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Chen H, Sahu SK, Wang S, Liu J, Yang J, Cheng L, Chiu TY, Liu H. Chromosome-level Alstonia scholaris genome unveils evolutionary insights into biosynthesis of monoterpenoid indole alkaloids. iScience 2024; 27:109599. [PMID: 38646178 PMCID: PMC11033161 DOI: 10.1016/j.isci.2024.109599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/25/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Alstonia scholaris of the Apocynaceae family is a medicinal plant with a rich source of bioactive monoterpenoid indole alkaloids (MIAs), which possess anti-cancer activity like vinca alkaloids. To gain genomic insights into MIA biosynthesis, we assembled a high-quality chromosome-level genome for A. scholaris using nanopore and Hi-C data. The 444.95 Mb genome contained 35,488 protein-coding genes. A total of 20 chromosomes were assembled with a scaffold N50 of 21.75 Mb. The genome contained a cluster of strictosidine synthases and tryptophan decarboxylases with synteny to other species and a saccharide-terpene cluster involved in the monoterpenoid biosynthesis pathway of the MIA upstream pathway. The multi-omics data of A. scholaris provide a valuable resource for understanding the evolutionary origins of MIAs and for discovering biosynthetic pathways and synthetic biology efforts for producing pharmaceutically useful alkaloids.
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Affiliation(s)
- Haixia Chen
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
- BGI Research, Wuhan 430074, China
| | - Sunil Kumar Sahu
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
- BGI Research, Wuhan 430074, China
| | - Shujie Wang
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
| | - Jia Liu
- Key Laboratory of Soybean Molecular Design Breeding, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Harbin 150081, China
| | - Jinlong Yang
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
| | - Le Cheng
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
| | - Tsan-Yu Chiu
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
| | - Huan Liu
- State Key Laboratory of Agricultural Genomics, Key Laboratory of Genomics, Ministry of Agriculture, BGI Research, Shenzhen 518083, China
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Bava R, Castagna F, Lupia C, Poerio G, Liguori G, Lombardi R, Naturale MD, Bulotta RM, Biondi V, Passantino A, Britti D, Statti G, Palma E. Hive Products: Composition, Pharmacological Properties, and Therapeutic Applications. Pharmaceuticals (Basel) 2024; 17:646. [PMID: 38794216 PMCID: PMC11124102 DOI: 10.3390/ph17050646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Beekeeping provides products with nutraceutical and pharmaceutical characteristics. These products are characterized by abundance of bioactive compounds. For different reasons, honey, royal jelly, propolis, venom, and pollen are beneficial to humans and animals and could be used as therapeutics. The pharmacological action of these products is related to many of their constituents. The main bioactive components of honey include oligosaccharides, methylglyoxal, royal jelly proteins (MRJPs), and phenolics compounds. Royal jelly contains jelleins, royalisin peptides, MRJPs, and derivatives of hydroxy-decenoic acid, particularly 10-hydroxy-2-decenoic acid (10-HDA), which possess antibacterial, anti-inflammatory, immunomodulatory, neuromodulatory, metabolic syndrome-preventing, and anti-aging properties. Propolis has a plethora of activities that are referable to compounds such as caffeic acid phenethyl ester. Peptides found in bee venom include phospholipase A2, apamin, and melittin. In addition to being vitamin-rich, bee pollen also includes unsaturated fatty acids, sterols, and phenolics compounds that express antiatherosclerotic, antidiabetic, and anti-inflammatory properties. Therefore, the constituents of hive products are particular and different. All of these constituents have been investigated for their properties in numerous research studies. This review aims to provide a thorough screening of the bioactive chemicals found in honeybee products and their beneficial biological effects. The manuscript may provide impetus to the branch of unconventional medicine that goes by the name of apitherapy.
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Affiliation(s)
- Roberto Bava
- Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy; (R.B.); (C.L.); (R.M.B.); (D.B.); (E.P.)
| | - Fabio Castagna
- Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy; (R.B.); (C.L.); (R.M.B.); (D.B.); (E.P.)
- Mediterranean Ethnobotanical Conservatory, Sersale (CZ), 88054 Catanzaro, Italy
| | - Carmine Lupia
- Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy; (R.B.); (C.L.); (R.M.B.); (D.B.); (E.P.)
