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Samuels J, Martin J, Richardson M, Skehan K. Effects of Dietary Supplements on Iron-Loading Susceptibility Artefacts in Pelvic MRI. Cureus 2024; 16:e65605. [PMID: 39205737 PMCID: PMC11350153 DOI: 10.7759/cureus.65605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2024] [Indexed: 09/04/2024] Open
Abstract
We present a case of an 80-year-old male who attended an MRI scan for his prostate cancer radiotherapy planning. His safety screening did not identify any contraindications to our department's MRI safety policy; however, his MRI images displayed significant susceptibility artefacts in the sigmoid colon and rectum and were not clinically acceptable. Further history revealed he had begun regularly taking curcumin supplements at the time of his prostate cancer diagnosis. The patient was instructed to cease taking the curcumin supplements and a repeat MRI appointment was scheduled for one week later. After discontinuing curcumin, repeat imaging was artefact-free and suitable for radiotherapy planning. The chelating properties of curcumin could potentially lead to an accumulation of iron in the bowel, causing MRI susceptibility artefacts in pelvic scans and presenting a possible negative impact on the clinical utility of the images. It may be helpful to screen regular medications including health supplements with known chelation properties where MRI scan quality may be affected.
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Affiliation(s)
- Justin Samuels
- Radiation Oncology, Calvary Mater Hospital, Newcastle, AUS
| | - Jarad Martin
- Radiation Oncology, Calvary Mater Hospital, Newcastle, AUS
| | | | - Kate Skehan
- Radiation Oncology, Calvary Mater Hospital, Newcastle, AUS
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2
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Keene MR, Heslop IM, Sabesan SS, Glass BD. Perspectives of Complementary and Alternative Medicine use by cancer patients in a regional hospital in North Queensland, Australia. Complement Ther Med 2022; 71:102879. [PMID: 36028116 DOI: 10.1016/j.ctim.2022.102879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/09/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES This study aimed to investigate CAMs used, and reasons for and disclosure of this use by cancer patients in a regional hospital in North Queensland, Australia. METHODS Patients attending the Day Oncology Unit of the Townsville University Hospital were invited to participate in a self-completed questionnaire or telephone interview regarding perspectives of their CAM use. Data were analysed using descriptive statistics and chi-squared and independent t-tests were performed to allow comparison between the responses by CAM users and non-users. RESULTS 102 completed questionnaires were used in the analysis, where 40.2 % of respondents were found to be using some form of CAM. Cannabis, magnesium, and massage were the most prominent therapies used, with cannabis use in cancer, not commonly reported in prior literature. The main reasons given for using CAM were to treat symptoms of cancer, side-effects of treatment or to improve general health. Two-thirds of these respondents disclosed their CAM use to health professionals mostly to obtain a professional opinion or due to concerns of interactions with cancer treatment. CAM users were statistically more likely to have used CAM prior to their cancer diagnosis and have lower emotional wellbeing than non-users. Non-CAM users indicated that a lack of knowledge of CAM or concerns regarding interactions with cancer treatment were the most popular reasons for not adopting these therapies. CONCLUSION While lower than the averages of previously published CAM use, our study highlights that there is still a significant group of cancer patients in the North Queensland region using CAMs.
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Affiliation(s)
- Martin R Keene
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811, Australia.
| | - Ian M Heslop
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811, Australia
| | - Sabe S Sabesan
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811, Australia
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland 4811, Australia
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3
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Hoosen M, Roman NV, Mthembu TG. The Development of Guidelines for the Inclusion of Spirituality and Spiritual Care in Unani Tibb Practice in South Africa: A Study Protocol. JOURNAL OF RELIGION AND HEALTH 2022; 61:1261-1281. [PMID: 33108598 DOI: 10.1007/s10943-020-01105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
Unani Tibb is a holistic form of medicine, which highlights the interconnectedness of mind, body and soul. Despite this, there is very little evidence of spiritual care practices by Unani Tibb practitioners in South Africa. This protocol outlines a proposed process for developing guidelines to integrate spirituality and spiritual care in Unani Tibb practice. In phase one, a document review will be conducted on spirituality and spiritual care in complementary and alternative medicine and Unani Tibb. A series of quantitative and qualitative enquiries will follow to obtain the perspectives of various stakeholders in the Unani Tibb profession. Phase two will rely on the findings of phase I to develop guidelines according to the Delphi method. Experts in the relevant fields will be soliciting their opinions on the nature and content of the proposed guidelines. The data will be analysed using descriptive statistical analyses, thematic analysis and narrative synthesis. Ethics clearance has been obtained from the ethics committee of the university.
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Affiliation(s)
- Mujeeb Hoosen
- School of Natural Medicine, Faculty of Community and Health Sciences, The University of the Western Cape, Bellville, South Africa.
