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Yap HYY, Ariffeen Rosli MF, Tan SH, Kong BH, Fung SY. The Wound Healing Potential of Lignosus rhinocerus and Other Ethno-myco Wound Healing Agents. MYCOBIOLOGY 2023; 51:1-15. [PMID: 36846625 PMCID: PMC9946334 DOI: 10.1080/12298093.2022.2164641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 06/18/2023]
Abstract
Wound care has become increasingly important over the years. Various synthetic products for wound care treatment have been reported to cause toxic side effects and therefore natural products are in significant demand as they have minimal side effects. The presence of bioactive compounds in medicinal mushrooms contributes to various biological activities which assist in the early inflammatory phase, keratinocyte proliferation, and its migration enhancement which are pertinent to wound rehabilitation. Lignosus rhinocerus (tiger milk mushroom) can reduce the inflammation phase in wound healing by fighting off bacterial infection and modulating pro-inflammatory cytokines expression in the early stage to avoid prolonged inflammation and tissue damage. The antibacterial, immunomodulating, and anti-inflammatory activities exhibited by most macrofungi play a key role in enhancing wound healing. Several antibacterial and antifungal compounds sourced from traditional botanicals/products may prevent further complications and reoccurrence of injury to a wounded site. Scientific studies are actively underway to ascertain the potential use of macrofungi as a wound healing agent.
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Affiliation(s)
- Hui-Yeng Y. Yap
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Selangor, Malaysia
| | - Mohammad Farhan Ariffeen Rosli
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, Selangor, Malaysia
- Medicinal Mushroom Research Group (MMRG), Department of Molecular Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Soon-Hao Tan
- Department of Biomedical Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Boon-Hong Kong
- Centre of Excellence for Research in AIDS (CERiA), Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shin-Yee Fung
- Medicinal Mushroom Research Group (MMRG), Department of Molecular Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Johannessen H, Von Bornemann Hjelmborg J, Pasquarelli E, Fiorentini G, Di Costanzo F, Miccinesi G. Prevalence in the use of Complementary Medicine among Cancer Patients in Tuscany, Italy. TUMORI JOURNAL 2018; 94:406-10. [DOI: 10.1177/030089160809400318] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and Background A previous survey by Molassiotis et al. (Ann Oncol, 16: 655–663, 2005) on the use of complementary and alternative medicines (CAM) among cancer patients in Europe reported that 73% of the Italian cancer patients had used CAM, a number well above the European average of 36%. Some national variation in preference of CAM was reported, and Italian cancer patients were reported to have high use of homeopathy, herbal medicine, and spiritual therapies. The difference between CAM use in Italy and other European countries intrigued a further investigation of CAM use among Italian cancer patients. Methods A survey using the same questionnaire as Molassiotis et al. was conducted at two oncology day hospitals in Tuscany and included 132 patients (55% male, 45% female, with various forms of cancer) on chemotherapy. The response rate was 71%. Results The incidence of CAM use after the cancer diagnosis among the Tuscan cancer patients was 17%. The most widely used forms were herbal medicine (52%), homeopathy (30%) and acupuncture (13%). Use was higher in the urban area and among women, breast cancer patients, and persons with a higher education. These results agree with results of other studies on the use of CAM among Italians and Europeans in general, as well as among cancer patients in Italy. Conclusions The high prevalence of CAM use among Italians reported by Molassiotis et al. cannot be regarded a national estimate on the use of CAM for cancer in Italy. Rather it may reflect a relatively high use of CAM in palliative care, in Northern Italy and in urban areas. CAM use among Italians in general as well as among Tuscan cancer patients in chemotherapy is modest compared with the overall European use and reflects a general high use of CAM among urbanites, women and those with a higher education. Most commonly used forms of CAM are herbal medicine and homeopathy.
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Affiliation(s)
- Helle Johannessen
- Institute of Public Health, Research Unit Health, Man and Society, University of Southern Denmark, Denmark
| | | | | | | | | | - Guido Miccinesi
- Center for the Study and Prevention of Oncology, Florence, Italy
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Criscitiello MF. What the shark immune system can and cannot provide for the expanding design landscape of immunotherapy. Expert Opin Drug Discov 2014; 9:725-39. [PMID: 24836096 DOI: 10.1517/17460441.2014.920818] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sharks have successfully lived in marine ecosystems, often atop food chains as apex predators, for nearly one and a half billion years. Throughout this period they have benefitted from an immune system with the same fundamental components found in terrestrial vertebrates like man. Additionally, sharks have some rather extraordinary immune mechanisms which mammals lack. AREAS COVERED In this review the author briefly orients the reader to sharks, their adaptive immunity, and their important phylogenetic position in comparative immunology. The author also differentiates some of the myths from facts concerning these animals, their cartilage, and cancer. From thereon, the author explores some of the more remarkable capabilities and products of shark lymphocytes. Sharks have an isotype of light chain-less antibodies that are useful tools in molecular biology and are moving towards translational use in the clinic. These special antibodies are just one of the several tricks of shark lymphocyte antigen receptor systems. EXPERT OPINION While shark cartilage has not helped oncology patients, shark immunoglobulins and T cell receptors do offer exciting novel possibilities for immunotherapeutics. Much of the clinical immunology developmental pipeline has turned from traditional vaccines to passively delivered monoclonal antibody-based drugs for targeted depletion, activation, blocking and immunomodulation. The immunogenetic tools of shark lymphocytes, battle-tested since the dawn of our adaptive immune system, are well poised to expand the design landscape for the next generation of immunotherapy products.
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Affiliation(s)
- Michael F Criscitiello
- Texas A&M University, College of Veterinary Medicine and Biomedical Sciences, Texas A&M Health Science Center, Comparative Immunogenetics Laboratory, Department of Veterinary Pathobiology , Mailstop 4467, College Station, TX 77843 , USA +1 979 845 4207 ; +1 979 862 1088 ;
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Étude de prévalence des effets indésirables liés à l’utilisation des plantes médicinales par les patients de l’Institut National d’Oncologie, Rabat. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s10298-013-0828-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Prajongtat P, Phromyothin DST, Hannongbua S. Key role of hydrazine to the interaction between oxaloacetic against phosphoenolpyruvic carboxykinase (PEPCK): ONIOM calculations. J Mol Model 2013; 19:3165-74. [DOI: 10.1007/s00894-013-1842-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 04/01/2013] [Indexed: 11/24/2022]
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Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study. Altern Ther Health Med 2011; 11:71. [PMID: 21871124 PMCID: PMC3175209 DOI: 10.1186/1472-6882-11-71] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 08/28/2011] [Indexed: 11/18/2022]
Abstract
Background The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. Methods We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. Results There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. Conclusions The current status quo with respect to the regulation of CAM products in Lebanon is not conducive to public safety, nor does it support the integration of CAM products into the healthcare system. The Ministry of Health indeed plays a dominant role in the regulation of these products through a combination of mixed and compulsory policy instruments. Yet, the proper implementation of these regulations requires political resolve coupled with the cooperation of all CAM stakeholders.
