The article by Drs. Labriola and Livingston is the first written collaboration of which I am aware between a doctor of naturopathic medicine and a professor of medicine at a major state university. The authors present a thorough review of the available information on interactions between dietary antioxidants, both natural and supplements, and chemotherapy.
Of necessity, the review relies heavily on interactions observed in the laboratory and animals, since little, if any, human data appear to be available. In fact, the only reference cited that seems to bear directly on this issue in humans, by Erhola et al, was published in the fairly obscure journal Free Radical Biology and Medicine. Even this reference contains no clinically useful information, however. Also, it provides no data to justify the assertion by Labriola and Livingston that such a reduction in concentration of free radicals generated by chemotherapeutic agents has the same effect as a reduction in dose.
Nonetheless, the authors raise grave concerns about the possibility that cancer patients may jeopardize their ultimate chance of cure and survival by taking various dietary supplements with antioxidant activity during chemotherapy programs. If this may be a potentially major public health issue, however, the authors remedies are surprisingly low key. One would have expected that, given that there is proven scientific evidence of the value of chemotherapy and no evidence for the value of dietary supplements, the authors would have recommended against dietary supplements entirely!
Drs. Labriola and Livingston are very well known to the medical community, as well as the press in the Northwest. Their article received wide coverage in the local media. One would have hoped that such prominent authors, whose opinion carries great weight with both their professional peers and laypeople, would have made a stronger statement against the use of dietary supplements during chemotherapy. Media coverage of such a recommendation might have saved lives.
Charles M. Bagley, Jr, MD
Northwest Cancer Center