
Predicting recurrence in CRC using post-operative circulating tumour DNA
September 2023 Circulating tumour DNA (ctDNA) refers to the fragmen [...]
READ MOREIn this Q&A, Suzanne Zwicker, Clinical Pharmacist on the National Pharmacy Team for Innomar in Dartmouth, Nova Scotia, responds to your questions about herbal supplements and ileostomy care.
Question: I was told not to take anything (vitamins, herb supplements during chemo and radiation). I also hear that some herbs do not work well with these types of treatments but not sure why. Now that my treatments are over I am taking supplements again under the guidance of doctor and naturopath, I wonder if the pharmacist can comment on the power of herbs vs other medicines
Answer:
Considering being told not to take anything during chemo and radiation:
The usual recommendation is to avoid natural health products during chemo and radiation. This is because the effects of taking certain products or combinations of products can produce unpredictable effects.
Possible risks of taking natural and herbal products include:
• Depending on the source the exact amount of the natural or herbal medicine may not be known
• They may decrease the effectiveness of the cancer treatment (chemotherapy or radiation) by reducing it in the bloodstream or blocking its action.
• They may increase the amount of chemotherapy in the bloodstream by interfering with drug metabolism and increasing toxicity
• Depending on the source -they may have unsafe substances in them because natural and herbal products do not go through the same testing as other medicines
• They may have side effects that can make the effects of chemo or radiation worse. For example, some supplements like garlic, ginkgo biloba, ginseng and Vitamin E can increase risk of bleeding. Also, some supplements can have effects on Blood Pressure, Nausea, Diarrhea, Constipation, Headaches and dizziness for example.
• There is conflicting information about antioxidants during cancer treatment
The Memorial Sloan Kettering Cancer Center in the United States looked at how herbal medicines can change the way drugs work:
Herbal Remedies and Cancer Treatment:
https://www.mskcc.org/cancer-care/patient-education/herbal-remedies-and-treatment
Comment on Herbs:
It is very important to discuss all complimentary treatments with your healthcare team. These treatments can affect your cancer treatments and/ or your other health conditions (like diabetes or high blood pressure).
Many patients use complimentary medicine, and it is important for your healthcare team to know so that they understand the benefits and the risks involved with your whole treatment plan. Supplements are important and relevant to your treatment.
It is important to be fully aware of the product you are purchasing. All NPHs sold in Canada must have either an NPN (Natural Product Number) or DIN-HM (Drug Identification Number – Homeopathic Medicine). These numbers tell you that the product meets Canadian regulations and is licensed by Health Canada. Health Canada’s rules do not cover NHPs bought in other countries or from Internet pharmacies. Health Canada does not regulate whole plants or herbs or products made by a practitioner. For example, if a naturopathic doctor or traditional Chinese medicine practitioner prepares a tea from herbs, that tea is not covered by these rules.
CAMEO (Complimentary Medicine Education and Outcomes Program) from the University of Manitoba offers some very useful resources and patient education courses for patients wishing to know more about evidenced based research in complimentary medicine.
It is important to know that many chemotherapeutic drugs used in cancer are in fact derived from plants. These drugs have been developed after rigorous clinical trials for safety and efficacy. Likewise, advice for complimentary medicine needs to be based on current and evidence -based evaluations. There are a number of very good resources to assist patients and Health Care Professionals in making a good, informed decision about supplements or herbals and what can be used when.
The National Cancer Institute (US Site) has a useful resource called CAM (Complimentary and Alternative Medicine) Therapies: A – Z: https://cam.cancer.gov/health_information/cam_therapies_a-z.htm
Question: Are there any symptoms to watch out for if we have an ileostomy during heat waves?
