Detox During Chemotherapy: What the Research Shows

Table of Contents

1. What the Presentation Said
2. Chemotherapy Half-Lives on the Drug Labels
3. Supplements and Herbs Taken During Chemotherapy
4. Coffee Enemas: Case Reports and Studies
5. Insulin Potentiation Therapy
6. Hyperthermia: The Randomized Trials
7. Hyperbaric Oxygen and Cancer
8. Juicing and Fasting Around Chemotherapy
9. Complementary Medicine Use and Survival
10. How the Claim Compares With the Research
11. What Is Not Known
12. Connections
13. Key Research Papers
14. Featured Videos

What the Presentation Said

In the question session at the end of the webinar, a viewer asked whether it is possible to detox while having chemotherapy. The speaker, the medical director of an integrative cancer clinic, answered yes, and gave this reasoning:

• The 48-hour rule. The speaker said the half-life of most chemotherapy agents is 48 hours, so that within two to three days the drug "has been utilized" and has acted on the cells it is going to affect.
• Timing of a detox. On that basis the speaker described starting a detox about 72 hours after a chemotherapy dose, aimed at "the liver" and "your cells".
• The clinic's combination. The speaker said that at one of the clinic's centres patients receive low-dose chemotherapy given "very selectively" as insulin potentiation therapy, combined with coffee enemas, hyperbaric oxygen, hyperthermia, juicing, nutrition and detox, and closed by describing detoxing alongside chemotherapy as "highly recommended".

Earlier in the talk, answering a viewer who used coffee enemas, binders and a whole-food diet, the speaker said these do not necessarily target parasites but help create a "healthy terrain". The speaker did not cite a study for the 48-hour figure, for the 72-hour timing, or for the combined programme.

"Detox" has no single medical definition in this context. In pharmacology, detoxification means the body's own processing of chemicals — mainly by liver enzymes and the kidneys — and those same pathways also handle the chemotherapy drugs themselves. The sections below take each part of the answer in turn.

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Chemotherapy Half-Lives on the Drug Labels

A drug's half-life is the time it takes for its concentration in the blood to fall by half. After one half-life, half of the drug is still present; after five half-lives, about 3 percent remains (half of a half of a half, five times). A half-life therefore does not mark the moment a drug is "used up", and many drugs have several half-lives — a fast early fall as the drug spreads into tissues and a slow late one as it leaves them.

The U.S. Food and Drug Administration labels for six widely used chemotherapy drugs, read on the National Library of Medicine's DailyMed database on 2026-10-23, report the following:

• Fluorouracil (used for bowel, breast and other cancers): after a single injection, the elimination half-life rose with dose from 8 to 20 minutes. In the bowel-cancer schedule described on the oxaliplatin label, however, fluorouracil is given as an injection followed by a 22-hour pump infusion, on two days in a row — so a short half-life does not mean a short exposure.
• Gemcitabine (pancreatic, lung, breast and ovarian cancer): the half-life ranged from 42 to 94 minutes for short infusions and from 245 to 638 minutes for long infusions, depending on age and sex. The active form built up inside white blood cells (gemcitabine triphosphate) had a terminal half-life of 1.7 to 19.4 hours.
• Cisplatin (testicular, ovarian, bladder and other cancers): the parent drug fell with a half-life of about 20 to 30 minutes, but platinum bound to the blood protein albumin was eliminated with a half-life of "five days or more", and platinum in red blood cells had a terminal half-life of 36 to 47 days.
• Oxaliplatin (bowel cancer): unbound platinum in the blood showed two early phases (0.43 and 16.8 hours) and a long terminal elimination phase of 391 hours — a little over 16 days.
• Doxorubicin (breast cancer, lymphomas, sarcomas): a distribution half-life of about 5 minutes and a terminal half-life of 20 to 48 hours, longer in men than in women in one analysis (54 versus 35 hours).
• Paclitaxel (breast, ovarian and lung cancer): in the label's pharmacokinetic table the mean half-life ranged from 13.1 to 52.7 hours, depending on the dose and on whether the infusion lasted 3 or 24 hours.

