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Andreazzoli F, Levy Yurkovski I, Ben-Arye E, Bonucci M. Conceptualizing an Integrative Multiple Myeloma Care: The Role of Nutrition, Supplements, and Complementary Modalities. Nutrients 2024; 16:237. [PMID: 38257130 PMCID: PMC10818534 DOI: 10.3390/nu16020237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Multiple Myeloma (MM) is the second most prevalent hematologic malignancy, and its incidence has been increasing enormously in recent years. The prognosis of MM has changed radically with the introduction of new drugs that have improved life expectancy; recurrences are a common occurrence during the course of the disease and are characterized by an increase in refractory to treatment. Moreover, MM patients are challenged by quality of life-related concerns while limited conventional therapy may be offered. This includes bone pain and dialysis due to the complications of acute renal failure. We, therefore, believe that it is very important to add new treatment modalities, including supplements, nutritional modifications, acupuncture, and mind-body therapies, with the goal of improving treatment tolerance, effectiveness, and patients' quality of life. Moreover, many patients use some of these supplements on their own, in the hope of reducing the side effects, so it is even more important to know their action and potential. The purpose of this review is to illustrate all these strategies potentially available to enrich our approach to this, to date, incurable disease.
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Affiliation(s)
- Francesca Andreazzoli
- Department of Hematology, Versilia’s Hospital, Viale Aurelia, 335, 55049 Camaiore, Italy
| | - Ilana Levy Yurkovski
- Hematology Unit, Bnai Zion Medical Center, Haifa 3339419, Israel
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel;
- Complementary and Integrative Medicine Service, Bnai Zion Medical Center, Haifa 3339419, Israel
| | - Eran Ben-Arye
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel;
- Integrative Oncology Program, The Oncology Service, Lin Carmel, and Zebulun Medical Centers, Clalit Health Services, Haifa 3535152, Israel
| | - Massimo Bonucci
- Artoi Foundation, Via Ludovico Micara, 73, 00165 Rome, Italy;
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Veleber S, Cohen MR, Weitzman M, Maimon Y, Adamo CA, Siman J, Lu W, Sajdyk T, Stone JA. Characteristics and Challenges of Providing Acupuncture and Chinese Herbal Medicine in Oncology Treatment: Report of Survey Data and Experience of Five Unique Clinical Settings. Integr Cancer Ther 2024; 23:15347354241226640. [PMID: 38288552 PMCID: PMC10826404 DOI: 10.1177/15347354241226640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Acupuncture is an integrative therapy with strong evidence to support its use in the oncology setting, yet barriers exist for implementation into conventional medical clinics. Though acupuncture is recommended in clinical practice guidelines for oncology, there is little data in the literature showing how acupuncture and other related therapies, including herbal medicine are successfully implemented in some oncology clinics, while others experience barriers to care. To characterize the current use of acupuncture (ACU) and herbal medicine (HM) in oncology clinics, we collected general demographic and usage data from 5 example clinics. In addition, to better understand the barriers faced by ACU and HM clinics in implementing acupuncture as a treatment modality, a survey was deployed to 2320 members of the Society for Integrative Oncology. This article examines the characteristics of oncology settings around the world, and shares data from the survey on the use of these therapies in the field of oncology. The primary barrier to acupuncture care, as reported by providers, was cost. With just under 70% of the oncologists reporting it as the most important obstacle. Additional barriers to implementation included concerns about competency and training, accessibility and safety of herbal medicine during treatment. Though acupuncture is being incorporated into more conventional oncology settings, organized strategies for implementation involving payers and policymakers is needed.
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Affiliation(s)
| | | | | | - Yair Maimon
- Refuot Integrative Medical Center, Tel Aviv Israel
| | - Christine A. Adamo
- California Cancer Associates for Research and Excellence, San Diego, CA, USA
| | | | - Weidong Lu
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Tammy Sajdyk
- Indiana University School of Medicine, Bloomington, IN, USA
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Zhao YX, Yao MJ, Shen JW, Zhang WX, Zhou YX. Electroacupuncture attenuates nociceptive behaviors in a mouse model of cancer pain. Mol Pain 2024; 20:17448069241240692. [PMID: 38443317 PMCID: PMC11010748 DOI: 10.1177/17448069241240692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/31/2024] [Accepted: 03/01/2024] [Indexed: 03/07/2024] Open
Abstract
Pain is a major symptom in cancer patients, and cancer-induced bone pain (CIBP) is the most common type of moderate and severe cancer-related pain. The current available analgesic treatments for CIBP have adverse effects as well as limited therapeutic effects. Acupuncture is proved effective in pain management as a safe alternative therapy. We evaluated the analgesic effect of acupuncture in treatment of cancer pain and try to explore the underlying analgesic mechanisms. Nude mice were inoculated with cancer cells into the left distal femur to establish cancer pain model. Electroacupuncture (EA) treatment was applied for the xenograft animals. Pain behaviors of mice were evaluated, followed by the detections of neuropeptide-related and inflammation-related indicators in peripheral and central levels. EA treatment alleviated cancer-induced pain behaviors covering mechanical allodynia, thermal hyperalgesia and spontaneous pain, and also down-regulated immunofluorescence expressions of neuropeptide CGRP and p75 in the skin of affected plantar area in xenograft mice, and inhibited expressions of overexpressed neuropeptide-related and inflammation-related protein in the lumbar spinal cord of xenograft mice. Overall, our findings suggest that EA treatment ameliorated cancer-induced pain behaviors in the mouse xenograft model of cancer pain, possibly through inhibiting the expressions of neuropeptide-related and inflammation-related protein in central level following tumor cell xenografts.