Answer: The key thing to watch out for if you have an ileostomy during hot weather is the increased risk of dehydration. When you have an ileostomy there is no functioning colon (large intestine) to absorb water from food waste. In the hot weather we lose more fluid due to the heat itself and increased perspiration. Some symptoms of dehydration include headache, fatigue, dark or decreased urine, dry mouth, lips and eyes, dry skin, stomach cramps, leg cramps, feeling thirsty, feeling dizzy or light-headed. It is important always to monitor fluid intake and stoma output, but doubly important in hot weather. Fluid replacement is very important and the type of fluid likewise. Consider electrolyte replacement (Like Sports Drinks) and avoid artificial sweeteners, caffeine (diuretic effect can be more dehydrating) and alcohol (dehydrating). Salty snacks are a good idea for electrolyte intake too, if permitted.
Keeping cool and planning to keep cool in hot weather is a strategy to prevent heat stroke and dehydration. Wearing breathable fabrics like cotton or linen are more comfortable in the heat. Staying in the shade versus the sun will help you to manage the heat more easily. Thinking about the hot weather may involve a little more planning for supplies and skin protection. It is good to prepare for summer activities such as swimming and discussing with your entero-stomal therapy nurse the needed supplies. It is good to have extra supplies and have a strategy for skin protection around the stoma site should hot weather contribute to more frequent ostomy changes, perspiration, leaks, and skin rashes. Always remember sunscreen for skin protection all over to prevent a sunburn which, in itself, can cause dehydration. Remember to avoid application of creams in an area that may affect adhesives of base plates or other ostomy supplies.
In summary prepare well for outings, have a strategy for staying hydrated, keeping cool, and monitoring (signs of dehydration, ostomy output, fluid and electrolyte intake, skin condition, and amount and storage of ostomy supplies).
September 2023 Circulating tumour DNA (ctDNA) refers to the fragmen [...]
READ MORESeptember 2023 After a cancer diagnosis, the impact of exercise on [...]
READ MORELearning that you have metastatic cancer can be a physically and emoti [...]
READ MOREAugust 2023 The US Food and Drug Administration (FDA) has approved [...]
READ MOREAugust 2023 A recent study demonstrated that a liver transplant pro [...]
READ MOREIf you or a loved one has been diagnosed with cancer, you know that it [...]
READ MOREJuly 2023 Fruquintinib is a small molecule inhibitor of the vascula [...]
READ MOREJuly 2023 Phase III studies have shown the advantage of combining c [...]
READ MOREA recent analysis from the PROSPECT trial examined trends in patient-r [...]
READ MOREThe DESTINY-CRC01 trial was one of the first studies to show that the [...]
READ MORESome forms of stress are not harmful to our body such as the stress we [...]
READ MOREMay 2023 Recent data presented at Digestive Disease Week in Chicago [...]
READ MOREMay 2023 A patient navigator helps patients through the healthcare [...]
READ MOREAttending a medical appointment can be daunting for some people. It is [...]
READ MOREApril 2023 A recent study published in JAMA Oncology found that amo [...]
READ MOREApril 2023 A recent study published in JAMA Network Open showed tha [...]
READ MOREMarch 2023 - Results from a phase I study presented at the American So [...]
READ MOREMarch 2023 -A German study published in BMC Cancer explored the emotio [...]
READ MOREJanuary 2023 There is increasing evidence to support the use of cir [...]
READ MOREJanuary 2023 Findings from the phase III SUNLIGHT trial were presente [...]
READ MORELocations: BC, AB, ON, QC Status: currently recruiting Trial descr [...]
READ MORENovember 2022 A new study involving patients with different cancer [...]
READ MORENovember 2022 To better understand the role of the gut microbiome i [...]
READ MOREOctober 2022 A recent study published in the Journal of the Nationa [...]
READ MOREEarlier this month, controversial news headlines emerged: “Colonoscopi [...]
READ MORELocation: Canada-wide Status: Currently recruiting Trial Descrip [...]
READ MOREFindings from the global FRESCO-2 trial showed that a drug called fruq [...]
READ MOREFindings from a study published in the Journal of Clinical Oncology de [...]
READ MOREUlcerative colitis is a chronic inflammatory bowel disease that affect [...]
READ MORECrohn’s disease is a chronic (long-term) inflammatory disease that can [...]
