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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65890_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65890_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65890_"><span class="title" itemprop="name">Coenzyme Q10 (PDQ®)</span></h1><div class="subtitle whole_rhythm">Health Professional Version</div><p class="contrib-group"><span itemprop="author">PDQ Cancer Complementary and Alternative Medicine Editorial Board</span>.</p><p class="small">Published online: May 14, 2014.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062979__62">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of coenzyme Q10 in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p><p id="CDR0000062979__63">This summary is reviewed regularly and updated as necessary by the PDQ Cancer Complementary and Alternative Medicine Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p></div><div id="CDR0000062979__1"><h2 id="_CDR0000062979__1_">Overview</h2><p id="CDR0000062979__2">This <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044964/" class="def">complementary
|
|
and alternative medicine</a> (CAM) information summary provides an overview of
|
|
the use of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346488/" class="def">coenzyme</a> Q<sub>10</sub> in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> therapy. The summary includes a
|
|
history of coenzyme Q<sub>10</sub> research, a review of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044512/" class="def">laboratory studies</a>,
|
|
and data from investigations involving human subjects. Although several
|
|
naturally occurring forms of coenzyme Q have been identified, Q<sub>10</sub>
|
|
is the predominant form found in humans and most mammals, and it is the form
|
|
most studied for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043985/" class="def">therapeutic</a>
|
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potential. Thus, it will be the only form of coenzyme Q discussed in this
|
|
summary. </p><p id="CDR0000062979__3">This summary contains the following key information:</p><ul id="CDR0000062979__4"><li class="half_rhythm"><div>Coenzyme Q<sub>10</sub> is made naturally by the human body.</div></li><li class="half_rhythm"><div>Coenzyme Q<sub>10</sub> helps <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> to produce energy, and it acts as an
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043997/" class="def">antioxidant</a>.</div></li><li class="half_rhythm"><div>Coenzyme Q<sub>10</sub> has shown an ability to stimulate the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune
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system</a> and to protect the heart from damage caused by certain
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> drugs.</div></li><li class="half_rhythm"><div>Low <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> levels of coenzyme Q<sub>10</sub> have been detected in
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patients with some types of cancer.</div></li><li class="half_rhythm"><div>No report of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045858/" class="def">randomized clinical trial</a>
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of coenzyme Q<sub>10</sub> as a treatment for cancer has been published in a
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peer-reviewed scientific journal.</div></li><li class="half_rhythm"><div>Coenzyme Q<sub>10</sub> is marketed in the United States as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373932/" class="def">dietary
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supplement</a>.</div></li></ul><p id="CDR0000062979__34">Many of the medical and scientific terms used in the summary are hypertext linked (at first use in each section) to the <a href="http://www.cancer.gov/dictionary/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI Dictionary of Cancer Terms</a>, which is oriented toward nonexperts. When a linked term is clicked, a definition will appear in a separate window.</p><p id="CDR0000062979__35">Reference citations in some <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> CAM information summaries may include links to external Web sites that are operated by individuals or organizations for the purpose of marketing or advocating the use of specific treatments or products. These reference citations are included for informational purposes only. Their inclusion should not be viewed as an endorsement of the content of the Web sites, or of any treatment or product, by the PDQ Cancer CAM Editorial Board or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a>.</p></div><div id="CDR0000062979__5"><h2 id="_CDR0000062979__5_">General Information</h2><p id="CDR0000062979__6"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346488/" class="def">Coenzyme</a> Q<sub>10</sub> (also known as CoQ<sub>10</sub>, Q<sub>10</sub>,
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vitamin Q<sub>10</sub>, ubiquinone, and ubidecarenone) is a benzoquinone
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compound synthesized naturally by the human body. The “Q” and the “10” in the
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name refer to the quinone chemical group and the 10 isoprenyl subunits that are part of this compound’s structure. The term
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“coenzyme” denotes it as an organic (contains carbon atoms), nonprotein <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045065/" class="def">molecule</a> necessary for the proper
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functioning of its <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> partner (an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzyme</a> or an enzyme complex). Coenzyme
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Q<sub>10</sub> is used by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> of the body in a process known variously as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043993/" class="def">aerobic respiration</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043992/" class="def">aerobic metabolism</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044071/" class="def">oxidative metabolism</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044008/" class="def">cell respiration</a>. Through this
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process, mitochondria produce energy for cell growth and maintenance.[<a class="bk_pop" href="#CDR0000062979_rl_5_1">1</a>-<a class="bk_pop" href="#CDR0000062979_rl_5_4">4</a>]
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Coenzyme Q<sub>10</sub> is also used by the body as an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044026/" class="def">endogenous</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043997/" class="def">antioxidant</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_2">2</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_4">4</a>-<a class="bk_pop" href="#CDR0000062979_rl_5_8">8</a>] An antioxidant is a substance that protects cells from
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044030/" class="def">free radicals</a>, which are highly
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reactive chemicals, often containing oxygen atoms, capable of damaging
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important cellular components such as <a href="/books/n/pdqcis/glossary_gen/def-item/glossary_gen_CDR0000044393/" class="def">DNA</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046068/" class="def">lipids</a>. In addition, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045839/" class="def">plasma</a> level of coenzyme Q<sub>10</sub> has
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been used in studies as a measure of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044072/" class="def">oxidative stress</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_9">9</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_10">10</a>]</p><p id="CDR0000062979__7">Coenzyme Q<sub>10</sub> is present in most <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a>, but the highest
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concentrations are found in the heart, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidneys</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_11">11</a>] The lowest concentration is
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found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lungs</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_11">11</a>] Tissue levels of this compound decrease as people age,
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due to increased requirements, decreased production,[<a class="bk_pop" href="#CDR0000062979_rl_5_11">11</a>] or insufficient intake
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of the chemical precursors needed for synthesis.[<a class="bk_pop" href="#CDR0000062979_rl_5_12">12</a>] In humans,
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normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> levels of coenzyme Q<sub>10</sub> have been defined variably,
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with reported normal values ranging from 0.30 to 3.84 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306521/" class="def">µg</a>/<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044214/" class="def">mL</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_2">2</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_4">4</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_13">13</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_14">14</a>]</p><p id="CDR0000062979__8">Given the importance of coenzyme Q<sub>10</sub> in optimizing cellular energy
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production, use of this compound as a treatment for diseases other than <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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has been explored. Most of these investigations have focused on coenzyme
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Q<sub>10</sub> as a treatment for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044005/" class="def">cardiovascular</a> disease.[<a class="bk_pop" href="#CDR0000062979_rl_5_2">2</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_4">4</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_15">15</a>] In patients with cancer, coenzyme Q<sub>10</sub> has been shown to
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protect the heart from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044916/" class="def">anthracycline</a>-induced
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044004/" class="def">cardiotoxicity</a> (anthracyclines are
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a family of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> drugs, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045140/" class="def">doxorubicin</a>, that have the potential to
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damage the heart)[<a class="bk_pop" href="#CDR0000062979_rl_5_3">3</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_16">16</a>-<a class="bk_pop" href="#CDR0000062979_rl_5_18">18</a>] and to stimulate the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_19">19</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_20">20</a>] Stimulation of the immune system by this compound has also been observed
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in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454774/" class="def">animal studies</a> and in humans without cancer.[<a class="bk_pop" href="#CDR0000062979_rl_5_21">21</a>-<a class="bk_pop" href="#CDR0000062979_rl_5_27">27</a>] In part because of its
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000285968/" class="def">immunostimulatory</a> potential, coenzyme Q<sub>10</sub> has been used as an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a> in patients with
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various types of cancer.[<a class="bk_pop" href="#CDR0000062979_rl_5_17">17</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_20">20</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_28">28</a>-<a class="bk_pop" href="#CDR0000062979_rl_5_33">33</a>]</p><p id="CDR0000062979__9">While coenzyme Q<sub>10</sub> may show indirect anticancer activity through