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Zwierzina H, Bergmann L, Fiebig H, Aamdal S, Schöffski P, Witthohn K, Lentzen H. The preclinical and clinical activity of aviscumine: A potential anticancer drug. Eur J Cancer 2011; 47:1450-7. [PMID: 21482461 DOI: 10.1016/j.ejca.2011.02.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 02/28/2011] [Indexed: 12/28/2022]
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Aydin Avci I, Koç Z, Sağlam Z. Use of complementary and alternative medicine by patients with cancer in northern Turkey: analysis of cost and satisfaction. J Clin Nurs 2011; 21:677-88. [PMID: 21714820 DOI: 10.1111/j.1365-2702.2011.03732.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aims of this study were to determine (1) the prevalence of complementary and alternative medicine use among patients with cancer, (2) the method of use of the particular therapy, (3) the reasons for using complementary and alternative medicine therapies, (4) the benefits experienced by the use of complementary and alternative medicine, (5) the source of information about complementary and alternative medicine therapies and, (6) the satisfaction and cost of complementary and alternative medicine. BACKGROUND Complementary and alternative medicine consists of diverse medical and healthcare systems, practices and products that are not considered at present to be a part of conventional medicine. The majority of patients who use complementary and alternative medicine use more than one method. Complementary and alternative medicine use is more common in cases of advanced disease or poor prognosis. DESIGN This is a descriptive study of complementary and alternative medicine. METHODS This study was conducted in the Chemotherapy Unit at Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, between 18 March 2008-30 June 2008. Two hundred fifty-three patients with cancer, among 281 patients who applied to the chemotherapy clinic between these dates, agreed to take part in the study with whom contact could be made were included. A questionnaire including descriptive characteristics in collecting data, characteristics about diseases and their treatments, complementary and alternative medicine information and implementation situations and a control list about complementary and alternative medicine implementations were given. The collected data were evaluated by computer using descriptive statistics, the chi-square test and Student's t-test. RESULTS In this study, 94·1% of the patients were content with medical treatment, 58·9% of them used complementary and alternative medicine treatments, 41·1% did not use any complementary and alternative medicine treatments. The satisfaction level of the patients with complementary and alternative medicine methods was slightly above mediocre (2·33 SD 0·64, on a scale of 1-3). The average cost per capita spent by the patients using complementary and alternative medicine for all the different methods was US$288·26. CONCLUSIONS It was determined that although patients did not have enough knowledge about complementary and alternative medicine methods, the prevalence of complementary and alternative medicine and satisfaction levels are high that complementary and alternative medicine users spend substantial sums of money for these methods. RELEVANCE TO CLINICAL PRACTICE To sustain medical treatment and prognosis of cancer, it is important for nurses to consult with their patients regarding the use and potential risks of some complementary and alternative medicine.
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Affiliation(s)
- Ilknur Aydin Avci
- Nursing Department, Samsun Health School, Ondokuz May University, Sivas, Turkey.
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Vyas T, Hart RD, Trites JR, Philips TJ, Archibald KEM, Phillips JE, Taylor SM. Complementary and alternative medicine use in patients presenting to a head and neck oncology clinic. Head Neck 2009; 32:793-9. [PMID: 19890909 DOI: 10.1002/hed.21255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among patients presenting to a head and neck oncology clinic prior to a diagnosis. METHODS The study was conducted by administering questionnaires to 102 patients after being seen in the Head and Neck Oncology clinic for their initial consultation. The questionnaire assessed the extent of CAM use, types of CAMs used, and their reasons for use. RESULTS A total of 132 CAMs were currently being used among 56 patients. The most common CAMs in use were multivitamins (26/132) and vitamin D (21/132). Meditation and yoga were associated with the greatest perceived benefit. The majority of patients obtained their information from family and friends. Most patients were using CAMs for physical health and well-being. CONCLUSION As CAM use among the population is widespread, it is important for clinicians to specifically address their use on initial presentation.
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Affiliation(s)
- Tarren Vyas
- Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Micke O, Bruns F, Glatzel M, Schönekaes K, Micke P, Mücke R, Büntzel J. Predictive factors for the use of complementary and alternative medicine (CAM) in radiation oncology. Eur J Integr Med 2009. [DOI: 10.1016/j.eujim.2009.02.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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PIRRI C, KATRIS P, TROTTER J, BAYLISS E, BENNETT R, DRUMMOND P. Use of complementary and alternative therapies by Western Australian cancer patients. Asia Pac J Clin Oncol 2008. [DOI: 10.1111/j.1743-7563.2008.00180.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leitão AJ, Salvador JA, Pinto RM, Sá e Melo ML. Hydrazine sulphate: a cheap and efficient catalyst for the regioselective ring-opening of epoxides. A metal-free procedure for the preparation of β-alkoxy alcohols. Tetrahedron Lett 2008. [DOI: 10.1016/j.tetlet.2007.12.121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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EVANS M, SHAW A, SHARP D, THOMPSON E, FALK S, TURTON P, THOMPSON T. Men with cancer: is their use of complementary and alternative medicine a response to needs unmet by conventional care? Eur J Cancer Care (Engl) 2007; 16:517-25. [DOI: 10.1111/j.1365-2354.2007.00786.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Risk management of nutritional supplements in chronic illness: the implications for the care of cancer and depression. Proc Nutr Soc 2007; 66:483-92. [DOI: 10.1017/s0029665107005800] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The use of complementary medicines in patients suffering from chronic illnesses such as cancer and depression is widely documented. Current studies suggest that the prevalence of the use of complementary medicines in patients with cancer ranges from 7% to 80%. In patients suffering from severe depression the use of complementary medicines may be >40%. The aim of the present review is to systematically explore the main dimensions that clinicians have to consider when advising patients suffering from these conditions. The Medline and Cochrane databases were searched for evidence relating to the benefits and risks of supplements in the treatment of cancer and depression, including the potential interactions with pharmaco- and radiotherapy. Supplements predominantly used by patients with cancer include vitamins A, C and E, β-carotene and ubiquinone 10. Supplements predominantly used by patients with depression include S-adenosylmethionine, l-tryptophan and 5-hydroxytryptophan and inositol. Supplements potentially used by both groups include n-3 fatty acids, Se and folic acid. Four dimensions are identified and discussed: effectiveness; safety; communication; medico-legal aspects. These dimensions have to be addressed in an illness- and case-specific context. This task can be complex given the emerging clinical evidence, patients' own preferences and expectations and current prescribing guidelines.
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Schroeder A. [Secondary prevention after urological cancers. What are the pertinent facts about aftercare?]. Urologe A 2007; 46:642-5. [PMID: 17447048 DOI: 10.1007/s00120-007-1343-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Secondary prevention and aftercare of urological cancers are an essential part of outpatient care provided by the urologist in private practice. More than one-half of the patients who are confronted with the diagnosis of cancer turn to so-called unconventional treatment procedures. The difficulties for those affected and caregivers lie in equal measure in distinguishing between sensible and less advisable or even counterproductive treatment options. Fixed plans of action for aftercare do not do justice to the exigencies of individualized care of cancer patients in private practice, especially with respect to longer survival. Early detection of local recurrence and metastases and the management of complications are determined by the individual disease course and have to be measured against the improvement in quality of life. Secondary preventive measures in the sense of complementary medicine can be helpful. Current evidence is quite promising only for prostate cancer and is of some importance in urological practice.
