Gastric

In Japanese oncology, mushroom extracts including turkey tail (PSK) and shitakke (lentinan) have a long track record. Mushroom and yeast based beta glucan 1,3/1,6 are now sources for emerging branded products too. Also from asian oncology, analysis across multiple clinical trials concludes that astragalus root extract also reduces relative risks, and improve side effects. Astragalus can re-balance immune related inflammatory responses, so called neutrophil-to-lymphocyte ratios. This inflammation often flares up due to treatments or disease progression.

Research on statin use in gastric cancer has varied findings, but a recent national scale study in Tiawan explains some of this. And finds that there are risk reductions that increase with use over time. In other cancers, results show its “responders” to cholestrol control that see large benefits. Also with somewhat mixed research results in gastric cancer, vitamin D3 , results in a recent trial named AMATERASU headlines with no effects. But a detailed look at that data clearly shows tendencies to reduce progression, and much more so in older patients, male and early phase.

A prebiotic in anti-aging science, lactoferrin, is found to significantly improve side effects of chemotherapy. And, fascinatingly, it drives strong reductions in key biomarkers of disease activity and progression such as carcinoembryonic antigen (CEA) seen in 90% of gastric cancer patients. Lactoferrin is a strong regulator of iron absorption, and its actions can help decrease anemia which is very common in gastric cancers, and predicts poor response rates to treatments, especially immunotherapy. But in the opposite direction, it can help bring excess stored iron in the tumor regions (“ferrtin”) back to normal ranges. High iron in the tumor regions or circulating as ferritin also worsens oncology outcomes and increases risk. Perhaps an even bigger driver of progression are studies showing elevated platelet levels from upregulated “clotting” thromboxanxe enzymes, which are strikingly elevated in gastric cancers. These increase metastatic spread rates. A sub study of the ADD-ASPIRIN ongoing trial shows effective suppression of thomboxane at low dose level.

Citrus Pectin has ongoing trials in oncology, even patented drug development targeting the same mechanisms. There are results showing some benefits in treatment, and importantly good evidence in case studies that citrus pectin can bind toxic heavy metals. Copper is usually elevated by digestive system cancer to increase its growth, higher levels are reported to very strongly increase progression risk. Another typical dysregulation are higher levels of circulating fatty acids to drive growth of gastric cancer. In anti-aging trials, Urolithin A supplementation could help improve metabolism of these compounds.

Vitamin B3 supplementation during treatment for digestive cancers has been shown to extend survival rates in case history data. More specific to gastric cancer, new research has also shown improved outcomes with K3 supplementation https://www.annalsofoncology.org/article/S0923-7534(24)03015-1/fulltext . Dysregulated metabolism of amino acid tryptophan is shown increasing gastric cancer patient progression. In sports science, regulation of tryptophan metabolism by gut microobe akkermansia with lactate (eg yoghurt) can help promote healthy tryptophan absorption.

Systemic inflammation has been shown to substantially increase risk of progression. Curcumin is a useful anti-inflammatory supplement, as is garlic while pro-inflammatory diets are similarly found to be negative in case records. The inflammatory response seen in immune system markers may equally be helped by beta glucans.

The so called Th1/Th2 immune system balance is strongly linked to the progression and to treatment resistance. Molecular iodine solutions are emerging in this area in breast cancer management and seen boosting Th1 anti tumor activity and helping suppress over active Th2 used in resistance. The has improved results in surgery plus chemotherapy and may support increased response 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

Liver is the most common metastatic site, it may be useful to take a look for inspiration in that Pathfinder too. There is some compelling indirect evidence that luteolin can reduce metastatic activity too, something to consider in both dietary and supplement regimes.

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Turkey tail has broad evidence of improved outcomes especially in digestive system cancers

Analysis of patient data where one fifth added turkey tail to chemotherapy
There is a relative risk reduction effect of almost a quarter with turkey tail
Mushroom beta glucans immune system boosting effects also help manage side effects

This study provides real-world evidence of overall survival benefits with PSK [turkey tail] in combination with adjuvant chemotherapy for resected gastric cancer patients. After adjusting for all other confounding factors, the use of PSK with adjuvant chemotherapy was the most important factor for better survival. The proposed mechanism is that PSK may act as an immune modulator or biological response modifier to potentially change the patient-tumor microenvironment…Adjuvant chemotherapy combined with PSK significantly prolonged overall survival in gastric cancer patients after gastre...