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its effect(s) on the immune system, there is evidence to suggest that
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044919/" class="def">analogs</a> of this compound can suppress
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cancer growth directly. Analogs of coenzyme Q<sub>10</sub> have been shown to
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inhibit the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044572/" class="def">proliferation</a> of cancer cells <i><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045733/" class="def">in vitro</a></i> and the growth of cancer cells
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046631/" class="def">transplanted</a> into rats and mice.[<a class="bk_pop" href="#CDR0000062979_rl_5_12">12</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_34">34</a>] In view of these findings, it has
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been proposed that analogs of coenzyme Q<sub>10</sub> may function as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045152/" class="def">antimetabolites</a> to disrupt normal
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044124/" class="def">biochemical reactions</a> that are required for cell growth and/or survival and,
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thus, that they may be useful as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044009/" class="def">chemotherapeutic
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agents</a>.[<a class="bk_pop" href="#CDR0000062979_rl_5_12">12</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_34">34</a>]</p><p id="CDR0000062979__10">Several companies distribute coenzyme Q<sub>10</sub> as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373932/" class="def">dietary
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supplement</a>. In the United States, dietary supplements are regulated as foods,
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not drugs. Therefore, premarket evaluation and approval by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454785/" class="def">U.S. Food and Drug
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Administration</a> (FDA) are not required unless specific disease <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">prevention</a> or
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treatment claims are made. The FDA can, however, remove from the market dietary supplements that it deems unsafe. Because dietary supplements are not formally
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reviewed for manufacturing consistency, there may be considerable variation
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from lot to lot. The FDA has not approved coenzyme Q<sub>10</sub> for the treatment of cancer or any other medical condition.</p><p id="CDR0000062979__11">To conduct <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044168/" class="def">clinical</a> drug research in the United States, researchers must
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file an Investigational New Drug (IND) application with the FDA. The IND
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application process is highly confidential, and IND information can be
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|
disclosed only by the applicants. To date, no investigators have announced
|
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that they have applied for an IND to study coenzyme Q<sub>10</sub> as a
|
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treatment for cancer.</p><p id="CDR0000062979__12">In animal studies, coenzyme Q<sub>10</sub> has been administered by
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injection</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046682/" class="def">intravenous</a>,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046339/" class="def">intraperitoneal</a>,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044048/" class="def">intramuscular</a>, or
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045914/" class="def">subcutaneous</a>). In humans, it is
|
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usually taken
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044068/" class="def">orally</a> as a pill (gel bead or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455334/" class="def">capsule</a>), but
|
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intravenous <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusions</a> have been
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given.[<a class="bk_pop" href="#CDR0000062979_rl_5_4">4</a>] Coenzyme Q<sub>10</sub> is absorbed best with fat; therefore, lipid
|
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preparations are better absorbed than the purified compound.[<a class="bk_pop" href="#CDR0000062979_rl_5_2">2</a>,<a class="bk_pop" href="#CDR0000062979_rl_5_4">4</a>]
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In human studies, supplementation <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">doses</a> and administration schedules have
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varied, but usually have been in the range of 90 to 390 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044213/" class="def">mg</a>/day.</p><div id="CDR0000062979_rl_5"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062979_rl_5_1">Crane FL, Sun IL, Sun EE: The essential functions of coenzyme Q. Clin Investig 71 (8 Suppl): S55-9, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8241706" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8241706</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_2">Pepping J: Coenzyme Q10. Am J Health Syst Pharm 56 (6): 519-21, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10192685" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10192685</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_3">Folkers K, Wolaniuk A: Research on coenzyme Q10 in clinical medicine and in immunomodulation. Drugs Exp Clin Res 11 (8): 539-45, 1985. [<a href="https://pubmed.ncbi.nlm.nih.gov/3836873" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3836873</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_4">Overvad K, Diamant B, Holm L, et al.: Coenzyme Q10 in health and disease. Eur J Clin Nutr 53 (10): 764-70, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10556981" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10556981</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_5">Beyer RE, Nordenbrand K, Ernster L: The role of coenzyme Q as a mitochondrial antioxidant: a short review. In: Folkers K, Yamamura Y, eds.: Biomedical and Clinical Aspects of Coenzyme Q. Vol 5. Amsterdam, The Netherlands: Elsevier Science Publishers B V (Biomedical Division), 1986, pp 17-24.</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_6">Gordon M: Dietary antioxidants in disease prevention. Nat Prod Rep 13 (4): 265-73, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8760864" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8760864</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_7">Palazzoni G, Pucello D, Littarru GP, et al.: Coenzyme Q10 and colorectal neoplasms in aged patients. Rays 22 (1 Suppl): 73-6, 1997 Jan-Mar. [<a href="https://pubmed.ncbi.nlm.nih.gov/9250020" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9250020</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_8">Ernster L, Dallner G: Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta 1271 (1): 195-204, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7599208" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7599208</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_9">Yamamoto Y, Yamashita S, Fujisawa A, et al.: Oxidative stress in patients with hepatitis, cirrhosis, and hepatoma evaluated by plasma antioxidants. Biochem Biophys Res Commun 247 (1): 166-70, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9636673" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9636673</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_10">Yamamoto Y, Yamashita S: Plasma ratio of ubiquinol and ubiquinone as a marker of oxidative stress. Mol Aspects Med 18 (Suppl): S79-84, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9266509" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9266509</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_11">Ernster L, Forsmark-Andrée P: Ubiquinol: an endogenous antioxidant in aerobic organisms. Clin Investig 71 (8 Suppl): S60-5, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8241707" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8241707</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_12">Folkers K: The potential of coenzyme Q 10 (NSC-140865) in cancer treatment. Cancer Chemother Rep 2 4 (4): 19-22, 1974. [<a href="https://pubmed.ncbi.nlm.nih.gov/4218125" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4218125</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_13">Folkers K, Osterborg A, Nylander M, et al.: Activities of vitamin Q10 in animal models and a serious deficiency in patients with cancer. Biochem Biophys Res Commun 234 (2): 296-9, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9177262" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9177262</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_14">Jolliet P, Simon N, Barré J, et al.: Plasma coenzyme Q10 concentrations in breast cancer: prognosis and therapeutic consequences. Int J Clin Pharmacol Ther 36 (9): 506-9, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9760013" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9760013</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_15">Baggio E, Gandini R, Plancher AC, et al.: Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 15 (Suppl): s287-94, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752841" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752841</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_16">Cortes EP, Gupta M, Chou C, et al.: Adriamycin cardiotoxicity: early detection by systolic time interval and possible prevention by coenzyme Q10. Cancer Treat Rep 62 (6): 887-91, 1978. [<a href="https://pubmed.ncbi.nlm.nih.gov/667863" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 667863</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_17">Folkers K, Brown R, Judy WV, et al.: Survival of cancer patients on therapy with coenzyme Q10. Biochem Biophys Res Commun 192 (1): 241-5, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8476426" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8476426</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_18">Iarussi D, Auricchio U, Agretto A, et al.: Protective effect of coenzyme Q10 on anthracyclines cardiotoxicity: control study in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma. Mol Aspects Med 15 (Suppl): s207-12, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752832" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752832</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_19">Folkers K, Shizukuishi S, Takemura K, et al.: Increase in levels of IgG in serum of patients treated with coenzyme Q10. Res Commun Chem Pathol Pharmacol 38 (2): 335-8, 1982. [<a href="https://pubmed.ncbi.nlm.nih.gov/7163631" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7163631</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_20">Complementary treatments highlighted at recent meeting. Oncology (Huntingt) 13 (2): 166, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10079467" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10079467</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_21">Bliznakov E, Casey A, Premuzic E: Coenzymes Q: stimulants of the phagocytic activity in rats and immune response in mice. Experientia 26 (9): 953-4, 1970. [<a href="https://pubmed.ncbi.nlm.nih.gov/5478631" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 5478631</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_22">Folkers K, Hanioka T, Xia LJ, et al.: Coenzyme Q10 increases T4/T8 ratios of lymphocytes in ordinary subjects and relevance to patients having the AIDS related complex. Biochem Biophys Res Commun 176 (2): 786-91, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1673841" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1673841</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_23">Kawase I, Niitani H, Saijo N, et al.: Enhancing effect of coenzyme, Q10 on immunorestoration with Mycobacterium bovis BCG in tumor-bearing mice. Gann 69 (4): 493-7, 1978. [<a href="https://pubmed.ncbi.nlm.nih.gov/101414" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 101414</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_24">Bliznakov EG: Effect of stimulation of the host defense system by coenzyme Q 10 on dibenzpyrene-induced tumors and infection with Friend leukemia virus in mice. Proc Natl Acad Sci U S A 70 (2): 390-4, 1973. [<a href="/pmc/articles/PMC433266/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC433266</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/4510283" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4510283</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_25">Bliznakov EG, Adler AD: Nonlinear response of the reticuloendothelial system upon stimulation. Pathol Microbiol (Basel) 38 (6): 393-410, 1972. [<a href="https://pubmed.ncbi.nlm.nih.gov/4346875" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4346875</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_26">Bliznakov EG: Coenzyme Q in experimental infections and neoplasia. In: Folkers K, Yamamura Y, eds.: Biomedical and Clinical Aspects of Coenzyme Q. Vol 1. Amsterdam, The Netherlands: Elsevier/North-Holland Biomedical Press, 1977, pp 73-83.