So the labels show half-lives ranging from minutes to weeks rather than clustering at 48 hours. Of the six, only doxorubicin and paclitaxel have half-lives near the figure given in the presentation. How long a drug acts is also not the same as how long it stays in the blood: gemcitabine and cisplatin both act through forms that stay in cells or tissue after the blood level has fallen, and many regimens repeat doses every one to three weeks or run as continuous infusions or daily tablets. No study was found that defines a "72-hour" point after which chemotherapy has finished acting, or that tested a detox programme timed to it.

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Supplements and Herbs Taken During Chemotherapy

Many "detox" programmes include supplements, herbs or antioxidants. Two lines of research bear on what happens when these are combined with chemotherapy.

Antioxidants and other supplements in a breast cancer trial

Researchers asked 1,134 women enrolled in a United States cooperative-group breast cancer trial of cyclophosphamide, doxorubicin and paclitaxel about the supplements they took before and during treatment (Ambrosone and colleagues, 2020). This was an observational analysis inside a trial, so it shows associations, not cause and effect. They found:

• Use of any antioxidant supplement (vitamins A, C and E, carotenoids, coenzyme Q10) both before and during chemotherapy was associated with a higher risk of the cancer returning (adjusted hazard ratio 1.41; the result was at the edge of statistical significance, P = 0.06) and, less clearly, of death (hazard ratio 1.40, P = 0.14).
• Vitamin B12 use before and during chemotherapy was associated with poorer disease-free survival (hazard ratio 1.83) and overall survival (hazard ratio 2.04), and iron use during chemotherapy with recurrence (hazard ratio 1.79).
• Multivitamin use was not associated with survival outcomes.

The authors wrote that their findings are consistent with recommendations for caution about supplements other than a multivitamin during chemotherapy.

An herb that lowered a chemotherapy drug's active form

Irinotecan, a bowel-cancer drug, is converted in the body into its active form SN-38 and is processed by the liver and gut enzyme cytochrome P450 3A4 (CYP3A4). In a small randomized crossover study, five cancer patients received irinotecan with and without 18 days of St. John's wort, an herb known to increase that enzyme's activity (Mathijssen and colleagues, 2002). Blood levels of SN-38 fell by 42 percent with the herb, and the fall in white blood cells — a marker of the drug's effect — was substantially smaller. The authors concluded that the reduced levels "may have a deleterious impact on treatment outcome". In other words, "speeding up" the body's drug-clearing enzymes can mean clearing the chemotherapy too. The site's page on St. John's wort drug interactions covers this in more detail.

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Coffee Enemas: Case Reports and Studies

A coffee enema is brewed coffee run into the lower bowel and held for several minutes. It is the central "liver detoxification" step of the Gerson therapy; the site's page on coffee enemas in the Gerson therapy sets out that therapy's own explanation (bile-duct dilation, the enzyme glutathione S-transferase, coffee palmitates) as its books state it. The mouse studies cited there measured the enzyme after coffee beans were added to the animals' food, not after enemas.

What studies in people measured

• A systematic review. A 2020 systematic review searched English, Korean, Chinese and Japanese databases for any study of self-administered coffee enemas (Son and colleagues, 2020). It found no study that reported effectiveness for any condition. It found nine case reports of harm: seven described inflammation of the colon (colitis) or rectal burns and perforation, and two described deaths.
• The deaths. As summarised in that review, a 1980 report in the Journal of the American Medical Association described two people — one with cancer — who used frequent coffee enemas and died; autopsy findings showed low sodium, chloride and potassium levels, and electrolyte imbalance was judged the most plausible cause. A 1984 report described a woman with breast cancer that had spread to the liver who began frequent coffee enemas and developed blood poisoning from gut bacteria (polymicrobial enteric septicaemia) before dying of liver failure.
• Inflammation of the bowel. A 2020 case report from Detroit described proctocolitis (inflammation of the rectum and colon) in a healthy person after coffee enemas and noted that only three earlier cases of this complication had been published (Lee and colleagues, 2020).
• How much caffeine is absorbed. In a randomized crossover study of 11 healthy men, caffeine reached the blood after a 500-millilitre coffee enema, but its peak level and total exposure were about 3.5 times lower than after drinking a coffee beverage with a similar caffeine content (Teekachunhatean and colleagues, 2013). The study did not measure liver detoxification or any cancer outcome.

