Category: Breast cancer · Chemotherapy · Herbs and supplements · Drug interactions · Cancer nutrition
Breast Cancer on Chemotherapy: Are Herbs, Supplements, and Vitamins Safe? Liver-Enzyme Drug Interactions, High-Dose Antioxidants, Plant Estrogens, and 4 Safe Nutrition Steps
AI Overview / Quick Answer (BLUF)
Some herbs speed or slow the liver enzymes that clear chemotherapy, pushing drug levels too low to work or too high. High-dose antioxidants may blunt treatment, so tell the oncology team before using any product. A standard-dose multivitamin was not linked to worse outcomes; soy foods are fine.
Complementary and alternative medicine in cancer (National Cancer Institute, NIH) ·
What people with cancer should know before using herbs and supplements (NCCIH, NIH) ·
liver-enzyme interactions · antioxidants · vitamin B12 and iron · soy versus Pueraria mirifica · food · white cells · exercise
·
Urgent symptoms ·
Why caution matters ·
How interactions happen ·
Plant estrogens ·
4 nutrition steps ·
FAQ
Note: in this article, “herbs” and “supplements” mean tablets, capsules, powders, decoctions, or concentrated extracts — not culinary herbs used in ordinary cooking amounts.
A reader’s question: Mom has stage 2 breast cancer and is on chemotherapy — can she take herbs or vitamins?
A community member asked whether her mother, who has stage 2 breast cancer and is receiving chemotherapy, can take herbal medicine, supplements, or vitamins to build strength.
The question comes from love: during treatment many people feel drained and lose their appetite, and families want something that helps.
This article does not diagnose anyone. It answers what families usually ask: why some herbs interact with chemotherapy,
which vitamins carry a warning signal and which do not, whether soy is safe, how to eat, and what actually helps according to evidence, citing research indexed in PubMed.
Go to hospital urgently (Red Flags)
- Fever of 38 °C or higher, or shaking chills during chemotherapy may mean infection with low white cells. Go to hospital right away; do not wait at home.
- Yellow skin or eyes, tea-colored urine, or unusual nausea, especially after starting a new herb or supplement, may signal drug- or herb-induced liver injury.
- Bruising, nosebleeds that do not stop, bleeding gums, or black stools may mean low platelets — call 1669 for heavy bleeding.
- Vomiting or diarrhea that stops eating and drinking for more than 24 hours, very little urine, or fainting on standing.
- Breathlessness, chest pain, unusual palpitations, or swelling of one leg.
- Severe rash, peeling skin, swelling of the lips or face, or trouble breathing after a new product.
- Numbness in the fingers or toes that makes buttons or walking hard — tell the treatment team before the next dose, as the dose may need adjusting.
- Thoughts of death or self-harm, in the patient or the caregiver — in Thailand call the mental health hotline 1323 or 1669, available 24 hours.
If weight drops more than 1 kilogram a week, or intake stays below half of normal for over a week, contact the treatment team before the next appointment.
1. Why herbs and supplements need caution during chemotherapy
How breast cancer chemotherapy works
Common regimens for stage 2 breast cancer are AC (doxorubicin plus cyclophosphamide) followed by a taxane (paclitaxel or docetaxel), or docetaxel plus cyclophosphamide.
These drugs kill fast-dividing cells in different ways: doxorubicin slips into DNA and generates free radicals, cyclophosphamide must first be activated by the liver, and taxanes stop cell division and are cleared by the liver.
Chemotherapy has a narrow window between an effective and a toxic dose (Meijerman 2006), so even a small change in drug level affects both tumor control and side effects.
Not everything is forbidden, but tell the oncology team before using any product
The evidence does not say every product is equally risky. The SWOG S0221 study (Ambrosone 2020) followed 1,134 people with breast cancer receiving cyclophosphamide, doxorubicin, and paclitaxel.
A standard-dose multivitamin was not linked to worse outcomes, but antioxidants, vitamin B12, and iron showed worrying signals, and most herbs have no safety data with chemotherapy at all.
The Society for Integrative Oncology guideline (Greenlee 2017) concluded that no strong evidence supports swallowing supplements to manage breast cancer treatment side effects.
The safe rule is to tell the oncology team before using any product, not to buy and try.
Never use them instead of the main treatment
A US cancer database study (Johnson 2018 JNCI) found that people with breast cancer who chose alternative medicine alone instead of standard treatment had a higher risk of death, with a hazard ratio of 5.68.
