Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetyl-cysteine (NAC) is primarily justified by scientific evidence for use in supporting chemotherapy by reducing some of its side effects, especially those related to oxidative stress and organ toxicity. NAC is a precursor to glutathione, a key antioxidant in cells, and has been shown in preclinical and some clinical studies to mitigate chemotherapy-induced toxicity, such as nephrotoxicity (kidney damage) from cisplatin, and hepatotoxicity (liver damage) from various chemotherapeutic agents. For example, animal and small-scale human studies indicate that NAC can help preserve kidney function and reduce oxidative damage when administered alongside certain chemotherapies.

However, the evidence base is mixed and not yet robust enough for routine clinical use. There are concerns that antioxidant supplementation, including NAC, might reduce the effectiveness of chemotherapy by protecting cancer cells from oxidative damage, which is one of the mechanisms by which many chemotherapeutic agents kill tumor cells. Large, well-designed clinical trials are lacking, and some oncology guidelines recommend caution with antioxidants during chemotherapy unless under medical supervision.

In summary, while there is promising scientific rationale and early evidence for NAC in reducing certain chemotherapy side effects, especially organ toxicity, the overall clinical evidence is moderate at best (rating: 2 out of 5), and its use should be carefully considered on a case-by-case basis.

More about n-acetyl-cysteine (NAC)
More about Chemotherapy (reducing side effects)

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