READ MOREIn this Q&A, Dr. Brandon Sheffield, Pathologist with the William O [...]
READ MOREJuly 2022 The annual ESMO World Congress on Gastrointestinal (GI) C [...]
READ MOREJuly 2022 Patients who have colorectal cancer that has spread to th [...]
READ MOREJune 2022 Minimal residual disease (MRD) is a term that refers to cance [...]
READ MOREMay 2022. Image source: https://www.whathealth.com/breastcancer/her2rec [...]
READ MOREMay 2022 The KEYNOTE-177 trial is a landmark study in colorectal ca [...]
READ MOREApril 2022. A new study from Australia found that heavy drinking in [...]
READ MOREApril 2022. A study published in JAMA Network Open investigated whe [...]
READ MOREMarch 2022. While obesity is a known risk factor for colorectal can [...]
READ MOREhttps://youtu.be/-Oi2jBJDUNc February 2022. Join Patient Support Spe [...]
READ MOREJanuary 2022 Total neoadjuvant therapy (TNT) is a standard approach [...]
READ MOREJanuary 2022 Oxaliplatin is an important intravenous chemotherapy d [...]
READ MOREJanuary 2022. Laura Ferguson, a current ileostomy patient, and Karen Br [...]
READ MOREJoin Chana, our Patient Support Specialist, as she sits down to a cand [...]
READ MOREJoin Dr. Scott Berry, Professor & Department Head, Department of O [...]
READ MORELeft: Laura A. Dawson, MD, FRCPC, Princess Margaret Cancer Centre/Univ [...]
READ MOREThis month, the Food and Drug Administration (FDA) cleared an investig [...]
READ MOREIn 2016, the United States Preventive Services Task Force (U [...]
READ MOREIn 2020, Jason was diagnosed with stage 3b colorectal cancer at age 36. In [...]
READ MOREDr. Megan Bernard, naturopathic doctor, discusses a variety of tips and su [...]
READ MORENutritionist Jill Haverstock discusses a variety of tips and suggestions t [...]
READ MOREDr. Mel Borins is a family practitioner based in Toronto, Ontario. He crea [...]
READ MOREJason Abramovitch is an early age onset stage 3b colon cancer survivor who [...]
READ MOREOn December 3rd 2021, Physiotherapist Thi Tran gave a compelling session o [...]
READ MORENovember 2021 Findings from a recent study published in JAMA Networ [...]
READ MORENovember 2021 Findings from phase II of the CheckMate-142 trial sho [...]
READ MOREThe EPOCH trial is the first phase III international study evaluating the [...]
READ MOREImmunotherapy has revolutionized the way cancer is treated by boosting [...]
READ MOREColorectal (CRC) cancer screening and diagnosis during the COVID-19 pa [...]
READ MOREA Swedish population study published this month in the Journal of the [...]
READ MOREAdjuvant (post-surgical) chemotherapy is useful in reducing the risk o [...]
READ MOREThe fecal immunochemical test (FIT) is a widely used colorectal cancer [...]
READ MORENew findings from a study presented at the European Society for Medica [...]
READ MOREWhile many different risk factors for colorectal cancer (CRC) have bee [...]
READ MOREFindings from a recent study show that multigene panel testing of patients [...]
READ MOREThe final recommendation from the United States Preventive Services Ta [...]
READ MOREPeriodontal disease (PD) is a set of inflammatory conditions that affect t [...]
READ MOREThe US Food and Drug Administration (FDA) recently approved the market [...]
READ MOREWe've posted some new recipe videos on our sister site, Foods that Fight C [...]
READ MOREThe Ontario Cancer Research Institute (OICR) held a conference on Tran [...]
READ MOREApril is Diversity Month dedicated to celebrating and honouring all in [...]
READ MOREResults from a systematic review published in JAMA Oncology found that [...]
READ MOREA study published in the Journal of Clinical Oncology Precision Oncology s [...]
READ MOREMolecular profiling in gastrointestinal (GI) cancer has been named by [...]