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Affiliation(s)
- A Schroeder
- Facharzt für Urologie & ambulantes Operieren, Haart 87-89, 24534 Neumünster, Germany.
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Catt S, Fallowfield L, Langridge C. What non-prescription treatments do UK women with breast cancer use? Eur J Cancer Care (Engl) 2007; 15:279-85. [PMID: 16882125 DOI: 10.1111/j.1365-2354.2006.00652.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Understanding the self-prescribing behaviours of patients as well as their attitudes towards prescribed medication regimens is essential if healthcare professionals are to support treatment adherence and avoid unwanted pharmacological interactions and compromises in treatment efficacy. Evidence shows that women with breast cancer are particularly likely to use complementary and alternative therapies. This paper describes the reported treatment profile of a sample of 208 women with breast cancer in the UK. The information was gathered as part of a study exploring the preferences for injection or tablets in the administration of breast cancer treatment. Almost two-thirds of the sample were currently taking prescribed breast cancer treatment, mostly a single hormone therapy. Prescribed medications for co-morbid diseases were also common, and 53% of the women were self-medicating mainly with supplements, principally vitamins, various oils and minerals. In line with other studies, higher levels of education, socio-economic status and internal locus of control were associated with non-prescription use as well as a body mass index <30.
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Affiliation(s)
- S Catt
- Cancer Research UK, Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, UK.
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Lawsin C, DuHamel K, Itzkowitz SH, Brown K, Lim H, Thelemaque L, Jandorf L. Demographic, medical, and psychosocial correlates to CAM use among survivors of colorectal cancer. Support Care Cancer 2007; 15:557-64. [PMID: 17205277 DOI: 10.1007/s00520-006-0198-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Accepted: 11/16/2006] [Indexed: 11/24/2022]
Abstract
GOALS OF WORK Complementary and alternative medicines (CAM) use among cancer patients is becoming more prevalent; however, our understanding of factors contributing to patients' decisions to participate in CAM is limited. This study examined correlates of CAM use among colorectal cancer (CRC) survivors, an understudied population that experiences many physical and psychological difficulties. MATERIALS AND METHODS The sample was 191, predominantly white, CRC survivors (mean age = 59.9 +/- 12.6) who were members of a colon disease registry at a NYC metropolitan hospital. Participants completed assessments of sociodemographic characteristics, psychosocial factors [e.g., psychological functioning, cancer specific distress, social support (SS), quality of life (QOL)], and past CAM use (e.g., chiropractic care, acupuncture, relaxation, hypnosis, and homeopathy). MAIN RESULTS Seventy-five percent of participants reported using at least one type of CAM; most frequently reported was home remedies (37%). Younger (p < 0.01) or female patients (p < 0.01) were more likely to participate in CAM than their older male counterparts. Among psychosocial factors, poorer perceived SS (p = 0.00), more intrusive thoughts (p < 0.05), and poorer overall perceived QOL (p < 0.05) were associated to CAM use. In a linear regression model (including age, gender, SS, intrusive thoughts, and perceived QOL), only age remained a significant predictor of CAM use. CONCLUSION These findings demonstrate that CAM use is prevalent among CRC survivors and should be assessed routinely by providers. CAMs may serve as a relevant adjunct to treatment among CRC patients as well as an indication of need for additional SS, especially among younger patients.
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Affiliation(s)
- Catalina Lawsin
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Triterpene einschließlich Steroide. PHARMAKOGNOSIE — PHYTOPHARMAZIE 2007. [PMCID: PMC7136901 DOI: 10.1007/978-3-540-34281-6_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kulp KS, Montgomery JL, Nelson DO, Cutter B, Latham ER, Shattuck DL, Klotz DM, Bennett LM. Essiac and Flor-Essence herbal tonics stimulate the in vitro growth of human breast cancer cells. Breast Cancer Res Treat 2006; 98:249-59. [PMID: 16541326 DOI: 10.1007/s10549-005-9156-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2005] [Accepted: 12/23/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND People diagnosed with cancer often self-administer complementary and alternative medicines (CAMs) to supplement their conventional treatments, improve health, or prevent recurrence. Flor-Essence and Essiac Herbal Tonics are commercially available complex mixtures of herbal extracts sold as dietary supplements and used by cancer patients based on anecdotal evidence that they can treat or prevent disease. In this study, we evaluated Flor-Essence and Essiac for their effects on the growth of human tumor cells in culture. METHODS The effect of Flor-Essence and Essiac((R)) herbal tonics on cell proliferation was tested in MCF-7, MDA-MB-436, MDA-MB-231, and T47D cancer cells isolated from human breast tumors. Estrogen receptor (ER) dependent activation of a luciferase reporter construct was tested in MCF-7 cells. Specific binding to the ER was tested using an ICI 182,780 competition assay. RESULTS Flor-Essence and Essiac herbal tonics at 1%, 2%, 4% and 8% stimulated cell proliferation relative to untreated controls in both estrogen receptor positive (MCF-7 and T47D) and estrogen receptor negative (MDA-MB-231 and MDA-MB-436) cell lines. Exposure to the tonics also produced a dose-dependent increase in ER dependent luciferase activity in MCF-7 cells. A 10(-7) M concentration of ICI 182,780 inhibited the induction of ER dependent luciferase activity by Flor-Essence and Essiac, but did not affect cell proliferation. CONCLUSION Flor-Essence and Essiac Herbal Tonics can stimulate the growth of human breast cancer cells through ER mediated as well as ER independent mechanisms of action.
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Affiliation(s)
- Kristen S Kulp
- Biosciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA.
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Abstract
BACKGROUND The use of complementary medicines in those with mental health problems is well documented. However, their effectiveness is often not established and they may be less harmless than commonly assumed. AIMS To review the complementary medicines routinely encountered in psychiatric practice, their effectiveness, potential adverse effects and interactions. METHOD Electronic and manual literature search on the effectiveness and safety of psychotropic complementary medicines. RESULTS Potentially useful substances include ginkgo and hydergine as cognitive enhancers, passion flower and valerian as sedatives, St John's wort and s-adenosylmethionine as antidepressants, and selenium and folate to complement antidepressants. The evidence is less conclusive for the use of omega-3 fatty acids as augmentation treatment in schizophrenia, melatonin for tardive dyskinesia and 18-methoxycoronaridine, an ibogaine derivative, for the treatment of cocaine and heroin addiction. CONCLUSIONS Systematic clinical trials are needed to test promising substances. Meanwhile, those wishing to take psychotropic complementary medicines require appropriate advice.
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Affiliation(s)
- Ursula Werneke
- Division of Psychiatry, Homerton University Hospital, East Wing, Homerton Row, London E9 6SR, UK.