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Affiliation(s)
- Yu-Xue Zhao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Beijing, China
| | - Ming-Jiang Yao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Beijing, China
- Institute of Basic Medical Sciences, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- Key Laboratory of Pharmacology of Chinese Materia Medica, Beijing, China
| | - Jian-Wu Shen
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Beijing, China
- Urology Department of Xiyuan Hospital, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Wen-Xi Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Beijing, China
| | - Yuan-Xi Zhou
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Beijing, China
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Xu T, Deng B, Lin S, Wang H, Xu Y, Chen G. Comparative efficacy of acupuncture-related therapy for postmenopausal osteoporosis: protocol for Bayesian network meta-analysis. BMJ Open 2023; 13:e074740. [PMID: 38159952 PMCID: PMC10759059 DOI: 10.1136/bmjopen-2023-074740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION The review aims to conduct the first network meta-analysis to comprehensively evaluate the application of multiple acupuncture techniques in patients with postmenopausal osteoporosis, ranking the best acupuncture treatment and providing a reference for clinical treatment extensively. METHODS AND ANALYSIS Randomised controlled trials of different acupuncture-related therapies for postmenopausal osteoporosis will be searched in the following databases from 1 January 2002 to 31 December 2022, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP Database, Wanfang Database and China Biomedical Literature Database. Overall, clinical efficacy rate, bone mineral density and a Visual Analogue Scale score are used as the primary outcome indicators. In addition, the secondary outcome indicator is adverse reactions. The entire screening process will be conducted by two independent investigators; meanwhile, Stata (V.14.0) and RevMan (V.5.4) will be used to conduct the network meta-analysis. If the data are permissible and feasible, we will also perform meta-regression and subgroup analyses to address the underlying causes of data inconsistency and heterogeneity in the statistical analyses. Besides, to improve the credibility of this network meta-analysis, we will evaluate the quality of evidence in this research according to the GRADE assessment. ETHICS AND DISSEMINATION Ethics approval is not required for network meta-analyses, which do not involve animals' or people's welfare. The results of this network meta-analysis will be submitted to a recognised journal for publication. PROSPERO REGISTRATION NUMBER CRD42023401003.
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Affiliation(s)
- Tiantian Xu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bing Deng
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shen Lin
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hongjin Wang
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yunxiang Xu
- Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Guizhen Chen
- The Seventh Clinical Medicial College of Guangzhou University of Chinese Medicine, Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
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Lyu Z, Tian S, Bao G, Huang R, Gong L, Zhou J, Kong X, Zhang W, Ran R, Nie N, Liu Y, Ji C, Liu S, Shao X, Kai G, Lin X, Fang J, Liang Y. Transcutaneous electrical acupoint stimulation for cancer-related pain management in patients receiving chronic opioid therapy: a randomized clinical trial. Support Care Cancer 2023; 32:16. [PMID: 38085376 DOI: 10.1007/s00520-023-08240-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE The opioid crisis resulting from its use disorder and overdose poses additional challenges for cancer pain management. The American Society of Clinical Oncology Practice Guideline recommends acupuncture therapy for the management of adult cancer-related pain (CRP), but the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) on CRP remains uncertain. METHODS This 5-week prospective randomized clinical trial was conducted at 2 hospitals in China, and participants with CRP receiving chronic opioid therapy were randomized 1:1 into two groups between December 2014 and June 2018. The true TEAS group underwent 15 sessions of TEAS treatments over 3 consecutive weeks, while the control group received sham stimulation. The primary outcome was the numerical rating scale (NRS) score in the past 24h at week 3. The secondary outcomes included morphine equivalent daily dose, quality of life and adverse events. RESULTS A total of 159 participants were included in the modified intention-to-treat population. The baseline characteristics were similar in both groups. The mean NRS scores were 0.98 points at week 3 in the true TEAS group and 1.41 points in the sham group, with the mean difference between groups of -0.43 points (P < 0.001; OR = 0.68, P < 0.05). The proportion of patients with NRS reduction more than thirty percentage at week 3 was 50.00% in the true TEAS group and 35.44% in the sham group (RD = 0.15, P > 0.05; RR = 1.41, P > 0.05). No significant difference in pain intensity between the two groups was observed during the follow-up period without TEAS intervention (week 4, OR = 0.83, P > 0.05; week 5, OR = 0.83, P > 0.05). The Karnofsky Performance Status value suggested that patients in the true TEAS group experienced an improved quality of life (Between-group differences: week 3, 3.5%, P < 0.05; week 4, 4.6%, P < 0.001; week 5, 5.6%, P < 0.001). CONCLUSIONS The 3-week application of TEAS in patients with CRP receiving chronic opioid therapy resulted in a statistically significant reduction in pain scores, but the observed reduction was of uncertain clinical significance. The prolonged analgesic effect of TEAS was not confirmed in this trial. CLINICALTRIAL GOV: ChiCTR-TRC-13003803.
