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Gordan JD, Chay WY, Kelley RK, Ko AH, Choo SP, Venook AP. “And What Other Medications Are You Taking?”. J Clin Oncol 2011; 29:e288-91. [DOI: 10.1200/jco.2010.32.8054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- John D. Gordan
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA
| | | | - R. Kate Kelley
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA
| | - Andrew H. Ko
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA
| | | | - Alan P. Venook
- Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA
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Ben-Arye E, Schiff E, Steiner M, Silbermann M. Wheatgrass in Afifi's garden: sprouting integrative oncology collaborations in the Middle East. J Clin Oncol 2011; 29:944-6. [PMID: 21220607 DOI: 10.1200/jco.2010.33.4532] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We suggest that bridging traditional and modern medicine can in many cases empower patients and enable them to better cope with cancer treatment. Our experiences in the Middle East might be applicable to other areas of the world facing a similar need to integrate evidence-based medicine with narrative-based, ethics-based, and ethnic medicine in the practice of oncology. In addition,we hope that our common efforts will encourage future collaboration among scientists and clinicians in the Middle East, which in turn might promote understanding, tolerance, and mutual respect among professionals in an area of the world troubled by ongoing geopolitical conflict.
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Affiliation(s)
- Eran Ben-Arye
- Lin Medical Center, Clalit Health Services; Technion-Israel Institute of Technology, Israel.
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Chow WH, Chang P, Lee SC, Wong A, Shen HM, Verkooijen HM. Complementary and Alternative Medicine among Singapore Cancer Patients. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v39n2p129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: This study evaluates determinants, expectations, association with quality of life (QOL) and doctor’s awareness of Complementary and Alternative Medicine (CAM) use in Singapore cancer patients. Material and Methods: We interviewed 316 patients visiting the Cancer Centre of the National University Hospital on behaviour, attitudes and expectations towards CAM and assessed QOL via Euroqol Questionnaire (EQ-5D). Medical information was obtained from oncologists. Results: One hundred and seventy-three patients (55%) reported CAM use after cancer diagnosis. Chinese ethnicity, tertiary education, age <65 years and previous CAM use were independent predictors of CAM use. Fifty-one per cent of CAM users informed their doctors about their use and 15% of doctors reported to be aware of CAM use in these patients. Thirty-seven per cent believed CAM to be equally or more effective than conventional cancer therapies and 78% expected at least basic knowledge about CAM from their oncologists. Twenty-five per cent of patients reported concurrent use of oral CAM and chemotherapy, of which oncologists were unaware in 86% of cases. CAM users had higher EuroQol utility scores than non-CAM users (0.79 versus 0.73, respectively, P = 0.03), in particularly those aged ≥65 years and those with stage IV disease. Conclusion: Singapore cancer patients show high prevalence of CAM use, high expectations regarding its effectiveness and doctors’ knowledge on CAM and many use it concurrently with chemotherapy or radiotherapy. Since oncologists are generally unaware of CAM use in their patients, doctor-patient communication on CAM use needs to be improved. The association of CAM use and higher QOL scores in some subgroups deserves further exploration.
