Chemotherapy, Antioxidants and ORAC Scores
January 5, 2006
Subject: The debate on whether antioxidants interfere with
chemotherapy or promote its effect continues; perhaps we need a different
way to see the question
Biology is messy. Physics may be elegant but tends
to be incomprehensible. The world and our lives are complicated.
How do we wade through the chaos? We simplify things and formulate
generalizations. We turn the full spectrum of our colorful world
into a black and white reality. If we can see a problem in black
and white, the answer is simple.
Though often helpful, this strategy doesn't always work.
I am led to these ruminations by the ongoing debate regarding the use
of antioxidants during chemotherapy. The medical community takes
a simple stance; antioxidant vitamins taken during chemotherapy may reduce
the toxic side effects of chemotherapy. Their argument is simple. If antioxidants
reduce the toxicity to healthy cells, they must reduce the toxic effect
on cancer cells, reducing the desired effect of treatment. Practitioners
of complementary medicine or medical doctors who are following the research
carefully point out the absence of any evidence to support this theory.
They then point out numerous studies suggesting that the opposite is true.
Adding antioxidants to chemotherapy would appear to both lower undesirable
toxic effects to normal cells while at the same time increasing the toxic
effect against cancer cells. This argument has been going on for
years with little change.
For those who need to follow this debate closely, two additions have appeared
in the last few months. In September, the American Cancer Society
journal CA - A Cancer Journal for Clinicians, published an article by
Gabriella D'Andrea, a medical oncologist at Memorial Sloan-Kettering Cancer
Center. The article, titled "Use of Antioxidants During Chemotherapy and
Radiotherapy Should be Avoided," is a sharp attack on the use of
antioxidant supplements by cancer patients. The full text can be downloaded
This article created a wave of negative publicity for antioxidants in
general, and for their concurrent use with radiation and chemotherapy
in particular. An articulate rebuttal was then written by Ralph
Moss and is set for publication this year. Moss is the researcher
behind the website CancerDecisions.com
If this issue is relevant to you and your ongoing treatment you should
read both articles.
Until Moss's article is published, you can download it for a small fee.
The listed price is US $9.95 but you pick the price you pay (more or less)
and can get a copy for as little as $1.00.
To Order Ralph Moss's Special Report: 'Do Antioxidants and Chemotherapy
Go to: https://webssl.cancerdecisions.com/list/optin.php?form_id=24
This debate is the result of oversimplification, of attempting to reduce
a complex world to black and white. Classifying chemicals as oxidants
or antioxidants sounds clear enough but biology is messy. Whether
a chemical has an oxidant or antioxidant effect in a living system varies
with what other chemicals surround it. As much as we would wish
it was simple, it isn't.
Take for example the poster child of antioxidants, ascorbic acid that
is, vitamin C. Following our simple black and white view, vitamin
C is an antioxidant, inactivating oxidative processes in the cells of
the body. Yet how do we explain the use of vitamin C and vitamin
K-3 in cancer treatment? The combination generates reactive oxygen
species (ROS) in cancer cells while having no damaging effect in normal
cells. I have written about the death of cancer cells caused by
these combined vitamins, a process called Autoschizis, in the past.
Recently this combination has been patented as a cancer therapy under
the name Apatone. See: http://scienceboard.net/resources/newswire.asp?action=article&news_id=931&criteria
Along the same line consider a recent study that suggests high dose intravenous
vitamin C kills cancer cells. After a one hour incubation, vitamin
C, "killed 50 percent of cancer cells in 5 of 10 cancer-cell cultures
but had no effect on healthy cells. Further tests found that a chemical
reaction on the outside of cancer cells converted vitamin C into hydrogen
peroxide, a potent free radical that kills cells." (Science News October
15, 2005 vol. 168 page 253) [i]
In our black and white view of the world, hydrogen peroxide is the classic
oxidant. What is our poster child antioxidant doing turning itself
into an oxidant? Biology is messy. It doesn't always cooperate
with our desire for a black and white view of the universe.
