Gallbladder

Gallbladder cancer is poorly researched, and its worthwhile reviewing the Supplements Library for inspiration beyond the list here. Nevertheless, there are a few useful supplements and dietary considerations based on research findings of improved treatment results. Whilst mostly the evidence here is indirect, there is validation for a lot of these supplements coming increasingly from other cancers. And they tend to reduce drug side effects.

Multiple analysis of large scale patient records show low dose aspirin is an effective addition to oncology treatment programs for biliary cancers including gallbladder. Data also confims the value of post-diagnostic use. Hepatobiliary cancers including gallbladder cause dysregulation of iron balance, or homeostasis, which they switch up in order to progress and spread. Analysis of patient records shows substantial effects on outcomes. A milk derived pre-biotic, lactoferrin, can counter this as it is a natural regulator of iron metabolism. Similarly, copper can also be upregulated by cancers to support growth rate needs, in gallbladder patients lower levels predict improved outcomes. Citrus Pectin can products that include alginates from seaweed can bind heavy metals and help restore copper balance. Additionally there are actions that might be relevant to gallbladder cancer too.

Poorly functioning glucose and lipid metabolism are reported as high risk markers for disease progression. Low glucose for instance reduces overall risks by more than 60%. Berberine is a well known natural anti-diabetic and has evidence of improving metabolic health in both areas. Emerging in anti-aging science Urolithin A is reported to improve fatty acid uptake, including specific acylcarnitine levels reported as elevated in gallbladder cancer progression.

Systemic inflammation is linked with increased risks for progression, especially in later stages. Both acute type inflammatory responses measured by C-reactive protein, and immune system related neutrophil-to-lymphocyte ratios (NLR). Maintaining relatively lower levels of both make a substantial difference. Astragalus root has evidence of improving immune system balance during oncology, reducing NLR while curcumin and other other functional foods including garlic can help bring down CRP, also seen with use of lactoferrin.

The so called Th1/Th2 immune system balance is strongly linked to the progression in gallbladder cancer, and to treatment resistance. Molecular iodine solutions are emerging in this area in breast cancer management, seen boosting Th1 anti tumor activity and helping suppress over active Th2 used in resistance. This has improved results in surgery plus chemotherapy and may support increased responses during immunotherapy (see Supplement Library). For immunotherapy the presence of high sodium levels is now identfied as a key marker for success in other cancers. Also in other cancers, AM treatment programs are substantially more effective that PM/evening sessions

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Aspirin has a majority of analysis in its favor including all-cause mortality

Nearly 3000 patient records of which 9% aspirin users
Around 40% improved relative survival with aspirin use
Slightly higher for those starting aspirin after diagnosis

We aimed to examine aspirin use on cancer‐specific survival in various BTC [Biliary Tract Cancers], including gallbladder cancer, ampulla of Vater cancer, and cholangiocarcinoma..The nationwide study revealed that postdiagnosis aspirin use was associated with improved BTC‐specific mortality of various subtypes. The findings suggest that additional randomized trials are required to investigate aspirin’s efficacy in BTC.

Lactoferrin increases iron balance and reduces anemia rates, countering cancers use of iron

Dysfunctional iron balance, homeostasis, increases progression rates
This study indicates a 60% increased cancer specific mortality rate
Even worse 70% increased relative risk of progression and recurrence

Elevated pretreatment SF [serum ferritin] was associated with worse OS and RFS/PFS/TTR in patients with HBP [includes gallbladder] cancers. Subgroup analysis further revealed that high SF was significantly associated with shorter OS in patients with HBP cancers regardless of cancer type, race, SF cut-off value, TNM stage and NOS score. Consequently, pretreatment SF may be considered as an available prognostic biomarker for patients with HBP cancers. These results were proved to be credible and stable based on sensitivity analysis.

Berberine evidence in metabolic health may help counter cancers use of lipids and sugars to grow

Relatively lower fasting blood glucose can radically affect prognosis
Both relative overall and recurrence free survival more than doubled
Berberine is a well proven natural anti-diabetic with multiple other benefits

This study demonstrates that preoperative fasting hyperglycemia is a reliable and objective indicator of GBC [gallbladder cancer] mortality and recurrence after GBC radical surgery. Preoperative fasting blood glucose levels can supplement clinical considerations for decision making in preoperative GBC patients…In the future, we need to prospectively and continuously check the fasting blood glucose levels in the months and years after surgery to detect the relationships between the average fasting blood glucose concentration and the survival time and/or RFS.

