadian Cancer Society; 2016. Available at: cancer.ca/Canadian-Cancer-Statistics-2016-EN.pdf (accessed 29 November 2016).
  2. Shevtsov M, Multhoff G. Immunological and Translational Aspects of NK Cell-Based Antitumor Immunotherapies. Front Immunol. 2016 Nov 11;7:492. URL: https://www.ncbi.nlm.nih.gov/pubmed/27891129
  3. Galluzzi L, Zitvogel L, Kroemer G. Immunological Mechanisms Underneath the Efficacy of Cancer Therapy. Cancer Immunol Res. 2016 Nov;4(11):895-902. URL: https://www.ncbi.nlm.nih.gov/pubmed/27803050
  4. Wei B, Yao M, Xing C, Wang W, Yao J, Hong Y, Liu Y, Fu P. The neutrophil lymphocyte ratio is associated with breast cancer prognosis: an updated systematic review and meta-analysis. Onco Targets Ther. 2016 Sep 8;9:5567-75. URL: https://www.ncbi.nlm.nih.gov/pubmed/27660475
  5. Yodying H, Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Yamada M, Uchida E. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis. Ann Surg Oncol. 2016 Feb;23(2):646-54. URL: https://www.ncbi.nlm.nih.gov/pubmed/26416715
  6. Fritz H, Kennedy DA, Ishii M, Fergusson D, Fernandes R, Cooley K, Seely D. Polysaccharide K and Coriolus versicolor extracts for lung cancer: a systematic review. Integr Cancer Ther. 2015 May;14(3):201-11. URL: https://www.ncbi.nlm.nih.gov/pubmed/25784670
  7. Eliza WL, Fai CK, Chung LP. Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Pat Inflamm Allergy Drug Discov. 2012 Jan;6(1):78-87. URL: https://www.ncbi.nlm.nih.gov/pubmed/22185453
  8. Jin X, Ruiz Beguerie J, Sze DM, Chan GC. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane Database Syst Rev. 2016 Apr 5;4:CD007731. URL: https://www.ncbi.nlm.nih.gov/pubmed/27045603
  9. He H, Zhou X, Wang Q, Zhao Y. Does the couse of astragalus-containing chinese herbal prescriptions and radiotherapy benefit to non-small-cell lung cancer treatment: a meta-analysis of randomized trials. Evid Based Complement Alternat Med. 2013;2013:426207. URL: https://www.ncbi.nlm.nih.gov/pubmed/24454494
  10. Kotzampassi K, Stavrou G, Damoraki G, Georgitsi M, Basdanis G, Tsaousi G, Giamarellos-Bourboulis EJ. A Four-Probiotics Regimen Reduces Postoperative Complications After Colorectal Surgery: A Randomized, Double-Blind, Placebo-Controlled Study. World J Surg. 2015 Nov;39(11):2776-83. URL: https://www.ncbi.nlm.nih.gov/pubmed/25894405
  11. Verhoeven V, Renard N, Makar A, Van Royen P, Bogers JP, Lardon F, Peeters M, Baay M. Probiotics enhance the clearance of human papillomavirus-related cervical lesions: a prospective controlled pilot study. Eur J Cancer Prev. 2013 Jan;22(1):46-51. URL: https://www.ncbi.nlm.nih.gov/pubmed/22706167
  12. Hauser G, Salkic N, Vukelic K, JajacKnez A, Stimac D. Probiotics for standard triple Helicobacter pylori eradication: a randomized, double-blind, placebo-controlled trial. Medicine (Baltimore). 2015 May;94(17):e685. URL: https://www.ncbi.nlm.nih.gov/pubmed/25929897
  13. Janz T, Pearson C. Vitamin D blood levels of Canadians. Statistics Canada. Statistics Canada Catalogue no. 82-624-X14. Updated 2015-11-27. Accessed 29 Nov 2016. URL: http://www.statcan.gc.ca/pub/82-624-x/2013001/article/11727-eng.htm
  14. Tagliabue E, Raimondi S, Gandini S. Vitamin D, Cancer Risk, and Mortality. Adv Food Nutr Res. 2015;75:1-52. URL: https://www.ncbi.nlm.nih.gov/pubmed/26319903
  15. Zhang L, Wang S, Che X, Li X. Vitamin D and lung cancer risk: a comprehensive review and meta-analysis. Cell Physiol Biochem. 2015;36(1):299-305. URL: https://www.ncbi.nlm.nih.gov/pubmed/25967968
  16. Ma Y, Zhang P, Wang F, Yang J, Liu Z, Qin H. Association between vitamin D and risk of colorectal cancer: a systematic review of prospective studies. J Clin Oncol. 2011 Oct 1;29(28):3775-82. URL: https://www.ncbi.nlm.nih.gov/pubmed/21876081
  17. Mohr SB, Gorham ED, Kim J, Hofflich H, Garland CF. Meta-analysis of vitamin D sufficiency for improving survival of patients with breast cancer. Anticancer Res. 2014 Mar;34(3):1163-6. URL: https://www.ncbi.nlm.nih.gov/pubmed/24596354
  18. Fritz H, Flower G, Weeks L, Cooley K, Callachan M, McGowan J, Skidmore B, Kirchner L, Seely D. Intravenous Vitamin C and Cancer: A Systematic Review. Integr Cancer Ther. 2014 Jul;13(4):280-300. URL: https://www.ncbi.nlm.nih.gov/pubmed/24867961
  19. Bar-Sela G, Wollner M, Hammer L, Agbarya A, Dudnik E, Haim N. Mistletoe as complementary treatment in patients with advanced non-small-cell lung cancer treated with carboplatin-based combinations: a randomised phase II study. Eur J Cancer. 2013 Mar;49(5):1058-64. URL: https://www.ncbi.nlm.nih.gov/pubmed/23218588
  20. Kienle GS, Glockmann A, Schink M, Kiene H. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. J Exp Clin Cancer Res. 2009 Jun 11;28:79. URL: https://www.ncbi.nlm.nih.gov/pubmed/19519890

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