CA Cancer J Clin 2001; 51:209
doi: 10.3322/canjclin.51.4.209
© 2001 American Cancer Society
VITAMINS C AND E DIMINISH RADIATION PROCTITIS SYMPTOMS
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Vitamins C and E reduce chronic radiation proctitis symptoms.
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Vitamins C and E were effective in significantly reducing chronic radiation proctitis in pelvic cancer survivors within six weeks, according to a report in The American Journal of Gastroenterology (2001;96:1080-1084).
In a preliminary, small-scale study of 10 prostate cancer survivors and 10 gynecologic cancer survivors suffering from chronic radiation proctitis, the vitamins were able to diminish symptoms of diarrhea, rectal bleeding, and fecal urgency. A substantial percentage of these patients said the impact of this condition on their lifestyle decreased or disappeared when they took the vitamins.
For most people who experience radiation proctitis, the condition usually clears up within a few weeks of treatment. But in 10% to 20% of the patients, it persists. "Radiation proctitis can be a very disabling condition for many people, and antioxidant treatment [with vitamins E and C] makes a lot of sense," says co-author Ece A. Mutlu, MD. "Our evidence suggests it may possibly work as a first-line treatment for patients who experience diarrhea, urgency, or fecal incontinence." Mutlu is a gastrointestinal disease fellow in the division of digestive diseases at Rush Presbyterian St. Luke’s Medical Center, in Chicago.
The aim of this study was to determine whether these antioxidant vitamins, by counteracting oxygen free radical injury, would relieve the symptoms of chronic radiation proctitis.
| Within two to six weeks after starting vitamin C and E, most of the patients in the study reported symptom improvements.
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Less Symptom-Related Inconvenience Reported After Treatment
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 Less Symptom-Related...
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All participants in the study had symptoms of rectal pain, bleeding, or diarrhea present for at lest six months, and all had failed to respond to other treatments, including oral sulfasalazine/mesalamine, glucocorticoids (orally or by enema), or 5-ASA enemas. These treatments were discontinued upon entering the study, and all patients received 400 IU vitamin E and 500 mg vitamin C, both taken orally three times daily, for eight weeks.
Within two to six weeks after starting the vitamins, most reported symptom improvements, based on self-reporting of symptom severity and frequency. For example, 14 of 16 patients reported less diarrhea (the two who did not also had radiation ileitis), and 8 said their diarrhea stopped completely. Among patients with rectal bleeding or fecal urgency, these symptoms completely resolved in 36% and 19%, respectively.
Two thirds of patients who initially reported that symptoms affected their lifestyle noted less symptom-related inconvenience after treatment. Seven patients reported returning to their usual lifestyle after treatment.
In using vitamins C and E, timing is very important, says David Rosenthal, MD, a professor of medicine at Harvard Medical School, and director of the Zakim Center for Integrative Therapies at the Dana-Farber Cancer Institute. "There is some evidence from in vitro and animal studies that suggests taking high levels of antioxidants at the same time you are actually receiving radiation therapy might reduce effectiveness of the treatment."