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Affiliation(s)
- Zhengyi Lyu
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005, China
| | - Shuxin Tian
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005, China
| | - Guanai Bao
- Department of Integrated Chinese Traditional Medicine and Western Medicine, Zhejiang Cancer Hospital, Hangzhou, 310022, China
| | - Rui Huang
- Department of Acupuncture and Tuina, Wenzhou Central Hospital, Wenzhou, 325000, China
| | - Liyan Gong
- Department of Integrated Chinese Traditional Medicine and Western Medicine, Zhejiang Cancer Hospital, Hangzhou, 310022, China
| | - Jie Zhou
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Xiangming Kong
- Department of Integrated Chinese Traditional Medicine and Western Medicine, Zhejiang Cancer Hospital, Hangzhou, 310022, China
| | - Weiping Zhang
- Department of Oncology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Ran Ran
- Department of Oncology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Na Nie
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Yang Liu
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310005, China
| | - Conghua Ji
- Zhejiang Chinese Medical University, Hangzhou, 310005, China
| | - Shan Liu
- Department of Clinical Evaluation Center, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, 310000, China
| | - Xiaomei Shao
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Guoyin Kai
- Zhejiang Chinese Medical University, Hangzhou, 310005, China
| | - Xianming Lin
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China
| | - Jianqiao Fang
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China.
| | - Yi Liang
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310000, China.
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Pei LX, Yi Y, Guo J, Chen L, Zhou JY, Wu XL, Sun JH, Chen H. The effectiveness and safety of acupuncture/electroacupuncture for chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Acupunct Med 2022; 41:73-85. [PMID: 35695033 DOI: 10.1177/09645284221076512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse effect of anticancer agents with virtually no effective treatment. Safe and effective therapies are needed urgently. Acupuncture shows therapeutic possibilities in this regard but needs to be further evaluated. METHODS A systematic search was conducted in seven databases from their inception to April 2020. Randomized controlled trials (RCTs) focused on acupuncture/electroacupuncture (EA) for the treatment of CIPN were included. Revman 5.3 software was used for meta-analysis if there was no significant heterogeneity. Otherwise, qualitative analysis was utilized. RESULTS Nine studies involving 582 patients were included in this review. Most of the studies exhibited unclear risk of bias because some details were not mentioned. As the clinical heterogeneity was significant, qualitative analysis was performed to describe nerve conduction velocity, effective rate for motor neuropathy, pain scores, quality of life and adverse events. Meta-analysis was performed on four studies to analyze the effective rate for sensory neuropathy due to inconspicuous heterogeneity. The results indicated that acupuncture may generate a better effect on sensory neuropathy than vitamin B (risk ratio = 1.60, 95% confidence interval = 1.31-1.95, I2 = 0%, p < 0.00001). The efficacy of EA plus glutathione (GSH) appeared to be better than that of GSH alone in alleviating sensory neurotoxicity and in improving nerve conduction velocity. Acupuncture plus methylcobalamin showed more favorable effects than methylcobalamin alone in relieving neuralgia, restoring nerve conduction velocity and improving quality of life. In terms of pain relief and improved CIPN-specific quality of life, acupuncture plus standard care was better than standard care alone. In terms of pain relief, EA was more effective than usual care. CONCLUSION Acupuncture may be effective and safe in the treatment of CIPN according to the analyzed studies. However, more studies with higher methodological quality are warranted in order to be able to draw firmer conclusions. Future rigorous RCTs will be necessary to confirm the effectiveness and safety of acupuncture for CIPN.