- Mediterranean Ethnobotanical Conservatory, Sersale (CZ), 88054 Catanzaro, Italy
| | - Giusi Poerio
- ATS Val Padana, Via dei Toscani, 46100 Mantova, Italy;
| | | | - Renato Lombardi
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), 71013 Foggia, Italy;
| | - Maria Diana Naturale
- Ministry of Health, Directorate General for Health Programming, 00144 Rome, Italy;
| | - Rosa Maria Bulotta
- Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy; (R.B.); (C.L.); (R.M.B.); (D.B.); (E.P.)
| | - Vito Biondi
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (V.B.); (A.P.)
| | - Annamaria Passantino
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (V.B.); (A.P.)
| | - Domenico Britti
- Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy; (R.B.); (C.L.); (R.M.B.); (D.B.); (E.P.)
| | - Giancarlo Statti
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, 87036 Cosenza, Italy;
| | - Ernesto Palma
- Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy; (R.B.); (C.L.); (R.M.B.); (D.B.); (E.P.)
- Center for Pharmacological Research, Food Safety, High Tech and Health (IRC-FSH), University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy
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Silici S, Kaynar L, Okan A, Doğanyiğit Z. Protective role of olive oil extract of propolis on short and long-term administration of tamoxifen in rats. ENVIRONMENTAL TOXICOLOGY 2024; 39:2102-2122. [PMID: 38108573 DOI: 10.1002/tox.24091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/27/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Abstract
Tamoxifen (TAM) is an antiestrogenic agent used for adjuvant treatment in estrogen receptor-positive breast cancers in the pre/post-menopausal period. This study, it was aimed to determine the effect of olive oil extract of propolis (OEP) on short and long-term administration of TAM in rats. Wistar albino rats were divided into groups with eight animals in each. Groups: control, OEP, TAM, and OEP + TAM. At the end of the experiment, oxidative stress tests were performed with Enzyme-Linked ImmunoSorbent Assay (ELISA) on blood and tissue samples (liver, kidney, and ovary) taken from rats. After single-dose TAM administration, there was a significant increase in red blood cell, hematocrit, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration levels compared to the control group, a decrease in low-density lipoprotein (LDL) value, a significant increase in liver enzymes and fasting glucose values was detected compared with the control and propolis groups. A normalizing effect was observed in the group given OEP and TAM combined. The increase in Malondialdehyde (MDA) and the decrease in enzyme activities in tissues are also noteworthy. Propolis application reduced the tissue damage caused by TAM. In addition, improved cytokine levels, which increased with TAM administration. It has been concluded that OEP can be given in supportive treatment, as it improves hematological and antioxidant parameters in TAM treatment.
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Affiliation(s)
- Sibel Silici
- Faculty of Agriculture, Department of Agricultural Biotechnology, Nutral Therapy Co., Erciyes Technopark, Erciyes University, Kayseri, Turkey
| | - Leylagül Kaynar
- Faculty of Medicine, Department of Hematology, Istanbul Medipol University, Istanbul, Turkey
| | - Aslı Okan
- Faculty of Medicine, Department of Histology and Embryology, Yozgat Bozok University, Yozgat, Turkey
| | - Züleyha Doğanyiğit
- Faculty of Medicine, Department of Histology and Embryology, Yozgat Bozok University, Yozgat, Turkey
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Gu J, Zhang H, Hu M, Liu L, Chen C, Wang J, Zhu F, Wei G, Huo J. Complementary and alternative medicine in relation to chemotherapy-induced peripheral neuropathy: A narrative review. Explore (NY) 2024; 20:181-187. [PMID: 37652788 DOI: 10.1016/j.explore.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/29/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE To summarizes the available evidence on the effectiveness, safety, and feasibility of complementary and alternative medicine (CAM) in the management of chemotherapy-induced peripheral neuropathy (CIPN). METHODS We searched for systematic reviews, and meta-analyzes published up to April 2023 in the Pubmed and Web of Science databases. The latest original research on related topics was also reviewed. The search was restricted to English-language papers. Two independent reviewers performed a quality assessment of the identified literature. RESULTS The results of 35 systematic reviews and meta-analyzes were included in this study. Preliminary evidence suggests that CAM, including acupuncture, physical activity (PA), herbal and nutritional supplements, mind-body therapies, touch therapy, and non-invasive neuromodulation techniques, have shown tremendous potential for the prevention and treatment of CIPN. Of these, there is strong evidence supporting acupuncture, PA, and herbal medicine. However, existing clinical studies are also limited by the heterogeneity of study methods, insufficient sample size, and poor study design. Further studies are needed to validate the efficacy of CAM in patients with CIPN and to elucidate potential therapeutic mechanisms. CONCLUSIONS Current research has reached a preliminary conclusion suggesting the potential efficacy of certain CAMs in the management of CIPN. Future clinical trials should incorporate more robust study design protocols and larger sample sizes to enhance the validity of findings.
