Editor's note: Dajen Williams is a Novant Health pharmacist.
Many patients experience symptoms and side effects during and after cancer treatment due to changes in hormones. These changes may occur naturally and gradually with age, but for many patients they occur abruptly and are surgically or medically induced. Most patients with hormone-driven cancers are not candidates for hormone replacement therapy (HRT), which is often the most effective treatment. Integrative medicine provides multiple safe, hormone-free options to reduce side effects and encourages patients to take an active role in their treatment and overall health.
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Hot flashes and night sweats are some of the most common symptoms and side effects patients experience.
There are several mind and body treatments available that may provide relief, including:
- Acupuncture
- Weighted or cooling blankets and pillows
- Regular exercise
- Yoga
- Mindfulness meditation
- Limiting dietary triggers such as sugar, hot spices and alcohol
- Following Mediterranean-style diet
- Maintaining a healthy weight
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There are many herbal supplements marketed for menopausal symptoms with limited evidence for use and a lack of government regulation to ensure safety and purity. It is important to discuss taking any of these with a trained healthcare professional prior to use, as many of these products could interact or interfere with treatment and contain ingredients with estrogenic effects that could be harmful. Always check with a trained healthcare professional before starting any new supplement.
Hormone-free supplements and herbs that may be safe and effective include:
- Black cohosh, such as Remifemin
- Purified pollen extract, such as Relizen or Source Naturals Swedish pollen extract
- Clary sage and rose geranium essential oils used topically, mixed into a bath or diffused
Many products marketed as “natural and safe” contain proprietary blends and ingredients with hormonal effects.
The following are some common supplements that should be avoided in patients with some hormone-driven cancers:
- Red clover, such as Promensil
- Soy isoflavones (does not include whole soy foods), such as One A Day Menopause,
- Estroven, Centrum Restful Sleep Menopause Support
- Dong quai
- Kudzu
- Wild yam
- Hops
- Chasteberry
- DHEA
- Ginseng
- DIM (diindolylmethane)
- Maca
- Siberian rhubarb
Sexual health is a sensitive topic for many patients. Sexual side effects including loss of libido, vaginal dryness, erectile dysfunction and pain with intercourse are common in cancer patients following surgery, radiation therapy, chemotherapy and hormone therapy.
There are a variety of nonhormone options available to patients, including:
- Consuming whole soy foods in diet. Avoid soy isoflavone supplements.
- Regular exercise.
- Maintaining a healthy weight.
- Proper hydration.
- Vaginal lubricants, such as Replens, or olive, coconut or other natural oils.
- Hyaluronic acid lubricants, such as Revaree, Good Clean Love.
- Physical therapy.
- Dilator therapy.
Weight gain is a troubling side effect of treatment for many patients. Unfortunately, there is not any clinical evidence to support the use of any supplement for weight loss. Many supplements marketed for weight loss are unsafe, very expensive and have little or no evidence for use. The most important parts of maintaining a healthy weight are eating a healthy diet with plenty of protein and getting regular exercise. The Mediterranean diet is rich in vegetables, fruits, whole grains, beans, legumes, fish, lean non-processed meat, eggs, olive oil and nuts. Limit intake of highly processed foods, saturated fats, sodium and added sugar.
There is strong evidence that regular exercise improves physical function, fatigue, anxiety and depressive symptoms, mortality and risk of cancer recurrence and quality of life. Studies suggest that practicing yoga also improves quality of life, reduces stress, lowers heart rate and blood pressure, helps relieve anxiety and depression and insomnia.
At Novant Health Integrative Medicine, with locations in Charlotte and Winston-Salem, you will find many options to help you take control of your health and manage your mental, emotional and physical well-being during treatment and beyond.
Novant Health Integrative Medicine offers individual yoga instruction as well as free online classes for anyone who is interested. To register for classes, visit NovantHealth.org/Calendar, choose “classes, events” and “virtual.”
