ADT in Prostate Cancer: Managing Cardiovascular Risk - Episode 6
Susan F. Slovin, M.D., Ph.D.: I want to jump ahead and ask you about the role of complementary medicine.
Andy Rochester: Yes.
Susan F. Slovin, M.D., Ph.D.: Because I’m sure in your many studies you’ve already investigated it. I have a lot of respect for alternative and complementary approaches, but sometimes the medications can interfere with the clearance or metabolism of the drugs that we use to treat cancer. Ergo alcohol very often can interfere with liver function and it could also cause toxicity if you happen to be on drugs like abiraterone. Thoughts at all? Sometimes people think the more holistic things they take, the better it is, they’re really building up their immune system. And that somehow tweaks a chord of misery in me because everybody seems to think that all these drugs work on the immune system, and they do indirectly, but don’t expect your B cells and T cells to improve because you’re taking a litany of drugs that I can’t even pronounce.
Andy Rochester: Well they’ve done that with vitamins. If you remember people were years ago very much into taking vitamins, and now there’s been a complete turnabout on vitamins, saying that people are getting problems with too many vitamins, and certain A, D, E, K [multivitamins], etcetera.
But you know what I did was, particularly after the radiation and I was on a different, increased number of pills. I had my box with all the compartments to make sure that I follow through very carefully, because your staff and the radiology staff were very exacting on “you need to take this at this time, you need to do this.” So it’s all very easy to follow the rules. But the catch is that, I also used an app to remind me to make sure that I got all my pills on time. Even if I’d missed it, the app tells you, wait, you can’t have grapefruit juice with this, and you can’t take the aspirin ….
Susan F. Slovin, M.D., Ph.D.: Really?
Andy Rochester: Near your prednisone, etcetera. So the app will catch you if you start to goof. And so to your point, for the basic thing, the rubric of taking all your pills and so forth and making sure you get right pills, right time, and then you have the overlay of the other things. Well, I want to take this too, etcetera. It’s worth reading the materials that come with these drugs because, “Oh, I shouldn’t be drinking grapefruit juice because it’ll bind something.” And hey, guess what? I need to take my statins. Well guess what, you don’t want to take your statins anywhere near calcium because it will inactivate them. There are all these different things. So I have to make sure that I take my statins at a time when, don’t take those right next to my calcium supplement that I take every day.
Now going off the regular drugs and getting on to people’s own approach to taking things, what I mentioned is just taking the regular medications and getting ducks in a row and making sure that it works properly with your food. I’ve taken the approach … that if I’m tempted to do something, I’m going to go look it up in the MSK [Memorial Sloan Kettering Cancer Center] other drugs site, because so many of these things have been addressed.
Should you do this? There’s no experiments on it …. The one that I was interested in is every once in a while instead of just drinking water all the time, I thought, I’d like to have maybe some cardamom and cinnamon in my tea instead of, I just drink a cup of hot water.
So I went straight to the Sloan Kettering site to read about is there anything known about cardamom being a problem, does it interact with anything? How about cinnamon, right?
Susan F. Slovin, M.D., Ph.D.: I’m going to go to you next time.
Andy Rochester: Then I went to a couple of other places and just read about them and said, hey, guess what, I can have, for my situation with the drugs that I’m taking, that’s the asterisk, I can take those things. And so I do it periodically. But I’ve got to tell you, I mentioned earlier that because of the drugs that I’m taking right now, constipation is something you have to watch. Guess what cardamom does? Cardamom soothes the GI [gastrointestinal] system. So part of what I have to do to make my system work is a senna at the end of the day.
So if I have a nice cup of my wonderful cardamom tea in the evening, and then I go around and take the senna, the senna won’t work because the cardamom has already calmed the GI system down so you can’t irritate it with the senna.
Susan F. Slovin, M.D., Ph.D.: Interesting.
Andy Rochester: So all of these things play well together, and here’s something you can say, they come in and the person is miserable and they’re constipated and they can’t figure out why. Well, they started drinking cardamom tea and it’s not listed on any site [as] “non tea.”
Susan F. Slovin, M.D., Ph.D.: It’s very beneficial to know.
Andy Rochester: And I love it, but I just learned not to have it anywhere near my senna. So I’ve taken that approach with other drugs that people offer me, and most of the time I just blame you. I tell them my oncologist would not approve of that. So I cheat. But I think people really need to be very careful about what they put in their bodies. And if it’s a somewhat complex therapy that some of these are, why would you take a chance with your health and just take something because someone said it’s going to help you? If it really helps, everyone would be taking it.
Transcript Edited for Clarity