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Affiliation(s)
- Jialin Gu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hongqun Zhang
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Miao Hu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Ling Liu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chen Chen
- Department of Oncology, Yancheng Hospital Affiliated to Nanjing University of Chinese Medicine, Yancheng, Jiangsu, China
| | - Jianmei Wang
- Department of Oncology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Fabing Zhu
- Department of General Surgery, Yancheng Second People's Hospital, Yancheng, Jiangsu, China
| | - Guoli Wei
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Oncology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China; Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
| | - Jiege Huo
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
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Taniura T, Ishitobi K, Hidaka M, Harada M. Modulatory effects of supplementation of Lentinula edodes mycelia extract and l-arginine on the therapeutic efficacy of immunogenic chemotherapy in colon cancer-bearing mice. Microbiol Immunol 2024; 68:15-22. [PMID: 37964433 DOI: 10.1111/1348-0421.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023]
Abstract
Some chemotherapeutic drugs can induce cancer cell death and enhance antitumor T-cell immunity in cancer-bearing hosts. Immunomodulatory reagents could augment such chemotherapy-induced effects. We previously reported that oral digestion of Lentinula edodes mycelia (L.E.M.) extract or l-arginine supplementation can augment antitumor T-cell responses in cancer-bearing mice. In this study, the effects of L.E.M. extract with or without l-arginine on the therapeutic efficacy of immunogenic chemotherapy by 5-fluorouracil (5-FU)/oxaliplatin (L-OHP) and/or cyclophosphamide (CP) are examined using two mouse colon cancer models. In MC38 and CT26 cancer models, therapy with 5-FU/L-OHP/CP significantly suppressed tumor growth, and supplementation with L.E.M. extract halved the tumor volumes. However, the modulatory effect of L.E.M. extract was not significant. In the CT26 cancer model, supplementation with L.E.M. extract and l-arginine had no clear effect on tumor growth. In contrast, their addition to chemotherapy halved the tumor volumes, although the effect was not significant. There was no difference in the cytotoxicity of tumor-specific cytotoxic T cells generated from CT26-cured mice treated by chemotherapy alone versus chemotherapy combined with L.E.M. extract/ l-arginine. These results indicate that the antitumor effects of immunogenic chemotherapy were too strong to ascertain the effects of supplementation of L.E.M. extract and l-arginine, but these reagents nonetheless have immunomodulatory effects on the therapeutic efficacy of immunogenic chemotherapy in colon cancer-bearing mice.