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Affiliation(s)
- Li-Xia Pei
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yue Yi
- Wuxi Hospital of Traditional Chinese Medicine, Wuxi, China
| | - Jing Guo
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.,Nanjing University of Chinese Medicine, Nanjing, China
| | - Lu Chen
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Jin-Yong Zhou
- Central Laboratory, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiao-Liang Wu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Jian-Hua Sun
- Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hao Chen
- Nanjing University of Chinese Medicine, Nanjing, China
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Tümkaya Yılmaz S, Malfliet A, Elma Ö, Deliens T, Nijs J, Clarys P, De Groef A, Coppieters I. Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors? J Clin Med 2022; 11:653. [PMID: 35160104 PMCID: PMC8837082 DOI: 10.3390/jcm11030653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
Evidence for the relationship between chronic pain and nutrition is mounting, and chronic pain following cancer is gaining recognition as a significant area for improving health care in the cancer survivorship population. This review explains why nutrition should be considered to be an important component in chronic pain management in cancer survivors by exploring relevant evidence from the literature and how to translate this knowledge into clinical practice. This review was built on relevant evidence from both human and pre-clinical studies identified in PubMed, Web of Science and Embase databases. Given the relationship between chronic pain, inflammation, and metabolism found in the literature, it is advised to look for a strategic dietary intervention in cancer survivors. Dietary interventions may result in weight loss, a healthy body weight, good diet quality, systemic inflammation, and immune system regulations, and a healthy gut microbiota environment, all of which may alter the pain-related pathways and mechanisms. In addition to being a cancer recurrence or prevention strategy, nutrition may become a chronic pain management modality for cancer survivors. Although additional research is needed before implementing nutrition as an evidence-based management modality for chronic pain in cancer survivors, it is already critical to counsel and inform this patient population about the importance of a healthy diet based on the data available so far.
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Affiliation(s)
- Sevilay Tümkaya Yılmaz
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Ömer Elma
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Tom Deliens
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (T.D.); (P.C.)
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Institute of Neuroscience and Physiology, Unit of Physiotherapy, Department of Health & Rehabilitation, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Peter Clarys
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (T.D.); (P.C.)
| | - An De Groef
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, 3000 Leuven, Belgium
- Department of Rehabilitation Sciences, MOVANT Research Group, University of Antwerp, 2000 Antwerp, Belgium
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, 3000 Leuven, Belgium
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Karadag E, Yüksel S. Complementary, Traditional and Spiritual Practices Used by Cancer Patients in Turkey When Coping with Pain: An Exploratory Case Study. JOURNAL OF RELIGION AND HEALTH 2021; 60:2784-2798. [PMID: 33990887 DOI: 10.1007/s10943-021-01276-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
This study was conducted to determine the complementary and traditional-spiritual practices applied by individuals diagnosed with cancer when experiencing significant pain. This descriptive and cross-sectional study was conducted with 110 patients who were receiving chemotherapy treatment in a university hospital outpatient treatment unit (Chemotherapy Unit) between 1st March and 30th June 2019. The study sample size was calculated using the 'unknown-population sample selection formula' (n = t2·p·q·/d2). Study data were collected using a patient information form comprising 13 questions about the participants' sociodemographic characteristics, diseases, and complementary practices. The data were analyzed using descriptive percentage tests and the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) software. The study found that 45.5% of the cancer patients took a walk, 38.2% listened to music, 27.3% watched movies, 24.5% received massages, 20.0% read newspapers or books, 20.0% did sports, and 10.9% dreamed in painful situations. Spiritual practices used by the patients were determined as praying (46.4%), engaging in salat (the daily ritual prayers of Islam) (30.9%) and reading religious books (23.6%). The herbal practices applied by the patients include the use of garlic, mulberry molasses, pomegranate, green tea; furthermore, herbs such as honey, sage, lime, black cumin, ginger, centaury, thyme, nettle, flaxseeds, and rosehip were also used. Most of the patients learned complementary practices from television programs (62.7%); only 8.2% learned these practices from healthcare professionals. Nurses should investigate patients' use of complementary practices and provide them with the necessary evidence-based information to prevent unconscious use of these practices. Considering that determining patients' spiritual needs and practices is seen as the first step in the holistic care of patients, it is important to satisfy cancer patients by providing necessary healthcare services and help them improve their physical and mental health.
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Affiliation(s)
- Ezgi Karadag
- Department of Oncology Nursing, Faculty of Nursing, Dokuz Eylul University, 35340, Inciraltı/Izmir, Turkey.