A comparison study involving "detoxification"

A study sponsored by the United States National Cancer Institute began in 1998 as a randomized trial in inoperable pancreatic cancer, comparing an enzyme-based regimen — pancreatic enzymes, nutritional supplements, "detoxification" and an organic diet — with gemcitabine-based chemotherapy (Chabot and colleagues, 2010). Because most eligible patients refused to be randomized, it was changed into an observational study in which patients chose their treatment. Among 55 patients, median survival was 14 months with chemotherapy and 4.3 months with the enzyme regimen; at one year 56 percent of the chemotherapy group and 16 percent of the enzyme group were alive, and quality-of-life ratings were better in the chemotherapy group. The abstract does not list the detoxification steps used.

No randomized trial of coffee enemas given alongside chemotherapy was found.

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Insulin Potentiation Therapy

Insulin potentiation therapy means giving insulin to lower blood sugar and then giving chemotherapy at a fraction of the standard dose, on the idea that insulin makes cancer cells take up more of the drug. The idea was set out in a 1986 paper in the journal Medical Hypotheses, whose authors described it as a "potentially revolutionary concept" that deserved laboratory work and "properly conducted human clinical trials" (Ayre and colleagues, 1986).

A PubMed search for the phrase "insulin potentiation therapy" in titles and abstracts returned five records on 2026-10-23. The clinical data found were:

• A small randomized trial of tumour size. Thirty women with breast cancer that had spread and had stopped responding to earlier chemotherapy and hormone therapy were randomized, 10 per group, to insulin plus methotrexate, methotrexate alone or insulin alone for two 21-day courses (Lasalvia-Prisco and colleagues, 2004). The insulin-plus-methotrexate group most often had stable disease, and the median growth in tumour size was smaller than with either drug alone. The trial measured tumour size over about six weeks; it did not report survival.
• An uncontrolled series. Sixteen men with prostate cancer that had stopped responding to hormone treatment received low-dose chemotherapy with insulin plus hormone therapy, in two groups of eight with no untreated comparison group (Damyanov and colleagues, 2012). Blood levels of prostate-specific antigen fell partly in 8 of 16 men, and median survival was 11.7 months. The authors called the results preliminary.

No trial was found that compared insulin potentiation therapy with standard-dose chemotherapy for survival. A 2019 commentary by clinical pharmacologists at the National Cancer Institute in The Lancet Oncology was titled "Insulin potentiation therapy for cancer?"; its full text was not available to this page, so its conclusions are not summarised here.

The U.S. Food and Drug Administration label for regular human insulin states that hypoglycaemia (low blood sugar) "is the most common adverse reaction of all insulins" and "may be life-threatening", and that low blood potassium (hypokalaemia) may also be life-threatening. The site's page on insulin types explains how insulin is used in diabetes.

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Hyperthermia: The Randomized Trials

Hyperthermia means heating tissue, usually to about 40–43 °C. It is the one item on the speaker's list with large randomized trials behind it in some cancers. In those trials the heat is given at the same time as chemotherapy, to strengthen the drug's effect inside the tumour, not afterwards to clear it.

Regional hyperthermia in soft-tissue sarcoma

A European and North American phase 3 trial randomized 341 adults with large, high-grade soft-tissue sarcomas to chemotherapy (etoposide, ifosfamide and doxorubicin) with or without regional hyperthermia, in which the tumour area is heated with radio-frequency energy (Issels and colleagues, 2010):

• At two years, 76 percent of the hyperthermia group were alive without local progression, compared with 61 percent of the chemotherapy-only group (relative hazard 0.58).
• The tumour response rate was 28.8 percent with hyperthermia and 12.7 percent without.
• Severe falls in white blood cells were more frequent with hyperthermia (128 of 165 patients versus 106 of 167). Pain, pressure from the heating device and skin burns occurred and were severe in a few patients; two deaths were attributed to treatment in the hyperthermia group and one in the chemotherapy-only group.

Long-term results after a median 11.3 years of follow-up showed longer survival with hyperthermia: 62.7 percent versus 51.3 percent at five years, and 52.6 percent versus 42.7 percent at ten years (hazard ratio 0.73) (Issels and colleagues, 2018). Some authors reported fees or travel support from makers of hyperthermia equipment.