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Affiliation(s)
- Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Masaaki Hidaka
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Mamoru Harada
- Department of Immunology, Shimane University Faculty of Medicine, Shimane, Japan
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Nehme M, Braillard O, Rodondi PY, Guessous I. Use of complementary medicine and its association with SARS-CoV-2 vaccination during the COVID-19 pandemic: a longitudinal cohort study. Swiss Med Wkly 2023; 153:3505. [PMID: 38579302 DOI: 10.57187/s.3505] [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: 04/07/2024] Open
Abstract
AIMS OF THE STUDY Patients are increasingly using and requesting complementary medicine therapies, especially during the COVID-19 pandemic. However, it remains unclear whether they use them in conjunction with conventional medicine or to replace vaccination or other approaches and whether they discuss them with their physicians as part of shared decision-making. This study aimed to evaluate the use and initiation of complementary medicine during the COVID-19 pandemic, focusing on the association between complementary medicine use and COVID-19 vaccination status. METHODS This study is a part of the longitudinal cohort of the CoviCare program, which follows all outpatients tested for COVID-19 at the Geneva University Hospitals. Outpatients tested for COVID-19 were contacted 12 months after their positive or negative test between April and December 2021. Participants were asked about their vaccination status and if they had used complementary medicine in the past 12 months. Complementary medicine use was defined based on a specific list of therapies from which participants could choose the options they had used. Logistic regression models adjusting for age, sex, education, profession, severe acute respiratory system coronavirus 2 (SARS-CoV-2) infection, and pre-existing conditions were used to evaluate the association between being unvaccinated and complementary medicine use. SARS-CoV-2 infection status was evaluated for effect modification in the association between being unvaccinated and complementary medicine use. RESULTS This study enrolled 12,246 individuals (participation proportion = 17.7%). Their mean age was 42.8 years, 59.4% were women, and 63.7% used complementary medicine. Complementary medicine use was higher in women, the middle-aged, and those with a higher education level, a SARS-CoV-2 infection, or pre-existing comorbidities. A third of cases initiated complementary medicine therapies as prevention against COVID-19. Being unvaccinated was associated with complementary medicine use (adjusted odds ratio [aOR] 1.22 [1.09-1.37]), and more specifically when these therapies were used for COVID-19 prevention (aOR 1.61 [1.22-2.12]). Being unvaccinated was associated with the use of zinc (aOR 2.25 [1.98-2.55]), vitamin D (aOR 1.45 [1.30-1.62]), and vitamin C (aOR 1.59 [1.42-1.78]), and more specifically when these therapies were used for COVID-19 prevention. Only 4% of participants discussed using complementary medicine with their primary care physicians. CONCLUSION While complementary medicine is increasingly used, it is rarely discussed with primary care physicians. Complementary medicine use, especially for COVID-19 prevention, is associated with COVID-19 vaccination status. Communication between physicians, patients, and complementary medicine therapists is encouraged to facilitate a truly holistic approach to making a shared decision based on the best available information.
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Affiliation(s)
- Mayssam Nehme
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Braillard
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre-Yves Rodondi
- Institute of Family Medicine, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Idris Guessous
- Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Schils A, Lechon AS, Rondeaux S, Souard F, Van Laethem JL, Pochet S, Mathieu V, De Vriese C. Cancer patients' behaviors and attitudes toward natural health products. BMC Complement Med Ther 2023; 23:442. [PMID: 38057795 DOI: 10.1186/s12906-023-04278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Natural health products (NHPs), including vitamins, minerals, and herbal supplements, are the most common complementary and alternative medicine (CAM) among cancer patients. Our survey determined the attitudes and behaviors of cancer patients toward natural complementary therapies that should be considered to implement an integrative approach in the future. METHODS Our survey was conducted in four hospitals in Belgium. Questionnaires were posted online from October 2020 to October 2021 for cancer patients. Descriptive statistics were used to analyze the data. A [Formula: see text] test was applied to study the type of NHP consumed according to diagnosis time. Fischer's exact test compared patients who had changed their consumption since diagnosis and those who had not. RESULTS Out of 349 questionnaires collected, only 59 met all inclusion criteria. 83.1 % of the patients agreed that conventional medicine (CM) could benefit from complementary therapies, but they did not estimate (72.3 % of the patients) that those latter are more effective than conventional medicine. More than half of the patients used five or more NHPs. The most frequent NHPs consumed daily were vitamins (64.4 %), followed by other products (i.e., probiotics, gemmotherapy, birch sap and omega 3/6) (42.4 %) and herbs (40.7 %). Almost all patients started taking NHPs before their cancer diagnosis, but 72.7 % have changed their consumption significantly (p = 0.009) since their diagnosis. Boosting the immune system (79.7 %) and limiting conventional treatment side effects (76.9 %) were the most common reasons for NHPs' use. 74.4 % of the patients did not take complementary therapies to delay or avoid conventional treatment. CONCLUSIONS The combination and high diversity of NHPs consumption highlight the importance of educating patients and healthcare providers (HCPs) about the risk of drug interactions associated with these natural products. Most cancer patients are more interested in using this non-mainstream medicine to complement their conventional treatment than as an alternative. Knowing the patients' reasons and understanding patients' attitudes toward NHPs will be essential for HCPs to address NHPs' use.
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Affiliation(s)
- Audrey Schils
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Anne-Sophie Lechon
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Sarah Rondeaux
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Florence Souard
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Jean-Luc Van Laethem
- Department of Gastroenterology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium
| | - Stephanie Pochet
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Veronique Mathieu
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Carine De Vriese
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium.