READ MOREYour physical, emotional and mental well-being are vital to your ability t [...]
READ MORENew findings from the University of Alberta published in the Journal of th [...]
READ MOREFindings from a recent study presented at the 2021 Gastrointestinal Ca [...]
READ MOREColorectal cancer is the second most diagnosed cancer in Canada. Twent [...]
READ MORE10 December 2020Findings from a recent study showed that people who regula [...]
READ MORE22 December 2020 Hepatic Artery Infusion (HAI) chemotherapy is sometime [...]
READ MORENovember 2020 Findings from a recent study conducted by the Mayo Clinic [...]
READ MOREThe non-surgical management or “watch-and-wait” approach for rectal c [...]
READ MOREThe incidence of colorectal cancer (CRC) is rising among young adults, who [...]
READ MOREOpportunity to Investigate the Microbiome’s Impact on Science and Treatmen [...]
READ MORENew findings from a study conducted at the University of Sheffield in [...]
READ MORESexuality and relationships during and after cancer is extremely impor [...]
READ MOREChadwick Boseman’s death from colorectal cancer (CRC) at age 43 was a shoc [...]
READ MOREToday, Wednesday September 30th, is World Metastatic Colorectal Cancer Day [...]
READ MOREDr. Heinz-Josef Lenz, MD, discusses optimal sequencing strategies for [...]
READ MOREThe European Society for Medical Oncology ESMO Virtual Congress 2020 t [...]
READ MOREJesse Fishman is a 17-year-old hockey player, currently playing for the Ki [...]
READ MORE12 August 2020 Recent findings from a Swedish cohort study found that p [...]
READ MOREIt was the day of the lockdown. My family doctor called. “The colorectal c [...]
READ MOREFill out the survey! The world was shocked late last week as we learned a [...]
READ MOREPrevious data have shown that certain species of intestinal bacteria not o [...]
READ MOREAs we transition into autumn, take a moment to appreciate the seasonal pro [...]
READ MOREThe COVID-19 pandemic has presented countless new challenges in cancer car [...]
READ MOREThe COVID-19 pandemic situation is constantly evolving. Canada is slowly r [...]
READ MOREResults of several new studies provide important perspectives on the use o [...]
READ MOREIn the past two years, findings from important clinical trials are shaping [...]
READ MOREHold the Date! On behalf of Colorectal Cancer Canada (CCC), you are cordi [...]
READ MOREWhat is Lynch Syndrome? Lynch syndrome is a genetically inherited conditi [...]
READ MORECoronavirus has taken the world by storm since the beginning of 2020, and [...]
READ MORETo ensure the health and safety of our participants, volunteers, staff and [...]
READ MOREThe American Society of Clinical Oncology (ASCO) held its annual meeting a [...]
READ MOREIn just a few months, coronavirus (COVID-19) has transformed our lives. De [...]
READ MOREIt has been known for millennia that what we eat can be powerful medicine [...]
READ MOREThe last few decades have seen important advances in colorectal cancer tre [...]
READ MORECo-leads of Push For Your Tush Ottawa share their connection to the cause [...]
READ MOREThe Centre de recherche of the Centre hospitalier universitaire de Sherbro [...]
READ MOREOn June 24, 2019, colorectal cancer screening in Ontario is changing to th [...]
READ MOREToday we remember Dr. Henry Lynch, esteemed researcher and father of hered [...]
READ MOREOn Tuesday, July 16, Colorectal Cancer Canada (CCC) held our third annual [...]
READ MOREResearchers with the World Health Organization confirm increased rates of [...]
READ MORELast Thursday and Friday, Morgan Kennedy, CCC’s Never Too Young Program Ma [...]
READ MOREColorectal Cancer Canada (CCC) is proud to announce the publication of the [...]
READ MOREToday, the Giant Colon Tour stopped at the University of Montreal Hospital [...]
READ MOREMost people do not know that cancer is the number one cause of death among [...]
READ MOREMarch is Colorectal Cancer Awareness Month! Colorectal cancer may touch yo [...]
READ MORE