Astragalus also balances immune responses and can reduce progression risks

Large scale analysis across several trials shows 24% improved treatment response
The targeted trials show >40% improved relative reduced risk in several cases
Significantly reduced side effects of oncology due to immune system support and activation

The results suggested that compared with PBC [chemotherapy] alone, both oral and injection-based administration of Astragalus containing [chinese herbal medicine] resulted in better tumor response in advanced gastric cancer patients. In addition, both Astragalus-containing TCM combined with cisplatin-based chemotherapy and oxaliplatin-based chemotherapy resulted in a better ORR [response rate] than chemotherapy alone. AGC patients that were given Astragalus-containing TCM plus oxaliplatin-based chemotherapy had better DCR; however, those who were given Astragalus-containing TCM plus cisplat...

Beta glucans protect and balance immune system activity improving outcomes

Use of beta glucans reduced relative risk levels by nearly a quarter
Higher risk reductions for reported in patients with lymph node metastases
Large scale study across 5 clinical trials of lentinan extract from shiitake mushroom

In conclusion, the addition of lentinan to standard chemotherapy offers a significant advantage over chemotherapy alone in terms of survival for patients with advanced, unresected/recurrent gastric cancer. It is hoped these results will result in wider acceptance of immunochemotherapy for the treatment of advanced gastric cancer…Lentinan (active compound from shiitake) significantly prolonged the overall survival . The overall hazard ratio (HR) was 0.80) and there was no heterogeneity between trials. Additionally, lentinan was possibly more effective in patients with lymph-node metast...

Red Yeast Rice or where possible a prescription statin have multiple beneficial actions including all-cause risks

Patient records study shows over 40% risk reduction with statin use
Longer OS numbers reported for longer term users beyond 6 months
Extensive analysis on why many statin studies report no significant effects

A notable dose–response relationship was observed between statin use and the OS of patients with GC post surgery and adjuvant chemotherapy. The adjusted HRs were 0.62 and 0.34 for statin users with 28–167 cDDDs [total numer of daily doses] and >168 cDDDs, respectively. The difference may have been due to practical issues such as different stages of GC, varied patient populations, uneven research duration, or categories of statin exposure … Nonetheless, the survival benefits of statin use for patients with GC after surgery and adjuvant chemotherapy were confirmed in Taiwan, cons...

Antihistamines have large scale analysis of case data supporting their use in most cancers

A 30% risk reduction reported for desloratadine use
Large scale analysis of patient records and outcomes
Successful interventional trial with sorafenib in colorectal cancer

Desloratadine use was associated with an improved survival for all immunogenic tumors, but not for the non-immunogenic ones. Loratadine use was associated with improved survival for some tumors. Use of the other antihistamines could not be shown to be consistently associated with improved survival to a statistically significant degree..Our hypothesis is that our findings result from immune checkpoint inhibition, and we believe both desloratadine and loratadine should be tested in randomized clinical trials

Vitamin D3 and its immune system health actions are key, higher doses being trialed in oncology

Data shows 40% risk reduction for men
Likelihood of benefit also increased with age
Gastric cancer specific survival increase 16%

The 5-year relapse-free survival was 77% with vitamin D vs 69% with placebo (hazard ratio [HR] for relapse or death, 0.76). The 5-year overall survival in the vitamin D vs placebo groups was 82% vs 81% (HR for all cause mortality). In the subgroup of patients with baseline serum 25(OH)D levels between 20 and 40 ng/mL, the 5-year relapse-free survival was 85% with vitamin D vs 71% with placebo (HR for relapse or death, 0.46)

Vitamin B3 in its niacinamide form is also emerging in lung cancer with TKI therapy

Patient case analysis shows benefits of vitamin B3 supplements
Compelling pre-clinical research on reducing immune evasion by tumors
Shows supporting actions wtih TKI therapy in other cancer types

In summary, our research uncovers the immune-modulatory activity of VB3 in the TME. Dietary supplementation of VB3 enhances the antitumor responses of adaptive immunity by counteracting immunosuppressive myeloid cells and improves the efficacy of immune/targeted therapy. These findings establish a mechanistic link between dietary vitamins supplementation and cancer progression, suggesting that VB3 could be readily translated into clinical use as an adjunctive treatment for liver cancer.

