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Alam F, Hwang SR, Al-Hilal TA, Chung SW, Kim HS, Kang BH, Zhang HS, Shin SH, Lee JY, Kang MS, Kwon GH, Jeon OC, Kim SY, Byun Y. Safety studies on intravenous infusion of a potent angiogenesis inhibitor: taurocholate-conjugated low molecular weight heparin derivative LHT7 in preclinical models. Drug Dev Ind Pharm 2015; 42:1247-57. [PMID: 26612099 DOI: 10.3109/03639045.2015.1122609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
CONTEXT As a class of angiogenesis inhibitors, heparin conjugates have shown significant effectiveness in several studies. OBJECTIVES The purpose of our current study is to evaluate the effectiveness and safety of infusing the conjugate of low molecular weight heparin and taurocholate (LHT7), which has been developed as a potent angiogenesis inhibitor. METHODS To evaluate its safety, the method of intravenous infusion was compared with its i.v. bolus administration. Intravenous infusion was administered at a rate of 400 μl/min/kg of body weight for 30 min. Pharmacokinetic (PK) analysis, organ accumulation, and plasma concentration profiles of LHT7 were measured. The anticancer effect of LHT7 was evaluated in murine and human xenograft models, and preclinical studies were performed in SD rats and beagle dogs. RESULTS The results of the PK studies showed reduced organ accumulation in mice and the AUC(0-96 h) (area under the curve) was increased up to 1485 ± 125 h × μg/ml. The efficacy, at dose 1 mg/kg/2 d was higher for i.v. infusion than for i.v. bolus administration in both murine and human cancer models. The preclinical studies showed the safety dose of LHT7 is less than 20 mg/kg in SD rats and in the next safety analysis in beagle dogs showed that there were no organ-specific adverse effects in higher doses, such as, 12 mg/kg. LHT7 showed sustained effects with minimized adverse events when administered through i.v. infusion. CONCLUSIONS LHT7 (i.v. infusion) could be safely used for further clinical development as a multi-targeting anti-angiogenic agent.
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Affiliation(s)
- Farzana Alam
- a Research Institute of Pharmaceutical Science, College of Pharmacy, Seoul National University , Seoul , South Korea
| | - Seung Rim Hwang
- b College of Pharmacy, Chosun University , Gwangju , South Korea
| | - Taslim A Al-Hilal
- c Center for Theragonosis, Biomedical Research Institute, Korea Institute of Science and Technology , Wolgog, Seoul , South Korea
| | - Seung Woo Chung
- a Research Institute of Pharmaceutical Science, College of Pharmacy, Seoul National University , Seoul , South Korea
| | - Hak-Soo Kim
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | - Boo-Hyun Kang
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | - Hu-Song Zhang
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | - Seo-Ho Shin
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | - Joo-Young Lee
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | - Min-Soo Kang
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | - Geum-Hee Kwon
- d ChemOn Inc., Bio-Research Center , Gyeonggi-Do , South Korea
| | | | - Sang Yoon Kim
- f Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology , Seoul , South Korea ;,g Department of Otolaryngology , Asan Medical Center, College of Medicine, University of Ulsan , Seoul , South Korea
| | - Youngro Byun
- a Research Institute of Pharmaceutical Science, College of Pharmacy, Seoul National University , Seoul , South Korea ;,e Mediplex Corp , Seoul , South Korea
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152
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Ali A, Katz DL. Disease Prevention and Health Promotion: How Integrative Medicine Fits. Am J Prev Med 2015; 49:S230-40. [PMID: 26477898 PMCID: PMC4615581 DOI: 10.1016/j.amepre.2015.07.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/22/2015] [Accepted: 07/26/2015] [Indexed: 01/06/2023]
Abstract
As a discipline, preventive medicine has traditionally been described to encompass primary, secondary, and tertiary prevention. The fields of preventive medicine and public health share the objectives of promoting general health, preventing disease, and applying epidemiologic techniques to these goals. This paper discusses a conceptual approach between the overlap and potential synergies of integrative medicine principles and practices with preventive medicine in the context of these levels of prevention, acknowledging the relative deficiency of research on the effectiveness of practice-based integrative care. One goal of integrative medicine is to make the widest array of appropriate options available to patients, ultimately blurring the boundaries between conventional and complementary medicine. Both disciplines should be subject to rigorous scientific inquiry so that interventions that are efficacious and effective are systematically distinguished from those that are not. Furthermore, principles of preventive medicine can be infused into prevalent practices in complementary and integrative medicine, promoting public health in the context of more responsible practices. The case is made that an integrative preventive approach involves the responsible use of science with responsiveness to the needs of patients that persist when conclusive data are exhausted, providing a framework to make clinical decisions among integrative therapies.
