Much ado about nothing

February 12, 2019

One could justifiably use the above-mentioned Shakespeare title about a newly published article (1) that supposedly shows that antioxidant supplements reduce the effectiveness of chemotherapy and radiation therapy in postmenopausal women.

Please note that this assertion is by no means proven; there is much research that points in both directions.

The above-mentioned journal article does not contribute to clarification of the issue, not least because of the weak design of the study.

The data in the study came from interviews of postmenopausal women in two regions in Germany. The researchers used data from the “Mamma Carcinoma Risk Factor Investigation,” a study that was first published more than 10 years ago to report on the risk factors associated with postmenopausal hormone therapy.

Despite the known weaknesses of the interview study, the Danish TV2 reported the results of the study as a great sensation and with a headline that announced:

“New research: Dietary supplements can spread breast cancer.
German researchers have learned that antioxidant supplements can worsen breast cancer in women. The Danish Cancer Society is concerned.
For many years, there have been discussions as to whether antioxidant supplements are good for human health or not. And now a German study makes it clear that they are definitely dangerous for women with breast cancer.”

No, no, and no again.

There is no evidence for the dramatic TV2 news statements.

The German study does not make anything clear.

And the journal article authors’ own conclusion is much more cautious than the TV2 news report.

The journal article authors write:

“Our data do not support an overall association of postdiagnosis supplement use with prognosis in postmenopausal breast cancer survivors. Our results, together with other clinical and experimental evidence, suggest that during breast cancer treatment, antioxidants should potentiall be used with caution.”

In their journal article, the authors do not even advise against the use of antioxidants during chemotherapy and radiation therapy. They just urge caution.

Normally, German research results are shrugged off in Denmark, and interview-format studies get the same treatment. But, this time, the German interview study could be used to advance specific points of view, and so it was.

There are many things in this German study that grab the attention of the alert reader, and a close reading of the study reveals that the authors are biased, not least in their selection of earlier research on the topic.

An interview study, with no blinding of at all, is certainly not the most valid form of research and cannot be compared with prospective randomized controlled trials (RCT’s).

In the German study, the researchers asked some 2000 breast cancer patients whether they took antioxidant supplements before and/or after the time of their diagnosis with breast cancer and/or during their chemotherapy and radiation therapy.

The women in the study were to answer yes if they had just taken one or another supplement three days a week for a year at a given point in time. A “current user” was any woman who used supplement postdiagnosis within the 6 months before the first follow-up interview.

The term “supplement” and the term “antioxidant” are used quite sloppily but with a noticeable consistency. Whenever the researchers discuss the study, the usage, or the statistics, they use the term “supplements.” Whenever they discuss the chemotherapy or the radiation therapy, however, they use the term “antioxidants” without specifying what the term “antioxidants” covers.

In other words, the researchers have had to extend the definition of antioxidants with other supplements in order to achieve sufficient statistical power and thereby just barely sneak over the line into statistical significance.

About this, the authors write in their article:

“The main exposures of interest included postdiagnosis use (no postdiagnosis use, postdiagnosis use, current use) of any type of supplement; specific supplements, such as magnesium and calcium; and supplement group, such as antioxidants, in which there was adequate statistical power to conduct analyses. Only a few women reported postdiagnosis use of multivitamins, vitamins A, C, E, zinc, and selenium, and therefore they were collectively evaluated together as antioxidants in all of our analyses.”

Above and beyond the fact that the researchers have jumbled everything together in a big group that they call “antioxidants,” there is also a total lack of information about daily dosages, single dosages, and preparation types.

This study has a weak design and has unclear results. Therefore, the authors are careful to settle for a cautious conclusion, which speaks for itself.

The misinformation occurs when the Danish media then trumpet the study conclusion as the definitive truth.

Any serious researcher would avoid making such bombastic statements.


  1. Jung AY et al. Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy. Am J Clin Nutr 2019;109:69–78.
  2. Flesch-Janys D, Slanger T, Mutschelknauss E, Kropp S, Obi N, Vettorazzi E, Braendle W, Bastert G, Hentschel S, Berger J. Risk of different histological types of postmenopausal breast cancer by type and regimen of menopausal hormone therapy. Int J Cancer 2008;123(4):933–41.