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

Halved levels of biomarkers of activity (CEA), while these levels doubled in the control group
Significantly improved quality of life during chemotherapy including fewer viral infections
Lowering circulating iron via ferritin whilst correcting anemia both are significant in data

Although, there was a significant effect of oral bLF (250 mg/day) that indicated a significant improvement in mean percent of change of all parameters 3 months after treatment, there was no significant difference between results of patients in the test group and patients in the control group after treatment. This result suggests that oral bLF has significant therapeutic effect on colorectal cancer patients. Our study suggests that daily administration of bLF showed a clinically beneficial effect to colorectal cancer patients with better disease prognosis but that needs further looking int...

Berberine is effective for glucose and lipid metabolic health

Many cancers upregulate lipid availability to fuel growth including gastric
Here, acylcarnitines are markers associated to increased progression
Berberine is able to inhibit this activity and may help counter progression

Increased C6DC, C16OH, C6, C0 and ARG expression distinguished GC from AG and SG, indicating C6DC, C16OH, C6, C0 and ARG are potential diagnostic markers of GC. This study was based on observed metabolite changes during the whole process from SG to AG and then to GC. Thus, our study provides insights in understanding metabolite profiles of amino acids and acylcarnitines also associated with gastric cancer and their use as cancer biomarkers. Further studies with larger patient cohorts to further assess clinical relevance are needed as patients is still limited.

Citrus Pectin has its own anti-cancer evidence and can help remove heavy metals

Inflammatory Galectin-3 protein levels are 70% higher in gastric cancer
Citrus Pectin suppresses Gal-3 and improves survival in some late stage patients
The study highlights clear connection to metastatic spread

In conclusion, we presented evidence that serum Gal-3 level was significantly elevated in GC patients, and serum Gal-3 level was significantly correlated with lymph node metastasis and distant metastasis. Due to its reasonable sensitivity and specificity for GC, Gal-3 could be useful as a potential circulating biomarker for GC diagnosis. In addition, Gal-3 shows a promising tendency as a prognostic marker in GC patients. Further studies should be conducted on larger cohorts to investigate correlations between Gal-3 and relevant clinicopathological parameters in defined subpopulations of pat...

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

Elevated platelets driven by increased lipids, thromboxane, strongly predict disease progression
Gastric cancer is particularly singled out in this research on patient levels of thromboxane
Low dose aspirin shows strong suppression in post surgery settings

In summary, this study found that patients who have had a recent diagnosis of cancer and radical therapy showed evidence of persistently increased thromboxane biosynthesis as measured by U-TXM excretion compared to healthy individuals. This was most marked in the colorectal and gastro-oesophageal participants independent of pro-inflammatory baseline characteristics and recent anti-cancer treatment. Our findings show comparable suppression of U-TXM with aspirin 100 and 300 mg daily and are consistent with the saturability of platelet COX-1 inactivation at low doses

Akkermansia gut bacteria levels are becoming a key marker of improved response in oncology, especially immunotherapy

Cancer can utilize essential amino acid tryptophan to grow and progress
This study reports specific so called IDO1 gene pathways in patients
Those with low activity rates have about half the progression risk

Aberrantly expressed Trp [tryptophan] metabolites are associated with diverse clinical features in digestive system tumors. Moreover, the levels of these metabolites can serve as prognostic indicators and predictors of recurrence risk in patients with digestive system tumors. Trp metabolites exert their influence on tumor growth and metastasis through multiple mechanisms, including immune evasion, angiogenesis promotion, and drug resistance enhancement. Suppressing the expression of key enzymes in Trp metabolism can reduce the accumulation of these metabolites.

