Grays

Household Spice Protects Against Radiation Treatment’s Horrible

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The humble spice turmeric, in doses available for pennies a day, has been found to reduce one of the most devastating side effects of radiation treatment for head and neck cancer.

Each year, 60,000 patients are diagnosed with ‘head and neck cancer,’ which includes cancer of the mouth, tongue, pharynx, larynx, oral cavity, and thyroid.[i] Sadly, within the conventional medical model, radiation therapy is the ‘standard of care’ for this type of cancer, which involves the use of up to 50-70 Grays of radiation over a 5-7 week period.  To put this dose into perspective, a whole-body exposure to 8 Grays of high-energy radiation in a single dose has a 100% mortality rate within two weeks.[ii] This is a major (if not the primary) reason why radiation oncologists use ‘fractionation,’ breaking the total dose up into smaller fractions over time (1.8-2 Grays per day), in order to prevent the rapid death of the patient from acute radiation poisoning.

The primary adverse symptoms experienced by post-radiation treatment survivors is known as ‘oral mucositis,’ involving tissue destruction and functional problems in the oral cavity, which is painful, affects nutrition, contributes to local and systemic infections and greatly reduces the quality of life.[iii]  There are other lesser known and potentially more lethal problems associated with radiotherapy, not the least of which is its ability to transform non-tumorigenic cancer cells into tumor-initiating ones (exhibiting cancer stem cell-like properties), but the medical establishment rarely if ever touches upon these downstream effects, many of which can not easily be linked to the treatment, or are conveniently written off as being caused by the recurrence of “treatment-resistant” cancer and not the inherent carcinogenicity of radiotherapy itself.

While in many ways the treatment of head and neck cancer through solely conventional means is tragic today, the medical establishment is beginning to wake up to the utility of natural compounds in at least reducing or preventing unnecessary harm caused by the use of chemotherapy and radiation. There is no denying that a massive body of research has now accumulated showing that spices as common as turmeric are capable of both increasing the effectiveness of conventional treatment while at the same time reducing the collateral damage to the patient caused by them. [Read: Integrative Cancer Research: Surviving Chemo & Radiation for more information]. From the perspective of a patient faced with the inevitable side effects of radiotherapy, it is clearly unethical for practicing physicians to ignore, or worse, deny the evidence that better outcomes are available using an integrative approach.

All the more reason why a new study published in the journal Integrative Cancer Therapies, should move the oncology community closer in this direction. Titled,”The Indian Spice Turmeric Delays and Mitigates Radiation-Induced Oral Mucositis in Patients Undergoing Treatment for Head and Neck Cancer: An Investigational Study,”[iv] researchers evaluated the efficacy of turmeric in preventing radiation-induced mucositis.

In the single-blinded, randomized, controlled clinical trial conducted with head and neck cancer patients requiring 70 Gray of radiation or chemoradiotherapy (daily radiotherapy plus carboplatin once a week), 80 eligible patients were randomly assigned to receive either turmeric gargle (40) or povidone-iodine (40) during chemo/radiotherapy during the period of treatment.

Oral mucositis was assessed before the start, during, and at the end of the treatment by an investigator unaware of the treatment. The primary endpoint of this study was the incidence of mucositis every week during the 7-week period. The secondary endpoint was the effect of turmeric gargle on the incidence of treatment breaks, loss of scheduled treatment days, and decrease in body weight at the end of the treatment.

The study produced the following results:

“This study clearly suggests that when compared with the cohorts using povidone-iodine gargle, the group using turmeric as a mouthwash had delayed and reduced the levels of radiation-induced oral mucositis and was statistically significant at all time points ( : < 0.001 to : < 0.0001). Additionally, the cohorts using turmeric had decreased intolerable mucositis ( : < 0.001) and lesser incidence of treatment breaks in the first half of the treatment schedule before 4 weeks ( : < 0.01) and reduced change in body weight ( : < 0.001).”

They concluded:

“Gargling with turmeric by head and neck cancer patients undergoing radiation therapy provided significant benefit by delaying and reducing the severity of mucositis. Turmeric is readily available, relatively inexpensive, and highly accepted making it useful in cancer treatment.”

While this study focused primarily on turmeric’s ability to reduce the side effects of conventional treatment, and not the intrinsic anti-cancer properties of the spice itself, there is a good amount research indicating that turmeric is one of Nature’s most powerful, affordable, safest and easily accessible anti-cancer agent.  For a review of the literature we have accumulated on its health benefits read: 600 Reasons Why Turmeric May Be The World’s Most Important Herb. With over 1500 studies indicating its health value, many of which focusing on turmeric’s (and its primary polyphenol curcumin) ability to kill over 100 different types of cancer cell lines, it is no surprise to find research on its ability to kill head and neck cancer:

We can only hope that the growing body of experimental, preclinical and clinical support for the use of natural substances in cancer treatment will break throw into the practice of so-called ‘evidence-based’ medicine. It would seem that given its self-definition, modern medicine has an obligation to do exactly that; especially when the result will be the reduction of human suffering.

[i] Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin. 2002; 52( 1): 23-47.

[ii] “Radiation Exposure and Contamination”. Merck Manuals. Retrieved 2 June 2013.