Key words: Oncology, Patients’ expectations, Quality of life, Survey
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Affiliation(s)
- Wen Hann Chow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Pearlly Chang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Han-Ming Shen
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Naing A, Aaron J, Kurzrock R. Juice plus or toxicity plus. Am J Med 2010; 123:e1-2. [PMID: 20102976 DOI: 10.1016/j.amjmed.2009.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 06/12/2009] [Accepted: 06/25/2009] [Indexed: 12/01/2022]
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Kristoffersen AE, Fønnebø V, Norheim AJ. Do cancer patients with a poor prognosis use complementary and alternative medicine more often than others? J Altern Complement Med 2009; 15:35-40. [PMID: 19769474 DOI: 10.1089/acm.2008.0262] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION One reason for patients with cancer to use complementary and alternative medicine (CAM) is that their cancer cannot be cured by conventional therapy. The aim of the present study is to explore whether use of CAM is associated with survival prognosis in long-term survivors of cancer. MATERIALS AND METHODS Cancer patients who were alive 5 years or more after diagnosis were chosen to participate in the study, one group with less than 20% and another group with 40%-60% expected five-year survival at the time of diagnosis. A total of 735 patients received a four-page postal questionnaire about CAM use; 397 questionnaires were returned (response rate = 54%). RESULTS The results are reported at five levels of CAM use. The poor prognosis group reported CAM use more often than the better prognosis group; however, only significantly higher at CAM level 2 (use of a CAM provider) (p = 0.021) and in use of self-support/CAM techniques (p < 0.001). Use of over-the-counter (OTC) dietary supplements and use of diet as treatment were not significantly different between the groups. DISCUSSION This study supports the suggestion that use of a CAM therapist and use of self-support/CAM techniques might be associated with less hope of cure given by the physician.
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Affiliation(s)
- Agnete Egilsdatter Kristoffersen
- National Research Centre in Complementary and Alternative Medicine, Tromsø Science Park, University of Tromsø, N-9037 Tromsø, Norway.
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Shafi G, Munshi A, Hasan TN, Alshatwi AA, Jyothy A, Lei DKY. Induction of apoptosis in HeLa cells by chloroform fraction of seed extracts of Nigella sativa. Cancer Cell Int 2009; 9:29. [PMID: 19943925 PMCID: PMC2794855 DOI: 10.1186/1475-2867-9-29] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 11/27/2009] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cancer remains one of the most dreaded diseases causing an astonishingly high death rate, second only to cardiac arrest. The fact that conventional and newly emerging treatment procedures like chemotherapy, catalytic therapy, photodynamic therapy and radiotherapy have not succeeded in reverting the outcome of the disease to any drastic extent, has made researchers investigate alternative treatment options. The extensive repertoire of traditional medicinal knowledge systems from various parts of the world are being re-investigated for their healing properties. This study progresses in the direction of identifying component(s) from Nigella sativa with anti cancer activity. In the present study we investigated the efficacy of Organic extracts of Nigella sativa seed powder for its clonogenic inhibition and induction of apoptosis in HeLa cancer cell. RESULTS Methanolic, n-Hexane and chloroform extracts of Nigella sativa seedz effectively killed HeLa cells. The IC50 values of methanolic, n-hexane, and chloroform extracts of Nigella sativa were 2.28 microg/ml, 2.20 microg/ml and 0.41 ng/ml, respectively. All three extracts induced apoptosis in HeLa cells. Apoptosis was confirmed by DNA fragmentation, western blot and terminal transferase-mediated dUTP-digoxigenin-end labeling (TUNEL) assay. CONCLUSION Western Blot and TUNEL results suggested that Nigella sativa seed extracts regulated the expression of pro- and anti- apoptotic genes, indicating its possible development as a potential therapeutic agent for cervical cancer upon further investigation.
