Types of Chemotherapy and Nutrition Considerations

Taxol is one chemotherapy agent that is derived from a plant, actually a tree. The bark of the Pacific Yew tree was discovered 40 years ago by a team of botanists led by Dr. Arthur Barclay of the U.S. Department of Agriculture in 1962. This was an effort by the Department of Agriculture to find plants that could cure cancer at the behest of the National Cancer Institute (NCI). At this time in American history people were opening their eyes and seeing that cancer was a problem for everyone.

Famous politicians, authors, actors and actresses were all coming forward and announcing to the public that they have cancer or family has cancer and something must be done! In 1972 Shirley Temple Black was outspoken about beast cancer but also the treatment for the cancer declaring ‘The doctor can make the incision; I’ll make the decision!”

This tree of life is useful in combating breast, ovarian, lung cancer and Karposi’s sarcoma. Unfortunately it was not made available to the United States cancer patients at that point in time, it would take many years until it would be deemed anti-neoplastic and allowed for consumer use.

Although the bark was harvested in 1962 it wasn’t until 1965 that Dr. Monroe E. Wall and Dr. Mansukh Wani discovered its bark was cytotoxic. This was only the beginning, now they needed to identify and purify the active component (paclitaxel) responsible for the cytotoxic action.

Modification

Once the isolate was identified researchers could begin experimentation in animal models.

Get quality help now

Bella Hamilton

Verified

Proficient in: Colon Cancer

5 (234)

“ Very organized ,I enjoyed and Loved every bit of our professional interaction ”

+84 relevant experts are online

Hire writer

This began in 1977 with melanoma, mammary, lung, and colon cancer models. There were many people invested in finding a cure for cancer including Dr. Horwitz. She discovered ‘that Taxol was able to bind to a cell’s microtubule assembly and slow cell division and growth by stabilizing the microtubules, preventing shrinkage and therefore blocking the segregation of the chromosomes’.  Cancer Researcher Susan Band Horwitz, PhD actually won the Warren Alpert Foundation Prize for Work Developing Taxol. Modifications had to made as the Pacific Yew tree was difficult to harvest.

Luckily the researchers identified a precursor more easily harvested, the common yew tree, this was made by subjecting it to a chemical reaction and thus producing Taxol. The next task at hand was to decide which route and method would be used for administration in humans. Attempts were made to using a suspended solution, but the dose was not effective. Next they formulated a substance that included  3 components: ethanol, cremophor, and saline solution (ratio 5:5:90) to a concentration of 0.3 to 0.6 mg/mL. The success led to Phase I clinical trials in 1984. Reports from Johns Hopkins reported a 30% partial or complete recovery in ovarian cancer patients, this made the drug high demand. In 1992 Taxol was approved for ovarian cancer in 1994 approved for breast cancer. Annual sales peaked in 2000 at 1.6 billion dollars(Taxol® (NSC 125973), n.d.).

Nutritional Considerations

Taxanes are notorious for producing neuropathy to the hands and feet including loss of sensation and is very painful. Often described as burning or stabbing pain. It is dose dependent so the higher the dose the worse the side effects. There is also motor weakness experienced in conjunction with the parasthesias. One of the ways to reduce these symptoms has been to increase the amount of Vitamin D in a patients diet. Vitamin D has been shown to neuro-protective and there may be a place for prophylactic administration if Taxanes are going to be used as part of the patients treatment regimen. Good source of Dietary Vitmain D are fatty fish, liver, eggs, and cheeses. Although dependent on patients ability to eat consideration should be given to supplementation with capsules or tablets possibly intravenously. Shitake Mushrooms, St. John’s Wart, and Ginkgo all interact with chemotherapy drugs.  D-glucan which is a polysaccharide located in shiitake mushrooms, has anti-neoplastic effects in colon cancer cells.

It is thought this is due to suppression of the cytochrome P450 1A enzymes, which prevents metabolization of pro-carcinogens to active forms. St. John’s Wort, also known as ‘God’s wonder Plant’ interacts with chemotherapy and should be stopped one week prior to administration of cytotoxic agents. St John’s wort interferes with chemotherapy, study shows St John’s Wort promotes the cytochrome P450 hepatic enzyme system. It ‘induces the expression of an isoform of the P450 enzyme system known as CYP3A4. This enzymatic cascade is heavily used by the body to break down a variety of drugs and toxins’.  There are approximately 200 different types of chemotherapy available and more than 50% can be broken down by the cytochrome system.Epidemiological studies show that in liver cancer Ginkgo can stop cells from replicating, decreases levels of proliferating cell nuclear antigen, and increases tumor suppressor genes. It also has benefits to help with memory which may help. to alleviate chemobrain.

References

1. Cassileth, B. R., Yeung, K. S., & Gubili, J. (2010). Herb-Drug Interactions in Oncology (2nd ed.). People’s Medical Publishing House–USA UNKNOWN. Herb-Drug Interactions in Oncology . PMPH-USA, Ltd.. Kindle Edition. .
2. Grim, J., Ticha, A., Hyspler, R., Valis, M., & Zadak, Z. (2017). Selected risk nutritional factors for chemotherapy-induced polyneuropathy. Nutrients, 9(535), 1–10. https://doi.org/10.3390/nu9060535
3. Josefson, D. (2002). St John’s wort interferes with chemotherapy, study shows. BMJ: British Medical Journal, 325(7362), 460. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1169455/?report=reader
4. Taxol® (NSC 125973). (n.d.). cancer.gov. Retrieved June 7, 2020, from https://dtp.cancer.gov/timeline/flash/success_stories/S2_Ta