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García-Padilla P, García-Padilla D, Ramírez-Castro MF, Pulido-Rincón P, Murillo R. Patient-doctor interactions around alternative and complementary medicine in the context of oncology care in a Latin American country. Complement Ther Med 2023; 78:102986. [PMID: 37734425 DOI: 10.1016/j.ctim.2023.102986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To characterize doctor-patient communication patterns around the use of complementary and alternative medicines (CAM) in the context of oncology care in Colombia. METHODS A qualitative study was conducted using snowball sampling until data saturation was reached. We included oncology specialists and cancer patients who were in active treatment. Semi-structured interviews were conducted following a guide designed for each group of participants. An analysis based on open coding was performed to identify thematic areas. The coherence of emerging categories was verified by contrasting the data set within the content of the participants' reports and existing literature. RESULTS In total, 10 oncologists and 16 cancer patients were included, representing diverse professional fields and cancer diagnoses, respectively. Communication patterns comprise themes regarding the beginning of the interaction (i.e., patient's anticipations), the patient-doctor relationship (i.e., confidence), the characteristics of the message (i.e., synthetic vs explanatory), the communication styles (i.e., confrontational vs conciliatory), and the closing of the interaction (i.e., continuity vs. end of communication). In addition, extrinsic factors influencing communication were found to be related to participants (i.e., knowledge, cultural background) and context (i.e., institutional procedures). CONCLUSIONS The low frequency of communication contrasts to the increasing use of CAM. Divergent perspectives between doctors and patients could limit shared decision-making on the use of CAM. Enhanced knowledge and education on CAM for both actors is fundamental to improve their interaction and to move away from paternalistic and confrontational communication, particularly in a world region with cultural backgrounds that influence the use of CAM.
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Affiliation(s)
- Pilar García-Padilla
- Centro Javeriano de Oncología - Hospital Universitario San Ignacio, Bogotá, Colombia; Facultad de Psicología, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | | | | | - Paula Pulido-Rincón
- Universidad Isep (Instituto Superior de Estudios Psicológicos), Sinaloa, Mexico
| | - Raúl Murillo
- Centro Javeriano de Oncología - Hospital Universitario San Ignacio, Bogotá, Colombia; Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Hutten RJ, Weil CR, King AJ, Barney B, Bylund CL, Fagerlin A, Gaffney DK, Gill D, Scherer L, Suneja G, Tward JD, Warner EL, Werner TL, Whipple G, Evans J, Johnson SB. Multi-Institutional Analysis of Cancer Patient Exposure, Perceptions, and Trust in Information Sources Regarding Complementary and Alternative Medicine. JCO Oncol Pract 2023; 19:1000-1008. [PMID: 37722084 DOI: 10.1200/op.23.00179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/02/2023] [Accepted: 07/11/2023] [Indexed: 09/20/2023] Open
Abstract
PURPOSE Complementary and alternative medicine (CAM) use during cancer treatment is controversial. We aim to evaluate contemporary CAM use, patient perceptions and attitudes, and trust in various sources of information regarding CAM. METHODS A multi-institutional questionnaire was distributed to patients receiving cancer treatment. Collected information included respondents' clinical and demographic characteristics, rates of CAM exposure/use, information sources regarding CAM, and trust in each information source. Comparisons between CAM users and nonusers were performed with chi-squared tests and one-way analysis of variance. Multivariable logistic regression models for trust in physician and nonphysician sources of information regarding CAM were evaluated. RESULTS Among 749 respondents, the most common goals of CAM use were management of symptoms (42.2%) and treatment of cancer (30.4%). Most CAM users learned of CAM from nonphysician sources. Of CAM users, 27% reported not discussing CAM with their treating oncologists. Overall trust in physicians was high in both CAM users and nonusers. The only predictor of trust in physician sources of information was income >$100,000 in US dollars per year. Likelihood of trust in nonphysician sources of information was higher in females and lower in those with graduate degrees. CONCLUSION A large proportion of patients with cancer are using CAM, some with the goal of treating their cancer. Although patients are primarily exposed to CAM through nonphysician sources of information, trust in physicians remains high. More research is needed to improve patient-clinician communication regarding CAM use.