</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_27">Barbieri B, Lund B, Lundström B, et al.: Coenzyme Q10 administration increases antibody titer in hepatitis B vaccinated volunteers--a single blind placebo-controlled and randomized clinical study. Biofactors 9 (2-4): 351-7, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10416052" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10416052</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_28">Lockwood K, Moesgaard S, Hanioka T, et al.: Apparent partial remission of breast cancer in 'high risk' patients supplemented with nutritional antioxidants, essential fatty acids and coenzyme Q10. Mol Aspects Med 15 (Suppl): s231-40, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752835" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752835</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_29">Lockwood K, Moesgaard S, Folkers K: Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochem Biophys Res Commun 199 (3): 1504-8, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7908519" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7908519</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_30">Lockwood K, Moesgaard S, Yamamoto T, et al.: Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochem Biophys Res Commun 212 (1): 172-7, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7612003" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7612003</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_31">Folkers K: Relevance of the biosynthesis of coenzyme Q10 and of the four bases of DNA as a rationale for the molecular causes of cancer and a therapy. Biochem Biophys Res Commun 224 (2): 358-61, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8702395" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8702395</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_32">Ren S, Lien EJ: Natural products and their derivatives as cancer chemopreventive agents. Prog Drug Res 48: 147-71, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9204686" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9204686</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_33">Hodges S, Hertz N, Lockwood K, et al.: CoQ10: could it have a role in cancer management? Biofactors 9 (2-4): 365-70, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10416054" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10416054</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_5_34">Folkers K, Porter TH, Bertino JR, et al.: Inhibition of two human tumor cell lines by antimetabolites of coenzyme Q10. Res Commun Chem Pathol Pharmacol 19 (3): 485-90, 1978. [<a href="https://pubmed.ncbi.nlm.nih.gov/653103" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 653103</span></a>]</div></li></ol></div></div><div id="CDR0000062979__13"><h2 id="_CDR0000062979__13_">History</h2><p id="CDR0000062979__14"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346488/" class="def">Coenzyme</a> Q<sub>10</sub> was first isolated in 1957, and its
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chemical structure (benzoquinone compound) was determined in 1958.[<a class="bk_pop" href="#CDR0000062979_rl_13_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_2">2</a>] Interest in coenzyme Q<sub>10</sub> as a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043985/" class="def">therapeutic</a> agent in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
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began in 1961, when a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321364/" class="def">deficiency</a> was noted in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> of both Swedish and
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American cancer patients, especially in the blood of patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">breast
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cancer</a>.[<a class="bk_pop" href="#CDR0000062979_rl_13_2">2</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_4">4</a>] A subsequent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044195/" class="def">study</a> showed a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044167/" class="def">statistically
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significant</a> relationship between the level of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045839/" class="def">plasma</a> coenzyme Q<sub>10</sub>
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deficiency and breast cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a>.[<a class="bk_pop" href="#CDR0000062979_rl_13_5">5</a>] Low blood levels of this
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compound have been reported in patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045771/" class="def">malignancies</a> other than breast
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cancer, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045795/" class="def">myeloma</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045368/" class="def">lymphoma</a>, and cancers of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidney</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257519/" class="def">head and neck</a>.[<a class="bk_pop" href="#CDR0000062979_rl_13_2">2</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_6">6</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_7">7</a>]
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Furthermore, decreased levels of coenzyme Q<sub>10</sub> have been detected in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> human <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>,[<a class="bk_pop" href="#CDR0000062979_rl_13_8">8</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_12">12</a>] but
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increased levels have been reported as well.[<a class="bk_pop" href="#CDR0000062979_rl_13_8">8</a>]</p><p id="CDR0000062979__15">A large amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044512/" class="def">laboratory</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454774/" class="def">animal</a> data on coenzyme Q<sub>10</sub> have
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accumulated since 1962.[<a class="bk_pop" href="#CDR0000062979_rl_13_2">2</a>] Research into cellular energy-producing mechanisms that involve this compound was awarded the Nobel Prize in
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Chemistry in 1978. Some of the accumulated data show that coenzyme
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Q<sub>10</sub> stimulates animal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune systems</a>, leading to higher <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibody</a> levels,[<a class="bk_pop" href="#CDR0000062979_rl_13_13">13</a>] greater numbers
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and/or activities of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044054/" class="def">macrophages</a> and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a> (T <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">lymphocytes</a>),[<a class="bk_pop" href="#CDR0000062979_rl_13_13">13</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_14">14</a>] and increased
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resistance to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>.[<a class="bk_pop" href="#CDR0000062979_rl_13_15">15</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_17">17</a>] Coenzyme Q<sub>10</sub> has also been
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reported to increase IgG (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045725/" class="def">immunoglobulin</a> G) antibody levels
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and to increase the CD4 to CD8 T-cell ratio in humans.[<a class="bk_pop" href="#CDR0000062979_rl_13_18">18</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_20">20</a>] CD4 and CD8
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are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> found on the surface of T cells, with CD4 and CD8 identifying
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044594/" class="def">helper T cells</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045664/" class="def">cytotoxic T cells</a>,
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respectively; decreased CD4 to CD8 T-cell ratios have been reported for cancer
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patients.[<a class="bk_pop" href="#CDR0000062979_rl_13_21">21</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_22">22</a>] Research subsequently delineated the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043997/" class="def">antioxidant</a> properties
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of coenzyme Q<sub>10</sub>.[<a class="bk_pop" href="#CDR0000062979_rl_13_23">23</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_27">27</a>]</p><p id="CDR0000062979__16">Proposed mechanisms of action for coenzyme Q<sub>10</sub> that are relevant
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to cancer include its essential function in cellular energy production and its
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stimulation of the immune system (which may both be related), as well as
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its role as an antioxidant. Coenzyme Q<sub>10</sub> is essential to
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043991/" class="def">aerobic</a> energy production,[<a class="bk_pop" href="#CDR0000062979_rl_13_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_25">25</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_28">28</a>] and it has been suggested that increased cellular energy leads to
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increased antibody synthesis in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045611/" class="def">B cells</a>
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(<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044953/" class="def">B lymphocytes</a>).[<a class="bk_pop" href="#CDR0000062979_rl_13_6">6</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_18">18</a>] As noted previously (<a href="#CDR0000062979__5">General Information section</a>),
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coenzyme Q<sub>10</sub> can also behave as an antioxidant.[<a class="bk_pop" href="#CDR0000062979_rl_13_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_25">25</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_27">27</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_29">29</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_32">32</a>] In this capacity, coenzyme Q<sub>10</sub> is thought to stabilize cell
