Tuesday, October 27, 2009

Immune weakness in a post Herceptin Treatment patient

I have been seeing a patient who recently stopped Herceptin. She was diagnosed with Her2/neu breast cancer and then a subsequent tumor on her spine. Recently she has had 4 minor infections in the past few months. The most recent was oral thrush. I recommended she treat it with a combination of diluted grapefruit seed extract, swishing and swallowing and acidophilus swishing and swallowing. I also gave her an astragalus based herbal formula.

The patient was not sure if i had diagnosed this correctly so she went to her ENT MD who also diagnosed it the same. He wrote her a prescription for Diflucan, an antifungal drug. The patient then called me up to ask if any of the herbs would interact with Diflucan. Good question. This is what I found in my search from a pharmacist/author John Chen whom I know is experienced with herbs:

On the other hand, drugs that inhibit liver metabolism have an immediate onset of action. The rate of liver metabolism may be greatly impaired within a few days. Therefore, there is a higher risk of herbs accumulating inside the body as the function of the liver to inactivate them is compromised. Examples of drugs that slow down or inhibit liver metabolism include, but are not limited to, Tagamet (cimetidine), erythromycin, ethanol, Diflucan (fluconazole), Sporonox (itraconazole) and Nizoral (ketoconazole). Therefore, the herbs may be inactivated more slowly and the overall effectiveness may be prolonged. In this case, one may need to lower the dosage of herbs to avoid unwanted side-effects. see complete article

After I explained to the patient that it was not a good idea to take herbs with Diflucan and why, the patient asked me what she should do. I told her to try the natural treatment over the weekend, rest and follow an antifungal diet (no sweets, alcohol, glutenous grains or fermented foods etc...) if it did not help than go on the drug. I saw the patient again today and thankfully the mouth sores were significantly better.

The question of why this patient is getting frequent infections and showing signs of weak immune system function is an interesting one and I will see how I can get her to feel better and hopefully prevent her cancer from returning by improving her overall functional health. One small victory today was good, very good.

Having had thrush as a teenager I know how painful this can be.