Citrus Pectin has been shown to bind heavy metals and has its own anti-cancer actions

Elevated copper levels are frequently seen in gallbladder cancer
Deficient zinc and selenium can potentially amplify the effects
Citrus Pectin can detoxify heavy metals used in disease progression

The mean serum zinc levels were significantly lower in patients with carcinoma of the gallbladder than in patients with cholelithiasis and in healthy controls . The mean serum copper levels were significantly higher in patients with carcinoma of the gallbladder as compared to patients with cholelithiasis and healthy controls..Our data support an association between lower zinc levels and consequently an increased Cu/Zn ratio and carcinoma of the gallbladder. Whether zinc supplementation has a protective effect in preventing carcinoma of the gallbladder needs to be studied

Urolithin A increases healthy cellular behaviors that may reduce cancers upregulated fatty acid metabolism

Upregulated lipid metabolism reported with increased metastasis
Lower activity via acylcarnitine levels shown as less than half the rate
Preclinical work confirms mechanisms for increased lipid uptake by tumors

Consistent with in vivo experiments, we analyzed 332 patients with complete biochemical indices and follow-up information from the Chinese GBC database of the Chinese Research Group of Gallbladder Cancer and 88 advanced GBC patients… High serum triglycerides (> 1.70 mmol/L) were found to be closely associated with tumor invasion and metastasis… GBC patients with high triglyceride levels had significantly shorter overall survival than those with low triglyceride levels (≤ 1.70 mmol/L) . Collectively, our data demonstrate that acylcarnitines and TG act as a tumor-promotin...

Oat and egg based functional foods are entering early stage clinical trials for several cancers

Rapid tumor growth includes an increased internal fluid pressure
This increases with growth and progression, and helps resistance
Functional food based anti-inflammatories may help reduce these effects

This desmoplasia progresses during disease progression and includes stromal fibroblasts, immune cells, and excessive deposition of a complex extracellular matrix which is often rich in hyaluronan. Proliferation of this tumor microenvironment forms an impediment to treating solid tumors such as CCA by increasing interstitial fluid pressure which compresses the surrounding vasculature and promotes tumor progression and the metastatic potential of cancer cells and reduces the beneficial effects of systemic chemotherapeutic agents

Curcumin has evidence for reducing levels of systemic inflammation used by cancers

Study of high inflammation vs post surgical outcomes
Reports a 4X to 8X risk reduction with low inflammation markers
Commentary also on increased challenges to oncology protocols

This study demonstrated that elevated CAR [c-reactive protein/ albumin ratio], and postoperative complications were independent prognostic factors of poor survival following GBC resection…. Moreover, only the CAR was evaluated as an independent preoperative prognostic factor. Furthermore, we noted that an increased CAR was significantly correlated with i) an advanced stage, ii) increased CEA, iii) longer duration of operation, iv) greater blood loss, and v) postoperative complications, suggesting that it may be correlated with more aggressive surgery and disease phenotype.

Astragalus actions include protecting and balancing immune responses often with clear effects reported

Meta-analysis links immune system related inflammation to risk
The two thirds or so with lower levels have a third reduced overall risk
Astragalus has evidence for re-balancing immune system inflammation

In conclusion, the present review indicated that an increased pretreatment NLR was significantly linked with detrimental long-term outcomes (OS and RFS) and clinicopathological parameters for patients with BTC. Thus, NLR, as a cost-effective and widely available marker with prognostic value, could be regularly surveyed in BTC patients receiving either surgical resection or chemotherapy…NLR was found to be positively correlated with higher CA199 levels, advanced TNM staging and greater lymph node involvement. Regarding BTC, such characteristics has been proven to be linked with tumor i...

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Pathfinder Element	Risk Reduction Factor	Anti-Metastatic	Reduces Side Effects	Research Study
Aspirin	26 - 50%	Yes	Maybe	Link
Astragalus	Indirect - High	Yes	Yes	Link
Lactoferrin	Indirect - High	Probably	Yes	Link
Citrus Pectin	Indirect - Moderate	Probably	Yes	Link
Berberine	Indirect - Moderate	Maybe	Maybe	Link
Curcumin	Indirect - Moderate	Maybe	Maybe	Link
Urolithin A	Indirect - Moderate	Probably	Maybe	Link
Oat and egg functional foods	Indirect - Moderate	Probably	Yes	Link