Another study (Johnson 2018 JAMA Oncol) found that people who added complementary medicine refused chemotherapy 34.1% of the time versus 3.2%, and the higher death risk was explained by refusing main treatment.
The biggest danger is not only an interaction; it is stopping or delaying chemotherapy because of a belief that herbs can replace it.
2. How interactions happen: liver enzymes, antioxidants, and liver injury
CYP450 liver enzymes decide how long a drug stays in the blood
Docetaxel and paclitaxel are cleared by the enzymes CYP3A4 and CYP2C8, and cyclophosphamide needs several CYP enzymes to become active.
Some herbal compounds switch on receptors in the nucleus of liver cells, which then make more enzymes and drug transporters. The drug is cleared faster, its level drops, and it may work less well without anyone noticing.
Meijerman 2006 listed compounds that may induce enzymes this way, including ginseng, garlic extract, vitamin E, quercetin, beta-carotene, and echinacea. Compounds that block the enzymes do the opposite, keeping the drug in the blood longer and making side effects worse.
Evidence in people: St John’s wort and docetaxel
In a study of 10 cancer patients (Goey 2014), 300 milligrams of St John’s wort extract three times daily for 14 days
raised docetaxel clearance from 47.2 to 53.7 liters per hour and lowered total drug exposure from 3,035 to 2,682 units. The authors concluded the combination should be avoided to prevent undertreatment.
Most Thai herbs, such as Andrographis, Thunbergia laurifolia, or lingzhi, have never been tested for chemotherapy levels in people. No data means we do not know whether it is safe, not that it is safe.
Liver injury: the liver is already working hard during chemotherapy
A report from Ramathibodi Hospital in Bangkok (Wanmuang 2007) described fatal acute liver failure after a patient switched from boiled lingzhi to lingzhi powder for 1–2 months, alongside other medicines.
A single case cannot show how often this happens, but it warns that concentrated forms differ from traditional use. Many chemotherapy drugs are cleared by the liver,
so if liver tests rise, the doctor may need to reduce or delay doses, and telling chemotherapy injury apart from herb injury becomes difficult.
High-dose antioxidants: protecting normal cells, or cancer cells too
Doxorubicin and some other drugs kill cancer cells partly through free radicals. A review by Lawenda 2008 found conflicting randomized trials:
some showed fewer side effects with antioxidants, while other data suggested tumor cells were protected too. The authors advised discouraging supplemental antioxidants during chemotherapy and radiation.
Data from people with breast cancer in SWOG S0221 fit this concern, as shown below.
Data from Ambrosone 2020. Bar length is relative to the reference HR of 1.00. HR 1.41 was close to statistical significance (P = 0.06); vitamin B12 and iron reached significance. All are observational, so they show association, not proof of cause.
A supplement meant to help made numbness worse
The randomized SWOG S0715 trial (Hershman 2013) gave acetyl-L-carnitine 3,000 milligrams a day for 24 weeks to 409 people with breast cancer receiving taxanes, hoping to prevent nerve damage.
Instead, at 24 weeks the supplement group had more numbness than placebo: neuropathy scores were 1.8 points worse, a clear worsening occurred in 38% versus 28%, and severe neuropathy occurred in 8 people versus 1.
The SIO guideline therefore recommends against acetyl-L-carnitine because of possible harm. Something that sounds natural and logical still has to be tested in real patients.
3. Plant estrogens: soy in food is different from concentrated herbs
Soy foods are fine
Many families fear that soy milk or tofu will feed hormone-sensitive breast cancer. But a study of 5,033 people with breast cancer in Shanghai (Shu 2009)
found that those eating the most soy protein had lower recurrence (HR 0.68) and lower mortality (HR 0.71) than those eating the least, in both estrogen receptor–positive and –negative tumors.
Pooled US and Chinese data on 9,514 people (Nechuta 2012) linked at least 10 milligrams of dietary isoflavones a day with lower recurrence, HR 0.75.
So soy foods are fine in normal amounts, such as 1–2 glasses of soy milk or tofu in meals.
Isoflavone pills are a different matter
These findings come from food, not concentrated tablets or capsules, which deliver far higher doses and lack enough safety data in people with breast cancer during treatment. Avoid them unless the treating doctor has assessed the case.