| | - Nicolette Vanessa Roman
- The Centre for Interdisciplinary Studies of Children, Family and Society, Faculty of Community and Health Sciences, The University of the Western Cape, Bellville, South Africa
| | - Thuli Godfrey Mthembu
- Department of Occupational Therapy, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
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Choi SJ, Kunwor SK, Im HB, Hwang JH, Choi D, Han D. Traditional and complementary medicine use among cancer patients in Nepal: a cross-sectional survey. BMC Complement Med Ther 2022; 22:70. [PMID: 35291988 PMCID: PMC8925159 DOI: 10.1186/s12906-022-03555-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/08/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Traditional and complementary medicine (T&CM) is commonly used in South Asian countries such as Nepal. There are various causes and contributing factors for patients with cancer to consider using T&CM. However, little is known about the use of T&CM among the cancer population in this region. METHODS The study followed a cross-sectional design using a structured survey questionnaire. Survey participants were recruited from two National hospitals in Kathmandu, Nepal. The survey instrument comprised 30 questions, including variables on demographics, use of T&CM, and perceived level of disease severity, and cancer treatment. Chi-square test and logistic regression were used for data analysis using SPSS ver. 23.0. RESULTS Of 908 participants, 31.6% used one or more modalities of T&CM after a cancer diagnosis. The most commonly used T&CM was Ayurveda (46.5%), followed by yoga (32.4%). About 46% of T&CM users discussed their use with their doctors. The main source of information on T&CM was their family members and relatives (55.7%). Cancer type (head and neck cancer OR: 2.30, CI: 1.23-4.29; abdominal cancer OR: 2.69, CI: 1.47-4.95; lung cancer OR: 5.88, CI: 2.69-12.89), cancer stage (Stage I OR: 1.92¸CI: 1.14-3.25; Stage II OR: 1.76, CI: 1.06-2.94), and the patients' self-rated disease severity (high perceived severity OR: 1.50, CI: 1.05-2.16) were strong predictors of T&CM use. CONCLUSION This study underlined that despite the widespread use of T&CM among cancer patients in Nepal, most patients obtained information on T&CM from informal sources and did not disclose their use to physicians. To ensure the safe use of T&CM modalities, physicians should integrate questions on T&CM use into routine patient assessments in order to facilitate active communication and improve the quality of care.
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Affiliation(s)
- Soo Jeung Choi
- Department of Global Health and Development, Graduate School, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Sangita Karki Kunwor
- Department of Global Health and Development, Graduate School, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Hyea Bin Im
- Department of Global Health and Development, Graduate School, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Jung Hye Hwang
- Institute of Health Services Management, Hanyang University, Seoul, South Korea.,Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, South Korea
| | - Dain Choi
- Department of Global Health and Development, Graduate School, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea.,Institute of Health Services Management, Hanyang University, Seoul, South Korea
| | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, South Korea. .,Institute of Health Services Management, Hanyang University, Seoul, South Korea. .,Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, South Korea.
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The effect of complementary and integrative medicine on symptom management and quality of life in Turkish oncology patients: a cross-sectional study. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2020.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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6
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Heydarirad G, Cramer H, Choopani R, Gharehgozlou R, Mosavat SH, Ameri A, Pasalar M. Topical Costus sp. Preparation as Palliative Care for Chemotherapy-Induced Peripheral Neuropathy of Patients: A Randomized Placebo-Controlled Pilot Trial. J Altern Complement Med 2021; 26:807-812. [PMID: 32924550 DOI: 10.1089/acm.2020.0012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of various anticancer regimens with different sensory-motor abnormalities in patients. The aim of this study was to examine the feasibility of using Costus sp. oil as a palliative treatment in such patients. Design: This was a pilot randomized placebo-controlled double-blind clinical study. Settings/Location: Imam Hossein Hospital, Tehran, Iran. Subjects: Patients 18-80 years of age undergoing chemotherapy treatment recently or during the last 6 months were enrolled after meeting the inclusion criteria. Interventions: The intervention group used Costus sp. as a topical ointment and the placebo group used topical paraffin for 4 weeks. Outcome measures: Feasibility of recruitment, including treatment acceptability (evaluated as number of patients leaving the study early), and compliance (defined as consumption of a minimum 80% of the ointment) with the intervention were assessed. Neuropathic pain change was defined as the secondary outcome, too. Results: Totally, 50 out of 73 participants were identified eligible and were randomly divided into intervention or placebo groups. There was no significant difference between groups in terms of sociodemographic data. At the end of the study, 24% (confidence interval [95% CI]: 9-45) (intervention group) and 12% (95% CI: 2-31) (placebo group) of patients revealed treatment unacceptability. Meanwhile, 12% (95% CI: 2-31) in the intervention group and 28% (95% CI: 12-49) in the placebo group did not show the compliance. Moreover, according to patients' records, pain reduction was higher in the intervention group compared to the placebo group (p = 0.001). Conclusions: This preliminary study showed that topical use of Costus sp. was feasible and acceptable in patients suffering from CIPN.
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Affiliation(s)
- Ghazaleh Heydarirad
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Rasoul Choopani
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Gharehgozlou
- Cancer Research Center, Shohada Tajrish Hospital, Department of Radiation Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Hamdollah Mosavat
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Ameri
- Department of Radiation Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Benedicto A, Sanz E, Márquez J. Ocoxin as a complement to first line treatments in cancer. Int J Med Sci 2021; 18:835-845. [PMID: 33437220 PMCID: PMC7797552 DOI: 10.7150/ijms.50122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
Chemotherapy and radiotherapy are the most frequent treatment for patients suffering from malignant progression of cancer. Even though new treatments are now being implemented, administration of these chemotherapeutic agents remains as the first line option in many tumor types. However, the secondary effects of these compounds represent one of the main reasons cancer patients lose life quality during disease progression. Recent data suggests that Ocoxin, a plant extract and natural compound based nutritional complement rich in antioxidants and anti-inflammatory mediators exerts a positive effect in patients receiving chemotherapy and radiotherapy. This mixture attenuates the chemotherapy and radiotherapy-related side effects such as radiation-induced skin burns and mucositis, chemotherapy-related diarrhea, hepatic toxicity and blood-infection. Moreover, it has been proven to be effective as anticancer agent in different tumor models both in vitro and in vivo, potentiating the cytotoxic effect of several chemotherapy compounds such as Lapatinib, Gemcitabine, Paclitaxel, Sorafenib and Irinotecan. The aim of this review is to put some light on the potential of this nutritional mixture as an anticancer agent and complement for the standard chemotherapy routine.
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Affiliation(s)
- Aitor Benedicto
- Department of Cellular Biology and Histology, School of Medicine and Nursing, University of the Basque Country, 48940, Leioa, Bizkaia, Spain
| | | | - Joana Márquez
- Department of Cellular Biology and Histology, School of Medicine and Nursing, University of the Basque Country, 48940, Leioa, Bizkaia, Spain
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8
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Tangkiatkumjai M, Boardman H, Walker DM. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther 2020; 20:363. [PMID: 33228697 PMCID: PMC7686746 DOI: 10.1186/s12906-020-03157-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. METHODS A literature search was performed on Pubmed, ScienceDirect and EMBASE. KEYWORDS 'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. RESULTS 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). CONCLUSIONS Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.
