Pat Killingsworth Pat Killingsworth

Anti-myeloma nutrition update/review

One of our readers, Deborah, left a number of questions about the supplements I use in the comment section following an article I wrote Wednesday.

Since so many of us don’t take the time to read comments following a blog post, I wanted to share the answers with you–written by our resident myeloma supplement expert, Danny Parker:

Deborah,

Here is the information you requested (Pat’s supplement protocol), with the very important proviso that you should consult you doctor first before trying any of these. They may not be very happy. My doc (a hard line guy) had about the best reaction you can hope for as he knew I would be consulting with a specialist in complimentary medicine who works with some other patients at the Myeloma Program at UCSF.  “The data are very soft,” he said, “but it might help…”

Also, not knowing how any of these supplements might interact with your medications and body, it is advisable to add things one at a time and slowly until you are sure that there is no trouble. This is particularly important if you have marginal CBCs, poor kidney function of other conditions from advanced disease. The starting point for my own protocol (which has evolved with my own research) came from Michael Broffman at the Pine Street Clinic in San Anselmo, California. Anyone serious about this might want to consult with Michael. Indeed, there is  real danger of just ingesting anything and everything without careful consideration of these issues. You might look at the link below to get an idea:

http://www.cancerworld.org/Articles/Issues_37/Cutting_Edge/Grapefruit_juice_and_St_John%92s_Wort_are_just_the_tip_of_the_iceberg.html

I’ve cut some things from Michael original protocol that I can’t find strong evidence for helping with myeloma (e.g. Saventaro), while adding other things which look potentially advantageous (Ursolic acid). The supplements in Pat’s protocol are only included where there are published peer-reviewed papers with medical data to back them up, suggesting that they might be helpful with myeloma.  Moreover, I have screened these to supplements with published evidence that they can help potentiate bortezomib and lenalidomide or thalidomide. That still doesn’t mean that this can be generally extended to other patients, however.  Be careful.

This is an update of the post a month ago, relative to Pat’s supplement schedule (we’ve cut the curcumin down for him and are looking to add Black Seed Cumin and Feverfew potentially). In response to questions from others, Michael believes in rotating some supplements and even brands so that the body (and the MM) doesn’t get used to the treatment.

Danny Parker

    Pat’s Winter 2012 Supplement Schedule

Morning upon waking with generous water and just before the meal (if Velcade day, delay until 30 minutes before Velcade infusion)

Fish Oil supplement (1000 mg) [Various brands: I like Nordic Naturals, Omega-3]
Four 500 mg curcumin capsules [Brand: Doctor's Best]


1 DHEA (50 mg) [Various brands]
2 papain (papaya enzyme tablets) [Wobenzym N]

If a Velcade day: 3 Ursolic acid capsules with water after infusion [Brand: Ursobolic (150 mg capsules]

Before lunch:
Resveratrol with Pterostilbene (1 capsule; [Life Extensions 100 mg])
Two 500 mg curcumin capsules
One 500 mg Black Seed Cumin capsule [Amazing Herbs]; this can be rotated every two weeks with 500 mg Feverfew (Nature’s Plus: Parthenolide). Both potentially help with MM:

http://www.myelomanews.com/2012/01/studies-on-parthenolide-extract-from.html

If tired and lackluster in the afternoon:
1 sub-lingual B-12, B6 tablet

Just before dinner:
Resveratrol with Pterostilbene (1 capsule)

Just before bed (all taken together with generous water):
3 Ursolic acid capsules (Ursobolic)
2 500 mg curcumin
Revlimid
1 Fish oil supplement capsule (1000 mg)
aspirin or other prophylactic blood thinner as prescribed.

If a Velcade and/or Dex day, add 1 Magnolia extract capsule [Nutncology; Honokiol + Magnoiol,200 mg] to the above midnight mix; this product helps with sleeping on Dex days and potentially has anti-MM activity:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895215/

Also, if the second Dex day, have mylanta handy for nighttime gastric distress

Medicinal foods:
One of the following each day:
- raw sliced radish (salad or on sandwich)
- raw or lightly cooked broccoli
- raw watercress (salad or on a sandwich)
- cabbage

And try to have one of the following  each day too:
- Apple with skin
- Fresh basil or pesto
- Cranberries
- Prunes (good on Velcade days to help with regularity)

Avoid:
-Asparagus.
-Heavy sugar, refined carbohydrates particularly on Dex days
-Any supplements with Glucosamine, hyaluronic acid. Avoid EGCG or green tea on day of and day after Velcade.
-Also, it seems wise to avoid Glutamine for similar reasons: helps your stomach, but  may also help MM cells avoid chemo and/or survive longer

Thanks Danny.  I hope this review helps you and others, Deborah!  I will finish my rambling rant which addresses misconceptions about projecting how well anti-myeloma therapies will work–and for how long–tomorrow.

Until then, feel good and keep smiling!  Pat