Pueraria mirifica and dong quai: used specifically to mimic hormones
Pueraria mirifica (white kwao krua) is a Thai herb traditionally used as a hormone substitute in menopause. A review of 8 studies in 309 menopausal women (Kongkaew 2018)
found breast pain and vaginal bleeding at rates similar to the estrogen group, no standardized amount of active compounds, and low-quality studies.
When the purpose of a product is to mimic estrogen, it does not suit hormone-sensitive breast cancer. Dong quai has no safety data in breast cancer, so it should also be avoided during treatment.
During chemotherapy, how urgent are the symptoms right now?
This score helps check whether symptoms during cancer treatment — such as fever, nausea that stops eating, heavy fatigue, numb fingers or toes, or yellowing after a new product — fit a pattern that needs the treatment team, how urgent they are, and which signs should not wait.
Analyze severity and get personalized guidance from our Advisory team
Take the Cancer Care Urgency Score (free)
The score sorts urgency only; it is not a diagnostic tool.
Risk table: common herbs and supplements during chemotherapy
| Product | Mechanism | Risk to treatment | Advice |
|---|---|---|---|
| St John’s wort | Induces CYP3A4 | Lower docetaxel levels (Goey 2014) | Do not use during chemotherapy |
| Ginseng, garlic extract, echinacea | May induce enzymes and drug transporters | Unpredictable drug levels (Meijerman 2006) | Avoid extracts; ask the doctor first |
| Lingzhi powder or extract | Reported liver toxicity | Acute liver failure (Wanmuang 2007) | Do not use during chemotherapy |
| Andrographis, Thunbergia laurifolia, decoctions, herbal pills | Unknown ingredients and doses | No data with chemotherapy | Do not start; show the product to the doctor |
| High-dose vitamin C, vitamin E, carotenoids, CoQ10 | Counter the free radicals some drugs use to kill cancer cells | Recurrence HR 1.41 (Ambrosone 2020) | Avoid high-dose pills; fruit and vegetables are fine |
| Self-prescribed vitamin B12 | Mechanism unclear | Worse disease-free survival HR 1.83 (Ambrosone 2020) | Use only for a confirmed deficiency |
| Self-prescribed iron | Mechanism unclear | Recurrence HR 1.79 (Ambrosone 2020) | Use only for confirmed iron deficiency |
| Acetyl-L-carnitine | Intended to prevent nerve damage | More numbness (Hershman 2013) | Do not use (SIO recommends against) |
| Pueraria mirifica | Potent estrogen-like compounds | Breast pain, vaginal bleeding (Kongkaew 2018) | Do not use with breast cancer |
| Dong quai and isoflavone pills | Possible hormone-like effects | No safety data in breast cancer | Avoid during treatment |
| Standard-dose multivitamin | Close to daily requirements | Not linked to worse outcomes (Ambrosone 2020) | Tell the doctor; use if they agree |
| Ginger | Eases nausea alongside antiemetics | 0.5–1.0 g a day reduced acute nausea (Ryan 2012) | Ginger in food is fine; ask before pills, especially with low platelets |
Generic drug names or herb names only; no brand names. A product missing from this table is not automatically safe — bring the actual product to the doctor or oncology pharmacist.
4. Four nutrition and home-care steps during chemotherapy
Step 1: Set protein and energy targets — whole eggs are fine
The ESPEN guideline (Muscaritoli 2021) recommends 1.0–1.5 grams of protein and 25–30 kilocalories per kilogram of body weight per day.
A person weighing 55 kilograms therefore needs about 55–82 grams of protein and 1,375–1,650 kilocalories a day.
Whole eggs are fine and give more energy than egg whites alone. Steamed fish, chicken, tofu, milk, and soy milk are good protein sources, and there is no need to avoid meat. If intake falls short, a complete oral nutrition drink can fill the gap.
Step 2: Five to six small meals, and a plan for nausea
In the 3–5 days after a dose, nausea, poor appetite, and taste changes are common. Small frequent meals add up to more energy, and cold or room-temperature foods smell less than hot dishes.
Take antiemetics on schedule rather than waiting to vomit. A randomized trial of 576 patients (Ryan 2012) found that 0.5–1.0 grams of ginger a day, on top of antiemetics, reduced acute nausea.
Ginger in food or mild ginger tea is fine; ask the doctor before ginger pills.
Step 3: Clean, well-cooked food, without restricting so much that eating stops
When white cells are low, avoid raw or undercooked foods such as soft-boiled eggs, raw shrimp salads, raw fish, and unpasteurized milk, and wash fruit and vegetables well.