Heated chemotherapy washed through the abdomen

Hyperthermic intraperitoneal chemotherapy bathes the inside of the abdomen with heated chemotherapy during surgery:

• In a Dutch phase 3 trial of 245 women with stage III ovarian cancer who had first received three cycles of chemotherapy, adding heated cisplatin to surgery lengthened median recurrence-free survival from 10.7 to 14.2 months and median overall survival from 33.9 to 45.7 months, with similar rates of severe side effects (27 versus 25 percent) (van Driel and colleagues, 2018).
• A Korean trial of 184 women with stage III or intravenous (IV) ovarian cancer found no overall difference in progression-free or overall survival; a benefit appeared only in the subgroup operated on after initial chemotherapy (Lim and colleagues, 2022).
• A 2022 meta-analysis of six randomized trials (737 patients) found improved five-year survival when heated chemotherapy was added to surgery after initial chemotherapy in newly diagnosed ovarian cancer, no survival advantage in recurrent ovarian cancer, and called its use in other settings investigational (Filis and colleagues, 2022).

Whole-body and electro-hyperthermia

The hyperthermia offered in many complementary settings is whole-body hyperthermia (raising the whole body's temperature) or electro-hyperthermia, rather than the monitored regional heating used in the trials above. A 2022 systematic review of 53 studies with 2,006 patients, most of them single-group studies and six randomized, concluded that for these two methods there is no evidence of improved survival or quality of life in people with cancer (Liebl and colleagues, 2022).

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Hyperbaric Oxygen and Cancer

Hyperbaric oxygen means breathing pure oxygen inside a chamber pressurised above normal air pressure, which raises the amount of oxygen dissolved in the blood. The site's page on hyperbaric oxygen therapy covers its established uses.

• Most cancer research on hyperbaric oxygen has asked whether it might feed tumour growth, since it helps wounds heal. A 2003 review of clinical, animal and cell-culture studies found "no more than a neutral effect" on tumour growth, with some studies suggesting a slowing effect, and concluded that a history of cancer was not a reason to withhold the treatment (Feldmeier and colleagues, 2003).
• A 2012 review of the work published from 2004 to 2012 likewise found no evidence that hyperbaric oxygen stimulates tumour growth or recurrence, and evidence — largely from laboratory and animal studies — that it may inhibit some tumour types (Moen and Stuhr, 2012).

None of these reviews describes hyperbaric oxygen as a way to remove chemotherapy drugs or "detox" the body, and no trial of hyperbaric oxygen as a detox step after chemotherapy was found.

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Juicing and Fasting Around Chemotherapy

Juicing

No randomized trial of fruit or vegetable juicing during chemotherapy was found in a PubMed search on 2026-10-23. One known interaction involving juice is documented by the U.S. Food and Drug Administration: grapefruit juice can block the gut enzyme cytochrome P450 3A4, so that "more of the drug enters the blood and stays in the body longer". The agency's consumer page lists examples from heart, transplant and anxiety medicines rather than cancer drugs. The site's modified Gerson therapy during chemotherapy page describes one juice-based programme as its proponents present it.

Fasting-mimicking diets

A fasting-mimicking diet is a very low-calorie, low-protein plant-based diet eaten for a few days. Two randomized trials tested it around chemotherapy for breast cancer:

• The Dutch phase 2 DIRECT trial randomized 131 women with stage II or III breast cancer negative for the growth-factor receptor HER2 (human epidermal growth factor receptor 2) to the diet or their usual diet for three days before and during each chemotherapy cycle given before surgery (de Groot and colleagues, 2020). Side effects did not differ between the groups, even though the anti-nausea steroid dexamethasone was left out in the diet group. Tumour shrinkage on scans was more frequent with the diet (odds ratio 3.17), and in a per-protocol analysis a near-complete loss of tumour cells was more likely (odds ratio 4.11). One author held equity in a company that sells a fasting-mimicking diet.
• An Iranian trial of 44 women found less severe vomiting and fewer severe falls in a type of white blood cell (neutropenia) with the diet, and a more frequent strong pathological response (Bahrami and colleagues, 2024).

