The strategy we recommend during Adriamycin (doxorubicin) chemotherapy and for the following month is to consume foods that enhance the effectiveness of Adriamycin, while limiting or avoiding the foods that should not be consumed while on Adriamycin, as well as those on our general avoid list.

Foods that enhance effectiveness or safely reduce side effects

The following foods are very good sources of compounds that have been shown to increase the anti-cancer effects of Adriamycin or reduce its side effects without interfering with treatment:

Foods that should be limited or avoided while on Adriamycin

The following foods have been found to interfere with the effectiveness of treatment with Adriamycin:

Supplements for patients being treated with Adriamycin

There is no supplement or combination of supplements that has been proven to reliably reduce the risk of breast cancer recurrence in women. Attempting to take advantage of the apparent treatment effects of micronutrients and other dietary components by using supplements carries the risk of adverse and paradoxical effects, including promoting breast cancer growth and metastasis.
Adriamycin can result in side effects such as hair loss, bone marrow suppression, nausea, fatigue, hand-foot syndrome, cognitive impairment (chemo brain), as well as serious infections. The most serious potential side effect is heart damage (cardiomyopathy), which can lead to heart failure. Patients with BRCA mutations appear to be particularly susceptible to Adriamycin-induced cardiomyopathy.
Compounds that provide relief from chemotherapy side effects may also provide some protection to breast cancer cells. It is important for breast cancer patients to avoid or taking supplements that will lessen the cytotoxic impact of Adriamycin on cancer cells. In fact, while micronutrients found in fruits, vegetables and other foods have been shown to help protect against breast cancer development and metastasis, some concentrated micronutrients might enable breast cancer cells to survive chemotherapy.
When a beneficial micronutrient is administered at low doses by consuming food, it is likely to have subtle chemopreventive effects, whereas when the same micronutrient is administered at high doses, it is more likely to have pharmacological effects, with mostly unknown results. Therefore, it is best to obtain beneficial compounds by consuming food, if possible. Supplements make sense if medically necessary or to make up for deficiencies that are difficult to correct through diet.
The following supplements generally have been found to be safe and beneficial for those being treated with Adriamycin:
CoQ10 (if needed for heart health)100 to 400 mg/day
Fish oil (from wild-caught fish)1000 to 2000 mg/day
Vitamin D1000 to 2000 IU/day
Avoid taking supplements during the two days before, the day of, and the day after each chemotherapy treatment. Please consult your oncology team for advice concerning your situation and dosages. It might make sense to be tested for deficiency in vitamin D and plan for follow up to determine if your reading has reached a desirable level.

Supplements & other that should not be used with Adriamycin

The following vitamins, supplements and other products have been reported to interfere with the effectiveness of Adriamycin. That is not to say that most other supplements are safe to take; there are no relevant scientific studies concerning the interactions between most supplements and Adriamycin.
Nicotine has been shown to reduce the effectiveness of Adriamycin in ER+/PR+ breast cancer cells, increasing the proportion of breast cancer stem cells. This suggests that smoking and other nicotine delivery mechanisms such as vaping should be avoided.

Hesperidin and saffron could reduce cyclophosphamide efficacy

Hesperidin, a flavonoid found in oranges, tangerines, kumquats, lemons, limes and grapefruit, has the potential to interfere with chemotherapy regimens containing cyclophosphamide, such as TAC (Taxotere, Adriamycin and cyclophosphamide). Cyclophosphamide is an alkylating agent frequently used in combination with anthracyclines and/or taxanes such as Taxol and Taxotere. Hesperidin is found most abundantly in the peel, pith and membranous parts of oranges and other citrus fruits. Prepared food sources include orange tea, commercial orange juice, orange marmalade, and dishes that incorporate citrus peel such as Szechuan Orange Chicken. See oranges for more information.
Saffron, as well as vitamin A, vitamin B12, vitamin C and vitamin E supplements, also have the potential to interfere with the treatment effects of cyclophosphamide.

BPA and BBP can interfere with Adriamycin treatment

Bisphenol A (BPA), an endocrine disruptor, is suspected of increasing the risk of breast cancer. BPA at low concentrations has been shown to reduce the efficacy of Adriamycin in both estrogen receptor positive (ER+) and triple negative (ER-/PR-/HER2-) breast cancer cells. BPA exposure can be limited by avoiding canned foods, canned sodas, and polycarbonate plastic bottles and food containers, which may be marked with a 7 or 3 recycling number in a triangle-shaped icon (normally found on the base).
The phthalate BBP (benzyl butyl phthalate) has been shown to increase resistance to Adriamycin (doxorubicin) plus cyclophosphamide chemotherapy regimens. BBP is used in making vinyl floor tiles, carpet backing, car trims and dashboards, as well as artificial leather. It is also added to some adhesives, perfumes, and hair sprays.

Fasting and weight gain during chemotherapy

Recent studies suggest that fasting around chemotherapy treatments could protect normal cells from the toxic effects of chemotherapy while sensitizing cancer cells to the treatment. However, a study in which rats were deprived of protein during anthracycline chemotherapy found that protein malnutrition reduced the elimination of both Adriamycin and epirubicin, prolonging the exposure of the heart to the drugs and increasing the anthracycline-associated heart damage. More studies and human trials are required before it can be determined under what conditions fasting during Adriamycin chemotherapy is safe and effective. Patients should rely on their oncology teams for guidance concerning fasting.
On the other hand, weight gain, which is common during chemotherapy for early stage disease, is known to be associated with less favorable prognosis and should be avoided.

Exercise during chemotherapy

Regular exercise has been shown to reduce fatigue in cancer patients undergoing chemotherapy. However, one study suggested that intense or prolonged physical activity a couple of days before the start of radiotherapy or chemotherapy has the potential to reduce the benefits of the treatment. Based on the available evidence, light to moderate aerobic exercise appears to be safe during treatment with Adriamycin and could help preserve heart health and reduce fatigue.

Sources of information provided in this webpage

This webpage lists foods that enhance the treatment effects of Adriamycin, as well as foods, supplements and other exposures that should be limited since they could interfere with the efficacy of Adriamycin treatment.
The food lists, which are updated continually as new research becomes available, have been developed based solely on the results of academic studies. Clicking on any of the foods will take you to its webpage, which contains specific information concerning that food's relationship to breast cancer (including its overall ranking), as well as links to supporting studies.
Below are links to 20 recent studies concerning Adriamycin and breast cancer. For a more complete list of studies, please click on the tag Adriamycin.