Strict restriction, however, does not reduce infection. A meta-analysis of 6 studies and 1,116 patients (Sonbol 2019) and a newer one of 15 studies and 4,320 patients (Jamal 2026)
found no reduction in major infections (RR 1.02). The practical rule is hygiene and thorough cooking, not cutting out fruit and vegetables until eating drops.
The truth about white blood cells
Food does not directly speed white cell recovery. White cells usually reach their lowest point about 7–14 days after a dose and recover on the bone marrow’s schedule. Enough energy and protein help the body tolerate treatment,
but no food or herb has been shown to raise white cells faster. If low counts keep delaying treatment, the doctor may use a G-CSF white cell booster or adjust the dose.
Step 4: Move and look after the mind — better evidence than supplements
A randomized trial of 242 people with breast cancer on chemotherapy (Courneya 2007) found that resistance exercise increased lean mass, strength,
and the rate of completing chemotherapy as planned, without causing arm swelling. Gentle walking for 10–20 minutes a day on days without fever or heavy fatigue is a good start.
The SIO guideline recommends meditation, yoga, music therapy, and stress management for anxiety, and acupressure or acupuncture for nausea.
Families help most by coming along on treatment days, logging symptoms, and listening without pressuring the patient to eat too much.
| Care area | Recommended | Avoid | Benefit |
|---|---|---|---|
| Protein | Whole eggs, steamed fish, chicken, tofu, milk, soy milk | Egg whites only, or cutting out meat without reason | Preserves muscle and treatment tolerance |
| Energy | 5–6 small meals, rice porridge, congee, bread | Cutting all starch or sugar to “starve the cancer” | Stable weight during treatment |
| Food hygiene | Cook thoroughly, wash produce, separate cutting boards | Soft-boiled eggs, raw seafood, unpasteurized milk | Fewer foodborne infections |
| Nausea | Antiemetics on schedule, ginger in food, cool foods | Strong smells, greasy food, large meals | Better intake after each dose |
| Vitamins and minerals | Colorful fruit and vegetables; standard multivitamin if the doctor agrees | High-dose antioxidants, self-prescribed B12 and iron | Nutrients without interfering with drugs |
| Soy | Soy milk and tofu in normal amounts | Isoflavone pills, Pueraria mirifica, dong quai | Protein without added risk in studies |
| Fluids | Frequent sips of clean water, clear soups | Alcohol, concentrated herbal drinks | Supports kidneys and eases constipation |
| Movement | Gentle walking, stretching, light resistance exercise | Heavy exertion on days with fever or low platelets | Keeps muscle; more complete chemotherapy |
Summarized from Muscaritoli 2021, Sonbol 2019, Jamal 2026, Ryan 2012, and Courneya 2007. Actual amounts must be adjusted to blood counts, liver and kidney tests, blood sugar, and dietitian advice.
and the questions “which should stop during chemotherapy?”, “which can continue?”, and “if I truly lack a vitamin or iron, what dose should I take?”
Comparing care options during chemotherapy: standard drugs, supplements, and lifestyle
| Option | Goal | Evidence | Notes |
|---|---|---|---|
| Chemotherapy as planned (e.g., AC then a taxane) | Lower recurrence | Standard treatment; refusing it raises death risk (Johnson 2018) | Do not delay or stop it for herbs |
| Antiemetics (5-HT3 antagonists, NK1 antagonists, dexamethasone) | Prevent nausea and vomiting | Background therapy in all trials, including Ryan 2012 | Take on schedule, not after vomiting starts |
| G-CSF white cell boosters | Fewer fevers from low white cells; doses on time | Used according to regimen risk | May cause bone pain; doctor decides |
| Complete oral nutrition drinks | Top up energy and protein | ESPEN guideline (Muscaritoli 2021) | Choose a formula that fits blood sugar and kidney tests |
| Ginger in food | Extra nausea relief | 0.5–1.0 g a day in 576 patients (Ryan 2012) | Ask before using pills |
| Resistance and aerobic exercise | Keep muscle, ease fatigue | Higher chemotherapy completion (Courneya 2007) | Skip on days with fever or low platelets |
| Meditation, yoga, music therapy, acupressure | Less anxiety and nausea | Recommended by SIO (Greenlee 2017) | Can be combined with treatment |
| Standard-dose multivitamin | Basic nutrient top-up | Not linked to worse outcomes (Ambrosone 2020) | Tell the doctor first |
| Self-prescribed high-dose antioxidants, B12, iron | Sellers claim strength or fewer side effects | Linked to worse outcomes, HR 1.41–1.83 (Ambrosone 2020) | Only for a confirmed deficiency |
| Herbs or alternative medicine instead of chemotherapy | Sellers claim they treat cancer | Higher death risk, HR 5.68 in breast cancer (Johnson 2018) | Never a replacement for standard treatment |
Generic drug names or drug classes only; no brand names. Treatment choices must be assessed by the treating team.
