New Evidence and Recommendations on Vitamins and Micronutrient Supplements in Children with Cancer
1. Micronutrient deficiencies are very common in children with cancer and may affect clinical outcomes. (Ganguly S. et al. 2022)
2. In a study of more than 500 children with cancer, vitamin B12 deficiency was found in approximately 39% of cases. Zinc and selenium deficiencies were also reported in a significant proportion of patients. (Ganguly S. et al. 2022)
3. Studies have shown that selenium deficiency in children with cancer, particularly in hematologic malignancies, is associated with poorer outcomes, including lower survival or a higher risk of relapse. (Ganguly S. et al. 2022)
4. In some studies, vitamin E, vitamin C, and selenium were associated with reduced severity of treatment-related complications, including those caused by chemotherapy or radiotherapy, without major safety concerns being reported in most studies. (Podpeskar A. et al. 2023)
5. However, these studies caution that the use of antioxidant supplements during chemotherapy requires careful consideration, as they may interfere with the effects of anticancer treatment or, under certain circumstances, potentially have adverse effects. Therefore, supplementation decisions should be individualized. (Podpeskar A. et al. 2023)
6. Vitamin D deficiency has also been reported to be very common in children with cancer. However, evidence that vitamin D supplementation improves bone mass or reduces fractures in these patients remains limited. (Podpeskar A. et al. 2023)
7. Based on these findings, pediatric oncologists are advised to assess micronutrient status, including vitamins, zinc, and selenium, at the beginning of treatment and at regular intervals. When a deficiency is identified, targeted supplementation should be considered in consultation with a nutrition specialist or the nutrition-oncology team.
Dr. Neda Ashayeri
Pediatric Hematologist & Oncologist
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