Talking with patients about use of supplements or wellness products during cancer care

People with cancer often consider the use of supplements (natural health products) or wellness products while receiving cancer treatment. They may do so in an attempt to improve energy, support the immune system, reduce treatment side effects, or feel more in control during a difficult period of their life. Patients may contemplate taking herbal supplements, detox cleanses, high-dose vitamin infusions, and products sold online as immune support or natural wellness products. Although some supplements may be safe or helpful in certain situations, others can interfere with cancer treatment, increase side effects, or add unnecessary cost without clear evidence that they are beneficial. Open conversations with patients can help them make informed decisions.Key points to discuss with patients: 1. “Natural” does not always mean safeMany wellness products are marketed as “natural,” but some supplements may reduce the effectiveness of cancer treatments, change how the liver or kidneys process medications, increase bleeding risk during surgery or procedures, and increase side effects when combined with cancer treatment. For example, St John’s wort, a herbal supplement sometimes used for mood support, can affect how certain cancer medications work.In some situations, the oncology team may recommend vitamins or nutrition support products, especially for patients with vitamin deficiencies, poor nutrition or weight loss. The team will assess whether a product is safe and appropriate for a specific patient’s treatment plan.2. It can be difficult to know what is safeMany wellness products are heavily marketed online and on social media using terms such as immune boosting, detoxifying or anti-inflammatory. These claims are often based on limited scientific evidence, and not every product has been carefully studied in people receiving cancer treatment. The quality and ingredients in these products may vary between brands. Some products may contain different amounts of ingredients than listed on the label, ingredients that interact with cancer medications or combine multiple supplements in one product. They may also make unproven claims about cancer treatment or prevention.3. Common wellness products patients with cancer ask aboutPatients with cancer often ask about multivitamins, herbal supplements, mushroom products, high-dose vitamin C infusions, detox programs, protein powders, cannabidiol or cannabis products, and other immune support products sold online. Some products may be reasonable in certain situations, while others may carry greater risks.Safety often depends on the type of cancer, the treatment being received, other medications, and liver or kidney function.4. Advise patients to partner with their care team on supplement decisionsBefore trying a supplement or wellness product, advise patients to ask their cancer care team (including their pharmacist):What exactly is in this product?Is there evidence that it helps people with cancer or cancer-treatment-related symptoms?Could it interfere with my cancer treatment or medications?Is there a safer or more effective way to address the symptom I am trying to manage?Pharmacists can also help by ensuring patients have an updated list of prescription medications, over-the-counter medicines, vitamins, supplements and wellness products. They can suggest that patients bring bottles or photographs of labels to oncology visits and advise them to tell the care team what symptom or concern they are hoping to improve. Above all, counsel patients to ask the care team before starting a new supplement or wellness product.The JAMA Oncology patient page on supplements and wellness products during cancer care can be downloaded or photocopied noncommercially by healthcare professionals to share with patients.Reference:Wang K, Singhi D, Singhi EK. Supplements and wellness products during cancer care. JAMA Oncol 2026; Published online August 27, 2026. (accessed August 27, 2026).

Talking with patients about use of supplements or wellness products during cancer care

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