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membranes (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046068/" class="def">lipid</a>-containing structures essential to maintaining cell
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integrity) and to prevent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044030/" class="def">free radical</a> damage to other important cellular
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components.[<a class="bk_pop" href="#CDR0000062979_rl_13_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_25">25</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_27">27</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_32">32</a>] Free radical damage to <a href="/books/n/pdqcis/glossary_gen/def-item/glossary_gen_CDR0000044393/" class="def">DNA</a> (and possibly to
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other cellular <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045065/" class="def">molecules</a>) may be a factor in cancer development.[<a class="bk_pop" href="#CDR0000062979_rl_13_11">11</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_23">23</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_30">30</a>,<a class="bk_pop" href="#CDR0000062979_rl_13_33">33</a>-<a class="bk_pop" href="#CDR0000062979_rl_13_36">36</a>]</p><div id="CDR0000062979_rl_13"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062979_rl_13_1">Pepping J: Coenzyme Q10. Am J Health Syst Pharm 56 (6): 519-21, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10192685" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10192685</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_2">Folkers K, Osterborg A, Nylander M, et al.: Activities of vitamin Q10 in animal models and a serious deficiency in patients with cancer. Biochem Biophys Res Commun 234 (2): 296-9, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9177262" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9177262</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_3">Lockwood K, Moesgaard S, Yamamoto T, et al.: Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochem Biophys Res Commun 212 (1): 172-7, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7612003" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7612003</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_4">Ren S, Lien EJ: Natural products and their derivatives as cancer chemopreventive agents. Prog Drug Res 48: 147-71, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9204686" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9204686</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_5">Jolliet P, Simon N, Barré J, et al.: Plasma coenzyme Q10 concentrations in breast cancer: prognosis and therapeutic consequences. Int J Clin Pharmacol Ther 36 (9): 506-9, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9760013" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9760013</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_6">Folkers K: The potential of coenzyme Q 10 (NSC-140865) in cancer treatment. Cancer Chemother Rep 2 4 (4): 19-22, 1974. [<a href="https://pubmed.ncbi.nlm.nih.gov/4218125" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4218125</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_7">Folkers K: Relevance of the biosynthesis of coenzyme Q10 and of the four bases of DNA as a rationale for the molecular causes of cancer and a therapy. Biochem Biophys Res Commun 224 (2): 358-61, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8702395" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8702395</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_8">Chipperfield B: Ubiquinone concentrations in some tumour-bearing tissues. Ubiquinone concentrations in tumours and some normal tissues in man. Nature 209 (29): 1207-8, 1966. [<a href="https://pubmed.ncbi.nlm.nih.gov/5225398" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 5225398</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_9">Eggens I, Elmberger PG, Löw P: Polyisoprenoid, cholesterol and ubiquinone levels in human hepatocellular carcinomas. Br J Exp Pathol 70 (1): 83-92, 1989. [<a href="/pmc/articles/PMC2040537/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2040537</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/2538136" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2538136</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_10">Mano T, Iwase K, Hayashi R, et al.: Vitamin E and coenzyme Q concentrations in the thyroid tissues of patients with various thyroid disorders. Am J Med Sci 315 (4): 230-2, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9537635" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9537635</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_11">Picardo M, Grammatico P, Roccella F, et al.: Imbalance in the antioxidant pool in melanoma cells and normal melanocytes from patients with melanoma. J Invest Dermatol 107 (3): 322-6, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8751964" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8751964</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_12">Portakal O, Ozkaya O, Erden Inal M, et al.: Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients. Clin Biochem 33 (4): 279-84, 2000. [<a href="https://pubmed.ncbi.nlm.nih.gov/10936586" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10936586</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_13">Bliznakov E, Casey A, Premuzic E: Coenzymes Q: stimulants of the phagocytic activity in rats and immune response in mice. Experientia 26 (9): 953-4, 1970. [<a href="https://pubmed.ncbi.nlm.nih.gov/5478631" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 5478631</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_14">Kawase I, Niitani H, Saijo N, et al.: Enhancing effect of coenzyme, Q10 on immunorestoration with Mycobacterium bovis BCG in tumor-bearing mice. Gann 69 (4): 493-7, 1978. [<a href="https://pubmed.ncbi.nlm.nih.gov/101414" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 101414</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_15">Bliznakov EG: Effect of stimulation of the host defense system by coenzyme Q 10 on dibenzpyrene-induced tumors and infection with Friend leukemia virus in mice. Proc Natl Acad Sci U S A 70 (2): 390-4, 1973. [<a href="/pmc/articles/PMC433266/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC433266</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/4510283" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4510283</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_16">Bliznakov EG, Adler AD: Nonlinear response of the reticuloendothelial system upon stimulation. Pathol Microbiol (Basel) 38 (6): 393-410, 1972. [<a href="https://pubmed.ncbi.nlm.nih.gov/4346875" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4346875</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_17">Bliznakov EG: Coenzyme Q in experimental infections and neoplasia. In: Folkers K, Yamamura Y, eds.: Biomedical and Clinical Aspects of Coenzyme Q. Vol 1. Amsterdam, The Netherlands: Elsevier/North-Holland Biomedical Press, 1977, pp 73-83.</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_18">Folkers K, Shizukuishi S, Takemura K, et al.: Increase in levels of IgG in serum of patients treated with coenzyme Q10. Res Commun Chem Pathol Pharmacol 38 (2): 335-8, 1982. [<a href="https://pubmed.ncbi.nlm.nih.gov/7163631" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7163631</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_19">Folkers K, Hanioka T, Xia LJ, et al.: Coenzyme Q10 increases T4/T8 ratios of lymphocytes in ordinary subjects and relevance to patients having the AIDS related complex. Biochem Biophys Res Commun 176 (2): 786-91, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1673841" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1673841</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_20">Barbieri B, Lund B, Lundström B, et al.: Coenzyme Q10 administration increases antibody titer in hepatitis B vaccinated volunteers--a single blind placebo-controlled and randomized clinical study. Biofactors 9 (2-4): 351-7, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10416052" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10416052</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_21">Shaw M, Ray P, Rubenstein M, et al.: Lymphocyte subsets in urologic cancer patients. Urol Res 15 (3): 181-5, 1987. [<a href="https://pubmed.ncbi.nlm.nih.gov/2957843" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2957843</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_22">Tsuyuguchi I, Shiratsuchi H, Fukuoka M: T-lymphocyte subsets in primary lung cancer. Jpn J Clin Oncol 17 (1): 13-7, 1987. [<a href="https://pubmed.ncbi.nlm.nih.gov/3494139" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3494139</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_23">Yamamoto Y, Yamashita S, Fujisawa A, et al.: Oxidative stress in patients with hepatitis, cirrhosis, and hepatoma evaluated by plasma antioxidants. Biochem Biophys Res Commun 247 (1): 166-70, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9636673" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9636673</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_24">Yamamoto Y, Yamashita S: Plasma ratio of ubiquinol and ubiquinone as a marker of oxidative stress. Mol Aspects Med 18 (Suppl): S79-84, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9266509" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9266509</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_25">Crane FL, Sun IL, Sun EE: The essential functions of coenzyme Q. Clin Investig 71 (8 Suppl): S55-9, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8241706" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8241706</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_26">Overvad K, Diamant B, Holm L, et al.: Coenzyme Q10 in health and disease. Eur J Clin Nutr 53 (10): 764-70, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10556981" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10556981</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_27">Ernster L, Forsmark-Andrée P: Ubiquinol: an endogenous antioxidant in aerobic organisms. Clin Investig 71 (8 Suppl): S60-5, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8241707" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8241707</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_28">Folkers K, Wolaniuk A: Research on coenzyme Q10 in clinical medicine and in immunomodulation. Drugs Exp Clin Res 11 (8): 539-45, 1985. [<a href="https://pubmed.ncbi.nlm.nih.gov/3836873" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3836873</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_29">Beyer RE, Nordenbrand K, Ernster L: The role of coenzyme Q as a mitochondrial antioxidant: a short review. In: Folkers K, Yamamura Y, eds.: Biomedical and Clinical Aspects of Coenzyme Q. Vol 5. Amsterdam, The Netherlands: Elsevier Science Publishers B V (Biomedical Division), 1986, pp 17-24.</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_30">Gordon M: Dietary antioxidants in disease prevention. Nat Prod Rep 13 (4): 265-73, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8760864" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8760864</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_31">Palazzoni G, Pucello D, Littarru GP, et al.: Coenzyme Q10 and colorectal neoplasms in aged patients. Rays 22 (1 Suppl): 73-6, 1997 Jan-Mar. [<a href="https://pubmed.ncbi.nlm.nih.gov/9250020" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9250020</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_32">Ernster L, Dallner G: Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta 1271 (1): 195-204, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7599208" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7599208</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_33">Aust AE, Eveleigh JF: Mechanisms of DNA oxidation. Proc Soc Exp Biol Med 222 (3): 246-52, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10601883" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10601883</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_34">Halliwell B: Oxygen and nitrogen are pro-carcinogens. Damage to DNA by reactive oxygen, chlorine and nitrogen species: measurement, mechanism and the effects of nutrition. Mutat Res 443 (1-2): 37-52, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10415430" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10415430</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_35">Burcham PC: Internal hazards: baseline DNA damage by endogenous products of normal metabolism. Mutat Res 443 (1-2): 11-36, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10415429" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10415429</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_13_36">Dreher D, Junod AF: Role of oxygen free radicals in cancer development. Eur J Cancer 32A (1): 30-8, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8695238" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8695238</span></a>]</div></li></ol></div></div><div id="CDR0000062979__17"><h2 id="_CDR0000062979__17_">Laboratory/Animal/Preclinical Studies</h2><p id="CDR0000062979__18"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044512/" class="def">Laboratory</a> work on <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346488/" class="def">coenzyme</a> Q<sub>10</sub> has focused primarily on its
