Lung Cancer

This article includes a discussion of studies that have assessed whether certain vitamins, minerals, herbs, or other dietary ingredients offered in dietary or herbal supplements may be beneficial in connection with the reduction of risk of developing lung cancer, or of signs and symptoms in people who have this condition.

However, this information is provided solely to aid consumers in discussing such supplements with their healthcare providers. It is not advised, nor is this information intended to advocate, promote, or encourage self use of these supplements for cancer risk reduction or treatment. Furthermore, none of this information should be misconstrued to suggest that dietary or herbal supplements can or should be used in place of conventional anticancer approaches or treatments.

It should be noted that certain studies referenced below, indicating the potential usefulness of a particular dietary ingredient or dietary or herbal supplement in connection with the reduction of risk of lung cancer, are preliminary evidence only.

Finally, some of the studies suggest an association between high blood or dietary levels of a particular dietary ingredient with a reduced risk of developing lung cancer. Even if such an association were established, this does not mean that dietary supplements containing large amounts of the dietary ingredient will necessarily have a cancer risk reduction effect.

Cancer of the lung is the leading cause of death from cancer in both men and women in the United States. Cigarette smoking is by far the most important risk factor for the development of lung cancer. Air pollution is another risk factor. A previous diagnosis of tuberculosis increases the risk of lung cancer by 5 to 10%.

Checklist for Lung Cancer

Rating Nutritional Supplements Herbs
3Stars Beta-carotene (reduces risk) Warning: Beta-Carotene increases the risk of lung cancer in smokers.  
2Stars Selenium (reduces risk)
Vitamin E (reduces risk)		 Coriolus versicolor
1Star Coenzyme Q10
Folic acid (reduces risk)
Melatonin
Multivitamins
Vitamin A
Vitamin B12 (reduces risk)		 Asian ginseng
Black tea (reduces risk)
Dr. Sun’s soup
Green tea (reduces risk)
Hoxsey Formula
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

What are the symptoms of lung cancer? In its early stages, lung cancer usually causes no symptoms. As a result, lung cancer is generally not diagnosed until the disease is relatively advanced. At the time of diagnosis, common symptoms of lung cancer are similar to those of some other respiratory diseases: cough, blood stained sputum, wheezing, and shortness of breath. Lung cancer is sometimes diagnosed from a chest x-ray done for another condition. Pneumonia lasting more than two months may indicate the presence of lung cancer and should be followed-up with further testing. Later symptoms of lung cancer generally result from spread to other parts of the body (metastasis). These symptoms may include chest or shoulder pain, unexplained weight loss, bone pain, hoarseness, headaches, seizures and swelling of the face or neck. Lung cancer is usually a fatal disease, except for the minority of patients diagnosed at the early stages of the disease.

How is it treated? When lung cancer is in its earliest stage, surgery is the primary treatment, sometimes accompanied by radiation and chemotherapy. In more advanced stages of the disease, chemotherapy and surgery may still be used, although the surgery is no longer likely to achieve a cure. The chemotherapeutic agents commonly used include cyclophosphamide (Cytoxan®), doxorubicin (Adriamycin®) and cisplatin (Platinol®). Immune system therapies, including bacillus Calmette-Guerin (BCG) and levamisole hydrochloride (Ergamisol) are also sometimes prescribed for lung cancer patients.

Dietary changes that may be helpful: The following dietary changes have been studied in connection with lung cancer.

Fruits and vegetables
Most studies suggest that as consumption of fruits and vegetables increases, risk of lung cancer decreases.1 Several ingredients in fruits and vegetables may be responsible for this apparent protective effect.

Flavonoids are found in virtually all fruits and vegetables. Onions and apples contain large amounts of a flavonoid called quercetin. Consumption of flavonoids in general, or quercetin-containing foods in particular, has been associated with a reduced risk of lung cancer in some preliminary reports,2 3 although not every study finds an association between flavonoid consumption and a reduced risk of cancer. 4

Researchers agree that people who eat yellow and orange fruits and vegetables—good sources of alpha-carotene and beta-carotene—are at lower risk for lung cancer. However, double-blind trials have shown that when nonsmokers supplement with (synthetic) beta-carotene, their risk of lung cancer is not reduced, and when smokers take (synthetic) beta-carotene supplements, their risk of lung cancer increases. These findings suggest that beta-carotene may not be the cause of the low lung cancer risk found in people who eat carotene-rich foods.

