Devita, Hellman, and Rosenberg's Cancer

LWBK1006-48 LWW-Govindan-Review December 12, 2011 20:53

596 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

concomitant use of grapefruit juice would decrease the clearance of these

drugs and thus increase the toxicity from these drugs. Patients should

discontinue grapefruit consumption for at least 96 hours before resuming

chemotherapy.

Answer 48.11. The answer is D.

Flaxseed and aloe vera are natural herbal laxatives. Ispaghula, another

agent useful in the treatment of constipation, is also a bulk laxative.

Answer 48.12. The answer is D.

Licorice inhibits platelet activity. Alfalfa and red clover are coumarin

constituents. All of these agents can increase the risk of bleeding and

should be avoided in a patient on anticoagulant therapy.

Answer 48.13. The answer is C.

Use of Kava may be associated with abnormal liver function tests, includ-

ing aspartate aminotransferase, alanine aminotransferase, alkaline phos-

phatase, and total and conjugated bilirubin. Patients taking Kava supple-

ments should be monitored closely for signs of liver dysfunction.

Answer 48.14. The answer is C.

Shark cartilage supplements are popular among patients with cancer.

However, several clinical trials evaluating these supplements have not

demonstrated any clinically significant benefit. In a randomized, placebo-

controlled, double-blind, phase III clinical trial to determine whether a

shark cartilage product improved overall survival or quality of life in

patients with advanced breast and colon cancer, there was no evidence of

benefit.