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Affiliation(s)
- Gowhar Shafi
- Molecular Cancer Biology Lab, Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
- Department of Molecular Biology, Institute of Genetics and Hospital for Genetic Diseases, Hyderabad, India
| | - Anjana Munshi
- Department of Molecular Biology, Institute of Genetics and Hospital for Genetic Diseases, Hyderabad, India
| | - Tarique N Hasan
- Molecular Cancer Biology Lab, Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Ali A Alshatwi
- Molecular Cancer Biology Lab, Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - A Jyothy
- Department of Molecular Biology, Institute of Genetics and Hospital for Genetic Diseases, Hyderabad, India
| | - David KY Lei
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA
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Guethlin C, Walach H, Naumann J, Bartsch HH, Rostock M. Characteristics of cancer patients using homeopathy compared with those in conventional care: a cross-sectional study. Ann Oncol 2009; 21:1094-9. [PMID: 19858085 DOI: 10.1093/annonc/mdp421] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are only few studies on cancer patients who are treated in complementary and alternative medicine clinics and comparing them with patients in conventional care. We will present the comparison of characteristics of two patient cohorts: one was treated in a homeopathic cancer care clinic and one was treated in a conventional oncology care (CC) outpatient clinic. PATIENTS AND METHODS Six-hundred and forty-seven patients were included in this cross-sectional cohort study and had to fill in questionnaires [health-related quality of life (QoL) (Functional Assessment of Cancer Therapy-General Scale), depression and anxiety (Hospital Anxiety and Depression Scale), fatigue (Multidimensional Fatigue Inventory) and expectancies toward treatment]. Clinical data were extracted from medical records. This study presents the comparison of both cohorts. RESULTS Patients in the homeopathy cohort are younger, better educated and more often employed than patients in the CC cohort. The most pronounced differences indicate longer disease histories and different diagnostic and clinical pretreatment variables. Despite the clinical differences, QoL as well as anxiety, depression and fatigue was similar in both the groups. CONCLUSIONS Homeopathic treatment is sought by cancer patients at a different phase during the course of the disease, which has particular implications for research. However, expectancies toward the benefit of the treatment as well as QoL data are similar.
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Affiliation(s)
- C Guethlin
- Institute for General Practice, Johann-Wolfgang Goethe-University, Frankfurt/Main, Germany.
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Stein KD, Kaw C, Crammer C, Gansler T. The role of psychological functioning in the use of complementary and alternative methods among disease-free colorectal cancer survivors: a report from the American Cancer Society's studies of cancer survivors. Cancer 2009; 115:4397-408. [PMID: 19731355 DOI: 10.1002/cncr.24591] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood. METHODS By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors. RESULTS Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements. CONCLUSIONS Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation.
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Affiliation(s)
- Kevin D Stein
- Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303, USA
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Ferrucci LM, McCorkle R, Smith T, Stein KD, Cartmel B. Factors related to the use of dietary supplements by cancer survivors. J Altern Complement Med 2009; 15:673-80. [PMID: 19489706 DOI: 10.1089/acm.2008.0387] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Estimates of the use of complementary and alternative medicine (CAM) among cancer survivors vary widely. Dietary supplements are an important CAM therapy to examine because of their potential to interact with conventional cancer therapies. We estimated the prevalence of dietary supplement use in a population-based sample of cancer survivors of the 10 most common cancers and examined potential correlates of use. DESIGN AND SUBJECTS This cross-sectional analysis included participants from the American Cancer Society's longitudinal Study of Cancer Survivors-I recruited in Connecticut who completed self-administered baseline and supplemental questionnaires. Using univariate and multivariate logistic regression, we examined demographic, clinical, and psychosocial predictors of dietary supplement use after cancer diagnosis. RESULTS Of the 827 cancer survivors, 573 (69.3%) reported using dietary supplements after their cancer diagnosis. Female gender [odds ratio (OR) = 1.72, 95% confidence interval (CI) = 1.25-2.36] and higher-education levels (OR = 5.44, 95% CI = 2.98-9.93) were significantly associated with supplement use. Common reasons for using dietary supplements included "something they could do to help themselves" (56.2%) and "to boost their immune system" (51.1%). Most survivors (82.4%) informed their physician of their supplement use. Patients obtained information from a variety of sources including physicians, friends or family, and magazines or books. CONCLUSIONS Use of dietary supplements after cancer diagnosis was quite common among this population-based sample of cancer survivors. Although gender and education were associated with use, it is important that clinicians discuss supplement use with all cancer survivors.