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Affiliation(s)
- Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand
| | - Helen Boardman
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, UK
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Abstract
Complementary and alternative medicine (CAM) approaches are widely used by patients throughout a broad range of medical fields and diseases, and often self-administered by patients without the involvement of physicians or other members of the health care team. CAM use is well documented in cancer and chronic illnesses, and emerging data in radiation oncology show CAM usage of 26% to 97% in radiation therapy patients. No information is, however, available on CAM usage in radiology and in the imaging procedure fields. This article reviews the fundamental principles and the experience with the wide spectrum of CAM in radiation oncology-a field that shares many parallels with radiology, such as prevalence of imaging, procedural requirements, and cooperation demanded from patients.CAM is defined as "approaches and practices that are typically not part of conventional medical care," and includes the use of mind- and body-based practices (eg, meditation, massage, acupuncture), natural products (eg, herbs, vitamins, minerals), and other interventions. Supplements are used frequently to alleviate side effects of therapy and promote overall well-being. Specifically, the mindfulness/meditation approaches of CAM are known to reduce anxiety and enhance physical and emotional wellbeing in patients with chronic diseases, such as cancer or neurologic diseases, through physiological, psychological, and perhaps placebo mechanisms. Such patients often require repetitive and invasive imaging examinations or procedures, such as for cancer treatment, cancer surveillance/follow-up, or monitoring of chronic diseases, for example, surveillance MRI in multiple sclerosis. Such parallels suggest that the vastly understudied area of CAMs deserve further investigation in both the radiation oncology and the imaging fields. Further research on CAM is needed to develop refined recommendations and national/and international guidelines on its use.
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10
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[Moderate or extreme hypofractionation and localized prostate cancer: The times are changing]. Cancer Radiother 2019; 23:503-509. [PMID: 31471253 DOI: 10.1016/j.canrad.2019.07.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023]
Abstract
There are many treatment options for localized prostate cancers, including active surveillance, brachytherapy, external beam radiotherapy, and radical prostatectomy. Quality of life remains a primary objective in the absence of superiority of one strategy over another in terms of specific survival with similar long-term biochemical control rates. Despite a significant decrease in digestive and urinary toxicities thanks to IMRT and IGRT, external radiotherapy remains a treatment that lasts approximately 2 months or 1.5 months, when combined with a brachytherapy boost. Given the specific radiosensitivity of this tumor, several randomized studies have shown that a hypofractionated scheme is not inferior in terms of biochemical control and toxicities, allowing to divide the number of fractions by a factor 2 to 8. Given that SBRT becomes a validated therapeutic option for a selected population of patients with localized prostate cancer, extreme hypofractionation is becoming a strong challenger of conventional external radiotherapy or brachytherapy.
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11
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Delaney LJ, Manley SJ. Complementary and alternative therapy use in a regional radiation oncology treatment centre: Can staff knowledge, views, confidence and documentation be improved? J Med Radiat Sci 2019; 66:191-199. [PMID: 31393077 PMCID: PMC6745355 DOI: 10.1002/jmrs.344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/20/2019] [Accepted: 06/19/2019] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Complementary and alternative therapies (CATs) are widely used by cancer patients but are infrequently disclosed and documented. This study aimed to improve radiation therapy staff knowledge, confidence, views and documentation of radiation oncology patients' use of CATs. METHOD Participants completed a baseline questionnaire regarding their knowledge, confidence, views and documentation relating to patients' CAT use. An intervention was undertaken whereby participants attended an educational session and a CAT screening tool was implemented simultaneously. Participants immediately completed a post-intervention questionnaire and later a 6-month follow-up questionnaire. A patient record audit was conducted to measure the documentation of CAT use pre- and post-intervention. RESULTS From baseline to post-intervention, there was a statistically significant shift in staff knowledge and confidence (P = 0.001-0.01). The observed shift was sustained over a 6-month period, (P = 0.453-1.00). Participants' perceived views of CATs did not change as a result of the intervention (P = 0.261-1.000). The post-intervention audit compared to the baseline audit yielded a statistically significant increase in documentation. There was an increase in CAT use mentioned in patient records from 14% (15/108) to 40% (35/88) (P < 0.001). CONCLUSIONS The implementation of a screening tool and staff education increased radiation therapy staff knowledge of CATs and increased staff confidence when discussing CAT use with patients. Documentation of CATs in the patient record increased post-intervention. These changes positively affected radiation therapy staff understanding the use of CATs by cancer patients.
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Affiliation(s)
- Lisa J. Delaney
- Department of Radiation OncologyNorth Coast Cancer InstituteLismoreNew South WalesAustralia
| | - Stephen J. Manley
- Department of Radiation OncologyNorth Coast Cancer InstituteLismoreNew South WalesAustralia
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Opioid-induced bowel dysfunction: suggestions from a multidisciplinary expert Board. Support Care Cancer 2019; 27:4083-4090. [PMID: 30778756 PMCID: PMC6803581 DOI: 10.1007/s00520-019-04688-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/05/2019] [Indexed: 02/07/2023]
Abstract
Constipation, one of the adverse effects of opioid therapy with a major impact on quality of life, is still an unmet need for cancer patients, particularly those with an advanced and progressive disease, and for non-cancer patients chronically treated with opioids. The awareness of this condition is poor among healthcare providers, despite the recent publication of guidelines and consensus conferences. An early multidisciplinary approach of opioid-induced bowel dysfunction (OIBD), based on available therapies of proven effectiveness, could support clinicians in managing this condition, thus increasing patients’ adherence to pain therapy. Several Italian experts involved in the management of patients suffering from pain (anaesthesia pain therapy, oncology, haematology, palliative care, gastroenterology) joined in a Board in order to draw up an expert opinion on OIBD. The most frequent and still unsolved issues in this field were examined, including a more comprehensive definition of OIBD, the benefits of early intervention to prevent its occurrence and the most appropriate use of peripherally acting mu-opioid receptor antagonists (PAMORAs). The use of the recently introduced PAMORA naloxegol was analysed, in light of the current literature. The Board proposed a solution for each open issue in the form of recommendations, integrated with the contribution of representatives from different disciplines and often accompanied by procedural algorithms immediately usable and applicable in daily clinical practice. Safety and quality of life of the patient suffering from pain and from the adverse effects of pain therapies have been the mainstays of this expert opinion, in cooperation with general practitioners and caregivers.