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Schöffski P, Breidenbach I, Krauter J, Bolte O, Stadler M, Ganser A, Wilhelm-Ogunbiyi K, Lentzen H. Weekly 24 h infusion of aviscumine (rViscumin): a phase I study in patients with solid tumours. Eur J Cancer 2005; 41:1431-8. [PMID: 15913988 DOI: 10.1016/j.ejca.2005.03.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Accepted: 03/31/2005] [Indexed: 11/17/2022]
Abstract
Aviscumine is a ribosome-inactivating protein with potent antitumour activity in vitro and in vivo and is an Escherichia coli-derived recombinant counterpart of natural mistletoe lectin-I. The current study was performed to determine the safety profile, dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of a prolonged infusion of aviscumine in cancer patients. Aviscumine was given once weekly as a 24 h central intravenous infusion in patients with advanced, refractory progressive solid malignant tumours. Fourteen fully eligible patients (11 male, 3 female) with a median age 58 yrs (range 41-77) were enrolled. They had histologically verified disease, were 18 yrs old, had an ECOG PS 2 and adequate bone marrow, liver and renal function. DLT was defined as any non-haematological grade 3-4 toxicity (Common Toxicity Criteria [CTC] version 2.0), neutrophil count <500/ microl for 7 days, febrile neutropenia or thrombocytopenia grade 4. The MTD was defined as the dose level below the dose at which 2 patients per dose level experienced a DLT during the first treatment cycle. Colorectal cancer, soft tissue sarcoma and pancreatic cancer were the most common tumour types. Dose levels of aviscumine ranged from 4 to 6 microg/kg. The median number of cycles was 2.8 (range, 2-8). Common side effects in cycle 1 were fatigue, fever, nocturia, urticaria, erythema and pruritus. DLTs occurred in 2/3 patients on the 6 microg/kg dose level and consisted of increases in ASAT grade 3, ALAT grade 3, gammaGT grade 3/4, hypokalemia grade 3 and fatigue grade 3. No DLTs were observed on dose levels 4 and 5 microg/kg. The best response (RECIST) was stable disease in 4 pts, lasting for 4-8 cycles. Pharmacokinetics indicated that potentially active plasma levels of the compound were maintained during the entire infusion. We conclude that the recommended dose for weekly 24 h infusions of Aviscumine should be 5 microg/kg.
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Affiliation(s)
- P Schöffski
- Department of Haematology and Oncology, Hannover Medical School, Germany.
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Schöffski P, Riggert S, Fumoleau P, Campone M, Bolte O, Marreaud S, Lacombe D, Baron B, Herold M, Zwierzina H, Wilhelm-Ogunbiyi K, Lentzen H, Twelves C. Phase I trial of intravenous aviscumine (rViscumin) in patients with solid tumors: a study of the European Organization for Research and Treatment of Cancer New Drug Development Group. Ann Oncol 2005; 15:1816-24. [PMID: 15550588 DOI: 10.1093/annonc/mdh469] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aviscumine is an Escherichia coli-derived recombinant type II ribosome-inactivating protein with potent antitumor activity in vitro and in vivo. It is the recombinant counterpart of natural mistletoe lectin-I. The current study was performed to determine the safety profile, dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of the intravenous (i.v.) administration of aviscumine in cancer patients. Translational research included the evaluation of pharmacokinetics and monitoring of plasma cytokine and anti-aviscumine antibody induction after administration of the drug. PATIENTS AND METHODS Aviscumine was given twice weekly as a 1 h central i.v. infusion in patients with advanced, refractory progressive, solid malignant tumors who had not been previously exposed to natural mistletoe preparations. They had histologically or cytologically verified disease, were > or =18 years old, had an Eastern Cooperative Oncology Group performance status < or =2 and adequate bone marrow, liver and renal function. DLT was defined as any non-hematological grade 3-4 toxicity (National Cancer Institute Common Toxicity Criteria version 2.0), neutrophil count <500/microl for > or =7 days, febrile neutropenia or thrombocytopenia grade 4. The MTD was defined as the dose at which >20% of patients experienced DLT during the first treatment cycle. The Continual Reassessment Method was used to determine the number of patients required per dose level. RESULTS Forty-one fully eligible patients (19 male, 22 female) with a median age of 56 years (range 37-74) were enrolled. Colorectal, ovarian, renal cell and breast cancer were the most common tumor types. Dose levels of aviscumine ranged from 10 to 6400 ng/kg. The median number of cycles was two (range one to eight). Common clinical toxicities in cycle 1 were fatigue, fever, nausea, vomiting and allergic reactions. Fatigue grade 3 was dose limiting in one of six patients at 4000 ng/kg and reversible grade 3 liver toxicity (elevation in alkaline phosphatase, transaminases and/or gamma-glutamyltransferase) occurred in one of 10 patients at 4800 ng/kg and in two of five patients at 6400 ng/kg. The best response (RECIST criteria) was stable disease in 11 patients, lasting for two to eight cycles. The pharmacokinetic evaluation revealed a short alpha half-life of 13 min and linear kinetics on dose levels > or =1600 ng/kg. Aviscumine stimulated the immune system with a release of cytokines such as interleukin (IL)-1beta, IL-6 and interferon-gamma, and induced immunoglobulin (Ig) G- and/or IgM-anti-aviscumine antibodies of uncertain clinical relevance. CONCLUSIONS The recommended dose for further clinical trials is 5600 ng/kg twice weekly. Based on the short half-life of the recombinant protein observed in this trial, the exploration of prolonged infusion schedules of aviscumine is warranted.
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MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Adjuvants, Immunologic/adverse effects
- Adjuvants, Immunologic/pharmacokinetics
- Adjuvants, Immunologic/therapeutic use
- Adult
- Aged
- Female
- Half-Life
- Humans
- Immune System/drug effects
- Infusions, Intravenous
- Male
- Maximum Tolerated Dose
- Middle Aged
- Neoplasms/drug therapy
- Plant Preparations/administration & dosage
- Plant Preparations/adverse effects
- Plant Preparations/pharmacokinetics
- Plant Preparations/therapeutic use
- Plant Proteins/administration & dosage
- Plant Proteins/adverse effects
- Plant Proteins/pharmacokinetics
- Plant Proteins/therapeutic use
- Ribosome Inactivating Proteins, Type 2
- Toxins, Biological/administration & dosage
- Toxins, Biological/adverse effects
- Toxins, Biological/pharmacokinetics
- Toxins, Biological/therapeutic use
- Treatment Outcome
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Affiliation(s)
- P Schöffski
- Department of Haematology and Oncology, Hannover Medical School, Hannover, Germany.
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Gray SL, Lackey BR, Tate PL, Riley MB, Camper ND. Mycotoxins in root extracts of American and Asian ginseng bind estrogen receptors alpha and beta. Exp Biol Med (Maywood) 2004; 229:560-8. [PMID: 15169976 DOI: 10.1177/153537020422900615] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The estrogenic activity of ginseng has been the subject of conflicting reports. Cell proliferation, induction of estrogen-responsive genes, and isolated cases of adverse reactions such as postmenopausal vaginal bleeding and gynecomastia have been reported after ginseng treatment. Other studies report antiproliferative effects with no induction of estrogen-responsive genes. We developed estrogen receptor (ER) alpha and ER alpha competitive binding assays using recombinant receptors and [(3)H]-17 alpha-estradiol to detect phytoestrogens in extracts of Asian ginseng root (Panax ginseng C. A. Meyer) and American ginseng root (Panax quinquefolius L.). Root extracts contained substances that bound both receptor isoforms. These substances had a two to three times greater affinity for ER alpha. Significantly higher binding was found in methanol extracts than in hot water extracts. Subsequent analysis of the extracts revealed significant ER binding attributable to zearalenone, the estrogenic mycotoxin produced by several Fusarium species. The ER showed no binding affinity for Rb1 and Rg1, the major ginsenosides found in P. quinquefolius and P. ginseng, respectively. Thus, ginseng extraction methods, plant species tested, and mycotoxin contaminants may help to explain the disparate literature reports. The prevalence and health significance of fungal contamination in herbal products used for medicinal purposes should be further investigated.