Plan Item	Cancers	Background Details	Trial Doses Under Supervision	References
Antihistamines	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Gastric, Ovarian, Cervical, Pancreatic, Melanoma, Lymphoma, Esophageal, Bladder	Research indicates desloratadine for localized cancers or loratadine for metastatic. There are examples of ebastine or other alternatives in certain cases. Growing research evidence indicates improved oncology responses. Taken between meals. Low histamine before and during treatment is beneficial.	Active use in clinical trials is still in early phase, follow the dose recommendation for instance 5mg daily unless under medical supervision where higher 10mg doses are frequent
Aspirin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Ovarian, Cervical, Endometrial, Pancreatic, Melanoma, Myeloma, Head and Neck, Bladder, Gallbladder, Non Melanoma Skin, Gastric	Use of low dose 75 or 81mg "baby" aspirin is reported to benefit many cancer types across an average study group, and even all cause mortality. There are some indications of specific "responders" for instance those with existing inflammatory conditions or certain gene expressions. With food.	In a colorectal cancer trial responders were tied to the expression of particular genes (PI3KA). Doses were 160mg	LINK
Astragalus	Breast, TNBC, Lung, Colorectal, Liver, Gastric, Cervical, Endometrial, Pancreatic, Prostate, Kidney, Ovarian, Glioblastoma, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Bladder, Gallbladder, Thyroid	A typical astraglaus membranaceus supplement may have 50mg of astragaloside IV the main active compound. Its possible with meals can reduce any stomach upset. Use of a standard dose to help immune system balance before treatment.	Here, Astragalus is added to standard oncology in lung cancer Doses are 2-3 tablets of 250mg AMe (Solgar, NJ, USA) minimum for 6 months in this example	LINK
Beta Glucans	TNBC, Lung, Liver, Gastric, Cervical, Pancreatic, Melanoma, Non Hodgkin, Lymphoma, Leukemia	There are many options for mushroom or yeast 1,3/1,6 glucan and branded products include California Gold Immune Defense/Wellmune, AHCC, Biogen/ Yestimun, ImmiFlex, IP6 and many more. A pharma grade product, odetiglucan, is continuing in trials. Take on an empty stomach. Use a standard dose to help balance the immune system before starting treatments.	AHCC is used at 3x1g per day over several months during treatment. Beta glucans are used at 1-2g per day and higher.	LINK
Danshen	Breast, Prostate, Lung, Colorectal, Liver, Leukemia, Myeloma, Bladder	The most common chinese herbal medicine in oncology, also known as red sage. Premium brands such as MCS may recommend 1g twice daily as an ongoing dose. Its possible with meals can reduce any stomach upset. Start a standard dose a couple of weeks before treatment to help balance the immune system.	3 x1g daily between meals , over at least 90 days ideally longer to get maximum benefits according to reported patient outcomes, though even shorter dose period reduced risk	LINK
Green Coffee Extract	Glioblastoma	Supplements vary in terms of their chlorogenic acid content, it can be up to 50%. Quality brand might specify this level under their recommended intake. High dose commercial brands may be over 1000mg total, take before meals.	Analysis across trials reports metabolic health benefits start are higher at >500mg or daily. High chlorogenic acid content supplements eg Svetol have been trialed safely for 12 weeks at 200mg x 5 daily dose. As always, be aware of possible drug interactions	LINK
Red Yeast Rice Or statin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Gastric, Ovarian, Cervical, Endometrial, Melanoma, Leukemia, Myeloma, Head and Neck, Esophageal	Red yeast rice is equivalent to lovastatin. Doses are essentially on the products, and there are many premium brands with guaranteed level of monokolin k around 3mg. A common theme is findings is those with improved cholesterol are "responders". With meals. Start cholesterol and inflammation reducing statins early.	Trial data is often case studies with multiple statins where lovastatin has average effects. Often atorvastatin and sometimes simvastatin come out on top. Research ususally reports intermediate doses ( 10-20mg) are effective but there are examples indicating higher doses under supervision.	LINK
Turkey Tail	Lung, Colorectal, Kidney, Liver, Gastric	A typical premium supplement such as MCS recommend 700mg twice daily with food. Mushroom based glucans can help balance immune response so start them before your treatment.	Pharma grade turkey tail, e.g PSP/ PSK/ Krestin is typically used at 3x 1g daily during oncology, up to 36 months and more. Trials in breast cancer have also used 3,6 and 9g daily regimes in 6 week periods	LINK
