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Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.
Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor or nurse, as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment.
1. What is Coenzyme Q?
Coenzyme Q is used by cells to produce energy needed for
cell growth and maintenance. It is also used by the body as an
antioxidant. An antioxidant is a substance that protects cells
from chemicals called free radicals. Free radicals are highly
reactive chemicals that can damage important parts of cells,
including deoxyribonucleic acid (DNA). (DNA is a molecule
inside cells that carries genetic information and passes it
from one generation to the next.) This damage may play a role in
the development of cancer.
Coenzyme Q is found in most body tissues. The highest
amounts are found in the heart, liver, kidneys, and
pancreas. The lowest amounts are found in the lungs. Tissue
levels of coenzyme Q decrease as people get older.
Coenzyme Q was first identified in 1957. Its chemical
structure was determined in 1958. Interest in coenzyme Q as a
potential treatment for cancer began in 1961, when a deficiency of
the enzyme was noted in the blood of cancer patients. Low blood
levels of coenzyme Q have been found in patients with
myeloma, lymphoma, and cancers of the breast, lung,
prostate, pancreas, colon, kidney, and head and neck.
Studies have yielded information about how coenzyme Q works in
the body to produce energy and act as an antioxidant. Some studies
have suggested that coenzyme Q stimulates the immune
system and increases resistance to disease. In part because of
this, researchers have theorized that coenzyme Q may be useful
as an adjuvant therapy for cancer. (Adjuvant therapy is
treatment given following the primary treatment to enhance the
effectiveness of the primary treatment.)
3. How is coenzyme Q administered?
Laboratory studies of coenzyme Q have focused on describing
its chemical structure and how it works in the body. Animal
studies have found that coenzyme Q stimulated the immune
system and increased resistance to disease. Coenzyme Q helped
to protect the hearts of animals given the anticancer drug
doxorubicin, which can cause damage to the heart muscle.
5. Have any clinical trials (research studies in humans) been
conducted with coenzyme Q?
The promising results from animal studies of coenzyme Q and
the anticancer drug doxorubicin led researchers to test coenzyme
Q in a randomized clinical trial with 20 patients. (A
randomized clinical trial is a study in which the participants are
assigned by chance to separate groups that compare different
treatments; neither the researchers nor the participants can
choose which group.) The researchers examined whether coenzyme
Q would protect the heart from the damage caused by
doxorubicin. The results of this trial and others have confirmed
that coenzyme Q decreases the effects of doxorubicin on the
heart. However, no report of a randomized clinical trial of
coenzyme Q as a treatment for cancer has been published in a
peer-reviewed, scientific journal.
6. Have other studies of coenzyme Q been conducted in people?
Three other small studies were conducted using coenzyme Q as a dietary supplement in patients undergoing conventional cancer treatment. In these studies, the researchers explored the potential use of coenzyme Q as an adjuvant therapy for cancer.
There have also been anecdotal reports that coenzyme Q has
increased the survival of patients with cancers of the pancreas,
lung, colon, rectum, and prostate. (Anecdotal reports are
incomplete descriptions of the medical and treatment history of
one or more patients.) The patients described in these reports
also received treatments other than coenzyme Q, including
chemotherapy, radiation therapy, and surgery.
7. Have any side effects or risks been reported from coenzyme Q?
No serious side effects have been reported from the use of
coenzyme Q. Some patients using coenzyme Q have
experienced mild insomnia (inability to sleep), elevated levels of
liver enzymes, rashes, nausea, and upper abdominal pain. Other
reported side effects have included dizziness, visual sensitivity
to light, irritability, headache, heartburn, and fatigue.
Patients should talk with their health care provider about
possible interactions between coenzyme Q and prescription
drugs they may be taking. Certain drugs, such as those that are
used to lower cholesterol or blood sugar levels, may reduce the
effects of coenzyme Q. Coenzyme Q may also alter the
body's response to warfarin (a drug that prevents the blood
from clotting) and insulin.
8. Are there any other potential drawbacks to taking coenzyme Q?
As noted in question 1, coenzyme Q is used by the body as an
antioxidant. Antioxidants protect cells from free radicals, which
are highly reactive chemicals that can damage cells. Some
conventional cancer therapies, such as anticancer drugs and
radiation treatment, kill cancer cells in part by causing free
radicals to form. Researchers are studying whether using coenzyme
Q along with conventional therapies is positive (i.e., does
not interfere with the effects of the conventional therapies, or
increases the therapies' beneficial effects on cancer cells while
protecting normal cells) or negative (i.e., interferes with the
therapeutic effects).
9. Has the Food and Drug Administration (FDA) approved coenzyme Q
for use in the United States?
Several companies distribute coenzyme Q as a dietary
supplement. In the United States, dietary supplements are
regulated as foods, not drugs. This means that evaluation and
approval by the FDA are not required before marketing, unless
specific health claims are made about the supplement. It should be
noted that, because dietary supplements are not formally reviewed
for manufacturing consistency, there may be variation in the
composition of the supplement from one batch to another.
Also, to conduct clinical drug research with humans in the United
States, researchers must file an Investigational New Drug (IND)
application with the FDA. Because an IND application is highly
confidential, it is not known whether one has been submitted or
approved for the study of coenzyme Q as a treatment for
cancer.
10. When considering complementary and alternative therapies, what
questions should patients ask their health care provider?
NCCAM and the NIH National Library of Medicine (NLM) jointly
developed CAM on PubMed, a free and easy-to-use search tool for
finding CAM-related journal citations. As a subset of the NLM's
PubMed bibliographic database, CAM on PubMed features more than
230,000 references and abstracts for CAM-related articles from
scientific journals. This database also provides links to the Web
sites of over 1,800 journals, allowing users to view articles in
full-text. (A subscription or other fee may be required to access
full-text articles.) CAM on PubMed is available through the NCCAM
Web site at Http: //nccam.nih.gov. It can also be accessed at
Http: //www.ncbi.nlm.nih.gov/PubMed by selecting "Limits" and
choosing "Complementary Medicine" as a subset.
The NCI Office of Cancer Complementary and Alternative Medicine
(OCCAM) coordinates the activities of the NCI in the area of
complementary and alternative medicine (CAM). OCCAM supports CAM
cancer research and provides information about cancer-related CAM
to health providers and the general public via its Web site
Http: //cancer.gov/cam on the Internet.
The Food and Drug Administration (FDA) regulates drugs and medical
devices to ensure that they are safe and effective.
Food and Drug Administration
5600 Fishers Lane
Rockville, MD 20857
Telephone: 1-888-463-6332 (toll free)
Web site: Http: //www.fda.gov/
The Federal Trade Commission (FTC) enforces consumer protection
laws. Publications available from the FTC include:
The information in this fact sheet is not presented as a substitute for informed medical advice. If you have any questions about your individual medical situation, please contact your doctor.
This fact sheet was reviewed on 10/10/01
You may want more information for yourself, your family, and your doctor. The following National Cancer Institute (NCI) services are available to help you.
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These web sites may be useful:
Http: //www.nci.nih.gov - NCI's primary web site; contains information about the Institute and its programs.
Http: //cancernet.nci.nih.gov - CancerNet; contains material for health professionals, patients, and the public, including information from PDQ about cancer treatment, screening, prevention, genetics, supportive care, and clinical trials, and CANCERLIT, a bibliographic database.
Http: //cancertrials.nci.nih.gov - cancerTrials; NCI's comprehensive clinical trials information center for patients, health professionals, and the public. Includes information on understanding trials, deciding whether to participate in trials, finding specific trials, plus research news and other resources.
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