Tomatoes
Tomatoes contain lycopene—an antioxidant similar in structure to beta-carotene. Most lycopene in our diet comes from tomatoes, though traces of lycopene exist in other foods. Lycopene has been reported to inhibit the proliferation of cancer cells in test tube research.5 6

A review of published research found that higher intake of tomatoes or higher blood levels of lycopene correlated with a reduced risk of cancer in 57 of 72 studies. Findings in 35 of these studies were statistically significant.7 Evidence of a protective effect for tomato consumption was strongest for several cancers including lung cancer.

Avoidance of meat and saturated fat
Consumption of fried and well-done red meat was associated with an elevated risk of lung cancer in one report.8 Consumption of red meat in general, as well as fried meat, correlated with a high risk of lung cancer in another study.9 People who cook with fat taken from meat (such as bacon fat and lard) have also been reported to be at high risk of lung cancer according to preliminary research.10

Incidence of lung cancer correlates with dietary fat intake from country to country.11 Some,12 but not all,13 preliminary studies report consumption of saturated fat in both meat and dairy fat correlates with the risk of lung cancer, even among nonsmokers.14 Lung cancer risk appears directly related to consumption of foods containing saturated fat––not only from consumption of well-cooked meat.15 In one trial that was unable to find an association between lung cancer risk and total saturated fat intake, people consuming skim milk nonetheless had a 50% reduction in risk compared with people drinking whole-fat milk.16

Avoidance of dietary cholesterol
Dietary cholesterol comes primarily from the consumption of eggs. Most,17 18 19 but not all, 20 studies have reported that as dietary cholesterol increases, so does the risk of lung cancer. No clear explanation has yet emerged to account for this association.

Fish
Fish eaters have been reported to have low risks of many cancers including lung cancer.21 The omega-3 fatty acids found in fish are thought by some researchers to be the components of fish responsible for protection against cancer.22

Avoidance of sugar
Preliminary studies have reported associations between an increasing intake of sugar or sugar-containing foods and an increased risk of several cancers including lung cancer.23 Whether this association exists because sugar directly promotes cancer or because sugar consumption is only a marker for some other dietary or lifestyle factor remains unknown.

Lifestyle changes that may be helpful: The following lifestyle changes have been studied in connection with lung cancer.

Smoking
Cigarette smoking is universally acknowledged to be the leading cause of lung cancer, both in the United States and worldwide. By far the most important way to reduce the risk of lung cancer is to not smoke.24

Passive smoke
Many studies now show that exposure to passive smoke—the cigarette smoke from others’ cigarettes—significantly increases the risk of lung cancer.25 As non-smoking sections of restaurants have nearly the same level of smoke as do the smoking sections, it makes sense to seek restaurants that do not permit any smoking and to avoid bars unless they are also non-smoking establishments.

Other inhalant pollution
Inhalant exposure to diesel exhaust, pitch and tar, dioxin, arsenic, chromium, cadmium, and nickel compounds may also increase the risk of lung cancer.26 Exposure to asbestos is associated with an increased risk of lung cancer.

Radon exposure has been reported to contribute to the risk of lung cancer in the general population.27 Radon, a natural radioactive substance, can leak into basements from the surrounding soil. Radon exposure can also occur from the water system of houses, particularly when people take showers. Underground miners are also exposed to varying amounts of radioactivity from radon.

Nutritional supplements that may be helpful: The following nutritional supplements have been studied in connection with lung cancer.

Folic acid and vitamin B12
Folic Acid and vitamin B12 work together in the body to help cells replicate normally. In a double-blind trial, smokers with precancerous changes in the lungs were given a placebo or the combination of 10,000 mcg of folic acid and 500 mcg of vitamin B12 per day for four months.28 A significant reversal of precancerous changes occurred in those given vitamin supplements compared with those given the placebo.29 No trials have investigated whether either vitamin given alone or the combination of both vitamins would help to treat people who already have lung cancer.

Beta-Carotene
In double-blind trials, synthetic beta-carotene supplementation has led to an increased risk of lung cancer in smokers,30 31 though not in groups consisting primarily of nonsmokers.32 Smokers should avoid synthetic beta-carotene supplements, including the relatively small amounts found in many multivitamins.

The researchers who conducted the lung cancer trials have been criticized for not having used the natural form of beta-carotene.33 Preliminary evidence suggests that natural beta-carotene supplementation results in better antioxidant activity34 and anticancer activity in humans35 than does supplementation with synthetic beta-carotene. Nonetheless, much less is known about natural beta-carotene and questions remain about its potential efficacy.36 The effect of natural beta-carotene supplementation on lung cancer risk has yet to be studied.