| | - Seda Yüksel
- SBÜ Ankara Dr.Sami Ulus Women, Children's Health And Diseases Education and Research Hospital, Ankara, Turkey
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Kocot-Kępska M, Zajączkowska R, Zhao J, Wordliczek J, Tomasik PJ, Przeklasa-Muszyńska A. The role of complementary and alternative methods in the treatment of pain in patients with cancer - current evidence and clinical practice: a narrative review. Contemp Oncol (Pozn) 2021; 25:88-94. [PMID: 34667434 PMCID: PMC8506432 DOI: 10.5114/wo.2021.105969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/11/2021] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Pain related to cancer, despite the numerous treatment options available, is still a challenge in contemporary pain medicine. The unsatisfactory treatment of cancer pain is one of the main reasons why patients seek complementary and alternative methods (CAM) and a more integrative/holistic approach to pain management. The popularity of CAM forces healthcare professionals to provide patients with current and evidence-based information on the effectiveness and safety of CAM. The aim of the paper is to present current evidence and limitations regarding CAM commonly used in the pain management of cancer patients. MATERIAL AND METHODS The paper comprehensively reviews the current and most relevant literature considering the integrative approach to management of pain due to cancer disease and/or cancer treatment. RESULTS The available data from clinical trials, meta-analyses, and systematic reviews supports the effectiveness of acupuncture, massage, physical exercises, music therapy, and mind-body therapies as adjunct therapies for alleviating pain in cancer patients, although the supporting evidence is weak or moderate. CONCLUSIONS Based on the available knowledge, physicians should be capable of advising the cancer patient as to which CAM methods can be used safely, which are contraindicated, and what therapeutic effects they may expect, especially when standard pain treatment fails or induces serious side effects. An integrative approach to cancer pain management may improve the quality of pain treatment, patients' quality of life, and satisfaction with pain relief.
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Affiliation(s)
- Magdalena Kocot-Kępska
- Department for Pain Research and Treatment, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Zajączkowska
- Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Krakow, Poland
| | - Jing Zhao
- Institute of Basic Research in Clinical Medicine, TCM Clinic, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jerzy Wordliczek
- Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Krakow, Poland
| | - Przemysław J. Tomasik
- Department of Clinical Biochemistry, Polish-American Children’s Hospital, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Przeklasa-Muszyńska
- Department for Pain Research and Treatment, Jagiellonian University Medical College, Krakow, Poland
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Correlation between an integrative oncology treatment program and survival in patients with advanced gynecological cancer. Support Care Cancer 2021; 29:4055-4064. [PMID: 33404816 DOI: 10.1007/s00520-020-05961-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/16/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Integrative oncology (IO) is increasingly becoming part of palliative cancer care. This study examined the correlation between an IO treatment program and rates of survival among patients with advanced gynecological cancer. METHODS Patients were referred by their oncology healthcare professionals to an integrative physician (IP) for consultation and IO treatments. Those undergoing at least 4 treatments during the 6 weeks following the consultation were considered adherence to the integrative care program (AIC), versus non-adherent (non-AIC). Survival was monitored for a period of 3 years, comparing the AIC vs. non-AIC groups, as well as controls who did not attend the IP consultation. RESULTS A total of 189 patients were included: 71 in the AIC group, 44 non-AIC, and 74 controls. Overall 3-year survival was greater in the AIC group (vs. non-AIC, p = 0.012; vs. controls, p = 0.003), with no difference found between non-AIC and controls (p = 0.954). Multimodal IO programs (≥ 3 modalities) were correlated in the AIC group with greater overall 3-year survival (p = 0.027). Greater rates of survival were also found in the AIC group at 12 (p = 0.004) and 18 months (p = 0.001). When compared with the AIC group, a multivariate analysis found higher crude and adjusted hazard ratios for 3-year mortality in the non-AIC group (HR 95% CI 2.18 (1.2-3.9), p = 0.010) and controls (2.23 (1.35-3.7), p = 0.002). CONCLUSION Adherence to an IO treatment program was associated with higher survival rates among patients with advanced gynecological cancer. Larger prospective trials are needed to explore whether the IO setting enhances patients' resilience, coping, and adherence to oncology treatment.
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Liang Q, Zhang K, Wang S, Xu X, Liu Y, Cui S, Liu L. Acupuncture for Cancer Pain - An Adjuvant Therapy for Cancer Pain Relief. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:1769-1786. [PMID: 33300479 DOI: 10.1142/s0192415x20500883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
As current pain management methods cannot effectively control pain among cancer patients, acupuncture has developed as an adjuvant therapy for cancer pain relief. However, the efficacy of acupuncture in treating cancer pain remains controversial. Here, we briefly introduced the development of pain management, analgesic mechanisms, and acupuncture methods. Meanwhile, a comprehensive overview of acupuncture programs was provided in terms of different cancer types, sources, and degrees. Interestingly, acupuncture can treat both tumor-induced pain and therapy-induced pain well among cancer patients. We preliminarily summarized frequently-used acupoints for different types of cancer pain and found that needle retention time was mostly 30 min, and treatment cycle was two weeks. Additionally, clinicians consistently selected Ashi acupoint or bilateral Zusanli acupoint and combined multiple acupuncture methods for different degrees of cancer pain.