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Affiliation(s)
- Sandra L Gray
- Department of Plant and Environmental Sciences, Clemson University, South Carolina 29634, USA.
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Cho J, Park W, Lee S, Ahn W, Lee Y. Ginsenoside-Rb1 from Panax ginseng C.A. Meyer activates estrogen receptor-alpha and -beta, independent of ligand binding. J Clin Endocrinol Metab 2004; 89:3510-5. [PMID: 15240639 DOI: 10.1210/jc.2003-031823] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
We studied the estrogenic activity of a component of Panax ginseng, ginsenoside-Rb1. The activity of ginsenoside-Rb1 was characterized in a transient transfection system, using estrogen receptor isoforms and estrogen-responsive luciferase plasmids, in COS monkey kidney cells. Ginsenoside-Rb1 activated both alpha and beta estrogen receptors in a dose-dependent manner with maximal activity observed at 100 microm, the highest concentration examined. Activation was inhibited by the estrogen receptor antagonist ICI 182,780, indicating that the effects were mediated through the estrogen receptor. Treatment with 17beta-estradiol or ginsenoside-Rb1 increased expression of the progesterone receptor, pS2, and estrogen receptor in MCF-7 cells and of AP-1-driven luciferase genes in COS cells. Although these data suggest that it is functionally very similar to 17beta-estradiol, ginsenoside-Rb1 failed to displace specific binding of [(3)H]17beta-estradiol from estrogen receptors in MCF-7 whole-cell ligand binding assays. Our results indicate that the estrogen-like activity of ginsenoside-Rb1 is independent of direct estrogen receptor association.
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Affiliation(s)
- Jungyoon Cho
- College of Life Science, Institute of Biotechnology, Department of Bioscience and Biotechnology, Sejong University, Kwang-Jin-Gu, Seoul 143-747, Korea
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Chatwin J, Tovey P. Complementary and alternative medicine (CAM), cancer and group-based action: a critical review of the literature. Eur J Cancer Care (Engl) 2004; 13:210-8. [PMID: 15196224 DOI: 10.1111/j.1365-2354.2004.00473.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Interest in complementary and alternative medicine (CAM) continues to grow at an exponential rate despite the advances made by conventional medicine. Complementary and alternative medicine use is increasingly manifest across a wide range of health care settings, and is particularly prevalent in cancer and palliative care. In these arenas, patient groups and self-help organizations play a significant supportive role. There is evidence that they are a key informative and pragmatic resource in the provision of CAM services to patients. However, there is a significant paucity of research dealing with the functional aspects of these groups and the way in which they advocate, promote and supply CAM. In this paper we provide a critical review of the literature pertaining to themes around CAM provision and cancer care, and suggest that for a more complete picture of the field, the impact of group mediation of CAM needs to be addressed, and attention focused on the social and interactional dynamics that underpin these groups and organizations.
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Affiliation(s)
- J Chatwin
- School of Healthcare Studies, Baines Wing, University of Leeds, Leeds, UK.
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Kaneno R, Fontanari LM, Santos SA, Di Stasi LC, Rodrigues Filho E, Eira AF. Effects of extracts from Brazilian sun-mushroom (Agaricus blazei) on the NK activity and lymphoproliferative responsiveness of Ehrlich tumor-bearing mice. Food Chem Toxicol 2004; 42:909-16. [PMID: 15110099 DOI: 10.1016/j.fct.2004.01.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2003] [Accepted: 01/18/2004] [Indexed: 11/29/2022]
Abstract
Agaricus blazei Murrill, is an edible and medicinal mushroom which is popularly consumed due to its antitumoral properties. The immunomodulatory effects of methanol (METH), dichloromethane (DM) and n-hexane (HEX) extracts of this mushroom were evaluated in Ehrlich tumor-bearing mice. Subcutaneous inoculation of Ehrlich tumor cells inhibited the natural killer (NK) activity of spleen cells (specific lysis=6.18+/-2.56%) compared with normal mice (17.59+/-7.77%). Treatment of tumor-bearing mice with the extracts for 10 days restored the natural killer activity against Yac-1 target cells and the best results were observed by treatment with the HEX extract (21.48+/-5.26%). Treatment of the animals with the HEX extract for 10 days was also able to stimulate the mitogen-induced lymphoproliferative activity of spleen cells. Thirty days after the treatment, all groups presented low proliferative activity. Specific antibody production was observed to be higher in the groups treated with the DM or METH extract 30 days after the treatment. Analysis of the 3 extracts by gas chromatography mass spectrum (GCMS) and magnetic nuclear resonance (MNR) showed that the HEX extract contains mainly sugar and fatty acids and that the METH extract also contains sugar and possibly amino acids.
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Affiliation(s)
- R Kaneno
- Department of Microbiology and Immunology, Institute of Biosciences-São Paulo State University, Botucatu-SP, Brazil.
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30
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Felton JS, Knize MG, Bennett LM, Malfatti MA, Colvin ME, Kulp KS. Impact of environmental exposures on the mutagenicity/carcinogenicity of heterocyclic amines. Toxicology 2004; 198:135-45. [PMID: 15138037 DOI: 10.1016/j.tox.2004.01.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Carcinogenic heterocyclic amines are produced from overcooked foods and are highly mutagenic in most short-term test systems. One of the most abundant of these amines, 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), induces breast, colon and prostate tumors in rats. Human dietary epidemiology studies suggest a strong correlation between either meat consumption or well-done muscle meat consumption and cancers of the colon, breast, stomach, lung and esophagus. For over 20 years our laboratory has helped define the human exposure to these dietary carcinogens. In this report we describe how various environmental exposures may modulate the risk from exposure to heterocyclic amines, especially PhIP. To assess the impact of foods on PhIP metabolism in humans, we developed an LC/MS/MS method to analyze the four major PhIP urinary metabolites following the consumption of a single portion of grilled chicken. Adding broccoli to the volunteers' diet altered the kinetics of PhIP metabolism. At the cellular level we have found that PhIP itself stimulates a significant estrogenic response in MCF-7 cells, but even more interestingly, co-incubation of the cells with herbal teas appear to enhance the response. Numerous environmental chemicals found in food or the atmosphere can impact the exposure, metabolism, and cell proliferation response of heterocyclic amines.
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Affiliation(s)
- James S Felton
- Biology and Biotechnology Research Program, L-452, Lawrence Livermore National Laboratory, Livermore, CA 94551, USA.