Dietary Supplement Strengthens Immuno-Therapy Against Breast Cancer

November 7, 2005

An American study has shown that the pioneering cancer medicine against breast cancer, Herceptin, can be made 30-40 times more effective when used in conjunction with a harmless dietary supplement: gamma-linolenic acid (GLA). The study’s results are preliminary but calls for further investigation.

Every year, almost 3,500 Danish women get breast cancer. Approx. every fifth of them have a particularly aggressive form of cancer, which you may fear in particular, if you find cancer in the lymph nodes of the armpit during surgery. The aggressive cancer is due to a gene in the affected women which is particularly active and forms large amounts of HER2, a protein. When HER2 adheres to the surface of a breast cell, it reacts with growth agents in the blood that can transform the cell into a cancerous cell and stimulate it to growth.

However, since 1998, there have been medicine available that, in the same way as an antibody, have been able to block HER2 and thus weaken the growth stimulation. The name of the drug is Herceptin® (Trastuzumab) and so far only women have been offered this, who in addition to being “HER2 positive”, have had recurrence of breast cancer that has spread.

More recently, however, research has shown that Herceptin also helps when it is given much earlier, namely as soon as it is known after the operation that the woman is HER2-positive. In Denmark, the treatment can be relevant for approx. 450 women annually. In an experiment with approx. In 3,350 women who received Herceptin for one year, the risk of recurrence of the disease was halved and mortality was reduced by a third. In a Belgian trial with just over 5,000 women, the risk of relapse was also halved – to approx. 6%. Overall mortality was also reduced in this trial, but only slightly and not statistically significantly.

The Danish Cancer Society is now calling on women who have had surgery for breast cancer to find out whether they are HER2-positive and should have the treatment. But unfortunately it is not as risk-free as it sounds. HER2 also plays a role in the heart, and chemotherapy along with blocking HER2 is a cocktail that can cause heart failure. This happens in up to 20%, many of whom have to stop the treatment. How they fare in the long term is not known.

GLA and Herceptin collaborate
All this is mentioned only to say that HER2 can apparently – sensationally – also be attacked from a completely unexpected angle. The vital fatty acid gamma-linolenic acid (GLA), used by many as a dietary supplement, also (in laboratory experiments) inhibits HER2, but by a different mechanism than Herceptin. According to researchers from Northwestern University in the USA, GLA enhances the effect of Herceptin no less than 30-40 times, without affecting healthy cells. The combination means that many more cancer cells die, while others are inhibited in their growth.

The way it works is complicated. The experiments suggest that GLA stimulates the formation of a protein (PEA3), which in turn inhibits the gene that must produce HER2. Since GLA and Herceptin therefore intervene separately – one blocks the formation of HER2, the other blocks the effect – they reinforce each other. Previous experiments have shown that GLA can also independently inhibit cancer in the laboratory.

If even a little of this applies to living people, it is a sensation. But it must be emphasized that these are only laboratory experiments at the cellular level. Further extensive research is needed. It is, as the authors write, on the other hand required. What women with HER2-positive breast cancer must do here and now is, among other things, for now up to the individual.

By: Vitality Council

1. Piccart-Gebhart et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 2005;353:1659-72.
2. Romond EH et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 2005;353: 1673-84.
3. Menendez JA et al. Effect of gamma-linolenic acid on the transcriptional activity of the Her2/neu (erbB-2) oncogene. J Natl Cancer Inst 2005;97:1611-15.

Breast Cancer Cannot Tolerate Iron Deficiency

September 21, 2005

Breast cancer is fought just as effectively by utilising the body’s iron deposits as by using chemotherapy. This has been shown in an American animal study.

TV and radio sometimes gives the impression that researchers have lost interest in antioxidants. Meanwhile, research in this field continues.

The following describes a study which has recently been published in the worlds leading journal for research in the field of free radicals. Free radicals are neutralised by antioxidants such as vitamins E and C etc.

The journal is called Free Radicals in Biology and Medicine. It comes out every 14 days with about 125 large pages which contain summary articles as well as 10-12 descriptions of new research. It has an editorial staff with nine members and an international review board with 73 members, all of whom are university-researchers. It is unfortunately written in such technical, biologic-biochemical, language that it is not understandable for normal nutrition experts and doctors. But the size and format of the journal is an expression of the intense international research which is still producing new information for the understanding of the roles of antioxidants and free radicals in disease.