Common beliefs versus the evidence
“Herbs are natural, so they cannot affect medicines”
Herbs contain active compounds that the liver must process just like drugs. Some induce enzymes enough to lower chemotherapy levels, and concentrated powders have caused liver failure.
“Every vitamin is dangerous during chemotherapy”
A standard-dose multivitamin was not linked to worse outcomes in SWOG S0221. The worrying signals came from high-dose antioxidants and self-prescribed vitamin B12 and iron.
“People with breast cancer must avoid soy milk and tofu”
Large studies found lower recurrence among people who ate more soy food. What to avoid are concentrated pills and herbs used to mimic estrogen.
“Eat only egg whites and avoid meat during chemotherapy”
Whole eggs are fine and give more energy. Well-cooked meat is a good protein source. Cutting out many food groups makes it hard to reach targets and leads to weight loss.
“Eating lots of tonics will bring white cells up in time”
White cells recover on the bone marrow’s schedule. Food helps the body tolerate treatment but does not directly raise counts; when needed, the doctor uses a white cell booster or adjusts the dose.
Frequently asked questions (FAQ)
Can someone with breast cancer take herbs or dietary supplements during chemotherapy?
Do not start anything on your own, and tell the oncology team before using any product. Many herbs and supplements change the liver enzymes that clear chemotherapy, some damage the liver, and some are linked to higher recurrence. That does not mean everything is forbidden: in the SWOG S0221 study, a standard-dose multivitamin was not linked to worse outcomes, and doctors may prescribe a vitamin or iron when a blood test shows a true deficiency. The safest step is to bring every actual bottle to the oncologist or oncology pharmacist.
Why can some herbs make chemotherapy weaker or more toxic?
Several breast cancer drugs are processed by CYP450 liver enzymes: docetaxel and paclitaxel use CYP3A4 and CYP2C8, and cyclophosphamide must be activated by the liver. Herbs that speed up these enzymes clear the drug faster and lower its level. In a study of 10 patients, St John’s wort raised docetaxel clearance from 47.2 to 53.7 liters per hour. Herbs that block the enzymes keep the drug in the body longer and make side effects worse. Chemotherapy has a narrow window between an effective and a toxic dose, so small changes matter.
Do high-dose vitamin C, vitamin E, or CoQ10 really weaken chemotherapy?
It is not proven either way, but there is a warning signal. Doxorubicin and some other drugs kill cancer cells partly through free radicals, so high-dose antioxidants could protect cancer cells too. In the SWOG S0221 study of 1,134 people with breast cancer, using antioxidants both before and during chemotherapy was linked to higher recurrence, with a hazard ratio of 1.41 that was close to statistical significance. Reviewers therefore advise avoiding high-dose antioxidant pills during chemotherapy. Fruits and vegetables in normal meals are fine.
Are a multivitamin, vitamin B12, and iron safe during chemotherapy?
In SWOG S0221, a standard-dose multivitamin was not linked to worse outcomes. Taking vitamin B12 both before and during chemotherapy was linked to worse disease-free survival, with a hazard ratio of 1.83, and iron during chemotherapy was linked to recurrence, with a hazard ratio of 1.79. These are observational findings and do not prove cause. The practical rule is not to self-prescribe, but if blood tests show a real B12 or iron deficiency, treatment ordered by the doctor is still needed.
Can people with breast cancer eat soy, soy milk, or tofu, and why are Pueraria mirifica and dong quai a concern?
Soy foods are fine. In a Shanghai study of 5,033 people with breast cancer, the group eating the most soy protein had lower recurrence, with a hazard ratio of 0.68, in both hormone-sensitive and hormone-insensitive tumors, and pooled data from 9,514 people pointed the same way. Concentrated isoflavone pills are different and lack safety data. Pueraria mirifica is used as an estrogen substitute, with reports of breast pain and vaginal bleeding and no standard dose of active compounds. Dong quai has no safety data in breast cancer, so neither should be used during treatment.
