Frequently Asked Questions

Can you provide a list of all chemotherapy drugs called alkylating agents that may potentially have interactions with antioxidant supplements during chemotherapy?

The question of potential harm vs. benefits of supplementing with antioxidants while undergoing chemotherapy is not yet resolved. Alkylating agents, like BCNU and Cytoxan, are believed to act by the induction of large amounts of free radicals within the cancer cell, which contribute to disruption of the cancer cell's growth. Thus concern has been raised about the potential for anti-oxidant supplements to decrease the effectiveness of this type of chemotherapy. There is a more extensive discussion of this concern on my web site at the following location:
http://www.CancerRD.com/FAQs/FAQ37.htm

The following list of chemotherapeutic alkylating agents has been put together by Christine Ingram, RD of Joliet Oncology-Hematology Associates, LTD.,
Joliet, IL and is reprinted with permission.

Alkylating Agents
Altretamine (Hexalen)
Asaley
AZQ (carbamic acid, diaziquone)
BCNU (carmustine)
Bisepoxide dianhydrogalactitol
Busulfan (myleran, BSF)
Carboxyphthalatoplatinum
CBDCA (carboplatin, paraplatin)
CCNU (lomustine, CeeNu)
CHIP (iproplatin)
Chlorambucil (leukeran)
Chlorozotocin
Cis-platinum (cisplatin, platinol)
Clomesone
Cyanomorpholinodoxorubicin
Cyclodisone
Cyclophosphamide (cytoxan)
Dianhydrogalactitol
Fluorodopan
Gliadel wafer (proliferprosan 20 with carmustine implant)
E09
Estramustine phosphate sodium (emcyst)
Hepsulfam
Hexamethylmelamine
Hycanthone
Ifosfamide (IFEX)
Mechlorethamine (mechlorethamine hydrochloride, mustargen, nitrogen mustard)
Melphalan (L-PAM, alkeran)
Mesna
Methyl CCNU (semustine)
Mitomycin C
Mitozolamide
Oxaliplatin
PCNU
Piperazine
Piperazinedione
Pipobroman
Poperazinedione
Porfiromycin
Procarbazine (matulane)
Spirohydantoin mustard
Streptozocin (zanosar)
Temodar (temozolomide)
Teroxirone
Tetraplatin
Thiophosphoramide
Thio-tepa (thioplex, TSPA, TESPA, triethylenethiophosphoramide)
Triazinate
Triethylenemelamine
Uracil nitrogen mustard
Yoshi-864

No responsibility will be assumed for use of this list of alkylating agents for any purpose without expressed written permission by Joliet Oncology-Hematology Associates, LTD.
2420 Glenwood Ave, Joliet, IL. 60435 815-725-1355.

Resources:
1. DTP Human Tumor Cell Line Screen: Anti-cancer Agents by Mechanism; Alkylating Agents. National Cancer Institute. Available at: http://dtp.nci.nih.gov/docs/cancer/searches/standard_mechanism_list.html. Accessed on August 28, 2002.
2. Alkylating Agent. Family Practice Notebook. Available at: http://www.fpnotebook.com/HEM156.htm. Accessed on August 28, 2002
3. Cancer Chemotherapy Guidelines and Recommendations For Practice 1999 (2nd edition). Oncology Nursing Society. Oncology Nursing Press, Inc.
4. Alkylating agents. DigitalMeD PDR. Available at: http://services.digitalmed.com/tenet/pdr/. Accessed on August 30, 2002.
5. Itano JK, Taoka KN. Core Curriculum For Oncology Nursing 1998 (3rd edition). Oncology Nursing Society. WB Saunders Company. Philadelphia, PN.
6. Oncology Prescribing Guide; PDR 2002 2nd edition. Thomson Medical Economics. Montvale, NJ.p. 173-212.
7. Alkylating Agents in the Standard Agent Database. National Cancer Institute at Fredrick. Available at http://dtpsearch.ncifcrf.gov/DOCS/COMPARE/examples/alkyl.html. Accessed on August 30, 2002.
8. Mechanisms of Action of Quinone-Containing Alkylating Agents I: NQO1-Directed Drug Development. Beall HD, Winski SL. Available at: www.bioscience.org/2000/v5/d/beal/fulltext.htm. Accessed on August 27, 2002.
9. Clinisphere, Pharmacological Drug Software. Facts and Comparisons, Alkylating Agents, 2002.
10. Cancer Drug Manual. BC Cancer Agency Care and Research. Available at www.bccancer.bc.ca/HPI/DrupDatabase/DrugIndexALPro/Oxaliplatin.htm. Accessed on September 9, 2002.