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Beliefs, attitudes towards, and experiences of using complementary and alternative medicine: A qualitative study of clinical psychologists in Indonesia. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Keene MR, Heslop IM, Sabesan SS, Glass BD. Complementary and alternative medicine use in cancer: A systematic review. Complement Ther Clin Pract 2019; 35:33-47. [PMID: 31003679 DOI: 10.1016/j.ctcp.2019.01.004] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE Complementary and alternative medicine (CAM) use in cancer is increasing. The purpose of this study was to systematically review the literature to determine demographic profiles and prevalence and reasons for use in cancer patients. METHODS In this systematic review, the databases OVID, PubMed, and Scopus were searched for studies on CAM use in cancer between 2009 and June 2018. RESULTS The results showed that an average of 51% of cancer patients used CAM. Common independent demographic characteristics associated with CAM use were younger, female cancer patients, having higher education, earning a higher income and having previously used CAM. Frequent reasons for use, grouped into themes were shown to be to influence their cancer and general health and to treat complications of the cancer or therapy. CONCLUSION The review provides an insight and will serve to better inform health professionals on how this population is using CAM.
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Affiliation(s)
- Martin R Keene
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia.
| | - Ian M Heslop
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
| | - Sabe S Sabesan
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
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15
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Martin JM, Supiot S, Keall PJ, Catton CN. Moderately hypofractionated prostate external-beam radiotherapy: an emerging standard. Br J Radiol 2018; 91:20170807. [PMID: 29322821 PMCID: PMC6223284 DOI: 10.1259/bjr.20170807] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 01/01/2023] Open
Abstract
Research over recent years has demonstrated that curative external-beam radiotherapy can be safely and efficaciously delivered with roughly half the number of treatments which was previously considered standard. We review the data supporting this change in practice, methods for implementation, as well as emerging future directions.
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Affiliation(s)
- Jarad M Martin
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, NSW, Australia
| | - Stephane Supiot
- Département de Radiothérapie, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - Paul J Keall
- Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney, New South Wales, NSW, Australia
| | - Charles N Catton
- Radiation Medicine Program, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
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Association of herbal/botanic supplement use with quality of life, recurrence, and survival in newly diagnosed stage II colon cancer patients: A 2-y follow-up study. Nutrition 2018; 54:1-6. [PMID: 29674230 DOI: 10.1016/j.nut.2018.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 01/11/2018] [Accepted: 02/03/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Our objective was to investigate the association between herbal/botanic supplement use and perceived quality of life (QoL), cancer recurrence, and all-cause mortality in colon cancer patients. METHODS Patients (n = 453) newly diagnosed with stage II adenocarcinoma of the colon between 2009 and 2011 were recruited from the North Carolina Central Cancer Registry. Data including demographic variables, herbal medicine use and frequency, lifestyle, diet, cancer treatment, and QoL were collected by interviews at diagnosis (baseline) and 1 and 2 y after diagnosis. Mortality information was obtained via the National Death Index. The Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and Medical Outcomes Short Form 12 (SF-12) were used to evaluate QoL. RESULTS At baseline, herbal/botanic supplement users were more likely to have a healthier lifestyle than non-users, including more physical activity (P <0.01), more fruit and vegetable consumption (P = 0.01), less smoking (P <0.01), and less energy intake from fat (P = 0.02). After adjustment for potential confounders, no significant association was found between herbal/botanic supplement use and QoL assessed by FACT-C and SF-12. Similarly, herbal/botanic supplement use was not associated with the risk of recurrence, all-cause mortality or the combined. CONCLUSION In this study, patients with stage II colon cancer using herbal/botanic supplements had no significant improvement in their QoL and no difference in odds of colon cancer recurrence and all-cause mortality over 2 y after diagnosis compared with those who did not use herbs/botanicals. Further studies are warranted to confirm the findings and to focus on types of herbal/botanic supplements.
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Juengel E, Euler S, Maxeiner S, Rutz J, Justin S, Roos F, Khoder W, Nelson K, Bechstein WO, Blaheta RA. Sulforaphane as an adjunctive to everolimus counteracts everolimus resistance in renal cancer cell lines. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2017; 27:1-7. [PMID: 28314474 DOI: 10.1016/j.phymed.2017.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/17/2017] [Accepted: 01/29/2017] [Indexed: 05/14/2023]
Abstract
BACKGROUND The mechanistic target of rapamycin (mTOR) inhibitors, everolimus and temsirolimus, have widened therapeutic options to treat renal cell carcinoma (RCC). However, chronic treatment with these inhibitors often induces resistance, leading to therapeutic failure. PURPOSE The natural compound, sulforaphane (SFN), was added to an everolimus based regime in vitro in the hopes of preventing resistance development. METHODS A panel of RCC cell lines (A498, Caki-1, KTCTL-26) was treated with everolimus or SFN or with an everolimus-SFN-combination, either short- (24h) or long-term (8 weeks), and cell growth, proliferation, apoptosis, and cell cycle phases were measured. The cell cycle regulating proteins cdk1, cdk2, cyclin A, cyclin B, akt and raptor (both total and activated) were also evaluated. RESULTS Short-term incubation with everolimus (1nM) or SFN (5µM) significantly reduced RCC cell growth. Additive effects on tumor growth and proliferation were evoked by the SFN-everolimus combination. Long-term everolimus-incubation led to resistance development in Caki-1 cells, evidenced by elevated growth and proliferation, associated with an increased percentage of G2/M (non-synchronized cell model) or S-phase (synchronized cell model) cells. Molecular analysis revealed up-regulation of the cdk1-cyclin B and cdk2-cyclin A axis, along with elevated phosphorylation of the mTOR sub-member, raptor. In contrast, resistance development was not observed with the long-term combination of SFN-everolimus. The combination suppressed Caki-1 growth and proliferation, and was associated with an increase in G0/G1-phase cells, diminished cdk1 and akt (both total and activated), cyclin B and raptor expression. CONCLUSION Adding SFN to an everolimus based RCC treatment regimen in vitro delayed resistance development observed with chronic everolimus monotherapy. Ongoing in vivo studies are necessary to verify the in vitro data.