Both trials were small and tested the diet as part of standard chemotherapy, not as a detox afterwards, and neither reported survival. DIRECT enrolled only women who were not underweight. The site's fasting page covers fasting research more broadly.

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Complementary Medicine Use and Survival

Several large studies from the United States National Cancer Database — a registry of about 1,500 hospital cancer programmes — have compared survival in people who used treatments given by non-medical practitioners with people who did not. They are observational: people chose their treatments, so the studies show associations, and they cannot say which specific practices (detox, diet, supplements) were used.

• Alternative medicine instead of standard treatment. Among patients with non-metastatic breast, prostate, lung or colorectal cancer, 281 chose alternative medicine as their only treatment. Compared with matched patients receiving standard treatment, their risk of death was 2.5 times higher overall, and 5.68 times higher for breast cancer (Johnson and colleagues, 2018, Journal of the National Cancer Institute).
• Complementary medicine alongside standard treatment. In a second analysis, 258 patients used complementary medicine in addition to at least one standard treatment. Their five-year survival was 82.2 percent versus 86.6 percent in matched controls. They refused chemotherapy far more often (34.1 versus 3.2 percent) and also refused surgery, radiotherapy and hormone therapy more often; once refusal and delay were taken into account, complementary medicine itself was no longer significantly linked to survival (Johnson and colleagues, 2018, JAMA Oncology). The authors concluded that the higher risk was mediated by refusal of standard treatment.
• A 2026 breast cancer analysis. Among more than 2.1 million women with breast cancer diagnosed from 2011 to 2021, 273 used complementary or alternative medicine alone and 568 combined it with standard treatment. Using it alone was linked to a mortality risk 3.67 times higher than standard treatment; combining it with standard treatment was linked to a 1.45-times higher risk, and these women were less likely to receive endocrine therapy and radiation (Ayoade and colleagues, 2026).

Decisions about cancer treatment belong with a clinician; the studies above describe outcomes in groups, not what will happen to any one person.

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How the Claim Compares With the Research

• "Most chemotherapy has a 48-hour half-life": not supported. The U.S. Food and Drug Administration labels checked give half-lives from 8 minutes (fluorouracil) to 391 hours for oxaliplatin's platinum and weeks for platinum in red blood cells after cisplatin. Two of six drugs (doxorubicin, paclitaxel) fall near 48 hours.
• "After 72 hours the chemotherapy has been utilized": not supported. A half-life marks when half the drug remains, not when it is used up, and several drugs act through forms that persist in cells. No study defining a 72-hour cut-off or testing a detox timed to it was found.
• Detoxing the liver during chemotherapy: no supporting trial; some research raises concerns. No trial of a detox programme during chemotherapy was found. Speeding up liver drug-processing with St. John's wort lowered an active chemotherapy compound by 42 percent, and antioxidant, vitamin B12 and iron supplement use was associated with poorer outcomes in one breast cancer cohort.
• Coffee enemas: no effectiveness study found; case reports of harm. A systematic review found no study reporting benefit and nine case reports of colitis, rectal burns, perforation and two deaths.
• Insulin potentiation therapy: very little research. One 30-patient randomized trial of tumour size and one 16-patient uncontrolled series were found; no survival comparison with standard chemotherapy. Insulin's label lists hypoglycaemia as a life-threatening risk.
• Hyperthermia: supported in specific settings, for a different purpose. Randomized trials show benefit when monitored regional hyperthermia or heated abdominal chemotherapy is given together with chemotherapy in high-risk soft-tissue sarcoma and in some ovarian cancer. A systematic review found no evidence of survival or quality-of-life benefit for whole-body or electro-hyperthermia.
• Hyperbaric oxygen: reviews find no tumour-promoting effect, but no research as a detox.
• Juicing: no trial found. Fasting-mimicking diet: two small, encouraging trials as part of chemotherapy, not survival data.
• Complementary medicine and survival: large registry studies link it to poorer survival, largely through refusal or omission of standard treatment.

