Melanoma

There are several supplements and other strategies that can markedly increase the success of oncology treatments for melanoma.

Research based on patient records reports strongly improved immunotherapy responses and lower progression risks with use of antihistamines, specifically H1 class such as loratadine. This effect is seen in other cancers, but is particularly in clear during treatment for melanoma. And well documented pre-clinical models describe how antihistamines re-regulate immune system behavior allowing oncology drugs to act on tumor cells. Histamine is identified as increasing risks for progression, a low histamine diet might be of use too. Also in immunotherapy responses, another study of case data crucially demonstrates that progression risks are more than halved for AM administration of immunotherapy vs PM https://www.mdpi.com/2073-4409/12/16/2068 Immune system behavior varies during the day, and here treatment response is much higher in the morning.

Sufficient and higher levels of vitamin D3 are also linked to much better immunotherapy treatment results and reduced risk of recurrence. As with many cancers, vitamin D3 deficiency is common in melanoma and should be corrected on a sustained basis. Studies of patient records have shown some strikingly large effects on progression in advanced stages, in those with higher vitamin D3 levels, and tendencies to lower risk for serious side effects too.

Similarly, large scale comparision of patient case data report that statin users have lower progression rates. Atorvastatin is the most widely researched, but when a prescription is lacking, well proven red yeast rice is a supplement equivalent. Its the source of lovastain, which interestingly can also help reduce “classic” systemic inflammation seen with so called CRP or c-reactive protein levels.

In patients that have relapsed from immunotherapy such as pembrolizumab (keytruda), significant numbers have benefitted from second round therapy when adding yeast derived beta glucans , getting more sustained responses. Also in immunotherapy, high dose aspirin is shown with improved outcomes for a sub-group of patients able to tolerate the dosages. Comparisons of patient records in melanoma also that even with low doses improve responses for earlier stage patients. Also in patent data, “responders” to immunotherapy have relatively higher levels of alpha ketoglutarate, now widely studied in anti-aging science. In melanoma there is very compelling evidence in lab study (mouse models) alongside the case data. Also crucial in reponse levels is a healthy gut microbiome with high bacteria diversity driven by fiber intake. Functional foods help this, and have their own anti-cancer mechanisms, such as walnuts. Along with these bacteria strains including akkermansia, the presence of inosine both natrually and supplemented has growing evidence of improving the response rates of immunotherapy. Significantly better responses are seen in case data for higher levels related to reduced treatment resistance.

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. Maintaining relatively lower levels of both make a substantial difference. Commonly used Astragalus root has evidence of improving immune system balance and NLR while curcumin and other other functional foods including garlic can help bring down inflammation levels.

The so called Th1/Th2 immune system balance is strongly linked to the progression and to treatment resistance including in melanoma. 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. This has improved results in surgery plus chemotherapy and may support increased response immunotherapy (see Supplement Library)

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Antihistamines have growing evidence of supporting treatment in many cancers

30 to 50% overall risk reductions when used during/after immunotherapy
Similar results seen in large case controlled meta analysis especially desloratadine
Reduces allergic reaction to drugs and tumor resistance through histamine levels

Allergy, via the histamine-HRH1 axis, facilitated tumor growth and induced immunotherapy resistance in mice and humans. Importantly, cancer patients with low plasma histamine levels had a more than tripled objective response rate to anti-PD-1 treatment compared with patients with high plasma histamine….only HRH1-specific antihistamines (eg desloratadine, loratadine, ebastine) significantly correlated with better survival…analysis also indicated significantly improved overall survival in melanoma and lung cancer patients who took H1-antihistamines during anti-PD-1/PD-L1 treatment...

Beta glucans protect and balance immune system activity improving outcomes

Patients that had previously relapsed during pembrolizumab immunotherapy
Revived immune responses in around half of patients adding odetiglucan
10% stablized over longer periods beyond 20 months or more

Overall, these data, albeit in a small population, demonstrate that [yeast derived beta glucan] Imprime/pembro combination can drive the innate/adaptive IPD responses that are critical for providing clinical benefit to the patients who have progressed through prior CPI treatments…Enhanced OS [overall survival] was observed in patients with >1.3 fold increase in CH50 (8/19; HR 0.385; p=0.1) or >1.5-fold reduction in the frequency of exhausted CD8 T cells (8/19; HR 0.102).

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

Trial of high dose aspirin during immunotherapy
Sub-group of patients able to continue aspirin show the superior outcomes
Patient data shows doubled relative survival rates are during stages I to III

We found that the 6 patients who stopped aspirin alone experienced a worse OS (median OS 8.5 months) and PFS (median PFS 2.76 months) compared to those that either continued aspirin or discontinued all treatment (median OS not reached), despite having similar demographic profiles. Confirming these results, a time-varying cox regression model, which accounts for survival bias, showed that patients on aspirin had a 0.24 fold hazard of progression relative to those that discontinued aspirin alone.