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Affiliation(s)
- Ather Ali
- Yale School of Medicine, New Haven, Connecticut.
| | - David L Katz
- Yale University Prevention Research Center, Derby, Connecticut
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153
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Zhang X, Wang Y, Mao Z, Huang D, Zhou J, Wang X. Expression of NF-κB-inducing kinase in breast carcinoma tissue and its clinical significance. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:14824-9. [PMID: 26823811 PMCID: PMC4713597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 10/26/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the expression of nuclear factor-κB-inducing kinase (NIK) in breast carcinoma tissue and tumor-adjacent normal breast tissue and evaluate its clinical significance. METHODS Surgically resected tissue specimens were collected from 82 patients with breast carcinoma who underwent surgical treatment at our hospital from March 2001 to December 2009. The diagnoses of all patients were confirmed by postoperative pathological examinations. NIK protein expression in breast carcinoma tissue and adjacent normal breast tissue was detected by immunohistochemistry; the association between NIK expression and the clinicopathological features and prognosis of patients with breast carcinoma was examined. RESULTS The positive expression rate of NIK in breast carcinoma tissue was significantly higher than that in normal tissue (63.4% vs. 25.6%, P < 0.05). Additionally, NIK expression showed no relationship to the tumor size, age, degree of differentiation, or pathological type; however, it showed a significant correlation with lymph node metastasis and the clinical stage of patients (P < 0.05). The five-year survival rate was significantly lower in breast carcinoma patients who were positive for NIK expression than in those who were negative for NIK expression (P = 0.006). CONCLUSION NIK expression was significantly increased in the tumor tissue of patients with breast carcinoma, which may be an important factor that affects the prognosis of these patients.
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Affiliation(s)
- Xuliang Zhang
- Department of Oncology, The Affiliated Hospital of Hubei Institute of Science and Technology, Huangshi Central Hospital Huangshi, Hubei, China
| | - Yong Wang
- Department of Oncology, The Affiliated Hospital of Hubei Institute of Science and Technology, Huangshi Central Hospital Huangshi, Hubei, China
| | - Zheyu Mao
- Department of Oncology, The Affiliated Hospital of Hubei Institute of Science and Technology, Huangshi Central Hospital Huangshi, Hubei, China
| | - Danqing Huang
- Department of Oncology, The Affiliated Hospital of Hubei Institute of Science and Technology, Huangshi Central Hospital Huangshi, Hubei, China
| | - Junwei Zhou
- Department of Oncology, The Affiliated Hospital of Hubei Institute of Science and Technology, Huangshi Central Hospital Huangshi, Hubei, China
| | - Xudong Wang
- Department of Oncology, The Affiliated Hospital of Hubei Institute of Science and Technology, Huangshi Central Hospital Huangshi, Hubei, China
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154
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Samuel SR, Veluswamy SK, Maiya AG, Fernandes DJ, McNeely ML. Exercise-based interventions for cancer survivors in India: a systematic review. SPRINGERPLUS 2015; 4:655. [PMID: 26543789 PMCID: PMC4628608 DOI: 10.1186/s40064-015-1456-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/20/2015] [Indexed: 01/03/2023]
Abstract