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31
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Wilcock A, Manderson C, Weller R, Walker G, Carr D, Carey AM, Broadhurst D, Mew J, Ernst E. Does aromatherapy massage benefit patients with cancer attending a specialist palliative care day centre? Palliat Med 2004; 18:287-90. [PMID: 15198118 DOI: 10.1191/0269216304pm895oa] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A randomised controlled pilot study was carried out to examine the effects of adjunctive aromatherapy massage on mood, quality of life and physical symptoms in patients with cancer attending a specialist unit. Participants were randomised to conventional day care alone or day care plus weekly aromatherapy massage using a standardised blend of oils for four weeks. At baseline and at weekly intervals, patients rated their mood, quality of life and the intensity and bother of two symptoms most important to them. Forty-six patients were recruited to the study. Due to a large number of withdrawals, only 11 of 23 (48%) patients in the aromatherapy group and 18 of 23 (78%) in the control group completed all four weeks. Mood, physical symptoms and quality of life improved in both groups. There was no statistically significant difference between groups in any of the outcome measures. Despite a lack of measurable benefit, all patients were satisfied with the aromatherapy and wished to continue. Whilst this pilot study has shown that a randomised controlled trial of complementary therapy is feasible, it has also identified several areas that would require further consideration when designing future studies, e.g., the recruitment and retention of appropriate numbers of patients and the outcome measures used.
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Affiliation(s)
- Andrew Wilcock
- Hayward House Macmillan Specialist Palliative Care Cancer Unit, Nottingham City Hospital NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.
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Werneke U, Earl J, Seydel C, Horn O, Crichton P, Fannon D. Potential health risks of complementary alternative medicines in cancer patients. Br J Cancer 2004; 90:408-13. [PMID: 14735185 PMCID: PMC2410154 DOI: 10.1038/sj.bjc.6601560] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Many cancer patients use complementary alternative medicines (CAMs) but may not be aware of the potential risks. There are no studies quantifying such risks, but there is some evidence of patient risk from case reports in the literature. A cross-sectional survey of patients attending the outpatient department at a specialist cancer centre was carried out to establish a pattern of herbal remedy or supplement use and to identify potential adverse side effects or drug interactions with conventional medicines. If potential risks were identified, a health warning was issued by a pharmacist. A total of 318 patients participated in the study. Of these, 164 (51.6%) took CAMs, and 133 different combinations were recorded. Of these, 10.4% only took herbal remedies, 42.1% only supplements and 47.6% a combination of both. In all, 18 (11.0%) reported supplements in higher than recommended doses. Health warnings were issued to 20 (12.2%) patients. Most warnings concerned echinacea in patients with lymphoma. Further warnings were issued for cod liver/fish oil, evening primrose oil, gingko, garlic, ginseng, kava kava and beta-carotene. In conclusion, medical practitioners need to be able to identify the potential risks of CAMs. Equally, patients should be encouraged to disclose their use. Also, more research is needed to quantify the actual health risks.
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Affiliation(s)
- U Werneke
- Homerton Hospital, East Wing, Department of Psychiatry, Homerton Row, London E9 6SR, UK.
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Risberg T, Kolstad A, Bremnes Y, Holte H, Wist EA, Mella O, Klepp O, Wilsgaard T, Cassileth BR. Knowledge of and attitudes toward complementary and alternative therapies. Eur J Cancer 2004; 40:529-35. [PMID: 14962719 DOI: 10.1016/j.ejca.2003.11.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Accepted: 11/07/2003] [Indexed: 10/26/2022]
Abstract
This study reports on oncology professionals' knowledge and attitude toward complementary and alternative medicines (CAM), classified according to their primary application as complementary or alternative methods. In June 2002, we conducted a national, multicentre survey of 828 Norwegian oncologists, nurses, clerks and therapeutic radiographers. A response rate of 61% was achieved. Only a few physicians (4%) described their reactions to alternative medicine as positive compared with nurses (33%), therapeutic radiographers (32%) and clerks (55%) (P<0.0001). Females showed a more positive view than males (33% versus 14%, P<0.0001). More participants expressed a positive attitude to complementary versus alternative medicines. Most respondents regarded healing by hand or prayer, homeopathy, and Iscador (mistletoe) as alternative therapies. In contrast, most respondents classified acupuncture, meditation, reflexology, music/art-therapy, aromatherapy and massage as complementary therapies. This survey demonstrates major differences, by gender as well as oncology health profession in views about and the classification of various CAM methods.
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Affiliation(s)
- T Risberg
- Department of Oncology, University Hospital of Tromsø, N-9038 Tromsø, Norway.
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Kolstad A, Risberg T, Bremnes Y, Wilsgaard T, Holte H, Klepp O, Mella O, Wist E. Use of complementary and alternative therapies: a national multicentre study of oncology health professionals in Norway. Support Care Cancer 2004; 12:312-8. [PMID: 14767750 DOI: 10.1007/s00520-004-0590-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2003] [Accepted: 01/12/2004] [Indexed: 10/26/2022]
Abstract
GOALS OF WORK It is well documented that an increasing proportion of cancer patients today use complementary and alternative medicine, mostly alongside conventional therapies. This study investigates the use of complementary and alternative medicine among oncology health workers and the reported effects. PATIENTS AND METHODS In June 2002, we conducted a national multicentre survey including 828 Norwegian oncologists, nurses, clerks and therapeutic radiographers. The response rate was 61.5%. MAIN RESULTS We found that females were more often users of both complementary and alternative methods than males (39% versus 15% and 47% versus 17%) and that few oncologists had tried such treatments compared to nurses, therapeutic radiographers and clerks (20/12% versus 50/40%, 41/33%,and 31/50%). Interestingly, the majority of those who had tried unconventional methods reported some or very good effects. Acupuncture, homeopathy, aromatherapy and massage were the most popular therapies. Sub-group analyses including only oncologists showed that female physicians were more often users of both complementary and alternative methods compared to males (33% versus 12%, 25% versus 3%). Moreover, participants below the age of 35 years and Christians more often reported use. CONCLUSIONS This survey demonstrates that significant proportion of oncology health workers in Norway have used non-proven therapies and that most have had a positive experience. Differences in use is highly dependent on gender, profession, age and religion.
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Affiliation(s)
- A Kolstad
- Department of Oncology, The Norwegian Radium Hospital, 0310, Oslo, Norway.
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Ben-Arye E, Frenkel M, Margalit RS. Approaching Complementary and Alternative Medicine Use in Patients With Cancer. J Ambul Care Manage 2004; 27:53-62. [PMID: 14717464 DOI: 10.1097/00004479-200401000-00007] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Complementary and alternative medicine (CAM) is becoming a significant factor in the arena of cancer care. There is an increasing body of research along with widespread popularity and use by patients with cancer. This article reviews current knowledge about the worldwide use of CAM in the treatment of cancer and patients' motives and reasoning for this use. Clinical research in CAM cancer treatments and physicians' attitudes toward this popular trend among patients with cancer are discussed as well. The physician-patient communication and its relevance to CAM use is emphasized. A step approach is suggested for primary care physicians including the discussion of CAM in the management of cancer in order to enrich the physician-patient dialogue and improve the quality of the clinical encounter.
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Affiliation(s)
- Eran Ben-Arye
- Complementary and Traditional Medicine Unit, Department of Family Medicine, The Bruce Rappaport Faculty of Medicine, Technion, Israel.