[iii] Plevovia P. Prevention and treatment of chemotherapy and radiotherapy induced oral mucositis: A review. Oral Oncol. 1999;35:453–70. [PubMed]

[iv] Suresh Rao, Chetana Dinkar, Lalit Kumar Vaishnav, Pratima Rao, Manoj Ponadka Rai, Raja Fayad, Manjeshwar Shrinath Baliga. The Indian Spice Turmeric Delays and Mitigates Radiation-Induced Oral Mucositis in Patients Undergoing Treatment for Head and Neck Cancer: An Investigational Study.

Radiation to pancreas may increase risk for diabetes in childhood cancer survivors.

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Little is known about the potential link between radiation exposure and diabetes. However, new data suggest that children and young adults treated with total body or abdominal radiation for childhood cancer may be at higher risk for diabetes.

Researchers conducted a retrospective cohort study by sending questionnaires to 3,468 survivors treated in eight centers throughout France and the United Kingdom from 1985 to 1995 for a solid cancer or lymphoma (excluding leukemia) during childhood. They obtained a response from 2,520 patients, with median follow-up of 30 years. Those who answered with a self-reported diabetes diagnosis were confirmed by the patients’ physician.

Florent de Vathaire, PhD, of the Centre for Epidemiology and Public Health (CESP) of INSERM at the Gustave Roussy Institute of France, and colleagues estimated the radiation dose received by the tail, head and body of the pancreas, besides 185 other sites during the course of radiotherapy. The information was updated for French patients from 2008 to 2010.

Of the 2,520 patients, 1,078 (43%) underwent 30 years of follow-up, and 795 (74%) had received radiotherapy. According to data, 95 of the 2,520 patients (4%) who returned a questionnaire reported they had developed diabetes. Fifteen patients were not confirmed by a physician, and 15 were excluded due to the gestational diagnosis.

Of 65 patients with a confirmed diagnosis of diabetes, 58 (89%) were on medication, 12 (18%) used insulin only, 35 (54%) used oral medication only, and 11 (17%) used both, researchers wrote.

“The pancreas needs to be regarded as a critical organ when planning radiation therapy, particularly in children. Until now, the pancreas was one of the few organs not considered at risk of normal tissue complication in the French and U.K. national guidelines for cancer radiation therapy. Our findings indicate that the pancreas is an organ at risk during radiation therapy and has to be contoured when planning treatment, to ensure a radiation dose of as low as possible,” de Vathaire said in a press release.

The risk for diabetes increased significantly with radiation doses administered to the tail of the pancreas — in sites where islets of Langerhans were concentrated — up to 20 Gy to 29 Gy, the researchers wrote, adding that the risk reached a plateau for higher radiation doses. The estimated RR at 1 Gy was 1.61 (95% CI, 1.21-2.68).

There was no significant association between radiation dose and other parts of the pancreas, they wrote.

Compared with patients who did not undergo radiation, the RR for diabetes was high among those who received 10 Gy or more to the tail of the pancreas (RR=11.5; 95% CI, 3.9-34). Adjustments for BMI, age and sex did not change results (P<.0001).

Children aged younger than 2 years at the time of radiation were more sensitive to treatment compared with older patients (RR at 1 Gy=2.1; 95% CI, 1.4-4.3 vs. 1.4; 95% CI, 1.1-2.2). Moreover, researchers discovered a 16% incidence of diabetes in the 511 patients who received more than 10 Gy to the tail of the pancreas.

Further data demonstrated that 14.7% patients who had been treated for neuroblastoma were diagnosed with diabetes by age 45 years compared with an average of 3.1% for other types of cancers, the researchers wrote.

In an accompanying editorial, Kevin C. Oeffinger, MD, of Memorial Sloan-Kettering Cancer Center, said, “The clinical implications of this study are important, since radiation remains an integral part of therapy for many children with Wilms’ tumor [a type of kidney cancer] or neuroblastoma. Diabetes is a major risk factor for all-cause and cardiovascular mortality.

“Further study is therefore needed to clarify the mechanisms underlying diabetes after abdominal radiation. Understanding these mechanisms will, hopefully, result in the development of targeted interventions that will lead to a reduction in risk in this population,” Oeffinger said.

For more information:

De Vathaire F. Lancet. 2012;doi:10.1016/S1470-2045(12)70323-6.

Oeffinger KC. Lancet. 2012;doi:10.1016/S1470-2045(12)70340-6.

Perspective

 

Mark A. Sperling

  • Total Body Irradiation (TBI) in preparation for bone marrow transplantation in children is known to be associated with potential endocrine disorders, especially impairment of reproductive function (depending on the age of the subject and caution to shield the gonads), pituitary hypofunction, occasional precocious puberty, and thyroid abnormalities. Short stature may result from radiation to the spine and long bones making them resistant to growth hormone. These endocrine abnormalities are related to the dose administered and may appear years after the irradiation. However, diabetes mellitus has not been considered as a consequence of the radiation dose administered to the pancreas. The present study draws important attention to this possible association and clearly demonstrates a dose-response relation between the extent of radiation exposure of the pancreas and likelyhood of developing a form of insulin dependent diabetes. Those caring for children who are long term survivors of cancer and experienced TBI will now be alerted to this possibility and educate parents and patients to the warning symptoms of increased urination, increased thirst, the recurrence of bed wetting, and weight loss to enable earlier diagnosis and treatment. Diabetes is an additional concern and possible burden for cancer survivors-but a treatable one.
    • Mark A. Sperling, MD

Source: Endocrine Today