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Can G, Erol O, Aydiner A, Topuz E. Quality of life and complementary and alternative medicine use among cancer patients in Turkey. Eur J Oncol Nurs 2009; 13:287-94. [DOI: 10.1016/j.ejon.2009.03.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Revised: 03/06/2009] [Accepted: 03/20/2009] [Indexed: 11/25/2022]
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Escudier B, Roigas J, Gillessen S, Harmenberg U, Srinivas S, Mulder SF, Fountzilas G, Peschel C, Flodgren P, Maneval EC, Chen I, Vogelzang NJ. Phase II study of sunitinib administered in a continuous once-daily dosing regimen in patients with cytokine-refractory metastatic renal cell carcinoma. J Clin Oncol 2009; 27:4068-75. [PMID: 19652072 DOI: 10.1200/jco.2008.20.5476] [Citation(s) in RCA: 168] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Sunitinib has demonstrated antitumor activity in metastatic renal cell carcinoma (mRCC) when given at 50 mg/d on a 4-weeks-on 2-weeks-off regimen. Herein, we report results of an open-label, multicenter phase II mRCC study of sunitinib administered on a continuous once-daily dosing regimen. PATIENTS AND METHODS Eligibility criteria included histologically proven mRCC with measurable disease, failure of one prior cytokine regimen, and good performance status. Patients were randomly assigned to a sunitinib starting dose of 37.5 mg/d in the morning (AM) or evening (PM). RECIST-defined objective response rate (ORR) was the primary end point. Secondary end points included progression-free survival (PFS), overall survival (OS), adverse events (AEs), and quality-of-life measures. RESULTS One hundred seven patients were randomly assigned to AM (n = 54) or PM (n = 53) dosing and on study for a median 8.3 months. Eighty-three patients discontinued, 65 due to disease progression and 16 because of AEs; two patients withdrew consent. Dosing was reduced to 25 mg/d in 46 patients (43%) due to grade 3/4 AEs. The most common grade 3 treatment-related AEs were asthenia/fatigue (16%), diarrhea (11%), hypertension (11%), hand-foot syndrome (9%), and anorexia (8%). ORR was 20% with a 7.2-month median response duration. Median PFS and OS were 8.2 and 19.8 months, respectively, at median follow-up of 26.4 months. Efficacy, tolerability, and quality-of-life results were similar between patients dosed in the AM or PM. CONCLUSION Sunitinib 37.5 mg, administered on a continuous once-daily dosing regimen, has a manageable safety profile as second-line mRCC therapy, providing flexible dosing, which can be explored in combination studies.
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Affiliation(s)
- Bernard Escudier
- Unité Immunothérapie, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France.
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Goulas V, Exarchou V, Troganis AN, Psomiadou E, Fotsis T, Briasoulis E, Gerothanassis IP. Phytochemicals in olive-leaf extracts and their antiproliferative activity against cancer and endothelial cells. Mol Nutr Food Res 2009; 53:600-8. [PMID: 19194970 DOI: 10.1002/mnfr.200800204] [Citation(s) in RCA: 158] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Olive oil compounds is a dynamic research area because Mediterranean diet has been shown to protect against cardiovascular disease and cancer. Olive leaves, an easily available natural material of low cost, share possibly a similar wealth of health benefiting bioactive phytochemicals. In this work, we investigated the antioxidant potency and antiproliferative activity against cancer and endothelial cells of water and methanol olive leaves extracts and analyzed their content in phytochemicals using LC-MS and LC-UV-SPE-NMR hyphenated techniques. Olive-leaf crude extracts were found to inhibit cell proliferation of human breast adenocarcinoma (MCF-7), human urinary bladder carcinoma (T-24) and bovine brain capillary endothelial (BBCE). The dominant compound of the extracts was oleuropein; phenols and flavonoids were also identified. These phytochemicals demonstrated strong antioxidant potency and inhibited cancer and endothelial cell proliferation at low micromolar concentrations, which is significant considering their high abundance in fruits and vegetables. The antiproliferative activity of crude extracts and phytochemicals against the cell lines used in this study is demonstrated for the first time.