Existing literature suggests that cancer survivors present with high rates of morbidity due to various treatment and disease induced factors. Research globally has shown exercise to be beneficial in improving treatment outcomes and quality of life. India has a high prevalence of cancer and not much is known about exercise interventions for cancer survivors in India. This review was planned to review the state of exercise based interventions for cancer survivors in India. A comprehensive literature search was performed in PubMed, CINAHL, EMBASE, Scopus, Cochrane Library, PEDro, IndMed, and Shoda Ganga. The search results were screened and data extracted by two independent reviewers. All eligible studies were assessed for methodological quality rating using Downs and Black checklist. Data was extracted using a pilot tested pro forma to summarize information on site and stage of cancer, type of exercise intervention and outcome measures. The review identified 13 studies, published from 1991 to 2013, after screening 4060 articles. Exercise interventions fell into one of three categories: (1) yoga-based, (2) physiotherapy-based and (3) speech therapy based interventions; and exclusively involved either breast or head and neck cancers. Studies were generally of low to moderate quality. A broad range of outcomes were found including symptoms, speech and swallowing, and quality of life and largely supported the benefits of exercise-based interventions. At present, research involving exercise-based rehabilitation interventions in India is limited in volume, quality and scope. With the growing burden of cancer in the country, there is an immediate need for research on exercise based interventions for cancer survivors within the sociocultural context of India.
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Affiliation(s)
- Stephen R Samuel
- Department of Physiotherapy, SOAHS, Manipal University, Manipal, India
| | - Sundar K Veluswamy
- Department of Physiotherapy, M S Ramaiah Medical College and Hospitals, MSR Nagar, MSR IT Post, Bangalore, 560054 Karnataka India
| | - Arun G Maiya
- Department of Physiotherapy, SOAHS, Manipal University, Manipal, India
| | - Donald J Fernandes
- Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal University, Manipal, India
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta Canada
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155
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Liu R, Chang A, Reddy S, Hecht FM, Chao MT. Improving Patient-Centered Care: A Cross-Sectional Survey of Prior Use and Interest in Complementary and Integrative Health Approaches Among Hospitalized Oncology Patients. J Altern Complement Med 2015; 22:160-5. [PMID: 26505257 DOI: 10.1089/acm.2015.0061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe cancer inpatients' prior-year use of complementary and integrative health (CIH) therapies and interest in receiving CIH therapies while in the hospital. DESIGN Observational, cross-sectional survey of prior-year use of 12 different CIH approaches and interest in receiving any of 7 CIH services in the hospital. SETTING Surgical oncology ward of an academic medical center. PARTICIPANTS 166 hospitalized oncology patients, with an average age of 54 years. RESULTS The most commonly used CIH approach was vitamins/nutritional supplements (67%), followed by use of a special diet (42%) and manual therapies (39%). More than 40% of patients expressed interest in each of the therapies if it was offered during their hospital stay, and 95% of patients were interested in at least one. More than 75% expressed interest in nutritional counseling and in massage. CIH use and interest varied somewhat by demographic and clinical characteristics. CONCLUSION Rates of CIH use among patients with cancer were high, as were their preferences to have these services available in the inpatient setting. Hospitals have the opportunity to provide patient-centered care by developing capacity to provide inpatient CIH services.
