Lowered immunity as a side-effect of chemotherapy usually occurs due to drug-induced suppression of the bone marrow where blood cells, including our immune cells, are produced. Neutrophils counts, the most common type of white blood cell, are usually most severely affected and the term given this condition is neutropenia.
Other immune effects can be mediated through the gut where the cells that regulate immune activity (T-regulatory cells) reside. Many chemotherapeutics impact the gut lining and may compromise systemic immunity via this mechanism.
Immune suppression following chemotherapy is usually temporary; however, in some individuals the immunity recovers very slowly or may be permanently compromised. If white counts are severely compromised chemotherapy treatment schedules may affected.
Luckily, there are several natural medicine approaches to maintaining immunity during cancer treatment and recovering it optimally post treatment.These include probiotic/prebiotics, nutritional medicines, herbal medicines and medicinal Chinese mushrooms.
Improving gut health
Firstly, gut health can be optimised to support immunity. For example, supporting normal flora with prebiotic and probiotics has been demonstrated in the scientific literature to assist with maintaining white cell counts. Specifically lactic acid bacteria (acidophillus) stimulate phagocytic activity and natural killer cell activity and modulate the host immune system (Kaminogawa A et al, Modulation of immune functions by foods, Evidence-based Complementary & Alternative Medicine, 2004, 1(3)). Natural killer cells are specific lymphocytes or white blood cells that kill cancer and viruses.
Glutamine, an amino acid, is useful on several levels. It not only helps restore the gut lining and also increases the number and activity of lymphocytes (another type of immune cell). Specifically glutamine can decrease tumour growth by enhancing natural killer cell activity and increasing neutrophil activation (Fahr et al, Glutamine enhances immunoregulation of tumor growth, JPEN J Parenter Enteral Nutr, 1994; 471-476).
Finally arabinogalactans, a fibre from the Western Larch Tree, also boost lymphocyte number and activity both locally in the gut and throughout the body. (Kim LS et al Immunological activity of larch arabinogalactan and echinacea: a preliminary, randomised, double-blind placebo-controlled trial. Altern Med Rev 2002; 7:138-49)
Vitamins, minerals and nutrients
A variety of vitamins, minerals and fatty acids support immune system function. These include zinc, selenium, betacarotene, vitamin C, vitamin E and omega-3 fatty acids. These and other nutrients enhance antigen-specific antibody production, augment their proliferative response and promote phagocytic activity and NK cell activity (Kaminogawa A et al, Modulation of immune functions by foods, Evidence-based Complementary & Alternative Medicine, 2004, 1(3)).
Numerous studies have examined the immune boosting benefits of herbs including Astragalus, Echinacea, Ashwagandha and Panax ginseng.
Astragalus has been shown to have immunologic benefits by stimulating macrophage and natural killer cell activity and inhibiting T-helper cell type 2 cytokines. (McCulloch M et al Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials, Journal of Clinical Oncology, Vol 24, No 3 (January 20), 2006: 419-430).
Specific Echinacea extracts have been shown to have multiple immune-stimulating effects including activating macrophages, natural killer cells, stimulate the secretion of cytokines (molecules involved in immune response). In vivo studies have shown that treatment with Echinacea extracts can increase the number of white blood cells in the circulatory system, enhance phagocytosis and trigger the alternate complementary pathway. (Wang Chien-Wu et al, Genomics and proteomics of immune modulatory effects of a butanol fraction of Echinacea purpurea in human dendritic cells, BMC Genomics 2008, 9:479doi:10.1186/1471-2164-9-479).
Ashwagandha and its constituents have immunomodulatory effects including the mobilisation of macrophages, phagocytosis, and lysosomal enzymes. Preliminary evidence suggests Ashwagandha might reduce chemotherapy (cyclophosphamide) induced immuno-suppression and leukopenia. Ashwagandha also seems to increase bone marrow cell and white blood cell count in radiation-treated animals.
Panax ginseng stimulates natural killer cell activity and possibly other immune-system activity (Natural Medicines Comprehensive Database).
Finally, a great deal of research has gone into the immune stimulating/modulating effects of medicinal Chinese mushrooms. Coriolus versicolor, also known as Trametes versicolor is one example. An extract of Coriolus improves immune function by increasing white cell, natural killer cell and antibody levels (Natural Medicines Comprehensive Database).
Seek professional advice
In summary, for cancer patients undergoing or recovering from treatment, support of the immune system is of paramount importance. However, it is advisable to seek professional advice as there may be specific considerations and contraindications in your case. For example, it is not advisable to take Panax ginseng if you are on blood thinners or have an oestrogen receptor positive cancer. It is also important that your doctor be informed of any natural medicines you are taking, including those purchased over the counter.
By Belle McCaleb
ND, RN, MSS-C, BSN