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Affiliation(s)
- Qi Liang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
| | - Ke Zhang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
| | - Sumeng Wang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
| | - Xian Xu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
| | - Yiqian Liu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
| | - Shiyun Cui
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
| | - Lingxiang Liu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China
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12
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Managing childhood cancer pain into survivorship: recognition and emerging principles. Curr Opin Support Palliat Care 2020; 14:100-106. [PMID: 32304399 DOI: 10.1097/spc.0000000000000492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Continual refinement and further stratification of childhood cancer treatment has led to increased survivorship with recognized improvements in many long-term health outcomes. Despite this progress, persisting pain prevalence in childhood cancer survivors is increasing and emerging as a significant long-term health concern. RECENT FINDINGS Currently, there is no guidance on how to approach and manage persisting pain in survivors of childhood cancer. SUMMARY Clinicians should work with children and young people to optimize the management of pain and other symptoms on treatment. Focusing on an early post treatment screening for pain and other symptoms (including sleep and fatigue), and the role of on-going analgesic use. Follow-up should offer a multidisciplinary approach, aimed at lessening reliance on pharmacological approaches to pain management, addressing psychological concerns and promoting increased physical activity. The onus is on clinicians to mitigate the long-term risk of pharmacological reliance, particularly opioid dependency, in patients leaving their care and heading into adulthood. In this article, we highlight the emerging evidence of persisting pain in survivors of childhood cancer as a significant long-term health outcome and consider some initial principles of management.
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13
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Lee JH, Cho TJ, Park MG, Kim JH, Song SK, Park SY, Sunwoo YY, Lee I, Park TY. Clinical study on concurrent use of electro-acupuncture or Chuna manual therapy with pregabalin for chemotherapy-induced peripheral neuropathy: safety and effectiveness (open-labeled, parallel, randomized controlled trial, assessor-blinded): A study protocol. Medicine (Baltimore) 2020; 99:e18830. [PMID: 32011497 PMCID: PMC7220112 DOI: 10.1097/md.0000000000018830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy (CIPN) is one of the major side effects of chemotherapy. Its main symptoms are pain, paresthesia, and numbness. However, the mechanisms underlying the development of CIPN remain unclear and standard treatments have not been established. Recently, there has been a growing interest in various approaches to overcome the limitations of the existing treatments. This study aims to evaluate the efficacy and safety of the concurrent use of two complementary and alternative therapies: electroacupuncture (EA) and Chuna manual therapy (CMT), with pregabalin, which is the conventional pharmacotherapy for neuropathic pain. METHODS/DESIGN This is an open-label, parallel, assessor-blinded randomized controlled trial, which includes 90 patients with colorectal and breast cancer, who developed CIPN. After a 2-week preparation period, the patients are divided into three groups (pregabalin administration group, pregabalin + EA treatment group, and pregabalin + CMT treatment group), treated for approximately 5 weeks and followed-up 4 weeks after treatment. The primary outcome is assessed using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity subscale score (version 4.0) and the secondary outcome is measured using the Quality of Life Questionnaire-CIPN 20-Item Scale (version 3.0) and the quality of life questionnaire (version 3.0) developed by the European Organisation for Research and Treatment of Cancer. Moreover, exploratory efficacy and safety evaluations will be conducted based on the chemotherapy-completion rate and nerve conduction studies.
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Affiliation(s)
- Jin-Hyun Lee
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital
| | | | - Min Geun Park
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine
| | - Ji-Hoon Kim
- Department of Surgery, Catholic University of Korea, Incheon St. Mary's Hospital
| | - Sung Kyu Song
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine
| | - Shin-Young Park
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine
| | | | | | - Tae-Yong Park
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital
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Zhao Q, Zheng S, Delaney GP, Moylan E, Agar MR, Koh ES, Lai H, Birling Y, Zhang GS, Wang K, Ma Y, Zhu X. Acupuncture for Cancer Related Pain: Protocol for a Pragmatic Randomised Wait-List Controlled Trial. Integr Cancer Ther 2020; 19:1534735420976579. [PMID: 33300382 PMCID: PMC7734530 DOI: 10.1177/1534735420976579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acupuncture has been proved effective for cancer related pain (CRP) in China, America and some other countries. However, there is relative lack of evidence to support the use of acupuncture for CRP in Australia. OBJECTIVES To assess the effectiveness and safety of acupuncture for management of CRP in a real-world setting and to understand cancer patients' experience of undergoing acupuncture for CRP. METHODS A pragmatic randomised controlled trial will be conducted in South Western Sydney Local Health District (SWSLHD) in NSW, Australia. Adults with cancer related pain (n = 106) will be randomised in a 1:1 ratio to receive the acupuncture intervention up front versus after a wait list period of 4 weeks. Pain level (by Numerical Rating Scale), analgesic use, auricular acupressure frequency and adverse events will be assessed at baseline, mid-treatment and post-treatment. Expectancy on trial outcome (by Credibility and Expectancy questionnaire) will be assessed at baseline. The perspective of the participants (by an interview) will be recorded after the last intervention. EXPECTED OUTCOMES We hypothesise that acupuncture will relieve cancer related pain at mid-treatment and post-treatment. We also hypothesise that few adverse events will be provoked by acupuncture. TRIAL REGISTRATION Australia New-Zealand Clinical Trial Registry (ACTRN12620000325909).