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

Reduced overall risk level of 40% with lower inflammation vs higher
Average across over 18,000 patient records, aligns with many other studies
Similar impact shown with immune system balance (NLR) where beta glucans help

In conclusion, our meta-analysis confirmed that elevations in CRP, NLR, and GPS/mGPS are associated with poorer survival outcome in GC patients, with a higher GPS/mGPS having a greater negative effect on overall survival. Subgroup analyses revealed that regardless of country, quality score, stage, or chemotherapy, higher levels of each inflammatory marker were associated with lower survival. Thus, interventions to modulate the inflammatory response and immune response before and after surgery could help to improve long-term cancer outcomes

Luteolin is strongly anti-inflammatory and probably anti-metastatic

Patient data is used to show about 40% reduced risk with low Notch1 signaling
The pre-clinical work established this as a key driver of metastatic activity
Luteolin is shown in a lab model to strongly reduce tumor growth and suppress Notch1

In this study, we found that luteolin significantly suppressed GC progression by inhibiting cell proliferation, migration, and invasion; inducing apoptosis; and reversing the EMT. Meanwhile, the Akt, β-catenin, and Notch signaling pathways were inhibited by luteolin. Furthermore, the effects of downregulation of Notch1 were similar to those observed upon treatment of GC cells with luteolin. In addition, higher Notch1 expression correlated with a poor OS. Luteolin suppressed tumor growth and Notch1 signaling in vivo. Therefore, luteolin may be an effective drug for GC treatment.

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GUIDE

Pathfinder Element	Risk Reduction Factor	Anti-Metastatic	Reduces Side Effects	Research Study
Astragalus	26 - 50%	Yes	Yes	Link
Vitamin D3	26 - 50%	Yes	Maybe	Link
Antihistamines with Immunotherapy	26 - 50%	Probably	Probably	Link
Red yeast rice/ statin	26 - 50%	Probably	Maybe	Link
Beta glucans	Up to 25%	Yes	Yes	Link
Turkey tail	Up to 25%	Yes	Yes	Link
Aspirin (low dose)	Indirect - High	Yes	Maybe	Link
Lactoferrin	Indirect - High	Probably	Yes	Link
Gut health including Akkermanisa	Indirect - High	Probably	Yes	Link
Citrus Pectin	Indirect - High	Probably	Probably	Link
Curcumin	Indirect - Moderate	Maybe	Maybe	Link
Vitamin B3	Indirect - High	Maybe		Link
Berberine	Indirect - Moderate	Maybe	Maybe	Link
Luteolin	Indirect - Moderate	Maybe		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