Vitamin D3	Breast, TNBC, Prostate, Lung, Colorectal, Gastric, Ovarian, Pancreatic, Glioblastoma, Melanoma, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Esophageal, Bladder	High dose commercial formulae can be 10,000IU. Which might be achieved by as little as 10 to 20 minutes in sunshine. Vitamin K2 is advised with D3. Take with some food containing fat. Its important to ramp these up before oncology treatments, and sustain the higher levels over time. Add magnesium for best absorption and metabolism.	The VITAL trial used 2000IU and discussed the potential of higher doses to increase responders especially higher BMI/ body weight. Whilst in prostate cancer there are trials demonstrating at least 10,000IU is required to see activity reducing PSA levels	LINK
Melatonin	Breast, TNBC, Prostate, Lung, Kidney, Liver, Ovarian, Cervical, Endometrial, Pancreatic, Glioblastoma	Commonly used in 10 to 40mg daily range no reported side effects, typically an hour before sleep.	Moderate and high dose trials report no significant side effects even at 1000mg daily	LINK
Citrus Pectin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Ovarian, Cervical, Endometrial, Pancreatic, Non Hodgkin, Leukemia, Myeloma, Head and Neck, Esophageal, Bladder, Gallbladder, Thyroid, Gastric	Trials use a recommended dose up to 5g x3 daily and no significant side effects. Taken 30 minutes before or 90 minutes after food. Ideally, start PectaClear or similar products at least 4 week before treatment to reduce heavy metals. But sustain zinc with supplementation	Even in children age 5 to 12 the daily regime 3 x 5g was safe and effective for heavy metal chelation	LINK
Soy Isoflavones	Breast, Prostate, TNBC	Often dietary sources, tofu and soy based and no evidence of side effects. Supplements generally with food.	In a clinical trial setting up to 900mg with no issues	LINK
Fermented Wheatgerm	Prostate, Colorectal, Melanoma	Trials are with Avemar brand products with no significant safety concerns reported	Typical dose regimes may be aroung 9g daily over longer time periods for instance 12 months	LINK
Iodine	Breast, TNBC	General usage around 1000mcg or 1mg generally with food	Successful pilot studies in breast cancer use 5mg molecular Iodine daily for the duration of therapy	LINK
Lactoferrin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Gastric, Ovarian, Cervical, Endometrial, Pancreatic, Glioblastoma, Melanoma, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Bladder, Esophageal, Gallbladder, Thyroid	200mg typical use daily , eg 10ml liposomal formula ideally 30 minutes before meals or 2 hours after. No side effects of note. Start this immediately to achieve and maintain healthy iron absorption, avoid deficiencies and reduce cancer related ferritin levels.	During oncology doses of up to 3g to 9g daily, even higher, have been used with significant side effects	LINK
Selenium	Breast, Lung, Kidney, Ovarian, Cervical, Endometrial, Pancreatic, Melanoma, Head and Neck	Supplements are 200ug doses and similar amounts from about 3 brazil nuts. Start buildin gup your levels immediately and keep them high during oncology. Selenium toxicity is a consideration for high doses over time, so seek medical advice. Ideally taken with meals.	This trial used 2500 to 4000ug 2x daily for 14 days then once daily in kidney cancer with no dose limiting toxicity	LINK
Vitamin B3	Liver, Gastric, Glioblastoma, Non Hodgkin, Lymphoma, Leukemia, Non Melanoma Skin	Typically 500mg for nicotinamide (niacinamide) form of B3 taken ideally with meals	Do not differ from standard doses, here 500mg twice daily related to skin cancer	LINK
Akkermansia	Breast, TNBC, Prostate, Lung, Kidney, Liver, Ovarian, Cervical, Pancreatic, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Gastric	Commercial products may be at 10B CFU typically 30 minutes before or 2 hours after food. Ramp up levels with diet and moderate supplementation before treatments, especially immunotherapy.	Under development. Results in oncology indicate this is one of many helpful guy bacteria. careful consideration and particularly following use of antibiotics. Diversity is crucial.	LINK
Berberine	Kidney, Liver, Cervical, Pancreatic, Non Hodgkin, Leukemia, Myeloma, Head and Neck, Esophageal, Gallbladder, Thyroid, Non Melanoma Skin, Melanoma, Bladder	A natural anti-diabetic used frequently at 400mg daily and above, shortly before meals	In metabolic health trials frequentlu use up to 500mg at 3 times daily .	LINK
Curcumin	Colorectal, Liver, Non Hodgkin, Myeloma, Bladder, Gallbladder, Non Melanoma Skin, TNBC, Breast, Prostate, Lung, Kidney, Gastric, Ovarian, Cervical, Endometrial, Glioblastoma, Melanoma, Lymphoma, Leukemia, Head and Neck, Thyroid	Doses from 500mg to 2000mg frequently seen. Piperine fron black pepper improves absorption, highly bioavailable formulae are available. Ideally with a meal containing fat.	Higher doses in trials are frequently 2 of 4 g daily (+40 mg piperine) during oncology for instance here at 3 periods of 30 days	LINK