The study in question has special interest for doctors who treat atherosclerosis with EDTA. EDTA is given intravenously and binds the bloods heavy metals as well as iron. Because both iron (excess) and heavy metals strain the organism with free radicals, EDTA works as an antioxidant.

In the study, mice were given a human form of breast cancer. The mice did not receive EDTA, but a related substance called desferal (desferoxamine) which is an old medication which removes iron from the blood. The question was whether the mice would be better off after, thanks to the desferal, they were drained of their iron deposits. They were!

Desferal halved the cancer growth and was just as effective as the much more poisonous chemotherapy (in this case, doxorubicin, which is commonly used against breast cancer). When the mice received both desferal and the chemotherapy, the cancer inhibiting effect was slightly larger than with each of the two treatments alone.

Antioxidants support chemotherapy
The method of action is unknown. It is known that an excess of iron can create free radicals and that desferal, like EDTA, can be regarded as an antioxidant. But some conditions of the study showed that that was not the determining factor. The explanation is more rather that the fast growing cancer cells need more iron than normal cells. Desferal starves them of iron which stops their growth.

Contrary to the expected, the study said nothing about the combination of chemotherapy and antioxidants. Cancer doctors in Denmark advise against this combination. They believe that chemotherapy works by creating free radicals and that the treatment therefore is ruined by antioxidants such as vitamins E and C, selenium, Q10, etc.

This is rejected by the article as an antiquated way of thinking. Typical chemotherapy (doxorubicin, cisplatin, etc.) does not work by creating free radicals, but by blocking vital enzymes with difficult names such as topoisomerase etc. This has been proven by a number of researchers (see ref.)

It is actually more probable that antioxidants support chemotherapy. In any case, studies have shown that chemotherapy can be weakened by adding free radicals (hydrogen peroxide). It therefore seems wise to get rid of them with antioxidants, and thereby both streamline chemotherapy and make it less poisonous.

The American researchers who published the study (and who, in addition, work for the American Food and Drug Administration) showed, sensationally, that breast cancer cells can be held in check if they are starved of iron. They also believe, based on their own research as well as the research of others, that cancer doctors should sooner ban free radicals than antioxidants.

This is just basic research. In the future there will be clinical trails which may show that this method works on humans.

By: Vitality Council

1. Hoke E.M et al. Desferal inhibits breast tumor growth and does not interfere with the tumoricidal activity of doxorubicin. Free Radical Biology & Medicine 2005;39:403-11.
2. Senturker S et al. Induction of apoptosis by chemotherapeutic drugs without generation of reactive oxygen species. Arch Biochem Biophys 2002;397:262-72.

Perhaps selenium can prevent hereditary breast cancer

May 30, 2005

Women with a genetic tendency towards breast cancer have unstable chromosomes. Studies now show that these chromosomes can be stabilized by taking selenium supplements.
About every twenty cases of breast cancer are due to inheritance. Most often, the cause is an innate mutation in the so-called BRCA1 gene, which, under normal circumstances, repairs damage to chromosomes.

If you carry this mutation, you already have a high risk of breast cancer: Approximately 60% will get the disease before they reach 50, and approximately 85% will get it before they reach 70. At the same time, the risk of ovarian cancer is no less than 60%.

It is a despairing situation to be born with this mutation, which presents the affected with difficult decisions. Some prefer to prevent the cancer by having their breasts and ovaries removed at a young age, while others wait and see if they are among the unlucky ones. Those affected must at least think about having the children they want at a young age if they want to retain the opportunity to breastfeed. There is no certainty as to when the disease will strike.

Now, however, a highly interesting Polish study suggests that the risk can be significantly reduced with a simple supplement of selenium. The supplement drastically reduces the frequency of chromosomal damage in women with the congenital defect. This can, if the results hold, buy the vulnerable women time and reduce their risk of instability in the protective chromosomes.

The experiment was carried out at the Pomeranian Academy of Medicine in Szczecin. It was about measuring the amount of mutations – so-called chromosome breaks – on white blood cells, which in the laboratory were exposed to “chemical radiation” in the form of the chemotherapy drug bleomycin.

Two experiments were performed. In one, chromosome breaks were compared in 26 women with and 26 women without the congenital defect. In the first, 0.59 fractures per cell were measured, while women without the defect had only 0.39.