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Affiliation(s)
- Qi Zhao
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
| | - Suyang Zheng
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
- Nanjing University of Chinese Medicine, Nanjing, China
| | | | - Eugene Moylan
- South Western Sydney Local Health District, NSW, Australia
| | - Meera R. Agar
- South Western Sydney Local Health District, NSW, Australia
- University of Technology Sydney, NSW, Australia
- University of NSW, NSW, Australia
| | - Eng-Siew Koh
- South Western Sydney Local Health District, NSW, Australia
| | - Hezheng Lai
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
| | - Yoann Birling
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
| | | | - Kang Wang
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
- Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yong Ma
- Nanjing University of Chinese Medicine, Nanjing, China
- Affiliated Hospital of Nanjing University of Chinese Medicine
| | - Xiaoshu Zhu
- Chinese Medicine Centre, Western Sydney University, NSW, Australia
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15
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Galantino ML, Tiger R, Brooks J, Jang S, Wilson K. Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors. Integr Cancer Ther 2019; 18:1534735419850627. [PMID: 31131640 PMCID: PMC6537287 DOI: 10.1177/1534735419850627] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective. Chemotherapy-induced peripheral neuropathy (CIPN)
syndrome causes significant pain as an adverse effect of treatment, with few
nonpharmacological interventions tested. A somatic yoga and meditation (SYM)
intervention on functional outcomes and quality of life (QOL) was investigated.
Design and methods. Individuals diagnosed with CIPN were
enrolled in an open-label, single-arm, mixed-methods feasibility trial.
Participants and Setting. In an outpatient rehabilitation
center, ten participants with median age 64.4 years (47-81) attended 61% of the
sessions with no adverse events. Intervention. SYM twice a week
for 8 weeks for 1.5 hours, with home program and journaling. Main
outcome measures. Primary functional outcomes included Sit and
Reach (SR), Functional Reach (FR), and Timed Up and Go (TUG). Self-reported
Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer
Therapy—Neurotoxicity (FACT-GOG-NTX) were secondary CIPN outcomes. Biomarkers
included salivary cortisol (stress) and bioesthesiometer (vibration).
Results: Quantitative findings. Significant improvements
were found in flexibility (SR; P = .006); balance (FR;
P = .001) and fall risk (TUG; P = .004).
PNQ improved significantly (P = .003) with other measures
improving non-significantly. Qualitative findings. Five themes
emerged: (1) vacillation of CIPN pain perception over time; (2) transferability
of skills to daily activities; (3) improvement in physical function; (4)
perceived relaxation as an effect of SYM; and (5) group engagement provided a
social context for not feeling isolated with CIPN. Conclusion.
Preliminary data suggest SYM may improve QOL, flexibility, and balance in cancer
survivors with CIPN, with a fully powered randomized controlled trial
indicated. Trial registration: NCT03786055
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Affiliation(s)
- Mary Lou Galantino
- 1 School of Health Sciences, Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA.,2 University of Pennsylvania, Philadelphia, PA, USA.,3 University of Witwatersrand, Johannesburg, South Africa
| | | | | | - Shera Jang
- 1 School of Health Sciences, Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA
| | - Kim Wilson
- 1 School of Health Sciences, Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA
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16
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Huang F, Zhao S, Qiu M, Li Y, Zhan X, Wu C, Shi C, Sun W, Chen G, Xu Y. Acupuncture for primary osteoporosis: A network meta-analysis of randomized controlled trials protocol. Medicine (Baltimore) 2019; 98:e15108. [PMID: 30985666 PMCID: PMC6485900 DOI: 10.1097/md.0000000000015108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A large number of randomized controlled trials (RCTs) have shown that acupuncture (ACU) has certain advantages over pharmacotherapies in the treatment of primary osteoporosis (POP). However, due to the diversity of ACU treatments, its relative effectiveness have not yet been studied and explained. Therefore, based on the network meta-analysis (NMA), this study will compare the differences in the efficacy of multiacupuncture in the treatment of POP, to provide a reference for clinical treatment. METHODS We will search PubMed, MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CHKD-CNKI), WANFANG database (Chinese Medicine Premier), Chinese Biomedical Literature database (CBM), and VIP for relevant RCTs of ACU treatments for POP, from their inceptions to January 2019. STATA 15.0 and GEMTC software will be used to perform a NMA. The evidence will be evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the type 1 error rate will be assessed by trial sequential analysis (TSA). RESULTS The results of this review will be submitted to a recognized journal for publication. CONCLUSION This proposed systematic review will evaluate the different advantages of various types of ACU in the treatment of POP. REGISTRATION PROSPERO (registration number CRD42019122724).