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What Is Not Known

• Whether any defined "detox" programme changes how much chemotherapy remains in the body, how well it works, or its side effects — no trial measuring this was found.
• Which specific practices were used by patients counted as complementary-medicine users in the registry studies; the database records only that a non-medical practitioner gave treatment.
• Whether insulin potentiation therapy affects survival, and how often it causes dangerous low blood sugar in practice.
• How often coffee enemas cause harm; case reports show that harm occurs but cannot give a rate.
• Whether the antioxidant and supplement associations seen in one breast cancer cohort hold in other cancers and other drug regimens.
• Whether fasting-mimicking diets improve survival, and in which patients they are tolerated; the published trials were small and short.
• Whether whole-body hyperthermia adds benefit to chemotherapy; the evidence so far comes mostly from single-group studies.

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Connections

• Cancer and Parasites
• Parasite Cleanse Claims: Phases, Timing and Lifestyle
• Blood Ozone and Ultraviolet Blood Irradiation
• Nutrition in Cancer Care and Medical Training
• Coffee Enemas in the Gerson Therapy
• Modified Gerson Therapy During Chemotherapy
• Coffee Enemas (Detox Protocols)
• Liver Detox
• Hyperbaric Oxygen Therapy
• Sauna
• Fasting
• St. John's Wort: Critical Drug Interactions
• Antioxidants
• Oncology