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Affiliation(s)
- Eva Juengel
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Stephanie Euler
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Sebastian Maxeiner
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Jochen Rutz
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Saira Justin
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Frederik Roos
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Wael Khoder
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany
| | - Karen Nelson
- Department of Vascular and Endovascular Surgery, Goethe-University, Frankfurt am Main, Germany
| | - Wolf O Bechstein
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany; Department of General and Visceral Surgery, Goethe-University, Frankfurt am Main, Germany
| | - Roman A Blaheta
- Department of Urology, Goethe-University, Interdisciplinary Science Building, Building 25A, Room 404, Theodor-Stern-Kai 7, Frankfurt am Main, D-60590, Germany.
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Matovina C, Birkeland AC, Zick S, Shuman AG. Integrative Medicine in Head and Neck Cancer. Otolaryngol Head Neck Surg 2016; 156:228-237. [PMID: 27729559 DOI: 10.1177/0194599816671885] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective Complementary and alternative medicine, or integrative medicine, has become increasingly popular among patients with head and neck cancer. Despite its increasing prevalence, many patients feel uncomfortable discussing such therapies with their physicians, and many physicians are unaware and underequipped to evaluate or discuss their use with patients. The aim of this article is to use recent data to outline the decision making inherent to integrative medicine utilization among patients with head and neck cancer, to discuss the ethical implications inherent to balancing integrative and conventional approaches to treatment, and to highlight available resources to enhance head and neck cancer providers' understanding of integrative medicine. Data Sources Randomized controlled trials involving integrative medicine or complementary and alternative medicine treatment for cancer patients. Review Methods Trials were drawn from a systematic PubMed database search categorized into cancer prevention, treatment, and symptom management. Conclusions Integrative medicine is gaining popularity for the management of cancer and is most commonly used for symptom management. A number of randomized controlled trials provide data to support integrative therapies, yet physicians who treat head and neck cancer may be faced with ethical dilemmas and practical barriers surrounding incorporation of integrative medicine. Implications for Practice In the management of head and neck cancer, there is an increasing demand for awareness of, dialogue about, and research evaluating integrative medicine therapies. It is important for otolaryngologists to become aware of integrative therapy options, their risks and benefits, and resources for further information to effectively counsel their patients.
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Affiliation(s)
- Chloe Matovina
- 1 Head and Neck Translational Oncology Laboratory, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Andrew C Birkeland
- 1 Head and Neck Translational Oncology Laboratory, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.,2 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Suzanna Zick
- 3 Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,4 Nutritional Sciences Program, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Andrew G Shuman
- 1 Head and Neck Translational Oncology Laboratory, Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, USA.,2 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.,5 Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Blaheta RA, Nelson K, Haferkamp A, Juengel E. Amygdalin, quackery or cure? PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:367-376. [PMID: 27002407 DOI: 10.1016/j.phymed.2016.02.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The cyanogenic diglucoside, amygdalin, has gained high popularity among cancer patients together with, or in place of, conventional therapy. Still, evidence based research on amygdalin is sparse and its benefit controversial. PURPOSE Since so many cancer patients consume amygdalin, and many clinicians administer it without clear knowledge of its mode of action, current knowledge has been summarized and the pros and cons of its use weighed. METHODS A retrospective analysis was conducted for amygdalin relevant reports using the PubMed database with the main search term "Amygdalin" or "laetrile", at times combined with "cancer", "patient", "cyanide" or "toxic". We did not exclude any "unwanted" articles. Additionally, internet sources authorized by governmental or national institutions have also been included. SECTIONS Individual chapters summarize pharmacokinetics, preclinical and clinical studies and toxicity. CONCLUSION No convincing evidence showing that amygdalin induces rapid, distinct tumor regression in cancer patients, particularly in those with late-stage disease, is apparent. However, there is also no evidence that purified amygdalin, administered in "therapeutic" dosage, causes toxicity. Multiple aspects of amygdalin administration have not yet been adequately explored, making further investigation necessary to evaluate its actual therapeutic potential.