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structure and its function in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044008/" class="def">cell respiration</a>. Studies in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454774/" class="def">animals</a> have
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demonstrated that coenzyme Q<sub>10</sub> is capable of stimulating the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune
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system</a>, with treated animals showing increased resistance to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044080/" class="def">protozoal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infections</a> [<a class="bk_pop" href="#CDR0000062979_rl_17_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_17_2">2</a>] and to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044629/" class="def">viral</a>
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and chemically-induced <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045801/" class="def">neoplasia</a>.[<a class="bk_pop" href="#CDR0000062979_rl_17_1">1</a>-<a class="bk_pop" href="#CDR0000062979_rl_17_4">4</a>] Early
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studies of coenzyme Q<sub>10</sub> showed increased <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044035/" class="def">hematopoiesis</a> (the formation of new
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> cells) in monkeys,[<a class="bk_pop" href="#CDR0000062979_rl_17_4">4</a>,<a class="bk_pop" href="#CDR0000062979_rl_17_5">5</a>] rabbits,[<a class="bk_pop" href="#CDR0000062979_rl_17_6">6</a>] and
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poultry.[<a class="bk_pop" href="#CDR0000062979_rl_17_5">5</a>] Coenzyme Q<sub>10</sub> demonstrated a protective
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effect on the heart muscle of mice, rats, and rabbits given the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044916/" class="def">anthracycline</a>
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anticancer drug <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045140/" class="def">doxorubicin</a>.[<a class="bk_pop" href="#CDR0000062979_rl_17_7">7</a>-<a class="bk_pop" href="#CDR0000062979_rl_17_12">12</a>] Although another study confirmed this
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protective effect with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046339/" class="def">intraperitoneal</a> administration of doxorubicin in mice,
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it failed to demonstrate a protective effect when the anthracycline was given
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046682/" class="def">intravenously</a>, which is the route of administration in humans.[<a class="bk_pop" href="#CDR0000062979_rl_17_13">13</a>]
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Researchers in one study sounded a cautionary note when they found that
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coadministration of coenzyme Q<sub>10</sub> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> decreased the
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effectiveness of the radiation therapy.[<a class="bk_pop" href="#CDR0000062979_rl_17_14">14</a>] In this study, mice inoculated with
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human <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045327/" class="def">small cell lung cancer</a> cells
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(a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044095/" class="def">xenograft</a> study), and then given
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coenzyme Q<sub>10</sub> and single-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> radiation therapy, showed
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substantially less inhibition of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> growth than mice in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044149/" class="def">control group</a>
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that were treated with radiation therapy alone. Since radiation leads to the
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production of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044030/" class="def">free radicals</a>, and since <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043997/" class="def">antioxidants</a> protect against free
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radical damage, the effect in this study might be explained by coenzyme
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Q<sub>10</sub> acting as an antioxidant. As noted previously (<a href="#CDR0000062979__5">General Information</a>), there is some evidence from
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laboratory and animal studies that <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044919/" class="def">analogs</a> of coenzyme Q<sub>10</sub> may
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have direct anticancer activity.[<a class="bk_pop" href="#CDR0000062979_rl_17_15">15</a>,<a class="bk_pop" href="#CDR0000062979_rl_17_16">16</a>]</p><div id="CDR0000062979_rl_17"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062979_rl_17_1">Bliznakov EG, Adler AD: Nonlinear response of the reticuloendothelial system upon stimulation. Pathol Microbiol (Basel) 38 (6): 393-410, 1972. [<a href="https://pubmed.ncbi.nlm.nih.gov/4346875" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4346875</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_2">Bliznakov EG: Coenzyme Q in experimental infections and neoplasia. In: Folkers K, Yamamura Y, eds.: Biomedical and Clinical Aspects of Coenzyme Q. Vol 1. Amsterdam, The Netherlands: Elsevier/North-Holland Biomedical Press, 1977, pp 73-83.</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_3">Bliznakov EG: Effect of stimulation of the host defense system by coenzyme Q 10 on dibenzpyrene-induced tumors and infection with Friend leukemia virus in mice. Proc Natl Acad Sci U S A 70 (2): 390-4, 1973. [<a href="/pmc/articles/PMC433266/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC433266</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/4510283" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4510283</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_4">Folkers K, Osterborg A, Nylander M, et al.: Activities of vitamin Q10 in animal models and a serious deficiency in patients with cancer. Biochem Biophys Res Commun 234 (2): 296-9, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9177262" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9177262</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_5">Folkers K, Brown R, Judy WV, et al.: Survival of cancer patients on therapy with coenzyme Q10. Biochem Biophys Res Commun 192 (1): 241-5, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8476426" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8476426</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_6">Ludwig FC, Elashoff RM, Smith JL, et al.: Response of the bone marrow of the vitamin E-deficient rabbit to coenzyme Q and vitamin E. Scand J Haematol 4 (4): 292-300, 1967. [<a href="https://pubmed.ncbi.nlm.nih.gov/6078061" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6078061</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_7">Choe JY, Combs AB, Folkers K: Prevention by coenzyme Q10 of the electrocardiographic changes induced by adriamycin in rats. Res Commun Chem Pathol Pharmacol 23 (1): 199-202, 1979. [<a href="https://pubmed.ncbi.nlm.nih.gov/441512" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 441512</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_8">Combs AB, Choe JY, Truong DH, et al.: Reduction by coenzyme Q10 of the acute toxicity of adriamycin in mice. Res Commun Chem Pathol Pharmacol 18 (3): 565-8, 1977. [<a href="https://pubmed.ncbi.nlm.nih.gov/928953" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 928953</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_9">Folkers K, Choe JY, Combs AB: Rescue by coenzyme Q10 from electrocardiographic abnormalities caused by the toxicity of adriamycin in the rat. Proc Natl Acad Sci U S A 75 (10): 5178-80, 1978. [<a href="/pmc/articles/PMC336288/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC336288</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/283424" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 283424</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_10">Lubawy WC, Dallam RA, Hurley LH: Protection against anthramycin-induced toxicity in mice by coenzyme Q10. J Natl Cancer Inst 64 (1): 105-9, 1980. [<a href="https://pubmed.ncbi.nlm.nih.gov/6928034" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6928034</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_11">Shinozawa S, Gomita Y, Araki Y: Protective effects of various drugs on adriamycin (doxorubicin)-induced toxicity and microsomal lipid peroxidation in mice and rats. Biol Pharm Bull 16 (11): 1114-7, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8312867" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8312867</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_12">Usui T, Ishikura H, Izumi Y, et al.: Possible prevention from the progression of cardiotoxicity in adriamycin-treated rabbits by coenzyme Q10. Toxicol Lett 12 (1): 75-82, 1982. [<a href="https://pubmed.ncbi.nlm.nih.gov/7112605" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7112605</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_13">Shaeffer J, El-Mahdi AM, Nichols RK: Coenzyme Q10 and adriamycin toxicity in mice. Res Commun Chem Pathol Pharmacol 29 (2): 309-15, 1980. [<a href="https://pubmed.ncbi.nlm.nih.gov/7414051" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7414051</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_14">Lund EL, Quistorff B, Spang-Thomsen M, et al.: Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiol (Praha) 43 (5): 505-6, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9821311" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9821311</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_15">Folkers K: The potential of coenzyme Q 10 (NSC-140865) in cancer treatment. Cancer Chemother Rep 2 4 (4): 19-22, 1974. [<a href="https://pubmed.ncbi.nlm.nih.gov/4218125" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4218125</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_17_16">Folkers K, Porter TH, Bertino JR, et al.: Inhibition of two human tumor cell lines by antimetabolites of coenzyme Q10. Res Commun Chem Pathol Pharmacol 19 (3): 485-90, 1978. [<a href="https://pubmed.ncbi.nlm.nih.gov/653103" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 653103</span></a>]</div></li></ol></div></div><div id="CDR0000062979__19"><h2 id="_CDR0000062979__19_">Human/Clinical Studies</h2><p id="CDR0000062979__20">The use of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346488/" class="def">coenzyme</a> Q<sub>10</sub> as a treatment for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> in humans has