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Affiliation(s)
- Rhianon Liu
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA
| | - Alexandra Chang
- 2 Departments of Anesthesiology and Internal Medicine, Loma Linda University , Loma Linda, CA
| | - Sanjay Reddy
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA.,3 Division of Hospital Medicine, University of California , San Francisco, San Francisco, CA
| | - Frederick M Hecht
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA
| | - Maria T Chao
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA.,4 Division of General Internal Medicine at San Francisco General Hospital, University of California , San Francisco, San Francisco, CA
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156
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Abstract
Safe, effective, and evidence-based management of cancer-related pain is a cornerstone of comprehensive cancer care. Despite increasing interest in and efforts to improve its management, pain remains poorly controlled in nearly half of all patients with cancer, with little change in the past 20 years. Limited training in pain assessment and management, overestimation of providers' own skills to treat pain, and failure to refer patients to pain specialists can result in suboptimal pain management with devastating effects on quality of life, physical functioning, and increased psychological distress. From a thorough assessment of cancer-related pain to appropriate treatments that may include opiates, adjuvant medications, nerve blocks, and nondrug interventions, this article is intended as a brief overview of the mechanisms and types of pain as well as a review of current, new, and promising approaches to its management.
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Affiliation(s)
- Thomas J Smith
- Harry J. Duffey Family Palliative Care Program of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medical Institutions, Baltimore, MD.
| | - Catherine B Saiki
- Harry J. Duffey Family Palliative Care Program of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Medical Institutions, Baltimore, MD
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157
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Autonomic dysfunction in early breast cancer: Incidence, clinical importance, and underlying mechanisms. Am Heart J 2015; 170:231-41. [PMID: 26299219 DOI: 10.1016/j.ahj.2015.05.014] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 05/25/2015] [Indexed: 12/14/2022]
Abstract
Autonomic dysfunction represents a loss of normal autonomic control of the cardiovascular system associated with both sympathetic nervous system overdrive and reduced efficacy of the parasympathetic nervous system. Autonomic dysfunction is a strong predictor of future coronary heart disease, vascular disease, and sudden cardiac death. In the current review, we will discuss the clinical importance of autonomic dysfunction as a cardiovascular risk marker among breast cancer patients. We will review the effects of antineoplastic therapy on autonomic function, as well as discuss secondary exposures, such as psychological stress, sleep disturbances, weight gain/metabolic derangements, and loss of cardiorespiratory fitness, which may negatively impact autonomic function in breast cancer patients. Lastly, we review potential strategies to improve autonomic function in this population. The perspective can help guide new therapeutic interventions to promote longevity and cardiovascular health among breast cancer survivors.
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158
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Rouleau CR, Garland SN, Carlson LE. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients. Cancer Manag Res 2015; 7:121-31. [PMID: 26064068 PMCID: PMC4457221 DOI: 10.2147/cmar.s64165] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs) in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness). This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients - namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic-pituitary-adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes.
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Affiliation(s)
- Codie R Rouleau
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Sheila N Garland
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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159
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Berger AM, Mitchell SA, Jacobsen PB, Pirl WF. Screening, evaluation, and management of cancer-related fatigue: Ready for implementation to practice? CA Cancer J Clin 2015; 65:190-211. [PMID: 25760293 DOI: 10.3322/caac.21268] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 12/13/2022] Open
Abstract
Answer questions and earn CME/CNE Evidence regarding cancer-related fatigue (fatigue) has accumulated sufficiently such that recommendations for screening, evaluation, and/or management have been released recently by 4 leading cancer organizations. These evidence-based fatigue recommendations are available for clinicians, and some have patient versions; but barriers at the patient, clinician, and system levels hinder dissemination and implementation into practice. The underlying biologic mechanisms for this debilitating symptom have not been elucidated completely, hindering the development of mechanistically driven interventions. However, significant progress has been made toward methods for screening and comprehensively evaluating fatigue and other common symptoms using reliable and valid self-report measures. Limited data exist to support the use of any pharmacologic agent; however, several nonpharmacologic interventions have been shown to be effective in reducing fatigue in adults. Never before have evidence-based recommendations for fatigue management been disseminated by 4 premier cancer organizations (the National Comprehensive Cancer, the Oncology Nursing Society, the Canadian Partnership Against Cancer/Canadian Association of Psychosocial Oncology, and the American Society of Clinical Oncology). Clinicians may ask: Are we ready for implementation into practice? The reply: A variety of approaches to screening, evaluation, and management are ready for implementation. To reduce fatigue severity and distress and its impact on functioning, intensified collaborations and close partnerships between clinicians and researchers are needed, with an emphasis on system-wide efforts to disseminate and implement these evidence-based recommendations.