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Affiliation(s)
- Roman A Blaheta
- Department of Urology, Goethe-University, Building 25A, Room 404, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
| | - Karen Nelson
- Department of Vascular and Endovascular Surgery, Goethe-University, Frankfurt am Main, Germany
| | - Axel Haferkamp
- Department of Urology, Goethe-University, Building 25A, Room 404, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany
| | - Eva Juengel
- Department of Urology, Goethe-University, Building 25A, Room 404, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany
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Hunter D, Marinakis C, Salisbury R, Cray A, Oates R. Complementary therapy use in metropolitan and regional Australian radiotherapy centres; do patients report effective outcomes? Support Care Cancer 2015; 24:1803-11. [DOI: 10.1007/s00520-015-2972-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/28/2015] [Indexed: 10/23/2022]
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Kodiyan J, Amber KT. Topical antioxidants in radiodermatitis: a clinical review. Int J Palliat Nurs 2015; 21:446-52. [DOI: 10.12968/ijpn.2015.21.9.446] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Joyson Kodiyan
- Joyson Kodiyan Medical Student, University of Miami Miller School of Medicine, Department of Radiation Oncology
| | - Kyle T Amber
- Physican, University of California Irvine, Department of Dermatology, Irvine, California
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Kodiyan J, Amber KT. A Review of the Use of Topical Calendula in the Prevention and Treatment of Radiotherapy-Induced Skin Reactions. Antioxidants (Basel) 2015; 4:293-303. [PMID: 26783706 PMCID: PMC4665477 DOI: 10.3390/antiox4020293] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/16/2015] [Accepted: 04/16/2015] [Indexed: 12/22/2022] Open
Abstract
Calendula is a topical agent derived from a plant of the marigold family Calendula Officinalis. Containing numerous polyphenolic antioxidants, calendula has been studied in both the laboratory and clinical setting for the use in treating and preventing radiation induced skin toxicity. Despite strong evidence in the laboratory supporting calendula's mechanism of action in preventing radiation induced skin toxicity, clinical studies have demonstrated mixed results. In light of the controversy surrounding the efficacy of calendula in treating and preventing radiodermatitis, the topic warrants further discussion.
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Affiliation(s)
- Joyson Kodiyan
- Miller School of Medicine, University of Miami, 1600 Northwest 10th Avenue, Miami, FL 33136, USA.
| | - Kyle T Amber
- Department of Medical Education, Macneal Hospital, 3231 South Euclid Avenue, Suite 203 Berwyn, IL 60402, USA.
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Sullivan A, Gilbar P, Curtain C. Complementary and Alternative Medicine Use in Cancer Patients in Rural Australia. Integr Cancer Ther 2015; 14:350-8. [DOI: 10.1177/1534735415580679] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim. Numerous studies have demonstrated the high prevalence of complementary and alternative medicine (CAM) use in metropolitan cancer cohorts but few have been conducted in regional and remote populations. This study aimed to investigate the trends and regional variations in CAM use by cancer patients at a regional cancer care center in Toowoomba, South East Queensland, Australia. Methods. All English-speaking adult cancer patients attending the regional cancer care center were invited to participate. Eligible patients were provided a self-administered questionnaire that was developed based on published surveys. Ethics approval was obtained. Results. Overall 142 patients completed the questionnaire and 68% were currently or had previously used at least one form of CAM. CAM users and nonusers did not differ significantly by region, age, gender, time since diagnosis, income, town size, treatment intent, or metastases. CAM users were more likely to have a higher level of education. Concurrent CAM use with conventional treatment was reported by approximately half of respondents. The most common reason for CAM use was “to improve general physical well-being.” The most common sources of CAM information were family (31%) and friends (29%). Disclosure of CAM use to either the general practitioner or specialist was reported by 46% and 33% of patients, respectively. The most common reason for nondisclosure was “doctor never asked.” Conclusion. This study supports previous research that CAM use is as common in regional and remote areas as metropolitan areas. Nondisclosure of CAM use to health professionals was common. Future research needs to focus on strategies to improve communication between patients and health professionals about the use of CAM.
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Affiliation(s)
- Aimee Sullivan
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Prince of Wales Hospital, Sydney, New South Wales, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Peter Gilbar
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Department of Medicine (Rural Clinical School), The University of Queensland, Toowoomba, Queensland, Australia
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Mani J, Juengel E, Arslan I, Bartsch G, Filmann N, Ackermann H, Nelson K, Haferkamp A, Engl T, Blaheta RA. Use of complementary and alternative medicine before and after organ removal due to urologic cancer. Patient Prefer Adherence 2015; 9:1407-12. [PMID: 26491269 PMCID: PMC4599187 DOI: 10.2147/ppa.s90061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Many patients use complementary and alternative medicine (CAM) as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use. METHODS From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%), who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery. RESULTS From the 172 patients returning questionnaires, 56 (33%) used CAM before and/or after surgery and 116 (67%) never used CAM. Of the 56 CAM users, 30 (54%) used CAM presurgery and 53 (95%) used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher) was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%), a manipulative and body-based method (50/19%), and a biological-based therapy (37/32%). Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not. CONCLUSION The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and understanding of CAM use by medical professionals could improve patient counseling.
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Affiliation(s)
- Jens Mani
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
- Correspondence: Jens Mani, Department of Urology, Goethe-University, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany, Tel +49 69 6301 7109, Fax +49 69 6301 7108, Email
| | - Eva Juengel
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Ilhan Arslan
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Georg Bartsch
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Karen Nelson
- Department of Vascular and Endovascular Surgery, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Axel Haferkamp
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Tobias Engl
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Roman A Blaheta
- Department of Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
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Changes in attitudes toward and patterns in traditional Korean medicine among the general population in South Korea: a comparison between 2008 and 2011. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:436. [PMID: 25380563 PMCID: PMC4233081 DOI: 10.1186/1472-6882-14-436] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 10/29/2014] [Indexed: 12/05/2022]
Abstract
Background Traditional Korean medicine (TKM) is acknowledged to be prevalent among the Korean public, but few follow-up studies are available to confirm this commonly held belief. Whereas most survey studies have focused on the demographic factors influencing the usage of TKM, only a few studies have conducted a pattern or trend analysis over time. The purpose of this paper is to observe and document recent trends in the usage of TKM in South Korea and to compare overall patterns of TKM use over a period of several years. Methods A cross-sectional survey was conducted in 2011 to assess TKM usage patterns and public perceptions regarding TKM. An online questionnaire was administered to consenting respondents that focused upon individual preferences between TKM and current Western medicine, respondents’ reasons for using TKM, the frequency of respondents’ visits to TKM clinics, the reasons respondents visited TKM clinics, and respondents’ perceived satisfaction. Results The results revealed that 66.6% of the respondents showed a positive attitude toward TKM. In addition, 69.3% of the respondents had visited TKM clinics one to four times during the previous year. Patients used TKM with the intentions of receiving acupuncture (95.3%), moxibustion (40.1%), and cupping (36.0%) treatments or to take herbal medicines (35.7%). Most respondents who had visited TKM clinics were largely satisfied with the clinics’ effectiveness (56.1%). The factors most commonly associated with TKM usage included sex (female), age (50s), and education (college or higher), but the within-factor differences were not significant. Compared with a previous survey of other groups, TKM usage was found to have increased from 45.8% in 2008 to 69.3% in 2011. With the exception of acupuncture and physical therapy, most usage doubled or more than doubled. Conclusions The attitudes toward and usage of TKM in South Korea have improved between 2008 and 2011. This result will be used to explain outcomes of certain social phenomena and to argue for national support in the promotion of TKM. Electronic supplementary material The online version of this article (doi:10.1186/1472-6882-14-436) contains supplementary material, which is available to authorized users.