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been investigated in only a limited manner. The studies that have been published consist of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045858/" class="def">randomized </a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044014/" class="def">controlled </a>trials, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043995/" class="def">anecdotal reports</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044007/" class="def">case reports</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044006/" class="def">case series</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044092/" class="def">uncontrolled clinical
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studies</a>.[<a class="bk_pop" href="#CDR0000062979_rl_19_1">1</a>-<a class="bk_pop" href="#CDR0000062979_rl_19_12">12</a>]</p><p id="CDR0000062979__21">In view of the promising results from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454774/" class="def">animal studies</a>, coenzyme
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Q<sub>10</sub> was tested as a protective agent against the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045634/" class="def">cardiac</a> toxicity observed in cancer
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patients treated with the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044916/" class="def">anthracycline</a> drug <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045140/" class="def">doxorubicin</a>. It has been
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postulated that doxorubicin interferes with energy-generating <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044124/" class="def">biochemical
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reactions</a> that involve coenzyme Q<sub>10</sub> in heart muscle <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044060/" class="def">mitochondria</a>
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and that this interference can be overcome by coenzyme Q<sub>10</sub>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045916/" class="def">supplementation</a>.[<a class="bk_pop" href="#CDR0000062979_rl_19_2">2</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_13">13</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_14">14</a>] Studies with adults and children, including the
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aforementioned randomized trial, have confirmed the decrease in cardiac
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toxicity observed in animal studies.[<a class="bk_pop" href="#CDR0000062979_rl_19_1">1</a>-<a class="bk_pop" href="#CDR0000062979_rl_19_3">3</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_7">7</a>] A randomized trial [<a class="bk_pop" href="#CDR0000062979_rl_19_7">7</a>] of 20 patients tested the ability of coenzyme Q<sub>10</sub> to reduce <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044004/" class="def">cardiotoxicity</a> caused by anthracycline drugs. </p><p id="CDR0000062979__60">A larger randomized, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044840/" class="def">placebo-controlled</a> trial of 236 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">breast cancer</a> patients concluded that coenzyme Q<sub>10</sub> at a daily <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of 300 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044213/" class="def">mg</a> combined with 300 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044764/" class="def">IU</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045023/" class="def">vitamin E</a>, divided into three doses, did not improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321374/" class="def">fatigue</a> levels or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> after 24 weeks of supplementation.[<a class="bk_pop" href="#CDR0000062979_rl_19_8">8</a>]</p><p id="CDR0000062979__22">The potential of coenzyme Q<sub>10</sub> as an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a> for cancer
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has also been explored. In view of observations that <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> levels of coenzyme
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Q<sub>10</sub> are frequently reduced in cancer patients,[<a class="bk_pop" href="#CDR0000062979_rl_19_6">6</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_10">10</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_11">11</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_15">15</a>,<a class="bk_pop" href="#CDR0000062979_rl_19_16">16</a>] supplementation with this compound has been tested in patients
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undergoing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044950/" class="def">conventional treatment</a>. An open-label (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044066/" class="def">nonblinded</a>), uncontrolled clinical study
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in Denmark followed 32 breast cancer patients for 18 months.[<a class="bk_pop" href="#CDR0000062979_rl_19_4">4</a>] The disease
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in these patients had spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045607/" class="def">axillary lymph nodes</a>, and an
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unreported number had distant <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastases</a>. The patients received
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043997/" class="def">antioxidant</a> supplementation (vitamin C, vitamin E, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045328/" class="def">beta carotene</a>), other
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a> and trace <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">minerals</a>, essential <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045689/" class="def">fatty acids</a>, and coenzyme
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Q<sub>10</sub> (at a dose of 90 mg/day), in addition to standard
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therapy (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>, with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045576/" class="def">tamoxifen</a>). The patients were seen every
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3 months to monitor disease status (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045850/" class="def">progressive disease</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045861/" class="def">recurrence</a>), and, if there was a
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suspicion of recurrence, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045996/" class="def">mammography</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046499/" class="def">bone scan</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> was performed. The survival rate for
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the study period was 100% (4 deaths were expected). Six
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patients were reported to show some evidence of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045867/" class="def">remission</a>; however, incomplete clinical
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data were provided, and information suggestive of remission was presented for
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only 3 of the 6 patients. None of the 6 patients had evidence of
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further metastases. For all 32 patients, decreased use of painkillers,
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improved <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>, and an
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absence of weight loss were reported. Whether painkiller use and quality of
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life were measured objectively (e.g., from pharmacy records and validated
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questionnaires, respectively) or subjectively (from patient self-reports) was
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not specified.</p><p id="CDR0000062979__23">In a follow-up study, 1 of the 6 patients with a reported remission and
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a new patient were treated for several months with higher doses of coenzyme
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Q<sub>10</sub> (390 and 300 mg/day, respectively).[<a class="bk_pop" href="#CDR0000062979_rl_19_5">5</a>] Surgical
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removal of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary</a> breast tumor in both patients had been incomplete.
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After 3 to 4 months of high-level coenzyme Q<sub>10</sub> supplementation,
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both patients appeared to experience complete
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046039/" class="def">regression</a> of their <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045869/" class="def">residual</a> breast
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tumors (assessed by clinical examination and mammography). It should be noted
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that a different patient identifier was used in the follow-up study for the
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patient who had participated in the original study. Therefore, it is
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impossible to determine which of the 6 patients with a reported remission
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took part in the follow-up study. In the follow-up study report, the
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researchers noted that all 32 patients from the original study remained alive
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at 24 months of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">observation</a>, whereas 6 deaths had been expected.[<a class="bk_pop" href="#CDR0000062979_rl_19_5">5</a>]</p><p id="CDR0000062979__24">In another report by the same <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044685/" class="def">investigators</a>, 3 breast cancer patients
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were followed for a total of 3 to 5 years on high-dose coenzyme Q<sub>10</sub>
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(390 mg/day).[<a class="bk_pop" href="#CDR0000062979_rl_19_6">6</a>] One patient had complete remission of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045316/" class="def">liver metastases</a> (determined by clinical examination and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045557/" class="def">ultrasonography</a>), another had
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remission of a tumor that had spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044996/" class="def">chest wall</a> (determined by clinical
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examination and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">chest x-ray</a>), and the third patient had no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044608/" class="def">microscopic</a>
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evidence of remaining tumor after a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045777/" class="def">mastectomy</a> (determined by biopsy of the
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tumor bed).</p><p id="CDR0000062979__25">All 3 of the above-mentioned human studies [<a class="bk_pop" href="#CDR0000062979_rl_19_4">4</a>-<a class="bk_pop" href="#CDR0000062979_rl_19_6">6</a>] had important design
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flaws that could have influenced their outcome. Study weaknesses include the
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absence of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044149/" class="def">control group</a> (i.e., all patients received coenzyme
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Q<sub>10</sub>), possible <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044087/" class="def">selection
|
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bias</a> in the follow-up investigations, and multiple confounding variables