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Affiliation(s)
- Ann M Berger
- University of Nebraska Medical Center College of Nursing, Fred and Pamela Buffett Cancer Center, Omaha, NE
| | - Sandra A Mitchell
- Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Paul B Jacobsen
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, FL
| | - William F Pirl
- Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA
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160
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Greenlee H, Zick SM, Rosenthal D, Cohen L, Cassileth B, Tripathy D. Integrative oncology - strong science is needed for better patient care. Nat Rev Cancer 2015; 15:165. [PMID: 25693833 DOI: 10.1038/nrc3822-c1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Heather Greenlee
- 1] Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. [2] Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society
| | - Suzanna M Zick
- 1] Department of Family Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA. [2] Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society
| | - David Rosenthal
- 1] Harvard Medical School and the Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. [2] Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society
| | - Lorenzo Cohen
- 1] Departments of General Oncology and Behavioural Science, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. [2] Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society
| | - Barrie Cassileth
- 1] Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA. [2] Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society
| | - Debu Tripathy
- 1] Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. [2] Society for Integrative Oncology, S.Z. currently serves as the President, and all other authors are Past Presidents of the Society
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161
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Gorski DH. Integrative oncology - strong science is needed for better patient care. Nat Rev Cancer 2015; 15:165. [PMID: 25693835 DOI: 10.1038/nrc3822-c2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- David H Gorski
- Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, 6C University Health Center, 4201 St. Antoine Street, Detroit, Michigan 48201, USA; and the Molecular Therapeutics Program and Department of Oncology, Barbara Ann Karmanos Cancer Institute, 4100 John R Street, Detroit, Michigan 48201, USA
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162
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Weeks J. End of a (Lucky) Era for Integrative Health Policy: Republican Wins Sweep Key Integrative Leaders From Powerful Committee Chairs … plus more. Integr Med (Encinitas) 2015; 14:16-18. [PMID: 26770126 PMCID: PMC4566452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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163
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Truant TL, Balneaves LG, Fitch MI. Integrating complementary and alternative medicine into cancer care: Canadian oncology nurses' perspectives. Asia Pac J Oncol Nurs 2015; 2:205-214. [PMID: 27981116 PMCID: PMC5123512 DOI: 10.4103/2347-5625.167233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The integration of complementary and alternative medicine (CAM) and conventional cancer care in Canada is in its nascent stages. While most patients use CAM during their cancer experience, the majority does not receive adequate support from their oncology health care professionals (HCPs) to integrate CAM safely and effectively into their treatment and care. A variety of factors influence this lack of integration in Canada, such as health care professional(HCP) education and attitudes about CAM; variable licensure, credentialing of CAM practitioners, and reimbursement issues across the country; an emerging CAM evidence base; and models of cancer care that privilege diseased-focused care at the expense of whole person care. Oncology nurses are optimally aligned to be leaders in the integration of CAM into cancer care in Canada. Beyond the respect afforded to oncology nurses by patients and family members that support them in broaching the topic of CAM, policies, and position statements exist that allow oncology nurses to include CAM as part of their scope. Oncology nurses have also taken on leadership roles in clinical innovation, research, education, and advocacy that are integral to the safe and informed integration of evidence-based CAM therapies into cancer care settings in Canada.
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Affiliation(s)
- Tracy L Truant
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Lynda G Balneaves
- Centre for Integrative Medicine, Faculty of Medicine and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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164
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Mao JJ, Cohen L. Advancing the Science of Integrative Oncology to Inform Patient-Centered Care for Cancer Survivors. J Natl Cancer Inst Monogr 2014; 2014:283-4. [DOI: 10.1093/jncimonographs/lgu038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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