Low-dose Naltrexone - CancerChoices

This prescription drug is used off-label in low doses to treat people with cancer, with notable but very preliminary successes in cases where the cancers were difficult-to-treat or quite advanced.

Low-dose naltrexone at a glance

Naltrexone is a pharmaceutical opioid antagonist approved by the Food and Drug Administration for use in conventional medicine at doses of 50 mg or higher to treat addiction (opioid or alcohol). Low-dose naltrexone (LDN) is used off-label—outside FDA’s approval—to treat cancer and other diseases and disorders. 

Every US state allows off-label drug use if supported by enough evidence. According to Dr. Linda Elsegood, off-label use of LDN is supported by sufficient evidence in small studies and case studiesa descriptive and exploratory analysis of a person, group, or event regarding changes observed over time; because changes due to treatment are not compared to similar changes over time without treatment, a case study is considered a weak study design.1Elsegood L. Ed. The LDN Book. Vermont: Chelsea Green Publishing. 2016.

The evidence to date for LDN in improving treatment outcomes is sparse but impressive, linking LDN to longer survival among people with a few difficult-to-treat cancers, including glioma and pancreatic cancer. LDN may also reduce non-cancer pain.

CancerChoices ratings for low-dose naltrexone

We rate low-dose naltrexone on seven attributes, with 0 the lowest rating and 5 the highest. We rate the strength of the evidence supporting the use of LDN for a medical benefit, such as improving treatment outcomes or managing side effects.

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Improving treatment outcomes

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Optimizing your body terrain

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Managing side effects and promoting wellness

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Reducing cancer risk

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Use by integrative oncology experts

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Affordability and access

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Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher


Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Dan Rubin, ND, FABNO

Naturopathic oncologist
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Dan Rubin, ND, FABNO, is a board certified naturopathic oncologist practicing in both Scottsdale and Flagstaff, Arizona. Dr. Rubin is the founding president of the Oncology Association of Naturopathic Physicians (OncANP) and has been a long-time member of the Arizona Naturopathic Physicians Medical Board. He is the co-founder of Naturopathic Specialists, LLC, with his wife, Debi Smolinski, ND. Dr. Rubin focuses on naturopathic and integrative approaches to people with cancer, treating both children and adults. He enjoys trail running in the Sonoran desert near his house.

Dan Rubin, ND, FABNO Naturopathic oncologist

Last update: December 12, 2023

Last full literature review: September 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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