How much protein is needed during chemotherapy, and should someone eat only egg whites?
The ESPEN guideline recommends 1.0 to 1.5 grams of protein and 25 to 30 kilocalories per kilogram of body weight per day. A person weighing 55 kilograms therefore needs about 55 to 82 grams of protein and 1,375 to 1,650 kilocalories a day. Whole eggs are fine and give more energy than egg whites alone. Fish, chicken, tofu, milk, and soy milk are good protein sources. If intake falls short, a complete oral nutrition drink can fill the gap.
What can I eat to raise white blood cells in time for the next dose?
Food does not directly speed white cell recovery. White cells usually reach their lowest point about 7 to 14 days after a dose, then the bone marrow recovers on its own schedule. Eating enough energy and protein helps the body tolerate treatment, but no food or herb has been shown to raise white cells faster. If low counts keep delaying treatment, the doctor may use a G-CSF white cell booster or adjust the dose.
Which symptoms during chemotherapy need urgent hospital care?
A fever of 38 degrees Celsius or higher or shaking chills, yellow skin or eyes or tea-colored urine, unusual bruising or bleeding, vomiting or diarrhea that stops eating and drinking for more than 24 hours, breathlessness or chest pain, a severe rash or lip swelling after a new product, and thoughts of self-harm. Numbness in the fingers or toes that makes buttons hard to fasten should be reported to the treatment team before the next dose.
Scientific mechanism: why something meant to strengthen can change how the drugs work
Summary by Asst. Prof. Dr. Norawit Raatpiboon:
chemotherapy works when blood levels are high enough to kill cancer cells within a set time, but not so high that they overwhelm the bone marrow and nerves.
Some herbal compounds bind receptors in the nucleus of liver cells, such as the pregnane X receptor, which then tell the liver to make more CYP3A4 and drug transporters over several days.
The drug is cleared faster and its level falls without any warning symptom. Compounds that block the enzymes do the reverse, keeping the drug in the body longer until white cells fall and numbness worsens.
High-dose antioxidants act through a different route. Doxorubicin generates free radicals that damage the DNA and membranes of cancer cells; large amounts of antioxidants may reduce that damage in both normal and cancer cells.
Meanwhile, estrogen-like compounds from concentrated herbs can bind estrogen receptors on hormone-sensitive breast cancer cells. Good care therefore means supplying energy and protein through food,
correcting a deficiency only when one is found, and using proven ways to reduce side effects, instead of adding active compounds with unknown effects on the drugs.
E-E-A-T and academic citations
Written and reviewed by Asst. Prof. Dr. Norawit Raatpiboon (ผศ.ดร.นรวิชญ์ ราษฎร์พิบูลย์)
from research and clinical guidelines indexed in PubMed.
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- Lawenda BD, et al. Should supplemental antioxidant administration be avoided during chemotherapy and radiation therapy? J Natl Cancer Inst. 2008. PubMed 18505970
- Meijerman I, et al. Herb-drug interactions in oncology: focus on mechanisms of induction. Oncologist. 2006. PubMed 16880233
- Goey AK, et al. The effect of St John’s wort on the pharmacokinetics of docetaxel. Clin Pharmacokinet. 2014. PubMed 24068654
- Wanmuang H, et al. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007. PubMed 17621752
- Hershman DL, et al. Randomized double-blind placebo-controlled trial of acetyl-L-carnitine for the prevention of taxane-induced neuropathy in women undergoing adjuvant breast cancer therapy. J Clin Oncol. 2013. PubMed 23733756
- Greenlee H, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. 2017. PubMed 28436999
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- Ryan JL, et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Support Care Cancer. 2012. PubMed 21818642
- Sonbol MB, et al. Neutropenic diets to prevent cancer infections: updated systematic review and meta-analysis. BMJ Support Palliat Care. 2019. PubMed 30948447
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Medical disclaimer
This article is educational information, not a diagnosis, prescription, or personal medical advice.
Starting, stopping, or changing chemotherapy, antiemetics, white cell boosters, vitamins, iron, supplements, or herbs must be supervised by the treating doctor, pharmacist, and dietitian.
If any symptom in the urgent symptoms section appears, go to hospital promptly. If there are thoughts of self-harm, in Thailand call 1323 or 1669.