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Affiliation(s)
- Ryan J Hutten
- Department of Radiation Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT
| | - Christopher R Weil
- Department of Radiation Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT
| | - Andy J King
- Department of Communication, University of Utah, Salt Lake City, UT
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT
| | - Brandon Barney
- Department of Radiation Oncology, Intermountain Cancer Centers, Salt Lake City, UT
| | - Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT
- Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT
| | - David K Gaffney
- Department of Radiation Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT
| | - David Gill
- Department of Medical Oncology, Intermountain Cancer Centers, Salt Lake City, UT
| | - Laura Scherer
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Gita Suneja
- Department of Radiation Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT
| | - Jonathan D Tward
- Department of Radiation Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT
| | - Echo L Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT
- College of Nursing, University of Utah, Salt Lake City, UT
| | - Theresa L Werner
- Department of Medicine, Oncology Division, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Gary Whipple
- Department of Radiation Oncology, Intermountain Cancer Centers, Salt Lake City, UT
| | - Jaden Evans
- Department of Radiation Oncology, Intermountain Cancer Centers, Salt Lake City, UT
| | - Skyler B Johnson
- Department of Radiation Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT
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Almouaalamy NA, Banjar LA, Alshaikh HM, Altowairqi JM, Alharbi NM, Alghamdi WA. The prevalence and pattern of complementary and alternative medicine use among cancer patients in a tertiary oncology center: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:5420-5427. [PMID: 37915654 PMCID: PMC10617909 DOI: 10.1097/ms9.0000000000001315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
Background Complementary and alternative medicine (CAM) is widely used nationally and internationally for multiple medical conditions, including different stages of cancer. It is used by the patients for multiple purposes, including to cure diseases or resolve symptoms, as patients have the misconception that natural remedies are safer than radiotherapy and chemotherapy. Objectives The aim of this research is to investigate the prevalence, pattern, and purpose of CAM use by cancer patients at Princess Noorah Oncology Center (PNOC), King Abdulaziz Medical City, in Jeddah (KAMC-JD). Methods This was a cross-sectional study that examined 293 patients (selected through random computerized sampling) who were seen at PNOC during the study period. To be eligible for the study, participants had to be cancer patients over the age of 18 who were seen at PNOC. The authors excluded patients who had privacy requests or did not fit our inclusion criteria. Results Of the sample, 52.9% [95% confidence interval (CI), 47.0-58.7] used CAM. Only 5.8% of patients delayed their medical treatment to use CAM. A significantly higher proportion of females used CAM than males (61.8% vs. 40.0%, P<0.001). The most common types of CAM were Zamzam water (67.7%), Quran recitation (42.6%), water read upon Quran (41.3%), and black seed (Nigella sativa) (41.3%). The most frequently reported reasons for CAM use were to treat cancer (53.5%), increase immunity (34.2%), and religious beliefs (23.9%). Generally, 57.4% of CAM users felt improvement with CAM modalities. Conclusion In conclusion, more than 50% of our sample used CAM; 5.8% of patients delayed the medical treatment to use CAM. The most common type of CAM was Zamzam water, and the most frequently reported reason for CAM use was to treat cancer. Of CAM users, 57.4% felt improvement with CAM modalities. Further studies that involve qualitative designs and include a more diverse sample are recommended in the Kingdom of Saudi Arabia to understand CAM utilization patterns.
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Affiliation(s)
- Nabil Abdullah Almouaalamy
- Oncology Department, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs
- King Abdullah International Medical Research Centre
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
| | - Lama A. Banjar
- Home Health Care Department, King Abdullah Medical Complex
| | - Haifa M. Alshaikh
- Palliative Care Department, East Jeddah Hospital, Jeddah, Saudi Arabia
| | - Jood M. Altowairqi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
| | - Nuha M. Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
| | - Waad A. Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
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Bally JMG, Burles M, Spurr S, McGrath J. Exploring the Use of Arts-Based Interventions and Research Methods in Families of Seriously Ill Children: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:395-416. [PMID: 37128884 PMCID: PMC10629247 DOI: 10.1177/10748407231165119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Family care is essential to pediatric nursing practice, as the entire family is affected by childhood illness. However, little is known about art making for therapeutic purposes and how art is used to better understand families' experiences. Our purpose was to examine the nature of arts-based interventions and research methods used with, and the experiences of families of children facing life-limiting and life-threatening illnesses, and those families who are bereaved. Academic peer-reviewed sources published between January 1999 and May 2022 were retrieved via four databases using key search terms. Twenty-five articles were analyzed, resulting in three multifaceted categories including Social, Emotional, and Family Health. Critical strengths and limitations were also identified. Art making has been incorporated into interventions and research studies due to its benefits for family well-being. Understanding the potential of art making can inspire nurses to implement such activities to enhance family nursing practice and research.