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Affiliation(s)
- Vlassios Goulas
- Section of Organic Chemistry and Biochemistry, Department of Chemistry, University of Ioannina, Ioannina, Greece
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George S, Merriam P, Maki RG, Van den Abbeele AD, Yap JT, Akhurst T, Harmon DC, Bhuchar G, O'Mara MM, D'Adamo DR, Morgan J, Schwartz GK, Wagner AJ, Butrynski JE, Demetri GD, Keohan ML. Multicenter phase II trial of sunitinib in the treatment of nongastrointestinal stromal tumor sarcomas. J Clin Oncol 2009; 27:3154-60. [PMID: 19451429 DOI: 10.1200/jco.2008.20.9890] [Citation(s) in RCA: 235] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To evaluate the potential benefit of continuous daily dosing sunitinib in patients with advanced nongastrointestinal stromal tumor (GIST) sarcomas. PATIENTS AND METHODS A total of 53 patients with advanced non-GIST soft tissue sarcomas received sunitinib 37.5 mg daily. Primary end point was Response Evaluation Criteria in Solid Tumors defined response. Secondary end points were stable disease at 16 and 24 weeks. [(18)F]-fluorodeoxyglucose positron emission tomography was performed on a subset of 24 patients at baseline and after 10 to 14 days of therapy. Results Forty-eight patients were eligible for response. One patient (desmoplastic round cell tumor [DSRCT]) achieved a confirmed partial response (PR) and remained on study for 56 weeks. Ten patients (20%) achieved stable disease for at least 16 weeks. Metabolic PR was seen in 10 (47%) of 21 of patients. Metabolic stable disease was seen in 11 (52%) of 21. There were no unexpected toxicities observed. CONCLUSION Sunitinib demonstrated notable evidence of metabolic response in several patients with non-GIST sarcoma. The relevance of disease control observed in subtypes with an indolent natural history is unknown, however, the durable disease control observed in DSRCT, solitary fibrous tumor, and giant cell tumor of bone suggests that future evaluation of sunitinib in these subtypes may be warranted.
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Affiliation(s)
- Suzanne George
- Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, 44 Binney St, D1210, Boston, MA 02115, USA.
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Complications of traditional Chinese/herbal medicines (TCM)--a guide for perplexed oncologists and other cancer caregivers. Support Care Cancer 2008; 17:231-40. [PMID: 19009311 DOI: 10.1007/s00520-008-0526-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 10/13/2008] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Cancer patients often seek complementary or alternative medicines to supplement or replace treatments prescribed by licensed medical practitioners. Traditional Chinese/herbal medicine (TCM) is a popular complementary intervention among cancer patients of Asian ethnicity, many of whom take it during their conventional treatment. Few of these patients inform their doctors, however, creating a risk of unexpected sequelae arising from either pharmacologic toxicity, unsuitable dosing, interactions with anti-cancer drugs or other medications, adulteration, or idiosyncratic reactions. If unrecognized, these problems may be misattributed to conventional treatment toxicity or disease progression, and remedial action may be inappropriate or delayed. GOALS OF WORK The purpose of this review is to help oncologists recognize the common presentations of TCM-related problems in cancer patients-such as abnormal liver function tests, unexpectedly severe myelosuppression, hemostatic defects, renal functional impairment, or suspected drug interactions-and to teach strategies by which these problems can be anticipated, prevented, or managed. CONCLUSION Through sensitive understanding of the reasons favoring TCM usage, oncologists can gain the trust and respect of their TCM-using patients while ensuring the safety and efficacy of conventional anticancer treatments.
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Abstract
Conventional wisdom generally recommends complete avoidance of all dietary supplements, especially during chemotherapy and radiation. This interdiction persists, in spite of high rates of dietary supplement use by patients throughout all phases of cancer care, and can result in patients' perceptions of physicians as negative, thus leading to widespread nondisclosure of use. A review of the clinical literature shows that some evidence for harm does exist; however, data also exist that show benefit from using certain well-qualified supplements. Physicians should increase their knowledge base about dietary supplement use in cancer and consider all of the data when advising patients. Strategies that are patient-centered and reflect the complete array of available evidence lead to more nuanced messages about dietary supplement use in cancer. This should encourage greater disclosure of use by patients and ultimately increase safety and efficacy for patients choosing to use dietary supplements during cancer care.