The resolution to this debate on antioxidants and chemotherapy is in viewing
it as the complex reality that it is and not trying to oversimplify it.
Not everything in our world can be simplified to black and white.
For many years the vitamin C content of a food was equated with the antioxidant
activity of the food. This has been proven to be an inaccurate measurement
to judge benefit. This was brought home to me by Rui Hai Liu's work
at Cornell. He has provided numerous examples of how cooking food although
it lowers vitamin C content increases overall antioxidant activity and
benefit in the body. It also may form or release other chemicals
with anticancer activity. http://www.denvernaturopathic.com/news/vegetables.html
Liu and other researchers now judge antioxidant activity of a food using
a score called Oxygen Radical Absorbance Capacity assay (ORAC).
These scores were once a laborious laboratory test but are now automated.
The U.S. Agricultural Research Service considers the automation of the
ORAC method as one of its major research accomplishment in 138 years.
The automation of ORAC testing has recently opened a new window for comparing
the health benefits of various foods
The recent study which told us that coffee is the greatest source of antioxidants
in the America diet used ORAC scores in a simple computation.
"Because Americans drink so much coffee, they get more of their antioxidants
from coffee than from any other dietary source. Nothing else comes close,"
Joe Vinson, the studies principal told Reuters.
For the study, Vinson determined the antioxidant content of more than
100 different foods and beverages and then analyzed data from the U.S.
Department of Agriculture on how much Americans consume of each item.
As mentioned, coffee came out on top, on the combined basis of both antioxidants
per serving size and frequency of consumption, followed by bananas, dry
beans, and corn.
By virtue of how much Americans consume, coffee far outranked many popular
sources of antioxidants such as tea, milk, wine, chocolate and cranberries.
Dates actually have the most antioxidants of all items analyzed based
solely on serving size but not many people eat dates.
Back to this chemo and antioxidant debate for a moment. When there
is evidence that a nutrient or vitamin both has an antitumor effect on
its own and also increases the antitumor effect of chemotherapy, it seems
reasonable to incorporate its use into a patient's treatment protocol.
The fact that it may decrease the negative side effects of treatment is
a poor excuse to argue against use. If and when any evidence surfaces
that a substance lessens the antitumor effect of treatment, then it makes
sense to not use it. But this rarely happens. Although the
hypothesis that chemo and antioxidants don't mix well makes sense at first
glance, the evidence isn't there to support it. The problem is one
of oversimplification; in attempting to understand a complex process we
have oversimplified the biochemistry to the point it doesn't make accurate
predictions. The classification of oxidant versus antioxidant is
to simple to explain the complex interactions within a cancer cell trig
While those who would worn us off antioxidants may have gotten carried
away, so may those promoting ORAC scores. Promoters of natural supplements
have taken ORAC scores and turned them into the holy grail of nutrition.
Their current promotions imply that a person's goal should be to consume
the highest daily ORAC score in food and vitamins as possible. It
is reasonable for most of us to increase our daily ORAC but is more and
more always better? We don't know this yet. There is probably
an upper limit to daily antioxidant effect, an ORAC score that maximizes
our benefit, above which more doesn't give more benefit. Is
there an upper limit above which antioxidant effect possibly backfires?
We don't know.
Leaving all of these weighty subjects alone for the time being, I've dug
out my grandmother's recipe for date nut bread that's handwritten on the
back cover of a tattered old cookbook.
Date Nut Bread Recipe
1 cup boiling water
3/4 cup honey
1 cup dates
egg sized chunk of butter [guess about ½ stick or so]
1 teaspoon soda
1 cup walnuts
1 ½ cups whole wheat flour
bake 50 minutes.
There are no directions written. Here's how I did it:
1. Pour the water over the dates and honey. Allow to stand for 30 minutes.
2. Add the nuts to the dates and beat, add the egg and then melted butter,
beating until creamy.
4. Stir the soda into the flour (I added some cinnamon) and mix into the
Bake at 350 for just under an hour
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