The strong association between increased intake of beta-carotene from food and a reduced risk of lung cancer37 does not necessarily mean that supplementation with natural beta-carotene supplements would reduce the risk of lung cancer. Dietary beta-carotene may be a marker for diets high in certain fruits and vegetables that contain other anticancer substances that may be responsible for the protective effects. Until more is known, some doctors advise smokers to avoid all forms of beta-carotene supplementation—even natural beta-carotene.

Selenium
Selenium has been reported to have diverse anticancer actions.38 39 Selenium inhibits cancer growth in animals.40 Low soil levels of selenium (probably associated with low dietary intake), have been associated with increased cancer incidence in humans.41 Blood levels of selenium have been reported to be low in patients with many cancers,42 43 44 45 46 47 48 49 including lung cancer.50 In preliminary reports, people with the lowest blood levels of selenium had between 3.8 and 5.8 times the risk of dying from cancer compared with those who had the highest selenium levels.51 52

The strongest evidence supporting the anticancer effects of selenium supplementation comes from a double-blind trial of 1,312 Americans with a history of skin cancer who were treated with 200 mcg of yeast-based selenium per day or a placebo for 4.5 years and then followed for an additional two years.53 Although no decrease in skin cancers occurred, a 50% reduction in overall cancer deaths and a 37% reduction in total cancer incidence was observed. A 46% decrease in lung cancer incidence and a 53% drop in deaths from lung cancer also occurred. These findings were all statistically significant.

Vitamin E
Relatively high blood levels54 55 and dietary levels56 of vitamin E have been associated with a reduced risk of lung cancer. In a preliminary trial, nonsmokers who took vitamin E supplements had a 45% lower risk of lung cancer compared with nonsmokers who did not supplement with vitamin E.57 While a double-blind trial reported that vitamin E supplementation had no effect on lung cancer risk,58 the amount used—approximately 50 IU per day—may have been too low to have a significant effect.

Vitamin A
In one trial, patients with very early stage lung cancer (“stage I”) were all treated with surgery and then given either 300,000 IU of vitamin A per day or no vitamin A.59 After one year, 63% of those taking vitamin A were free of cancer compared with 52% of those not assigned to vitamin A. The average time until the reoccurrence of cancer was significantly prolonged in the vitamin A group.

However, the vast majority of lung cancer patients are diagnosed when the disease is more advanced than stage I. In a trial studying patients with more advanced disease, supplementation with 300,000 IU per day for one year followed by 150,000 IU per day for another year did not reduce lung cancer recurrences.60 Moreover, another trial that studied smokers and workers exposed to asbestos found that daily supplementation with 25,000 IU of vitamin A plus 50,000 IU of synthetic beta-carotene (which can act as a vitamin A precursor in the body) for four years led to a slight increase in the risk of getting lung cancer compared to no treatment.61

These studies suggest that vitamin A supplementation is unlikely to either prevent lung cancer or effectively treat lung cancer patients.

Melatonin
Years ago, a preliminary study suggested that melatonin may help stabilize the condition of some people with advanced cancers.62 Since then, Italian researchers have been investigating the effects of melatonin in cancer patients, often with partial success.63 64 65 66 67 68 69 70 71 72 73 74

In patients with advanced lung cancer who were given 10 mg of melatonin at night in cycles of three weeks on followed by one week off, survival time was almost twice as long as survival in those not given melatonin—a statistically significant increase.75 Melatonin supplementation was not helpful to patients whose cancer had spread to the liver.76

Coenzyme Q10 supplementation
In an unpublished report, 4 of 11 lung cancer patients were said to be alive following ten years of supplementation with 100 mg of CoQ10 per day.77 Such undocumented case reports require confirmation from published research trials.

Zinc
Some lung cancer patients have been reported to lose excessive amounts of zinc in urine. In one trial, supplementing such patients with zinc led to an improvement in some aspects of immunity.78 However, no trial has yet explored whether zinc supplementation would help prevent lung cancer or improve survival in patients already diagnosed with this disease.

Vitamin supplement use in general
In a preliminary trial, lung cancer patients who reported using vitamin supplements survived almost four times as long as those who did not.79 This report did not determine which specific supplements were associated with extended survival although it is probable that many patients were using multivitamins. Possibly, use of supplements may have been a marker for other dietary or lifestyle factors responsible for the outcome. Nonetheless, the advantage favoring use of supplements was highly statistically significant.80

Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful: The following herbs have been studied in connection with lung cancer.

