Limited effects of selenium substitution in the prevention of radiation-associated toxicities. results of a randomized study in head and neck cancer patients.
B�ntzel J, Riesenbeck D, Glatzel M, Berndt-Skorka R, Riedel T, M�cke R, Kisters K, Sch�nekaes KG, Sch�fer U, Bruns F, Micke O.

Department of Otolaryngology, Head Neck Surgery, Sudharz-Krankenhaus Nordhausen, Nordhausen, Germany. [email protected]

Abstract
OBJECTIVE: The substitution of selenium activates the selenium-dependent enzyme glutathione peroxidase, which is important for scavenging free radicals. To date, only limited data are available about the clinical impact of selenium regarding the toxicities due to free radical producing therapies, e.g. irradiation or chemotherapy, and therefore the objective of this study was to investigate the clinical impact of selenium in such therapies.

PATIENTS AND METHODS: 39 patients (8 female, 31 male) with advanced head and neck cancer were included in a randomised phase II study. The mean age was 63.52+/-9.31 years. Tumour localizations: oral cavity 15 patients, oropharynx 19 patients, hypopharynx 5 patients, carcinoma of unknown primary 1 patient. Group A (n=22) received 500 microg sodium selenite on the days of radiotherapy and 300 microg sodium selenite on days without radiotherapy. Group B (17) was irradiated without any selenium substitution. Both groups were well balanced according to age, gender, localization and stage of the tumour. The RTOG grade of radiation-associated toxicities was evaluated once per week.

RESULTS: The following serious toxicities were observed (group A vs. group B): dysphagia 22.7% vs. 35.3%, loss of taste 22.7% vs. 47.1%, dry mouth 22.7% vs. 23.5%, and stomatitis 36.4% vs. 23.5%. A statistical trend (Fisher's exact test) was only seen for the loss of taste (p=0.172). The weekly patient analysis (Student's t-test) showed a significant reduction of dysphagia in the selenium group (Group 1) at the last week of irradiation.

CONCLUSION: This small randomised trial showed limited effects of selenium in the prevention of ageusia (loss of taste) and dysphagia due to radiotherapy of head and neck cancer.

Interesting

David,
My RO and my nutritionist had me taking zinc (for taste buds) and l-Glutamine (for tissue repair/salivary). My taste came back quickly and 100%, my saliva came back to 85-90% and is not a factor. I think there is some real value in this supplement(s).
Rob

Rob,

How much zinc and l-Glutamine did you take? Any particular brand? I assume you can get both over the counter?

Thanks.

Susan,
I was told to take zinc-150mg/day.
l-Glutamine-Don't remember the exact dose but it was 1 tablespoon of powder daily in a nutritional drink. Contact me personally if you would like more detail.
Regards,
Rob Jaffe

Rob, interesting indeed. Is there any indication from what you've learned that these supplements are of any efficacy post-RT?

d2

Took zinc here too. Was told a multi vitamin such as Centrum would be beneficial too.

David2,
Every time that I see my RO (2x's/yr now) at Beth Israel in NY, he comments on how positively my nutritional plan effected my recovery. My Dentist always comments on how well my mouth and teeth survived the chemo and radiation. I also make a daily drink with 2 nutritional powders, LivingFuel and NewGreens (or BerryFusion). I blend a scoop each with a tbls of coconut oil, fresh or frozen fruit, water and juice. My vitamin supplements now include COQ10, an all natural multi, and vit D3. My lab tests still always come back low on vit D, so 1-2x's/yr my Internist prescribes 50/IU's, once per week for 4 weeks. I suspect that my increased vigilance in using sunscreen, prevents a natural replenishing of vit D.
All the best,
Rob Jaffe

Rob

My doctors have me on CQ10 (100mg daily) but much higher D3 (4000 IU daily)so my blood work is excellent. I was very skeptical of the nutrition claims of Jevity 1.5 but I feel a lot better now that I went to the Living Fuel site and compared their nutritional labels. It was a relief to see that the "secret ingredients" in the LivingFuel powder are plant protein powder and FOS (Fructooligosaccharides). I had been worried about Jevity being mostly Soy & Whey protein and FOS with prebiotics. The label says LF does not use any Soy or Whey or Gluten for its protein powder but brown rice and yellow peas and I'm not allergic to anything.
One cautionary note, I did find that the FDA has had to issue "cautionary letters" to doctors and web sites with that claim [quote]Living Fuel Rx�
�In today�s society people are simply not meeting their nutritional needs. We see evidence of this with the rampant illnesses including cancer, cardiovascular disease, diabetes, autoimmune diseases, etc. Living Fuel Rx is an exceptional countermeasure to this lifestyle, meeting all of your nutritional needs[/quote]
The FDA warning letters state:
[quote]Many of these products may be
legally marketed as dietary supplements if claims about diagnosis, cure, mitigation, treatment, or prevention are removed from the promotional materials and the products otherwise comply with all applicable provisions of the Act and FDA regulations. With regard to your Living Fuel Rx� product, which your website describes as an �optimized superfood meal replacement,� please note that products represented for use as a meal replacement do not meet the definition of a dietary supplement in section 201(ff) of the Act [21 U.S.C. � 321(ff)] and may not be marketed as such.
[/quote]
I know you are NOT making such claims, but since you mentioned this product by name, I felt I should add the FDA warnings about it.
Charm

Charm,
Thank you, I never focused on the LF claims or saw the FDA's letter. I too am very skeptical of any claims made by anyone. I have no relationship with LF except using their product for the last 5 years. They stood out in that their ingredients are pure and extensive. Please don't take my post as any endorsement. I am sure that there are many great products out there, along with those that are a total rip-off. I happened to choose LF because they are very transparent with their igredients and vitamin contents. Many of the other products out there are less detailed.
All the best,
Rob Jaffe
Rob Jaffe