Benefits and risks from using supplements in cancer patients

Cilj istraživanja: s obzirom na nedostatak znanja o suplementaciji onkoloških bolesnika, a koji često posežu za „prirodnijim“ pripravcima u ljekarni, cilj ovoga rada prikazati je najnovije dokaze o potencijalnim benefitima i sigurnosti primjene pojedinih dodataka prehrani u bolesnika koji se liječe od različitih malignih bolesti. Metode: elektronska bibliografska baza podataka PubMed pregledana je u ožujku i srpnju 2023. godine; jednom koristeći općenite ključne riječi iz MeSH rječnika, a drugi put koristeći nazive različitih suplemenata od interesa za koje postoje podatci o učestalosti primjene u ovakvih bolesnika ili već neki objavljeni relevantni rezultati. Pretraga je ograničena na petogodišnje razdoblje (2018.-2023.). Uključeni su isključivo radovi na ljudskim ispitanicima, neovisno o ustroju istraživanja. Kriteriji isključenja, između ostalog, odnosili su se na istraživanja odabrane suplementacije i prevencije nastanka raka. Rezultati: primjena dodataka prehrani može biti povezana s pozitivnim ishodima u liječenju raka kroz jačanje učinka antitumorske terapije, odgađanje pojavnosti remisije ili smanjenje štetnih učinaka osnovne terapije, čime se osigurava i njezina veća podnošljivost. Dodatci prehrani koji bi mogli imati potencijalnu korist u onkoloških bolesnika, a prikazani su u ovome radu jesu redom beta-glukan, arabinoksilan, kvercetin, rutin, luteolin, kurkumin, berberin, epigalokatehin, graviola, beta-karoten, likopen, astaksantin, vitamin D te probiotici. Zaključak: kako bi službene preporuke jednom stupile u praksu, potrebno je još studija o koristima i rizicima primjene dodataka prehrani u onkoloških bolesnika, visoke kvalitete provedbe, kao i općenito standardiziranje korisnih pripravaka u smislu određivanja pravilne formulacije i doziranja te prepoznavanja svih indikacija za koje su primjenjivi.Objective: taking into account the knowledge gap on dietary supplement use in cancer patients, who often reach for more "natural" preparations in pharmacies, the aim of this study was to present the latest evidence on the potential benefits and safety profile of particular dietary supplements in patients being treated for various malignant diseases. Methods: the electronic bibliographic database PubMed was reviewed in March and July 2023; first using general keywords from the MeSH thesaurus, and the other time using the names of different supplements of interest for which there is data on the frequency of use in such patients, or previously published relevant findings. The search was limited to a five-year period (2018- 2023). Only articles reporting studies on human subjects were included regardless of the study design. Among the exclusion criteria were studies focused on supplementation and cancer prevention. Results: the use of dietary supplements can be associated with positive outcomes in cancer treatment by improving standard therapy, delaying remission, or reducing adverse effects of therapy, thus ensuring its better tolerability. Dietary supplements presented in this work from which cancer patients could potentially benefit are the following: beta-glucan, arabinoxylan, quercetin, rutin, luteolin, curcumin, berberine, epigallocatechin, graviola, beta-carotene, lycopene, astaxanthin, vitamin D and probiotics. Conclusion: in order for the official recommendations to be put into practice, more high-quality studies on the benefits and risks of using dietary supplements in oncology patients are needed, as well as standardization of useful products in terms of correct formulation and dosage, and recognition of all indications for which they could be applicable