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Correa-Velez I, Clavarino A, Barnett AG, Eastwood H. Use of complementary and alternative medicine and quality of life: changes at the end of life. Palliat Med 2003; 17:695-703. [PMID: 14694921 DOI: 10.1191/0269216303pm834oa] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this study was to compare the physical, psychological and social dimensions associated with quality-of-life outcomes over the last year of life, between advanced cancer users and nonusers of complementary and alternative medicine. One hundred and eleven patients were identified through Queensland Cancer Registry records, and followed up every four to six weeks until close to death using standardized protocols. Outcome measures were symptom burden, psychological distress, subjective wellbeing, satisfaction with conventional medicine and need for control over treatment decisions. At the initial interview, 36 (32%) participants had used complementary/alternative medicine the previous week; mainly vitamins, minerals and tonics and herbal remedies. Among all participants, 53 (48%) used at least one form of complementary/alternative medicine over the study period. Only six (11%) visited alternative practitioners on a regular basis. Overall, complementary/alternative medicine users reported higher levels of anxiety and pain, less satisfaction with conventional medicine and lower need for control over treatment decisions compared with nonusers. These differences tend to change as death approaches. A more rigorous assessment of complementary/alternative medicine use, psychological distress, pain and subjective wellbeing among patients with advanced cancer is needed in the clinical setting.
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Affiliation(s)
- Ignacio Correa-Velez
- School of Population Health, University of Queensland, Herston Rd, Herston, Queensland 4006, Australia.
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37
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Gray RE, Fitch M, Goel V, Franssen E, Labrecque M. Utilization of complementary/alternative services by women with breast cancer. JOURNAL OF HEALTH & SOCIAL POLICY 2003; 16:75-84. [PMID: 12943333 DOI: 10.1300/j045v16n04_04] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This paper reports on the utilization of complementary/alternative medicine (CAM) services by women with breast cancer. Study participants were women with invasive breast cancer diagnosed 23-36 months prior to contact about the study, and randomly selected from the Ontario Cancer Registry. From among 1,119 eligible women sent survey questionnaires, 731 returned completed questionnaires (65%). A total of 20% of respondents used at least 1 CAM service. Among those who responded to a question about whether they would have liked specific services, 39% reported that there was at least one CAM service they would have liked to use, but were unable to access. Factors shown to be related to greater utilization of services included: younger age, higher household income, employed or student status, private health insurance coverage, and having received chemotherapy. Study results speak to the importance of acknowledging that professionals outside of the formal cancer care system play an important role for many patients. Patients would welcome experimentation with service models in which CAM practitioners and cancer specialists collaborate in providing care.
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Affiliation(s)
- Ross E Gray
- Toronto-Sunnybrook Regional Cancer Centre, Psychosocial & Behavioural Research Unit, Ontario, Canada.
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Risberg T, Jacobsen BK. The association between mental distress and the use of alternative medicine among cancer patients in North Norway. Qual Life Res 2003; 12:539-44. [PMID: 13677498 DOI: 10.1023/a:1025063705413] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE OF THE STUDY To study the association between mental distress and the use of alternative medicine (AM) among cancer patients. PATIENTS AND METHODS A longitudinal questionnaire-based study was carried out at the Department of Oncology, University Hospital of Tromsø, Norway, during the period 1990-1991. The level of mental distress in 158 patients aged less than 75 years was assessed 4 months after first admission to the cancer ward. The patients answered five questions about mental distress selected from the General Health Questionnaire (GHQ). The questions were scored continuously according to the Likert scoring procedure. The level of mental distress was also ranked from 1 (little or no mental distress) to 3 (high mental distress). RESULTS A total of 53 of the 158 patients reported use of AM at inclusion of the study or during the 4 months of follow-up. Among patients with low mental distress, 21% were users of AM, 36% of patients with medium distress and 48% in patients with high level of mental distress (p-value for linear trend = 0.02). Adjusted for all known relevant variables, patients with medium level of mental distress had 1.9 times higher prevalence of use of AM than patients with low level of mental distress, patients with high mental distress had a 2.9 times higher prevalence (p = 0.15 and 0.07, respectively). Analyzed as a continuous variable (Likert score between 5 and 20), mental distress was associated with use of AM (p = 0.007). CONCLUSION These findings suggest that seeking alternative treatment is more common among mentally distressed cancer patients.
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Affiliation(s)
- T Risberg
- University Hospital of Tromsø, Tromsø, Norway.
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Hostanska K, Vuong V, Rocha S, Soengas MS, Glanzmann C, Saller R, Bodis S, Pruschy M. Recombinant mistletoe lectin induces p53-independent apoptosis in tumour cells and cooperates with ionising radiation. Br J Cancer 2003; 88:1785-92. [PMID: 12771996 PMCID: PMC2377150 DOI: 10.1038/sj.bjc.6600982] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mistletoe extracts are used as alternative cancer treatment in addition to standard chemotherapy and radiation treatment and have an immunostimulatory and pain-relieving effect. A direct antitumour effect of mistletoe extracts against tumour cells of lymphoid origin has been linked to the D-galactoside-specific mistletoe lectin I. In this study, we investigated the cellular effect of bacterially expressed, recombinant mistletoe lectin alone or in combination with ionising radiation in a genetically defined p53-wild-type and p53-deficient E1A/ras-transformed murine tumour cells system. Downregulation of the proliferative activity and cell killing by recombinant mistletoe lectin occurred in a clear dose response (0.1-1 ng ml(-1)). Induction of apoptosis was p53-independent, but apoptosis-associated factor-1-dependent. Cellular treatment with lectin in combination with ionising radiation resulted in both p53-wild-type and p53-deficient tumour cells in an at least additive, antiproliferative effect and enhanced activation of caspase-3. Combined treatment with ionising radiation and lectin revealed a similar cytotoxic effect in human, p53-mutated adenocarcinoma cells. Thus, recombinant mistletoe lectin alone and in combination with ionising radiation bypasses often prevalent apoptotic deficiencies in treatment-resistant tumour cells.
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Affiliation(s)
- K Hostanska
- Department of Internal Medicine, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
| | - V Vuong
- Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
| | - S Rocha
- Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
| | - M S Soengas
- Department of Dermatology, University of Michigan Health System, Ann Arbor, MI 48109, USA
| | - C Glanzmann
- Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
| | - R Saller
- Department of Internal Medicine, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
| | - S Bodis
- Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
| | - M Pruschy
- Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland
- Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland. E-mail:
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Galm O, Fabry U, Efferth T, Osieka R. Synergism between rViscumin and cisplatin is not dependent on ERCC-1 expression. Cancer Lett 2002; 187:143-51. [PMID: 12359362 DOI: 10.1016/s0304-3835(02)00411-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Interactions between recombinant mistletoe lectin (rViscumin) and anticancer drugs were investigated in vitro. rViscumin enhanced the cytotoxic effects of vincristine, mafosfamide, idarubicin and cisplatin in the human leukemia cell lines K562 and KG1a. In human marrow progenitor cells, rViscumin inhibited colony formation and did not exert any protective activity against cisplatin-induced inhibition of clonogenicity. Quantitative real-time reverse transcription polymerase chain reaction analysis revealed that cisplatin treatment of K562 cells resulted in a 1.9-fold increase in mRNA expression of the nucleotide excision repair gene ERCC-1. This upregulation was not prevented when cells were post-incubated with rViscumin. Our study provides evidence that rViscumin is capable of enhancing cytotoxicity of anticancer agents in vitro. This synergism appears to be independent of transcriptional activity of DNA repair relevant genes.