|
|
(i.e., the patients received a variety of supplements in addition to coenzyme
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Q<sub>10</sub>, and they received <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard therapy</a> either during or
|
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immediately before supplementation with coenzyme Q<sub>10</sub>). Thus, it is
|
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impossible to determine whether any of the beneficial results was directly
|
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related to coenzyme Q<sub>10</sub> therapy.</p><p id="CDR0000062979__26">Anecdotal reports of coenzyme Q<sub>10</sub> lengthening the survival of
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patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044074/" class="def">pancreatic</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044083/" class="def">rectal</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046317/" class="def">laryngeal</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046462/" class="def">colon</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> cancers
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also exist in the peer-reviewed scientific literature.[<a class="bk_pop" href="#CDR0000062979_rl_19_3">3</a>] The patients
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described in these reports also received therapies other than coenzyme
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Q<sub>10</sub>, including chemotherapy, radiation therapy, and surgery.</p><div id="CDR0000062979__TrialSearch_19_sid_5"><h3>Current Clinical Trials</h3><p id="CDR0000062979__TrialSearch_19_19">Check the list of NCI-supported cancer clinical trials for cancer CAM clinical trials on <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?idtype=1&id=39187&tt=0&format=2" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">coenzyme Q10</a> that are actively enrolling patients.</p><p id="CDR0000062979__TrialSearch_19_15">General information about clinical trials is also available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062979_rl_19"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062979_rl_19_1">Folkers K, Wolaniuk A: Research on coenzyme Q10 in clinical medicine and in immunomodulation. Drugs Exp Clin Res 11 (8): 539-45, 1985. [<a href="https://pubmed.ncbi.nlm.nih.gov/3836873" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3836873</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_2">Cortes EP, Gupta M, Chou C, et al.: Adriamycin cardiotoxicity: early detection by systolic time interval and possible prevention by coenzyme Q10. Cancer Treat Rep 62 (6): 887-91, 1978. [<a href="https://pubmed.ncbi.nlm.nih.gov/667863" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 667863</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_3">Folkers K, Brown R, Judy WV, et al.: Survival of cancer patients on therapy with coenzyme Q10. Biochem Biophys Res Commun 192 (1): 241-5, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8476426" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8476426</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_4">Lockwood K, Moesgaard S, Hanioka T, et al.: Apparent partial remission of breast cancer in 'high risk' patients supplemented with nutritional antioxidants, essential fatty acids and coenzyme Q10. Mol Aspects Med 15 (Suppl): s231-40, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752835" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752835</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_5">Lockwood K, Moesgaard S, Folkers K: Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochem Biophys Res Commun 199 (3): 1504-8, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7908519" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7908519</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_6">Lockwood K, Moesgaard S, Yamamoto T, et al.: Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochem Biophys Res Commun 212 (1): 172-7, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7612003" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7612003</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_7">Iarussi D, Auricchio U, Agretto A, et al.: Protective effect of coenzyme Q10 on anthracyclines cardiotoxicity: control study in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma. Mol Aspects Med 15 (Suppl): s207-12, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752832" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752832</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_8">Lesser GJ, Case D, Stark N, et al.: A randomized, double-blind, placebo-controlled study of oral coenzyme Q10 to relieve self-reported treatment-related fatigue in newly diagnosed patients with breast cancer. J Support Oncol 11 (1): 31-42, 2013. [<a href="/pmc/articles/PMC3501550/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3501550</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22682875" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22682875</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_9">Complementary treatments highlighted at recent meeting. Oncology (Huntingt) 13 (2): 166, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10079467" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10079467</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_10">Folkers K: Relevance of the biosynthesis of coenzyme Q10 and of the four bases of DNA as a rationale for the molecular causes of cancer and a therapy. Biochem Biophys Res Commun 224 (2): 358-61, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8702395" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8702395</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_11">Ren S, Lien EJ: Natural products and their derivatives as cancer chemopreventive agents. Prog Drug Res 48: 147-71, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9204686" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9204686</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_12">Hodges S, Hertz N, Lockwood K, et al.: CoQ10: could it have a role in cancer management? Biofactors 9 (2-4): 365-70, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10416054" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10416054</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_13">Usui T, Ishikura H, Izumi Y, et al.: Possible prevention from the progression of cardiotoxicity in adriamycin-treated rabbits by coenzyme Q10. Toxicol Lett 12 (1): 75-82, 1982. [<a href="https://pubmed.ncbi.nlm.nih.gov/7112605" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7112605</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_14">Iwamoto Y, Hansen IL, Porter TH, et al.: Inhibition of coenzyme Q10-enzymes, succinoxidase and NADH-oxidase, by adriamycin and other quinones having antitumor activity. Biochem Biophys Res Commun 58 (3): 633-8, 1974. [<a href="https://pubmed.ncbi.nlm.nih.gov/4152017" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4152017</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_15">Folkers K: The potential of coenzyme Q 10 (NSC-140865) in cancer treatment. Cancer Chemother Rep 2 4 (4): 19-22, 1974. [<a href="https://pubmed.ncbi.nlm.nih.gov/4218125" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4218125</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_19_16">Folkers K, Osterborg A, Nylander M, et al.: Activities of vitamin Q10 in animal models and a serious deficiency in patients with cancer. Biochem Biophys Res Commun 234 (2): 296-9, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9177262" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9177262</span></a>]</div></li></ol></div></div><div id="CDR0000062979__27"><h2 id="_CDR0000062979__27_">Adverse Effects</h2><p id="CDR0000062979__28">No serious <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043986/" class="def">toxicity</a> associated with the use of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346488/" class="def">coenzyme</a> Q<sub>10</sub> has
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been reported.[<a class="bk_pop" href="#CDR0000062979_rl_27_1">1</a>-<a class="bk_pop" href="#CDR0000062979_rl_27_4">4</a>] <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">Doses</a> of 100 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044213/" class="def">mg</a>/day or
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higher have caused mild <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044043/" class="def">insomnia</a> in
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some individuals. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">Liver</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzyme</a> elevation has been detected in
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patients taking doses of 300 mg/day for extended periods of time,
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but no liver toxicity has been reported.[<a class="bk_pop" href="#CDR0000062979_rl_27_1">1</a>] Researchers in one
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044005/" class="def">cardiovascular</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044195/" class="def">study</a> reported that coenzyme Q<sub>10</sub> caused rashes,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044027/" class="def">epigastric</a> (upper
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">abdominal</a>) pain that required withdrawal of a small number of patients from
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the study.[<a class="bk_pop" href="#CDR0000062979_rl_27_5">5</a>] Other reported <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> have included dizziness,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044077/" class="def">photophobia</a> (abnormal visual
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sensitivity to light), irritability,[<a class="bk_pop" href="#CDR0000062979_rl_27_5">5</a>] headache, heartburn, and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321374/" class="def">fatigue</a>.[<a class="bk_pop" href="#CDR0000062979_rl_27_6">6</a>]</p><p id="CDR0000062979__29">Certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046068/" class="def">lipid</a>-lowering drugs, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390255/" class="def">statins</a> (lovastatin,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430875/" class="def">pravastatin</a>, and simvastatin) and gemfibrozil, as well as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044068/" class="def">oral</a> agents that
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lower <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> sugar, such as glyburide and tolazamide, cause a decrease in
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044088/" class="def">serum</a> levels of coenzyme Q<sub>10</sub>
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and reduce the effects of coenzyme Q<sub>10</sub>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045916/" class="def">supplementation</a>.[<a class="bk_pop" href="#CDR0000062979_rl_27_1">1</a>,<a class="bk_pop" href="#CDR0000062979_rl_27_7">7</a>-<a class="bk_pop" href="#CDR0000062979_rl_27_9">9</a>] Beta-blockers (drugs that slow the heart rate and lower
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000462668/" class="def">blood pressure</a>) can inhibit coenzyme Q<sub>10</sub>-dependent enzyme
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reactions. The contractile force of the heart in patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000458091/" class="def">high blood pressure</a> can be increased by coenzyme Q<sub>10</sub>
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administration.[<a class="bk_pop" href="#CDR0000062979_rl_27_1">1</a>] Coenzyme Q<sub>10</sub> can reduce the body’s
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response to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046082/" class="def">anticoagulant</a> drug
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045249/" class="def">warfarin</a>.[<a class="bk_pop" href="#CDR0000062979_rl_27_9">9</a>] Finally,