35 other women, all of whom were carriers of the mutation, now participated in the second trial. Half of them received a daily supplement of approx. 280 mcg selenium a day, after which they had blood samples taken after 1-3 months, so that their blood cells could also be exposed to bleomycin. The result was almost exactly as in the first experiment: In the blood cells of the women who did not receive selenium, 0.63 chromosome breaks occurred per cell, while those who received the selenium had only 0.40 fractures per. cell.

In other words, women with the inherited mutation could increase the stability of their chromosomes to normal with something as simple as a daily selenium supplement. The question then is how this is to be interpreted. Does this mean that they also had their cancer risk reduced?

There are many indications of this, but one cannot be sure. Researchers have concluded that hereditary breast cancer is due in part to unstable chromosomes. Others have found that breast cancer patients have clearly more chromosomal abnormalities in their white blood cells than healthy ones. In addition, several experiments have shown a correlation between the susceptibility to cancer in general and the level of chromosome rupture.

In addition, a study of 3,812 workers who were exposed to mutation-promoting substances showed that those who had the most chromosomal abnormalities were also most likely to get cancer later on. The clues are many.

Selenium has an antioxidant effect and has been shown to be strongly anti-cancer in several trials. As the soil in Poland (just like Denmark) is very low in selenium, the researchers believe that a similar experiment in other countries could give a different result.

The participants received the equivalent of approx. three regular selenium tablets with organic selenium a day. It is a dose that certainly does not exceed what is allowed.

By: Vitality Council

Kowalska E. et al. Increased rates of chromosome breakage in BRCA1 carriers are normalised by oral selenium supplementation. Cancer Epidem Biomarkers Prev 2005;14(5):1302-6.

Breast Cancer may be Caused by Vitamin D Deficiency

October 19, 2004

Women who do not utilize vitamin D well enough will often get breast cancer and fibrocystic breasts are a sign of calcium and vitamin D deficiency.

Much suggests that vitamin D prevents breast cancer. If so, sunlight, which is the overall dominant source of vitamin D, can significantly prevent breast cancer.

The theory is now supported by a new English study that has shown that women who utilize vitamin D badly have doubled the risk of getting breast cancer.

Researchers from St. George’s Hospital in London compared tissue from approx. 400 women with breast cancer with tissue from an equal number of healthy women. In doing so, they discovered that women with aberrant receptors for vitamin D appeared twice as often in breast cancer statistics as others.

It is known that vitamin D exerts a normalizing effect on the cells in e.g. breast tissue. When the vitamin activates a receptor, a regulatory and growth-reducing effect is triggered inside the cell. Experiments have further shown that breast tissue can activate vitamin D so that it chemically matches the receptors. Previously, it was thought that this only happened in the kidneys.

The connection between vitamin D and breast cancer is supported by a new Canadian study of more than 500 40-60-year-old women. Mammograms showed that women with low vitamin D status have four times as many small nodules in their breasts as those who are better supplied with the vitamin.

Both a high intake of vitamin D and plenty of calcium in the diet were statistically very reliably associated with a tendency to nodules. It is already known that lumpy breasts are a pronounced risk factor for breast cancer.

The scientific interest in vitamin D as a remedy against cancer is increasing rapidly. In November, a three-day conference will be held in Maryland, supported by the American Institute of Health (NIH), with numerous presentations from the USA, Canada, France, England, Germany, Belgium, Austria and others. on this subject alone.

The interest was initially stimulated by the fact that the frequency of, among other things, cancer of the colon, prostate and breast is significantly less in sunny countries than in e.g. Denmark, where the sun is so low from October to May that the skin does not produce vitamin D.

Among researchers, strong voices have advocated for several years that the intake of vitamin D should be raised from the 10 micrograms per day recommended for the elderly (younger people are recommended half), to 25 micrograms per day or even more. The 25 micrograms correspond to the content in 10 ml of cod liver oil. Normal Danish diet contains only a few micrograms.

By: Vitality Council


1. Guy M, Lowe LC, Bretherton-Watt D et al. Vitamin D receptor gene polymorphisms and breast cancer risk. Clin Cancer Res. 2004 Aug 15;10(16):5472-81.
2. Bérubé S et al. Vitamin D, calcium, and mammographic breast densities. Cancer Epidemiology, Biomarkers & Prevention. 2004;13(9):1466-72.