DEAR DOCS: I’m undergoing radiation treatment for non-Hodgkin lymphoma, and things are going pretty well. But when I told my oncologist that I was taking supplements to get my strength back, he was upset with me for not telling him sooner. It all seems to be working, so what’s the big deal?
— Andrea M., Piedmont, New York
DEAR ANDREA: Two words: liver and kidney. In order to reap the benefits of your cancer treatment(s) you need to have all of your organs functioning at their best.
Even though your radiation treatments are working (congrats), you always need to keep your docs informed about any OTC meds, herbs and supplements you’re taking. There are many reports from doctors who have been puzzled by problems with kidney and liver function after successful cancer therapies, then they find out that their patients have been taking herbal and other OTC supplements!
A recent study in JAMA Oncology found that 36% of cancer patients use complementary therapies (most often herbal supplements), and 30% of those folks didn’t tell their physician. Why? Because they weren’t asked.
Docs need to bring up the subject, but as an empowered and engaged patient you need to bring up the topic too! For you, Andrea, that’s especially important, since you don’t know precisely what’s in those supplements. Certain supplements with very high levels of some antioxidants could make radiation less effective.
However, not all complementary therapies are discouraged; in fact, many can boost your recovery.
For example, Cleveland Clinic uses integrative medicine and complementary therapies to help maintain strength and boost mood during and after cancer treatments. That includes tai chi and yoga, acupuncture, massage, meditation and other relaxation techniques, as well as aroma and music therapy.
For an in-depth look at complementary therapies and a discussion guide to take to your oncologist, go to https://my.clevelandclinic.org/health/treatments/16883-complementary-therapy.
DEAR DOCS: My old college roommate turned 30 and was diagnosed with Type 2 diabetes, even though he’s a normal weight and fairly athletic. I told him that something doesn’t pass the smell test here and to get a second opinion. What do you docs think?
— Sheldon C., Los Angeles
DEAR SHELDON: Good call. He should get rechecked for Type 1 diabetes, which is an autoimmune disease where the immune system mistakenly sees the insulin-producing pancreatic beta cells as foreign invaders and destroys them. (We believe any diagnosis or treatment of a condition that requires more than three days of therapy deserves a second opinion.)
A new study published in Diabetologia found that more than 30% of people over 30 who are diagnosed with Type 2 diabetes actually have Type 1. The researchers also believe that more than 42% of Type 1 diabetes cases occur after age 30.
The researchers at the University of Exeter in England cite their Prime Minister Theresa May’s misdiagnosis with Type 2 diabetes as a classic example of this mistake.
Since Type 2 diabetes happens when the body develops a resistance to insulin (the body cannot properly break down glucose for energy) and is triggered by a poor diet, excess weight and inactivity, the PM was treated with “tablets” (probably metformin) and lifestyle changes.
But those measures didn’t work, so her docs did a reevaluation and found that she had Type 1 diabetes, which needs to be treated with insulin ASAP.
Why the mix-up? Well, with Type 1, after the initial onslaught, there’s often a “honeymoon” period, during which beta cells in the pancreas keep producing some insulin. This can lead doctors and patients to believe the prescribed therapy for Type 2 diabetes is working.
When the honeymoon is over, the patient will suffer insulin depravation — and insulin injections are the only effective initial therapy.
Without it there’s the risk of severe high blood glucose levels, coma and death. Your friend is lucky you urged him to get another opinion.