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coenzyme Q<sub>10</sub> can decrease <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046187/" class="def">insulin</a> requirements in individuals with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044911/" class="def">diabetes</a>.</p><div id="CDR0000062979_rl_27"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062979_rl_27_1">Pepping J: Coenzyme Q10. Am J Health Syst Pharm 56 (6): 519-21, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10192685" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10192685</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_2">Overvad K, Diamant B, Holm L, et al.: Coenzyme Q10 in health and disease. Eur J Clin Nutr 53 (10): 764-70, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10556981" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10556981</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_3">Hodges S, Hertz N, Lockwood K, et al.: CoQ10: could it have a role in cancer management? Biofactors 9 (2-4): 365-70, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10416054" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10416054</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_4">Heller JH: Disease, the host defense, and Q-10. Perspect Biol Med 16 (2): 181-7, 1973 Winter. [<a href="https://pubmed.ncbi.nlm.nih.gov/4689357" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4689357</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_5">Baggio E, Gandini R, Plancher AC, et al.: Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 15 (Suppl): s287-94, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752841" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752841</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_6">Feigin A, Kieburtz K, Como P, et al.: Assessment of coenzyme Q10 tolerability in Huntington's disease. Mov Disord 11 (3): 321-3, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8723151" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8723151</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_7">Kaikkonen J, Nyyssönen K, Tuomainen TP, et al.: Determinants of plasma coenzyme Q10 in humans. FEBS Lett 443 (2): 163-6, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/9989597" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9989597</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_8">Thibault A, Samid D, Tompkins AC, et al.: Phase I study of lovastatin, an inhibitor of the mevalonate pathway, in patients with cancer. Clin Cancer Res 2 (3): 483-91, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/9816194" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9816194</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062979_rl_27_9">Coenzyme Q10. In: Jellin JM, Hitchens K, eds.: Natural Medicines Comprehensive Database. Stockton, Calif: Therapeutic Research Faculty, 1999, pp 241-42.</div></li></ol></div></div><div id="CDR0000062979__30"><h2 id="_CDR0000062979__30_">Summary of the Evidence for Coenzyme Q<sub>10</sub></h2><p id="CDR0000062979__31">To assist readers in evaluating the results of human <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044195/" class="def">studies</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044964/" class="def">complementary and alternative medicine</a> (CAM)
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treatments for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>, the strength of the evidence (i.e., the “<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446533/" class="def">levels of
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evidence</a>”) associated with each type of treatment is provided whenever
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possible. To qualify for a level of evidence <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390238/" class="def">analysis</a>, a study must:</p><ul id="CDR0000062979__40"><li class="half_rhythm"><div>Be published in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000537399/" class="def">peer-reviewed scientific journal</a>.</div></li><li class="half_rhythm"><div>Report on a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000043985/" class="def">therapeutic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000467853/" class="def">outcome</a> or outcomes, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044085/" class="def">response</a>, improvement in survival, or measured improvement in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div>Describe clinical findings in sufficient detail that a meaningful evaluation can be made.</div></li></ul><p id="CDR0000062979__41">Separate levels of evidence scores are assigned to qualifying human studies on the basis of statistical strength of the study design and scientific strength of the treatment outcomes (i.e., <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346519/" class="def">endpoints</a>) measured. The resulting two scores are then combined to produce an overall score. A table showing the levels of evidence scores for qualifying human studies cited in this summary is presented below. For an explanation of the scores and additional information about levels of evidence analysis of CAM treatments for cancer, refer to <a href="/books/n/pdqcis/CDR0000256874/">Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine</a>.</p><div id="CDR0000062979__36" class="table"><h3><span class="title">Coenzyme Q<sub>10</sub> Summary: Reference Numbers and the Corresponding Levels of Evidence</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK65890.1/table/CDR0000062979__36/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__CDR0000062979__36_lrgtbl__"><table class="no_top_margin"><thead><tr><th colspan="1" rowspan="1" style="vertical-align:top;">Reference
|
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Number </th><th colspan="1" rowspan="1" style="vertical-align:top;">Statistical Strength of Study Design </th><th colspan="1" rowspan="1" style="vertical-align:top;">Strength of Endpoints
|
|
Measured </th><th colspan="1" rowspan="1" style="vertical-align:top;">Combined Score </th></tr></thead><tbody><tr><td colspan="1" rowspan="1" style="vertical-align:top;">[<a class="bk_pop" href="#CDR0000062979_rl_30_1">1</a>]</td><td colspan="1" rowspan="1" style="vertical-align:top;">3iii ­ <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044575/" class="def">Nonconsecutive case series </a></td><td colspan="1" rowspan="1" style="vertical-align:top;">Diii ­ Indirect surrogates -- tumor response rate </td><td colspan="1" rowspan="1" style="vertical-align:top;">3iiiDiii </td></tr></tbody></table></div></div><div id="CDR0000062979_rl_30"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062979_rl_30_1">Lockwood K, Moesgaard S, Hanioka T, et al.: Apparent partial remission of breast cancer in 'high risk' patients supplemented with nutritional antioxidants, essential fatty acids and coenzyme Q10. Mol Aspects Med 15 (Suppl): s231-40, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7752835" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7752835</span></a>]</div></li></ol></div></div><div id="CDR0000062979__37"><h2 id="_CDR0000062979__37_">Changes to This Summary (05/14/2014)</h2><p id="CDR0000062979__38">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information summaries are reviewed regularly and updated as
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new information becomes available. This section describes the latest
|
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changes made to this summary as of the date above.</p><p id="CDR0000062979__61">Editorial changes were made to this summary.</p><p id="CDR0000062979__disclaimerHP_3">This summary is written and maintained by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/cam" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Cancer Complementary and Alternative Medicine Editorial Board</a>, which is
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editorially independent of NCI. The summary reflects an independent review of
|
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the literature and does not represent a policy statement of NCI or NIH. More
|
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information about summary policies and the role of the PDQ Editorial Boards in
|
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maintaining the PDQ summaries can be found on the <a href="#CDR0000062979__AboutThis_1">About This PDQ Summary</a> and <a href="http://www.cancer.gov/publications/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ® - NCI's Comprehensive Cancer Database</a> pages.
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</p></div><div id="CDR0000062979__AboutThis_1"><h2 id="_CDR0000062979__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062979__AboutThis_2"><h3>Purpose of This Summary</h3><p id="CDR0000062979__AboutThis_3">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of coenzyme Q10 in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p></div><div id="CDR0000062979__AboutThis_4"><h3>Reviewers and Updates</h3><p id="CDR0000062979__AboutThis_5">This summary is reviewed regularly and updated as necessary by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/cam" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Cancer Complementary and Alternative Medicine Editorial Board</a>, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p><p id="CDR0000062979__AboutThis_22"> Board members review recently published articles each month to determine whether an article should:</p><ul id="CDR0000062979__AboutThis_6"><li class="half_rhythm"><div>be discussed at a meeting,</div></li><li class="half_rhythm"><div>be cited with text, or</div></li><li class="half_rhythm"><div>replace or update an existing article that is already cited.</div></li></ul><p id="CDR0000062979__AboutThis_7">Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.</p><p>The lead reviewer for Coenzyme Q10 is:</p><ul><li class="half_rhythm"><div>Jeffrey D. White, MD (National Cancer Institute)</div></li></ul><p id="CDR0000062979__AboutThis_9">Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's <a href="http://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.</p></div><div id="CDR0000062979__AboutThis_10"><h3>Levels of Evidence</h3><p id="CDR0000062979__AboutThis_11">Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Cancer Complementary and Alternative Medicine Editorial Board uses a <a href="/books/n/pdqcis/CDR0000256874/">formal evidence ranking system</a> in developing its level-of-evidence designations.</p></div><div id="CDR0000062979__AboutThis_12"><h3>Permission to Use This Summary</h3><p id="CDR0000062979__AboutThis_13">PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary].”</p><p id="CDR0000062979__AboutThis_14">The preferred citation for this PDQ summary is:</p><p id="CDR0000062979__AboutThis_15">National Cancer Institute: PDQ® Coenzyme Q10. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: <a href="http://www.cancer.gov/about-cancer/treatment/cam/hp/coenzyme-q10-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www.cancer.gov/about-cancer/treatment/cam/hp/coenzyme-q10-pdq</a>. Accessed <MM/DD/YYYY>.</p><p id="CDR0000062979__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in <a href="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>, a collection of over 2,000 scientific images.
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</p></div><div id="CDR0000062979__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062979__AboutThis_19">The information in these summaries should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the <a href="http://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062979__AboutThis_20"><h3>Contact Us</h3><p id="CDR0000062979__AboutThis_21">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="http://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="http://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65890</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389329" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389329</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65890.1/?report=reader">PubReader</a></li><li><a href="/books/NBK65890.1/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65890" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65890" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Cancer Complementary and Alternative Medicine Editorial Board. 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