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Affiliation(s)
- Fan Huang
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
| | - Siyi Zhao
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
| | - Mingwang Qiu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
| | - Yitong Li
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
| | - Xiaoxuan Zhan
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
| | - Cunshu Wu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
| | - Chushuo Shi
- The First Medical College, Guangzhou University of Chinese Medicine, Guangzhou
| | - Weipeng Sun
- The First Medical College, Guangzhou University of Chinese Medicine, Guangzhou
| | - Guizhen Chen
- Shenzhen Bao’an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Yunxiang Xu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation
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17
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Hsieh PC, Yang MC, Wu YK, Chen HY, Tzeng IS, Hsu PS, Lee CT, Chen CL, Lan CC. Acupuncture therapy improves health-related quality of life in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Complement Ther Clin Pract 2019; 35:208-218. [PMID: 31003660 DOI: 10.1016/j.ctcp.2019.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/14/2019] [Accepted: 02/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is highly prevalent around the world and has a large impact on its patients, leading to a poor health-related quality of life (HRQL) and exercise capacity. Even under optimal medications, there are still many patients with poor HRQL. Body acupuncture therapy (BAT) is a non-invasive and a popular therapy. Therefore, we aimed to comprehensively analyze the effects of BAT in COPD. MATERIALS AND METHODS Eight electronic databases were searched. We included randomized controlled trials (RCTs) that evaluated the effect of BAT, medication (M), and pulmonary rehabilitation (PR). The primary outcome was HRQL evaluated by St. George's respiratory questionnaire (SGRQ) or COPD assessment test (CAT). RESULTS Of the 922 articles, 12 studies were included with attesting a total of 798 participants. The result obtained indicated a significant improvement that favored the BAT + M group over the M group in CAT scores (MD: -4.77; 95% CI: -6.53 to -3.01; p < 0.00001). CONCLUSIONS BAT is an effective adjunctive non-pharmacological treatment to improve HRQL in patients under medical treatment for COPD. We suggested that BAT should be considered as one of the methods of management in patients with COPD.
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Affiliation(s)
- Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Hsin-Yi Chen
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Pei-Shan Hsu
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chang-Ti Lee
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan.
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18
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Lemanne D, Maizes V. Advising Women Undergoing Treatment for Breast Cancer: A Narrative Review. J Altern Complement Med 2018; 24:902-909. [PMID: 30247957 DOI: 10.1089/acm.2018.0150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A majority of women undergoing conventional treatment for breast cancer also undertake complementary and integrative approaches. Practitioners knowledgeable about the evidence base behind common integrative approaches can help patients attain improved quality of life, and at times, improved survival. Evidence-based recommendations include the following: a plant-based diet for general health after diagnosis, and carbohydrate restriction for patients with estrogen receptor-positive postmenopausal breast cancer may be prudent. Other dietary recommendations include a 13-h daily overnight fast. Carefully selected patients may choose to fast the day before and the day of chemotherapy to decrease side effects. Specific food recommendations include avoidance or limitation of alcohol, and liberal culinary use of cruciferous vegetables, coffee, green tea, soy, and flaxseed. Promising supplements include diindolylmethane and melatonin. Omega 3 fatty acids may help with bone density in patients on aromatase inhibitors, but may increase chemotherapy resistance. Findings regarding the usefulness of multivitamins, vitamin D, vitamin C, and vitamin E are weak and/or mixed different exercise modalities may have different effects and thus play different roles in breast cancer therapy. Aerobic and resistance training combined during breast cancer chemotherapy may confer a survival benefit, while yoga may improve outcome in lymphedema patients. Current evidence suggests that meditation, yoga, breathing, music therapy, guided imagery, and hypnosis may improve mood and quality of life during breast cancer treatment. Acupuncture is useful for treating side effects of breast cancer therapies, including hot flushes, aromatase inhibitor-induced joint pain, chemotherapy-induced peripheral neuropathy, and vulvodynia. Vaginal moisturizers and vaginal rings supplying low-dose estrogen can be useful in the treatment of symptoms of estrogen-deprivation states caused by breast cancer treatments; such symptoms include vaginal dryness, dyspareunia, and sexual dysfunction. Carbon dioxide laser technology can rejuvenate atrophied vaginal mucosa and relieve dyspareunia, allowing avoidance of estrogen therapy. Tertiary sexual health centers are available for referral.
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Affiliation(s)
- Dawn Lemanne
- 1 The University of Arizona Center for Integrative Medicine , Tucson, Arizona.,2 Oregon Integrative Oncology , Ashland, Oregon.,3 National Institute of Integrative Medicine , Melbourne, Australia
| | - Victoria Maizes
- 1 The University of Arizona Center for Integrative Medicine , Tucson, Arizona
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