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Makarević J, Rutz J, Juengel E, Kaulfuss S, Tsaur I, Nelson K, Pfitzenmaier J, Haferkamp A, Blaheta RA. Amygdalin influences bladder cancer cell adhesion and invasion in vitro. PLoS One 2014; 9:e110244. [PMID: 25333694 PMCID: PMC4198254 DOI: 10.1371/journal.pone.0110244] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/14/2014] [Indexed: 11/27/2022] Open
Abstract
The cyanogenic diglucoside amygdalin, derived from Rosaceae kernels, is employed by many patients as an alternative anti-cancer treatment. However, whether amygdalin indeed acts as an anti-tumor agent is not clear. Metastasis blocking properties of amygdalin on bladder cancer cell lines was, therefore, investigated. Amygdalin (10 mg/ml) was applied to UMUC-3, TCCSUP or RT112 bladder cancer cells for 24 h or for 2 weeks. Tumor cell adhesion to vascular endothelium or to immobilized collagen as well as tumor cell migration was examined. Effects of drug treatment on integrin α and β subtypes, on integrin-linked kinase (ILK) and total and activated focal adhesion kinase (FAK) were also determined. Integrin knock-down was carried out to evaluate integrin influence on migration and adhesion. A 24 h or 2 week amygdalin application distinctly reduced tumor cell adhesion and migration of UMUC-3 and RT112 cells. TCCSUP adhesion was also reduced, but migration was elevated under amygdalin. Integrin subtype expression was significantly and specifically altered by amygdalin depending on the cell line. ILK was moderately, and activated FAK strongly, lost in all tumor cell lines in the presence of amygdalin. Knock down of β1 integrin caused a significant decrease in both adhesion and migration of UMUC-3 cells, but a significant increase in TCCSUP adhesion. Knock down of β4 integrin caused a significant decrease in migration of RT112 cells. Since the different actions of amygdalin on the different cell lines was mirrored by β1 or β4 knock down, it is postulated that amygdalin influences adhesion and migratory properties of bladder cancer cells by modulating β1 or β4 integrin expression. The amygdalin induced increase in TCCSUP migratory behavior indicates that any anti-tumor benefits from amygdalin (seen with the other two cell lines) may depend upon the cancer cell type.
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Affiliation(s)
- Jasmina Makarević
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Jochen Rutz
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Eva Juengel
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Silke Kaulfuss
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Igor Tsaur
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Karen Nelson
- Department of Vascular and Endovascular Surgery, Goethe University Hospital, Frankfurt am Main, Germany
| | - Jesco Pfitzenmaier
- Department of Urology, Evangelical Hospital Bielefeld, Bielefeld, Germany
| | - Axel Haferkamp
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Roman A. Blaheta
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
- * E-mail:
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Braun L, Harris J, Katris P, Cain M, Dhillon H, Koczwara B, Olver I, Robotin M. Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients. Asia Pac J Clin Oncol 2014; 10:289-96. [PMID: 25244342 DOI: 10.1111/ajco.12227] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2014] [Indexed: 11/30/2022]
Abstract
Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy.
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Affiliation(s)
- Lesley Braun
- National Institute of Complementary Medicine, University of Western Sydney, Sydney, New South Wales, Australia; Alfred Hospital, Melbourne, Victoria, Australia
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Makarević J, Rutz J, Juengel E, Kaulfuss S, Reiter M, Tsaur I, Bartsch G, Haferkamp A, Blaheta RA. Amygdalin blocks bladder cancer cell growth in vitro by diminishing cyclin A and cdk2. PLoS One 2014; 9:e105590. [PMID: 25136960 PMCID: PMC4138189 DOI: 10.1371/journal.pone.0105590] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/23/2014] [Indexed: 12/16/2022] Open
Abstract
Amygdalin, a natural compound, has been used by many cancer patients as an alternative approach to treat their illness. However, whether or not this substance truly exerts an anti-tumor effect has never been settled. An in vitro study was initiated to investigate the influence of amygdalin (1.25–10 mg/ml) on the growth of a panel of bladder cancer cell lines (UMUC-3, RT112 and TCCSUP). Tumor growth, proliferation, clonal growth and cell cycle progression were investigated. The cell cycle regulating proteins cdk1, cdk2, cdk4, cyclin A, cyclin B, cyclin D1, p19, p27 as well as the mammalian target of rapamycin (mTOR) related signals phosphoAkt, phosphoRaptor and phosphoRictor were examined. Amygdalin dose-dependently reduced growth and proliferation in all three bladder cancer cell lines, reflected in a significant delay in cell cycle progression and G0/G1 arrest. Molecular evaluation revealed diminished phosphoAkt, phosphoRictor and loss of Cdk and cyclin components. Since the most outstanding effects of amygdalin were observed on the cdk2-cyclin A axis, siRNA knock down studies were carried out, revealing a positive correlation between cdk2/cyclin A expression level and tumor growth. Amygdalin, therefore, may block tumor growth by down-modulating cdk2 and cyclin A. In vivo investigation must follow to assess amygdalin's practical value as an anti-tumor drug.