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Affiliation(s)
- Mary L Hardy
- Simms/Mann-UCLA Center for Integrative Oncology, University of California at Los Angeles, 200 UCLA Medical Plaza, Suite 502 Los Angeles, CA 90095-9615, USA.
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Hensel M, Zoz M, Ho AD. Complementary and alternative medicine in patients with chronic lymphocytic leukemia. Support Care Cancer 2008; 17:47-52. [DOI: 10.1007/s00520-008-0452-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Accepted: 04/03/2008] [Indexed: 11/24/2022]
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Burstein HJ, Elias AD, Rugo HS, Cobleigh MA, Wolff AC, Eisenberg PD, Lehman M, Adams BJ, Bello CL, DePrimo SE, Baum CM, Miller KD. Phase II Study of Sunitinib Malate, an Oral Multitargeted Tyrosine Kinase Inhibitor, in Patients With Metastatic Breast Cancer Previously Treated With an Anthracycline and a Taxane. J Clin Oncol 2008; 26:1810-6. [DOI: 10.1200/jco.2007.14.5375] [Citation(s) in RCA: 403] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeSunitinib is an oral, multitargeted tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor, stem cell factor receptor (KIT), and colony-stimulating factor-1 receptor. This phase II, open-label, multicenter study evaluated sunitinib monotherapy in patients with metastatic breast cancer (MBC).Patients and MethodsSixty-four patients previously treated with an anthracycline and a taxane received sunitinib 50 mg/d in 6-week cycles (4 weeks on, then 2 weeks off treatment). The primary end point was objective response rate. Plasma samples were obtained for pharmacokinetic and biomarker analysis.ResultsSeven patients achieved a partial response (median duration, 19 weeks), giving an overall response rate of 11%. Three additional patients (5%) maintained stable disease for ≥ 6 months. Median time to progression and overall survival were 10 and 38 weeks, respectively. Notably, responses occurred in triple negative tumors and HER2-positive, trastuzumab-treated patients. Thirty-three patients (52%) required dose interruption during ≥ 1 cycle, and 25 patients required dose reduction (39%). Thirty-six patients (56%) had dose modifications due to adverse events (AEs). Treatment was associated with increases in plasma VEGF and decreases in soluble VEGFRs and KIT. The most common AEs were fatigue, nausea, diarrhea, mucosal inflammation, and anorexia. Most AEs were mild to moderate (grade 1 to 2) in severity and were effectively managed with dose delays or reductions.ConclusionSunitinib is active in patients with heavily pretreated MBC. Most AEs were of mild-to-moderate severity and manageable with supportive treatment and/or dose modification. Further studies in breast cancer are warranted.
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Affiliation(s)
- Harold J. Burstein
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Anthony D. Elias
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Hope S. Rugo
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Melody A. Cobleigh
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Antonio C. Wolff
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Peter D. Eisenberg
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Mary Lehman
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Bonne J. Adams
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Carlo L. Bello
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Samuel E. DePrimo
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Charles M. Baum
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
| | - Kathy D. Miller
- From the Dana-Farber Cancer Institute, Boston, MA; University of Colorado Health Sciences Center, Denver, CO; University of California San Francisco, San Francisco; California Cancer Care Inc, Greenbrae; Pfizer Inc, La Jolla; TRACON Pharmaceuticals Inc, San Diego, CA; Rush University Medical Center, Chicago, IL; Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; and the Indiana University Simon Cancer Center, Indianapolis, IN
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de Jong FA, Sparreboom A, Verweij J, Mathijssen RH. Lifestyle habits as a contributor to anti-cancer treatment failure. Eur J Cancer 2008; 44:374-82. [DOI: 10.1016/j.ejca.2007.12.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 12/20/2007] [Indexed: 01/07/2023]
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