Cloud mushroom (Coriolus versicolor)
Polysaccharopeptide (PSP) and polysaccharide krestin (PSK), both cloud mushroom extracts, have been studied in preliminary and double-blind trials and shown to be beneficial in extending the life of patients with several cancers81 82 83 84 85 including lung cancer.86 PSK and PSP are not available in the United States. Whether the hot water-extracted Coriolus products available in the United States are equivalent to the products used extensively in Japanese cancer research remains unknown. The amount used in most research trials is 3 grams per day.

Asian ginseng  (Panax ginseng)
Many studies of animals with cancer suggest Asian ginseng may improve immune function and increase lifespan.87 Although little is known about the effects of Asian ginseng in people already diagnosed with cancer, preliminary Chinese trials have shown increased survival or improvement of immune function in people with lung cancer already treated with chemotherapy, radiation therapy, and/or surgery.88

Green Tea and Black Tea (Camellia sinensis)
Numerous preliminary studies have shown an association between drinking green tea and a reduced risk of several types of cancer89 90 91 92 including lung cancer.93 In contrast, preliminary studies of black tea consumption have not found that it protected against any type of cancer.94 95 96

Dr. Sun’s Soup
The soup, develop by Alexander Sun, PhD, is prepared by heating the ingredients in water, freeze-drying them, then mixing the powder back into hot water or soup. In a preliminary trial, lung cancer patients were given 30 grams per day of Dr. Sun’s Soup.97 Dr. Sun’s Soup improved quality of life and survival compared with people with lung cancer not given Dr. Sun’s Soup.98 Everyone in the trial had previously been treated with conventional therapies, including chemotherapy. More research is needed to determine the efficacy of this mixture.

Hoxsey Formula
Harry Hoxsey, the son of a veterinarian, claimed to have obtained his cancer formula from his father, who in turn obtained it from his father (Harry’s grandfather).99 In all likelihood, the formula was developed by others as evidenced by the earlier appearance of an almost identical formula under other names in various medical and semi-official publications.100 The exact ingredients of the formula were changed over time. The following ingredients are listed on a bottle of the formula from 1954 and are likely to be very similar to the formula currently in use in what is frequently called the “Hoxsey Clinic” (the Bio-Medical Center in Tijuana, Mexico).

Ingredients are listed in order from most to least amount present:

Hoxsey also used externally-applied formulas, which are discussed below under cancer salves.

One small preliminary trial found that 6 of 15 people with a variety of mostly advanced cancers who attended the Bio-Medical Center and took the Hoxsey formula claimed to be disease-free after a follow-up period of five years, including two lung cancer patients.101 Average survival was surprisingly long, even for those who did eventually succumb to their cancers.102 Several of these patients appeared to have had a poor chance of survival before taking the Hoxsey formula. Larger, double-blind trials are needed to confirm or contradict these findings. Until it is confirmed in other trials, the Hoxsey formula should be considered unproven.

Limited evidence suggests that some of the components of the Hoxsey formula may have anticancer activity. In animal and/or test tube research, burdock root,103 104 berberine (a constituent of barberry),105 106 a protein found in poke root,107 108 109 110 licorice,111 112 stillingia,113 and red clover,114 have all been found to have anticancer activity. Constituents of alder buckthorn, cascara, and prickly ash bark have produced mixed results in preliminary testing investigating anticancer actions.115 116 117 118

Besides the small trial of cancer patients discussed above, no other human trials have studied the Hoxsey formula. The assertion by the American Cancer Society that the Hoxsey formula has been “extensively tested” and “found to be . . . useless”119 is therefore false.

The original Hoxsey formula is prepared as a water extract and is available only at the Bio-Medical Center in Tijuana, Mexico.120 Other versions of Hoxsey-like formulas are available, primarily from herbal companies that supply physicians. However, most of these are alcohol extracts (tinctures). Although these products may contain extracts from the same herbs, it is unknown whether these products have the same effects as does the original Hoxsey formula.

Cancer patients who attend the Bio-Medical Center in Mexico also are told to make several dietary changes and to take several supplements.121 No scientific evidence supports the use of these dietary changes or supplements in the treatment of people with cancer.

Are there any side effects or interactions? Refer to the individual herb for information about any side effects or interactions.

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