Fermented Wheatgerm multiple benefical effects invite wider scale testing with oncology

Relative overall survival rates reported 50% higher with chemotherapy
Almost a doubling of progression free survival and rediced side effects
Commercial brand fermented wheatgerm products used

At the end of an additional 7-year-long follow-up period, analyses showed significant differences in both progression-free (PFS) and overall survival (OS) in favor of the FWGE group. Mean PFS: 55.8 months (FWGE group) versus 29.9 months (control group) Mean OS: 66.2 months (FWGE group) versus 44.7 months (control group)..The inclusion of avemar into the adjuvant protocols of high-risk skin melanoma patients is highly recommended.

Alpha ketoglutarate anti-aging supplements are developing in cancer research including immunotherapy

Immunotherapy responses in patient data reveal reliance on higher relative levels of AKG
Confirmed in mouse models with particularly compelling improve outcomes
Anti-aging research shows overall systemic benefits of active supplementation over time

Here, our findings showed a significantly increased abundance of α-KG in healthy controls, anti-PD1-sensitive melanoma-bearing mice, and anti-PD1-sensitive melanoma patients; moreover, supplementation with α-KG [in a mouse model] enhanced the efficacy of anti-PD1 immunotherapy and increased PD-L1 expression in melanoma tumors via STAT1/3. We also found that supplementation with α-KG significantly increased the activity of the methylcytosine dioxygenases TET2/3, which led to an increased 5-hydroxymethylcytosine (5-hmC) level in the PD-L1 promoter.

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

The highly elevated fluid pressure in larger melanoma lesions is reported
Tumor nodes that responded to treatment were lower and declined during therapy
Cancers including glioblastoma have functional food trials targeted this effect

The mean baseline IP in melanoma nodules (n = 22) and lymphoma nodules (n = 7) was 29.8 and 4.7 mm Hg, respectively (P = 0.013 for the difference between tumor types). In a subset of melanoma nodules for which IP had been measured before and after treatment, the IP increased significantly over time for nonresponding melanoma lesions from a baseline of 24.4 to 53.9 mm Hg after treatment (P = 0.005) and decreased in melanoma lesions that responded to treatment where the mean baseline and post-treatment IPs were 12.2 and 0 mm Hg, respectively

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

Supplementation before treatment used to raise patient levels
Normal levels of vitamin D3 have 55% increased reponse vs insufficient group
Overall survival increased 16% and progression free period amost double

In our opinion, maintaining the vitamin D level within the normal range during anti-PD-1 immunotherapy in advanced melanoma patients should be a standard procedure allowing the improvement of treatment outcomes…The analysis showed a statistically significant, positive effect of normal serum vitamin D levels on increasing ORR and PFS as a result of anti–PD-1 immunotherapy in patients with locally advanced inoperable or metastatic melanoma….A potential determinant of the efficacy of anti–PD-1 antibodies also appears to be the serum vitamin D levels of patients. Currently, ther...

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

Statin users are reported with reduced recurrence risk of at least 34%
High risk reductions for more intensive and sustained users
Majority of 58% were lipophilic statins, where lovastatin/ RYR is an example

Our study suggests that patients with invasive cutaneous melanoma who are receiving statin therapy at diagnosis may be less likely to experience disease recurrence following definitive surgical resection. Lower rates of recurrence were observed particularly amongst statin users who were adherent to their statin therapy and those who were taking high dose statins, suggesting a dose-response relationship.The role of statins as antimelanoma agents is biologically plausible

Walnuts and the metabolite Urolithin A have suprising anti-cancer actions

Higher levels of dietary fiber intake strongly affect response and outcomes
With higher fiber diets and no probiotics, progression free survival more than 2X
Treatment response levels are increased by as much as 3X

In an observational study, the researchers found that melanoma patients reporting high fiber (prebiotic) consumption had a better response to checkpoint inhibitor immunotherapy compared with those patients reporting a low-fiber diet. The most marked benefit was observed for those patients reporting a combination of high fiber consumption and no use of over-the-counter probiotic supplements. These findings provide early insights as to how diet-related factors may influence the immune response

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

Improved patient survival with sufficient iron levels
Long term risk reductions from 3X to 4X reported
Iron deficiency is relatively common in melanoma

The evaluation of the cohort of 375 Polish MM [metastatic melanoma] cases revealed that a low serum iron concentration (i.e., below 893.05 μg/L) was associated with increased mortality. All study participants fasted before blood sample collection for iron level evaluation, and the examination was performed before treatment other than the surgical removal of melanoma. None of the host factors (e.g., Clark, Breslow status) was associated with iron concentrations; it is likely that the association was due to unrecognized confounding.