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Affiliation(s)
- Oliver Galm
- Medizinische Klinik IV, Universitätsklinikum Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
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Angen MJ, MacRae JH, Simpson JSA, Hundleby M. Tapestry: a retreat program of support for persons living with cancer. CANCER PRACTICE 2002; 10:297-304. [PMID: 12406052 DOI: 10.1046/j.1523-5394.2002.106008.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE In an effort to mitigate the negative psychological sequelae of a cancer diagnosis and cancer treatment, efforts have been made to explore a variety of psychosocial issues and interventions. This article describes the provision and preliminary evaluation of a novel psychosocial service delivery, a residential "retreat" program called Tapestry, which is run under the aegis of the established cancer care community in Alberta, Canada. OVERVIEW Retreat programs offer a novel way to provide psychosocial support for those persons who are living with cancer. The retreats are unique in the provision of a respite and the opportunity to address the isolation and other existential issues arising from a cancer diagnosis. The program described in this article has provided such a service six times per year since 1998. The intervention is described, and preliminary evaluation data are presented. CLINICAL IMPLICATIONS Cancer care has begun to move beyond a solely biomedical paradigm toward a more holistic ethos in service delivery and research orientation. While the face value of and demand for such programming continues to grow, few residential psychosocial programs are offered under the auspices of conventional cancer care centers, and little work has been done to examine the nature and possible efficacy of retreat programs as a valid forum for psychosocial service delivery.
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Affiliation(s)
- Maureen J Angen
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada
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Ernst E, Schmidt K. 'Alternative' cancer cures via the Internet? Br J Cancer 2002; 87:479-80. [PMID: 12189540 PMCID: PMC2376143 DOI: 10.1038/sj.bjc.6600513] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2002] [Accepted: 06/04/2002] [Indexed: 11/28/2022] Open
Abstract
British Journal of Cancer (2002) 87, 479–480. doi:10.1038/sj.bjc.6600513www.bjcancer.com © 2002 Cancer Research UK
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González RP, Leyva A, Moraes MO. Shark cartilage as source of antiangiogenic compounds: from basic to clinical research. Biol Pharm Bull 2001; 24:1097-101. [PMID: 11642310 DOI: 10.1248/bpb.24.1097] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The discovery that angiogenesis is a key condition for the growth of a tumor beyond a millimeter or two, brings about a new approach in the treatment of tumors using drugs able to inhibit the formation of new blood vessels. Also, it has been realized that antiangiogenic drugs can be useful in the treatment of other pathological processes, now classified as angiogenesis-dependent diseases. Initially, cartilage was considered as a possible natural source of antiangiogenic compounds due to its known avascular nature. To date, a number of in vitro and in vivo studies have suggested the existence of antiangiogenic and antitumor compounds in bovine and shark cartilage. However, the potential usefulness of shark cartilage in the treatment of cancer and other angiogenesis-dependent diseases have not been totally accepted due to (i) unsatisfactory patient outcome in clinical trials that have used shark cartilage in cancer patients, (ii) the lack of data that correlates bioavailability with pharmacological effects using oral shark cartilage. Thus, the objective of this review is to describe the main basic and clinical investigations reported in the literature, in which the antiangiogenic and/or antitumor properties of shark cartilage or of its extracts were evaluated. Possible explanations for conflicting results are discussed as well.
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Affiliation(s)
- R P González
- Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil.
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Abstract
The widespread interest in and use of complementary and alternative medicine (CAM) by patients in the United States has been established by multiple surveys. One-third of the U.S. population uses some form of CAM, and an estimated 23 billion dollars is spent annually on these therapies. Because of prevalent usage of CAM among patients, it is important that physicians have some knowledge of this subject. With this purpose in mind, this report reviews the current research on CAM as it relates to common disorders of the head and neck: rhinitis, sinusitis, tinnitus, vertigo, and head and neck oncology.
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Affiliation(s)
- B F Asher
- Department of Surgery and Pediatrics, Dartmouth Medical School, Hanover, New Hampshire, U.S.A
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Abstract
Complementary and alternative medicine (CAM) is frequently used by cancer patients, and many oncologists have limited knowledge of CAM. This article provides a brief, evidence-based introduction to several CAM treatments relevant in the context of cancer. "Alternative" diets, chiropractic, coffee enemas, ozone therapy, and shark cartilage seem to have little to offer cancer patients. The evidence for or against homoeopathy and spiritual healing is at present inconclusive. Acupuncture, aromatherapy, and meditation may be useful for nausea/vomiting, for mild relaxation, and for pain/anxiety, respectively. Herbal treatments offer no reasonable prospect of a cure (mistletoe), but could be useful as palliative treatments (eg, for depression [St John's wort] or anxiety [kava]). Our knowledge regarding the potential benefit and harm of CAM is insufficient.
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Affiliation(s)
- E Ernst
- School of Postgraduate Medicine and Health Sciences, University of Exeter, UK.
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Söllner W, Maislinger S, DeVries A, Steixner E, Rumpold G, Lukas P. Use of complementary and alternative medicine by cancer patients is not associated with perceived distress or poor compliance with standard treatment but with active coping behavior: a survey. Cancer 2000; 89:873-80. [PMID: 10951352 DOI: 10.1002/1097-0142(20000815)89:4<873::aid-cncr21>3.0.co;2-k] [Citation(s) in RCA: 157] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is often used by cancer patients. Data on characteristics of users, concomitant psychologic disturbance, and compliance with standard treatment continue to be controversial. Use of and interest in CAM and their correlation with psychologic disturbance, ways of coping with illness, and compliance with standard treatment were examined in this study. METHODS The authors conducted a survey in a consecutive sample of 205 cancer patients undergoing radiotherapy, using a structured questionnaire to record use of and interest in CAM, the Hospital Anxiety and Depression Scale, the Hornheide Questionnaire to assess patient distress and social support, and the Freiburg Questionnaire of Coping with Illness. RESULTS Of the 172 participants, 24.4% (response rate, 83.9%) reported use of CAM, and 31.4% reported not having used but being interested in such methods. Logistic regression analysis including clinical, demographic, and psychologic characteristics as independent variables yielded 3 predictors of use of or interest in CAM: younger age (P = 0.004; odds ratio (OR), 0.96), progressive cancer (P = 0.064; OR, 1.47), and active coping behavior (P = 0.016; OR, 1.65). Patients interested in or using CAM did not show more psychologic disturbance, poorer social support, or less trust in medicine or compliance with radiotherapy than subjects without such interest. CONCLUSIONS Use of CAM by cancer patients is not associated with perceived distress or poor compliance with medical treatment but with active coping behavior. Patients seem to consider CAM as supplementary to standard medical methods and one way of avoiding passivity and of coping with feelings of hopelessness.
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Affiliation(s)
- W Söllner
- Department of Medical Psychology and Psychotherapy, University Hospital, Innsbruck, Austria
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Ernst E. Unconventional cancer therapies : what We need is rigorous research, not closed minds. Chest 2000; 117:307-8. [PMID: 10669667 DOI: 10.1378/chest.117.2.307] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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