Quercetin	Glioblastoma, Myeloma	Can be found in a healty diet. Supplements often 500 or 1000mg and can be taken with tocotrienols for enhanced absorption, a form of vitamin E . Some evidence that Quercetin should be pulsed on/off.	Clincial trials have safely used up to 5g daily in adults, and 1 to 4g for rare forms of paediatric anemia	LINK
Urolithin A	Prostate, Lung, Colorectal, Kidney, Gastric, Glioblastoma, Melanoma, Myeloma, Gallbladder, Head and Neck	Typical commercial brands run at 500mg once or twice daily, with or without food, some brands suggest with meals	Trials eg in anti-aging science use the same dose range	LINK
Oat and Egg Functional Food	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Cervical, Pancreatic, Glioblastoma, Melanoma, Head and Neck, Gallbladder	Follow supplier guidance on dosage and use. https://shop.lantmannenfunctionalfoods.com/? Lowering tumor fluid pressure helps treatments work, start these before your treatment if possible. Use egg based salovum for short term "pulse" during therapy and oat products for sustained use over longer time periods	This trial in glioblastoma used 16g egg based Salovum four times daily. It discusses lowering that regime in follow on trials.	LINK
Coffee	Breast, Prostate, Colorectal, Liver, Non Melanoma Skin	Most dietary studies use standard 8oz servings as a guide. In many cases the findings are that benfits increase with intake. But in some cases such as prostate cancer there are important details in the PATHFINDER	No, but chlorogenic acid and, separately, green coffee extracts are used at 400mg and up to 2000mg
Flax	TNBC, Ovarian	Crushed flaxseed alone or in foods around 1/4 cup daily	Doses up to 50g daily in clinical trials for various diseases. Here a fairly typical 30g regime in inflammatory liver diseases	LINK
Propolis	Breast	Typical supplements range from 400 to 1000mg	Here 400mg x3 daily help recovery from radiotherapy	LINK
Walnuts	Prostate, Colorectal, Melanoma, Head and Neck	Dietary food item shown even at low useage to be helpful even at a few oz per week	Here, 2oz (56g) daily showed measurable activity in breast cancer	LINK
Mushroom	Prostate	Both dietary sources and many commercial supplements normally taken with food	In this example some patients saw responses between 8 and 14g daily of button mushroom extract	LINK
Zinc	Kidney, Ovarian, Cervical, Endometrial, Head and Neck, Non Melanoma Skin	Commercial supplements vary considerably . Moderate 20mg range generally advised	No
Intravenous HIgh Dose Vitamin C	Pancreatic, Glioblastoma	Commercial supplements vary. A moderate range around 20mg with food is generally accepted as safe.	Same as general guidance
Alpha Ketoglutarate	Melanoma, Kidney, TNBC, Non Hodgkin, Lymphoma	Typical usage is 1000mg daily with or without food, safety is good. Its especially important to ramp up and sustain your levels for maximum immunotherapy responses.	Larger doses of several grams have been safely used in various trials including here in bone disease at 6g daily	LINK
Horse Chestnut (Escin)	Thyroid	Common 300 to 600mg supplements contain 50 to 120mg of active compound, escin taken with food	Escin up to 150mg daily in vascular health. In oncology 0.6 mg/kg/day for 9 days, intravenous injection has been used, high absorption premium supplement would reacj this level	LINK

Gallbladder cancers can in some cases initally be treated with some combination of surgery, radio and/ or chemotherapy. Either at this stage or due to progression, immunotherapy drugs may be recommended. More specific targeted drugs might also be included in that list due to progression.

Your PATHFINDER brings together research that may help slow down early phase progression considerably, including reducing metastatic spread and recurrence. And, with advancing disease, maximize the effects of chemotherapy or immunotherapy. The IMPACTS tab summarizes these and can lead to Many more Good days by helping these treatments work, reducing your risk for progression and by easing treatment side effects. If you do elect both chemotherapy and immunotherapy, you can continue to look for ways to increase the results and reduce possible toxicities;

Be sure to fully read and absorb the PATHFINDER and its Impacts summary
If you have metastatic sites take a look into the corresponding Pathfinder for those too, for inspiration.
Use the Supplement Library Index and filter on “Chemotherapy” and “Targeted drugs” for ideas.
The Foods Library can complement your plan, including anti-metastatic strategies and metabolic health
In the Lifestyle section gathers fascinating evidence for diets and exercise
The PLANS section may have information from what others are doing and have learned

Gallbladder

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