Impact	What	Why	Dose	Impact summary	Additional treatment - targeted drug	Activity against Liver metastatic sites	Anti-metastatic in general	Higher doses eg in clinical trials	Other comments or sources
>50%	Turkey tail	Balance and help regenerate immune system, and reduce side effects	700mg twice daily	Almost 2X reported in late stage oncology. Large data analysis shows more moderate benefit	Not directly but many reports in digestive system cancers	Very likely, there is good evidence in liver cancers too	Yes	Yes trials have used several grams daily	Both dietary mushrooms and mushroom extracts continue to feature in clinical trials for cancer management
>50%	Astragalus	Natural immune system balance and activity, studies are in chemotherapy but also inflammatory marker NLR	At least 500mg daily (50mg astragalaside)	Several trials show 3X impacts at 2 years, and significant reductions in chemotherapy side effects	Astragalus has good results in chemo and TKI targeted drugs	Both reduced progression and improved side effects in liver cancer	Yes	Prescribed doses of 3g per day are typical in first months	Based on evidence of 2X effects in lung cancer, an excellent natural immune modulator alongside TKIs , eg sorafenib
>50%	Beta Glucans	Balance and help regenerate immune system, and reduce side effects	1 or 2x 250mg California Gold Immune Defense with Wellmune	Absolute impact is 2X looking at 2 year time line, and reduced side effects	Patented drugs pilot studies in other cancers having good effect	There are mulitple liver cancer trials showing impacts, so yes	Indirectly, lower NLR is linked to lower metastatic activity	As with astragalus	Could alternate with turkey tail. Research studies indicate benefits in managing treatment side effects
>50%	Lactoferrin	Large benefit to well balanced iron and hemoglobin through treatment	10ml lipsomal LF daily, ideally on empty stomach	The benefit of well functioning iron metabolism is very large, more than 2X	Evidence shows essential need for well balanced iron levels with all drug treatments	Indirectly since poor hemoglobin is strongly linked to faster progression in liver cancer	Low iron levels strongly linked to increased metastatic activity	1.5g lactoferrin twice daily 1.5 g for three 6-week cycles used in lung cancer	Reported impacts at least 2x for sustaining hemoglobin >90g/l through treatment, which otherwise depletes iron badly (especially chemo). See Supplement Library.
>50%	Red yeast rice or statin	Anti-lipid and anti-inflammation. Effects maybe linked to lowering LDL	Per the supplier guidance. Use a premium brand	Large scale analysis of patient records shows even higher impact for women/ younger patients	Effects are continuous across treatments, and in preventing new tumors after surgery or transplant	Yes, atorvastatin reported with a 59% improved risk level. Statin effects in general improve immunotherapy	Probably	Maybe. What is reported for sure is much bigger effects after at least 5 months use	Atorvastatin or similar prescription drug is likely a good option if available. Red yeast rice can potentially be combined with nattokinase
26-50%	Desloratadine	Help immune system function and side effects	1 or 2 x 5mg daily	A 30% impact reported in national patient data for prescriptions	Yes including lung cancer and more	Absolutely, there are large impacts reported for liver tumors	Probably	No current evidence but generally safe	Loratadine is reported as effective in metastatic disease stage . see Supplements Library
26-50%	Anti-inflammatory diet	Lowering inflammation is crucial	Continuous	Research evidence continues to grow for mainly vegetarian diet with higher fiber content	Always a valid approach	Likely helpful	Yes	Combine wtih supplements	Also read Lifestyle section for view on evidence in diets and eating patterns
26-50%	Vitamin D3	Boosts and activates immune response, enables strong anti tumor activity	At least 10,000IU daily with meals	Consistently reported to reduced progression and in particular in men	Across many other cancer types higher D3 levels are reported to improve results yes	No research on this	Yes	Research is into higher doses in order to increase the proportion of "responders"	Existing trials assessed 30ng/ml as sufficient. Other studies actively discuss supplementation to reach at least. 40ng/ml. Be sure to include magnesium and K2
Up to 25%	Propolis ( with radiotherapy)	Protective actions against radiation induced cell damage	Per supplier	The data available shows very beneficial support for radiotherapy	Focused on radiotherapy	No research on this	Maybe	Trials have used 400mg x3 daily doses	Specific to radiotherapy
Indirect - High	Gut health including akkermansia	Indirect importance of gut bacteria is large	Supplier dose, moderate level	Crucially, metastatic spread to the bone is linked to lack of a diverse microbiota including low akkermansia.	Has become a recognized factor in immunotherapy success, with likely strong importance here too	Poor microbiome is linked to progression of inflammatory responses	Yes	No, evidence is to apply moderation with supplements	Foundation here is high vegetable and high fiber diet
Indirect-high	Low dose Aspirin	Reduce blood clotting improves vascular health, specific reasons remain unclear	75mg	These effects are related to significantly lowered markers of metastatic activity	Yes the same activity applies	Play a role reducing metastatic activity and has clear evidence for liver cancer tumors	Yes	Colorectal cancer trial used 160mg.	Metformin use is reported to be damaging for digestive cancers. Low dose aspirin is protective against this
Indirect-high	Citrus Pectin / Pectaclear	Reduce copper and harmful metals, also help sugar metabolism and microbiome	Copper removal with Pectaclear at 2g x 2 daily on an empty stomach	Heavy metals strongly linked to poor prognosis. Possible anti-metastatic activity too.	Some positive research with citrus pectin has included chemo	Cadmium copper, where present, are known drivers of metastatic activity	Probably	Follow supplier program	Exposure to tobacco may contribute to heavy metal build up. In all cancers having sufficient selenium and zinc is important, including HCC
Indirect-moderate	Curcumin	Good supplement in anti-inflammatory diet	Per supplier. Get a high absorption formula	Has potential copper removal actions and more	No current evidence	As in most cancers, high inflammation is a major risk for metastatic activity	Maybe	Follow supplier program	Combine with piperine or black pepper. This is a single trial but the results are highly compelling, and there are no downside

For those who undergo surgery the most common regime is chemotherapy. With advancing disease, immunotherapy may also be included alongside chemo, typically nivolumab (Opdivo). With immunotherapy responses there will often be a smaller group with longer and more robust results. However, illustrating a common effect seen when combining two drugs, the typical impacts reported are around a 20% reduced risk for progression https://www.nature.com/articles/s41586-022-04508 Second line treatments pay also include targeted drugs such as Trastuzumab (Herceptin)

Your PATHFINDER brings together research that may help maximize the effects of chemotherapy and 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 “Immunotherapy” 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

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