Selenium is developing in kidney and ovarian cancer, high doses pulsed with oncology drugs

Analysis of long term patient data vs selenium levels
Particularly those with relatively high levels show large risk reduction
High dose selenium in showing promise in pilot trials in other cancers

Herein, we report the 10-year survival of 375 melanoma patients depending on their serum selenium levels. The study group was followed up from the date of melanoma diagnosis until death or 2020. Patients were assigned to one of four categories, in accordance with the increasing selenium level (I–IV quartiles). The subgroup with low selenium levels had a significant lower survival rate in relation to patients with high selenium levels…In conclusion, a low serum selenium level was associated with an increased mortality rate in the 10 years following melanoma diagnosis

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

Risk Analysis for inflammation and high c-reactive protein level
A risk reduction over 60% for lowest vs highest quintiles
Largest driver is poor prognosis for >10mg/L CRP level

In conclusion, these data provide strong evidence that CRP is an independent prognostic biomarker in patients with melanoma, including those with early-stage disease as well as those with advanced-stage disease. A markedly elevated CRP level in particular seems to identify a subgroup of patients at high risk for disease recurrence and death. On the basis of the data presented here, we believe it is reasonable to include measurement of CRP in prospective investigations of outcomes of patients with melanoma, including in trials of systemic therapy. Furthermore, although these data cannot dete...

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

Lower inflammatory immune system markers (NLR) improves outcomes
Neutrophil-to-Lymphocyte <5 halves overall progression rate
Maintaining NLR during treatment cuts overall risks by two thirds

In a cohort of patients who had metastatic melanoma treated with initial PD-1 inhibition, both the baseline NLR and changes in the NLR early during treatment are strongly prognostic of survival, and prognostication is improved when both biomarkers are used together. The combination of an elevated baseline NLR and an increase in the NLR early during treatment is associated with extremely poor outcomes and may be a sufficient reason to change therapy in this small subgroup. The baseline NLR is associated with both tumor and host factors, suggesting that the NLR in patients with cancer reflect...

Sodium levels are reported as independent markers of treatment response

Circulating levels of sodium strongly linked to immunotherapy response
Those with relatively high sodium have nearly 60% overall risk reductions
Also significantly improved periods free from disease progression

This study highlights that ICI-treated patients with higher sodium levels had significantly better OS, PFS, and anti-tumor responses. Baseline serum sodium levels could be cost-effective and valuable predictive biomarker for ICIs across diverse tumor types and ICI agents….Multivariate analysis revealed that serum sodium levels between 135–140 mmol/L were an independent predictor of improved OS (HR: 0.58) and PFS (HR: 0.76;) and those with levels > 140 mmol/L had an even lower HR of 0.43 [meaning 57% reduced overall risk levels] for OS and HR of 0.62 for PFS [progression...

Inosine is emerging as a strong enabler of increased immunotherapy impacts

Our results demonstrate that inosine overcomes tumour cell-intrinsic resistance to immunotherapy by inhibiting UBA6 in tumour cells to enhance tumour immunogenicity (Fig. 7). We identify UBA6 functions as a tumour-intrinsic checkpoint that limits antitumour immunity and implicate UBA6 as an attractive target for immunotherapy. Together with recent studies25,47, our findings highlight the potential application of inosine in combination with ICB for cancer patients with high UBA6 expression.

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GUIDE

Pathfinder Element	Risk Reduction Factor	Anti-Metastatic	Reduces Side Effects	Research Study
Aspirin with immunotherapy	>50%	Yes	Maybe	Link
Vitamin D3	>50%	Yes	Maybe	Link
Inosine with immunotherapy	>50%	Maybe	Maybe	Link
AM immunotherapy timing	>50%			Link
Sodium with immunotherapy	>50%			Link
Fermented wheatgerm	26 - 50%	Probably	Yes	Link
Antihistamines with Immunotherapy	26 - 50%	Probably	Probably	Link
Red yeast rice/ statin	26 - 50%	Probably	Maybe	Link
Melatonin	26 - 50%	Maybe	Yes	Link
Beta Glucan	Up to 25%	Yes	Yes	Link
Astragalus	Indirect - High	Yes	Yes	Link
Lactoferrin	Indirect - High	Probably	Yes	Link
Oat and egg functional foods	Indirect - High	Probably	Yes	Link
Walnuts	Indirect - High	Maybe	Maybe	Link
Alpha ketoglutarate	Indirect - High		Maybe	Link
Selenium	Indirect - High	Probably	Maybe	Link
Curcumin	Indirect - Moderate	Maybe	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

Beyond surgery the use of immunotherapy treatments like pembrolizumab (Keytruda) and nivolumab (Opdivo) and there is almost uniquely clear evidence that combining these with ipilimumab (Yervoy). Some second line treatment may add targeted drugs such as dabrafenib (Tafinlar) or trametinib (Mekinist)

Your PATHFINDER brings together research that may reduce the risk of recurrence or metastatic spread following surgery. And help maximize the effects of targeted drug treatments 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. 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 “Immunotherapy” 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

Melanoma

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