Check it for either the generic name or the trade (brand) name of the drug you are looking for. If you do not see the drug you are looking for, double-check with your oncologist or oncology pharmacist before assuming that it is not an alkylating agent.

If you are a patient reading this list for your own personal use, please discuss with your physician the use of antioxidant (and other dietary) supplements along with any additional complementary or alternative therapies you may choose to use as your means of fighting this disease.

Diana Dyer, MS, RD

FAQ posted 10/02

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Back to Main QandA Page Nutritional Concerns during Cancer Treatment (related to side effects) Can you provide a list of all chemotherapy drugs called alkylating agents that may potentially have interactions with antioxidant supplements during chemotherapy? posted 10/02 Dear Diana, I am undergoing treatments for cancer and am not eating well. What should I do? posted 7/01 Can I drink your soy shake recipes if my oncologist or dietitian has recommended that I follow a neutropenic diet due to my low white blood cell counts? posted 5/00, updated 7/01, updated 11/02, updated 8/03 Should I consume antioxidants during my cancer therapy? posted 12/01, updated 10/02 Can herbs interact with any of the chemotherapy drugs? posted 4/01, updated 9/02 Are there any diet changes to help relieve bloating during abdominal radiation? posted 4/03 Do you have diet suggestions for someone who has diarrhea after radiation therapy for rectal cancer? posted 1/04, updated 4/04, 11/04, 1/05 Is it safe to drink green tea if I have a port for administration of my chemotherapy? posted 1/04 Can you tell me foods to eat to reduce the acid in my urine and pain in my bladder and ureters? posted 2/04, updated 5/05 How can I eat a diet as healthy as you suggest if I need to be hospitalized for more than a day or two? posted 3/04 My husband is having chemotherapy treatments and has lost his sense of taste after one treatment. Are there any foods I can prepare that will give him some relief? posted 9/04 Is there a good web site describing the nutrition related side effects from chemo drugs? posted 10/04 Should I stop drinking green tea during chemotherapy to avoid consuming too many antioxidants? posted 7/05 How can I use the diet recommendations on your web site and in your book to both increase my intake of cancer fighting foods for optimizing my cancer recovery and lose weight at the same time? posted 3/06 What tips do you have to stay on a healthy diet during the holiday season? posted 11/06   Back to Main QandA Page Vitamins I have recently seen a lot of news articles about the relationship between vitamin D and cancer prevention. Should we all run out and get more Vitamin D supplements? posted 2/06 I am being treated for bladder cancer. I have heard that vitamins that might help me reduce my risk of recurrence. Do you know anything about this? posted 8/02 , updated 11/05 Do you have recommendations for herbs and vitamins that children should use to recover from a bone marrow transplant? posted 3/05 Can you provide a list of all chemotherapy drugs called alkylating agents that may potentially have interactions with antioxidant supplements during chemotherapy? posted 10/02 Should I consume antioxidants during my cancer therapy? posted 12/01, updated 10/02 Should I stop drinking green tea during chemotherapy to avoid consuming too many antioxidants? posted 7/05 I have recently heard that Vitamin A may be linked to osteoporosis. I see Vitamin A in nearly everything on food labels, even my soymilk. What is the connection and how much should I be consuming? posted 5/02, updated 2/03

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These questions and answers are intended to be of a general informative nature. Please consult with the Registered Dietitian in your cancer center or your health care provider for nutritional advice that can be individualized to your specific medical condition.