Key Research Papers

1. Ambrosone CB, Zirpoli GR, Hutson AD, McCann WE, McCann SE, Barlow WE, et al. Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221). J Clin Oncol. 2020;38(8):804-814. PubMed PMID: 31855498
2. Mathijssen RH, Verweij J, de Bruijn P, Loos WJ, Sparreboom A. Effects of St. John's wort on irinotecan metabolism. J Natl Cancer Inst. 2002;94(16):1247-9. PubMed PMID: 12189228
3. Son H, Song HJ, Seo HJ, Lee H, Choi SM, Lee S. The safety and effectiveness of self-administered coffee enema: A systematic review of case reports. Medicine (Baltimore). 2020;99(36):e21998. PubMed PMID: 32899046
4. Lee AH, Kabashneh S, Tsouvalas CP, Rahim U, Khan MY, Anees M, et al. Proctocolitis From Coffee Enema. ACG Case Rep J. 2020;7(1):e00292. PubMed PMID: 32309489
5. Teekachunhatean S, Tosri N, Rojanasthien N, Srichairatanakool S, Sangdee C. Pharmacokinetics of Caffeine following a Single Administration of Coffee Enema versus Oral Coffee Consumption in Healthy Male Subjects. ISRN Pharmacol. 2013;2013:147238. PubMed PMID: 23533801
6. Chabot JA, Tsai WY, Fine RL, Chen C, Kumah CK, Antman KA, et al. Pancreatic proteolytic enzyme therapy compared with gemcitabine-based chemotherapy for the treatment of pancreatic cancer. J Clin Oncol. 2010;28(12):2058-63. PubMed PMID: 19687327
7. Ayre SG, Perez Garcia y Bellon D, Perez Garcia D Jr. Insulin potentiation therapy: a new concept in the management of chronic degenerative disease. Med Hypotheses. 1986;20(2):199-210. PubMed PMID: 3526099
8. Lasalvia-Prisco E, Cucchi S, Vázquez J, Lasalvia-Galante E, Golomar W, Gordon W. Insulin-induced enhancement of antitumoral response to methotrexate in breast cancer patients. Cancer Chemother Pharmacol. 2004;53(3):220-4. PubMed PMID: 14655024
9. Damyanov C, Gerasimova D, Maslev I, Gavrilov V. Low-dose chemotherapy with insulin (insulin potentiation therapy) in combination with hormone therapy for treatment of castration-resistant prostate cancer. ISRN Urol. 2012;2012:140182. PubMed PMID: 22649741
10. Sissung TM, Schmidt KT, Figg WD. Insulin potentiation therapy for cancer? Lancet Oncol. 2019;20(2):191-192. PubMed PMID: 30712796
11. Issels RD, Lindner LH, Verweij J, Wust P, Reichardt P, Schem BC, et al. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol. 2010;11(6):561-70. PubMed PMID: 20434400
12. Issels RD, Lindner LH, Verweij J, Wessalowski R, Reichardt P, Wust P, et al. Effect of Neoadjuvant Chemotherapy Plus Regional Hyperthermia on Long-term Outcomes Among Patients With Localized High-Risk Soft Tissue Sarcoma: The EORTC 62961-ESHO 95 Randomized Clinical Trial. JAMA Oncol. 2018;4(4):483-492. PubMed PMID: 29450452
13. van Driel WJ, Koole SN, Sikorska K, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, et al. Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer. N Engl J Med. 2018;378(3):230-240. PubMed PMID: 29342393
14. Lim MC, Chang SJ, Park B, Yoo HJ, Yoo CW, Nam BH, et al. Survival After Hyperthermic Intraperitoneal Chemotherapy and Primary or Interval Cytoreductive Surgery in Ovarian Cancer: A Randomized Clinical Trial. JAMA Surg. 2022;157(5):374-383. PubMed PMID: 35262624
15. Filis P, Mauri D, Markozannes G, Tolia M, Filis N, Tsilidis K. Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: a systematic review and meta-analysis of randomized trials. ESMO Open. 2022;7(5):100586. PubMed PMID: 36116421
16. Liebl CM, Kutschan S, Dörfler J, Käsmann L, Hübner J. Systematic review about complementary medical hyperthermia in oncology. Clin Exp Med. 2022;22(4):519-565. PubMed PMID: 35767077
17. Feldmeier J, Carl U, Hartmann K, Sminia P. Hyperbaric oxygen: does it promote growth or recurrence of malignancy? Undersea Hyperb Med. 2003;30(1):1-18. PubMed PMID: 12841604
18. Moen I, Stuhr LE. Hyperbaric oxygen therapy and cancer--a review. Target Oncol. 2012;7(4):233-42. PubMed PMID: 23054400
19. de Groot S, Lugtenberg RT, Cohen D, Welters MJP, Ehsan I, Vreeswijk MPG, et al. Fasting mimicking diet as an adjunct to neoadjuvant chemotherapy for breast cancer in the multicentre randomized phase 2 DIRECT trial. Nat Commun. 2020;11(1):3083. PubMed PMID: 32576828
20. Bahrami A, Haghighi S, Moghani MM, Khodakarim N, Hejazi E. Fasting mimicking diet during neo-adjuvant chemotherapy in breast cancer patients: a randomized controlled trial study. Front Nutr. 2024;11:1483707. PubMed PMID: 39703333
21. Johnson SB, Park HS, Gross CP, Yu JB. Use of Alternative Medicine for Cancer and Its Impact on Survival. J Natl Cancer Inst. 2018;110(1). PubMed PMID: 28922780
22. Johnson SB, Park HS, Gross CP, Yu JB. Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers. JAMA Oncol. 2018;4(10):1375-1381. PubMed PMID: 30027204
23. Ayoade OF, Caturegli G, Canavan ME, Resio BJ, Berger ER, Boffa DJ. Use of Complementary and Alternative Medicine in the Management of Breast Cancer. JAMA Netw Open. 2026;9(3):e260337. PubMed PMID: 41770560

PubMed Topic Searches

1. Coffee enema
2. Insulin potentiation therapy
3. Regional hyperthermia with chemotherapy: randomized trials
4. Dietary supplement use during chemotherapy and survival
5. Fasting-mimicking diet and chemotherapy

Other Sources

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3. U.S. Food and Drug Administration prescribing information: cisplatin injection, Clinical Pharmacology section. DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov
4. U.S. Food and Drug Administration prescribing information: oxaliplatin injection, section 12.3 Pharmacokinetics and patient information. DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov
5. U.S. Food and Drug Administration prescribing information: doxorubicin hydrochloride injection, section 12.3 Pharmacokinetics. DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov
6. U.S. Food and Drug Administration prescribing information: paclitaxel injection, Clinical Pharmacology section (Table 1). DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov
7. U.S. Food and Drug Administration prescribing information: regular human insulin injection, Warnings and Precautions. DailyMed, U.S. National Library of Medicine. dailymed.nlm.nih.gov
8. U.S. Food and Drug Administration. Grapefruit Juice and Some Drugs Don't Mix (consumer update). fda.gov

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