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Affiliation(s)
- Jasmina Makarević
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Jochen Rutz
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Eva Juengel
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Silke Kaulfuss
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Michael Reiter
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Igor Tsaur
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Georg Bartsch
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Axel Haferkamp
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Roman A. Blaheta
- Department of Urology, Goethe University Hospital, Frankfurt am Main, Germany
- * E-mail:
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Stubbe CE, Valero M. Complementary strategies for the management of radiation therapy side effects. J Adv Pract Oncol 2014; 4:219-31. [PMID: 25032003 PMCID: PMC4093430 DOI: 10.6004/jadpro.2013.4.4.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Patients with cancer utilize complementary and alternative medicine (CAM) for a variety of purposes, one of which is the reduction of side effects of conventional treatment. With a large number of their patients using CAM, it is important for advanced practitioners in oncology to have an understanding of these therapies to better guide their patients. Side effects of radiation therapy that may have dose-limiting poten-tial include diarrhea, mucositis, skin toxicity, and xerostomia. A com-mon side effect that is not necessarily dose-limiting but considerably troublesome to patients is cancer- and treatment-related fatigue. The CAM therapies that may alleviate some of the side effects of radiation therapy include probiotics, psyllium, exercise, melatonin, honey, acu-puncture, and calendula. Therapies that require more research or have been shown to be ineffective include aloe vera, glutamine, and deglyc-yrrhizinated licorice. This article provides an overview of these thera-pies as well as related research and analysis.
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Affiliation(s)
- Christine E Stubbe
- Dr. Stubbe recently completed a 3-year residency at the Yellowstone Naturopathic Clinic and Frontier Cancer Center, Billings, Montana. Dr. Valero is a naturopathic doctor and researcher currently practicing in Windsor, Ontario
| | - Meighan Valero
- Dr. Stubbe recently completed a 3-year residency at the Yellowstone Naturopathic Clinic and Frontier Cancer Center, Billings, Montana. Dr. Valero is a naturopathic doctor and researcher currently practicing in Windsor, Ontario
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Chandwani KD, Heckler CE, Mohile SG, Mustian KM, Janelsins M, Peppone LJ, Bushunow P, Flynn PJ, Morrow GR. Hot flashes severity, complementary and alternative medicine use, and self-rated health in women with breast cancer. Explore (NY) 2014; 10:241-7. [PMID: 25037667 DOI: 10.1016/j.explore.2014.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Indexed: 11/12/2022]
Abstract
CONTEXT Hot flashes (HF) are a common distressing symptom in women with breast cancer (BC). Current pharmacologic options are moderately effective and are associated with bothersome side effects. Complementary and alternative medicine is commonly used by cancer patients. However, information on the association of hot flashes severity with such use and self-rated health is lacking. OBJECTIVE To examine the hot flashes severity in women with breast cancer and its association with complementary and alternative medicine use and self-rated health (SRH). DESIGN Longitudinal multicenter study to assess information needs of cancer outpatients. PARTICIPANTS Patients with a diagnosis of breast cancer who were scheduled to undergo chemotherapy and/or radiotherapy. OUTCOME MEASURES Hot flashes severity (0 = not present and 10 = as bad as you can imagine), use of complementary and alternative medicine (yes/no), and self-rating of health (SRH) status post-treatment and six-months thereafter (1-5, higher score = better SRH). RESULTS The majority of women with HF (mean age = 54.4 years) were Caucasian and married, with higher education, and 93% had received surgical treatment for BC. At the end of treatment, 79% women reported experiencing HF [mean severity = 5.87, standard deviation (SD) = 2.9]; significantly more severe HF were reported by younger women with poor SRH, poor performance status, and those reporting doing spiritual practices. At follow-up, 73% had HF (mean severity = 4.86, SD = 3.0), and more severe HF were reported by younger women with poor self-rated health who had undergone chemotherapy plus radiotherapy, used vitamins, and did not exercise. CONCLUSIONS A high percentage of women experienced hot flashes at the end of treatment and at six-month follow-up. A significant association of hot flashes severity with spiritual practice, increased vitamin use, and reduced exercise emphasize the need for future studies to confirm the results. This can facilitate safe use of complementary and alternative medicine and favorable outcomes while managing cancer-related hot flashes.
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Affiliation(s)
- Kavita D Chandwani
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY.
| | - Charles E Heckler
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
| | - Supriya G Mohile
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
| | - Karen M Mustian
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
| | - Michelle Janelsins
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
| | - Luke J Peppone
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
| | | | | | - Gary R Morrow
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
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Fouladbakhsh JM, Davis JE, Yarandi HN. A Pilot Study of the Feasibility and Outcomes of Yoga for Lung Cancer Survivors. Oncol Nurs Forum 2014; 41:162-74. [DOI: 10.1188/14.onf.162-174] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Amber KT, Shiman MI, Badiavas EV. The use of antioxidants in radiotherapy-induced skin toxicity. Integr Cancer Ther 2013; 13:38-45. [PMID: 23729466 DOI: 10.1177/1534735413490235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Radiation-induced skin damage is one of the most common complications of radiotherapy. In order to combat these side effects, patients often turn to alternative therapies, which often include antioxidants. Antioxidants such as those in the polyphenol chemical class, xanthine derivatives, tocepherol, sucralfate, and ascorbate have been studied for their use in either preventing or treating radiotherapy-induced skin damage. Apart from their known role as free radical scavengers, some of these antioxidants appear to alter cytokine release affecting cutaneous and systemic changes. We review the role of antioxidants in treating and preventing radiation-induced skin damage as well as the possible complications of using such therapy.
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