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12
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Jin Q, Liu L, Chen Y, Yin P. Non-pharmaceutical interventions in complementary and alternative medicine for insomnia in breast cancer survivors: a protocol for a systematic review and network meta-analysis. BMJ Open 2023; 13:e071784. [PMID: 37142314 PMCID: PMC10163449 DOI: 10.1136/bmjopen-2023-071784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Insomnia has a high incidence in patients with breast cancer, which not only affects the quality of life of patients, but also affects the efficiency of later treatment and rehabilitation. Although the sedative and hypnotic drugs commonly used in clinical practice have a rapid onset of action, they are also accompanied by different degrees of sequelae, withdrawal effects and dependence and addiction. Complementary and alternative medicine (CAM) or complementary and integrative medicine, complementary integrative therapies, including natural nutritional supplement therapy, psychotherapy, physical and mental exercise, physiotherapy, have been reported to be used to treat cancer-related insomnia. Its clinical results are increasingly recognised and accepted by patients. However, the effectiveness and safety of these CAM are uneven, and there is no standard clinical application method. Therefore, in order to objectively evaluate the effects of different non-pharmaceutical interventions in CAM on insomnia, we will conduct a network meta-analysis (NMA) to explore the effects of different CAM interventions on improving sleep quality in patients with breast cancer. METHODS AND ANALYSIS We will search all Chinese and English databases from the inception of the database to 31 December 2022. The databases include PubMed, Medline, Embase, Web of Science and Cochrane Central Register of Controlled Trials and the Chinese literature databases include CBM, CNKI, VIP, WANFANG. The Insomnia Severity Index and the Pittsburgh Sleep Quality Index will be considered as the primary outcomes in the study. STATA V.15.0 software will be used to conduct pairwise meta-analysis and NMA. Finally, we will use the recommended risk assessment tool RoB2 for risk and bias assessment, and use the Grading of Recommendations Assessment, Development and Evaluation evaluation method to evaluate the quality of evidence. ETHICS AND DISSEMINATION Ethical approval will not be required because the study will not include the original information of participants. The results will be published in a peer-reviewed journal or disseminated in relevant conferences. PROSPERO REGISTRATION NUMBER CRD42022382602.
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Affiliation(s)
- Qi Jin
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Acupuncture Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Lumin Liu
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuelai Chen
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Yin
- Sleep Medicine Center, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Gahtori R, Tripathi AH, Kumari A, Negi N, Paliwal A, Tripathi P, Joshi P, Rai RC, Upadhyay SK. Anticancer plant-derivatives: deciphering their oncopreventive and therapeutic potential in molecular terms. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2023. [DOI: 10.1186/s43094-023-00465-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Over the years, phytomedicines have been widely used as natural modalities for the treatment and prevention of various diseases by different ethnic groups across the globe. Although, 25% of drugs in the USA contain at least one plant-derived therapeutic compound, currently there is a paucity of plant-derived active medicinal ingredients in the pharmaceutical industry. Scientific evidence-based translation of plant-derived ethnomedicines for their clinical application is an urgent need. The anticancer and associated properties (antioxidative, anti-inflammatory, pro-apoptotic and epithelial-mesenchymal transition (EMT) inhibition) of various plant extracts and phytochemicals have been elucidated earlier. Several of the plant derivatives are already in use under prophylactic/therapeutic settings against cancer and many are being investigated under different phases of clinical trials.
Main body
The purpose of this study is to systematically comprehend the progress made in the area of prophylactic and therapeutic potential of the anticancerous plant derivatives. Besides, we aim to understand their anticancer potential in terms of specific sub-phenomena, such as anti-oxidative, anti-inflammatory, pro-apoptotic and inhibition of EMT, with an insight of the molecules/pathways associated with them. The study also provides details of classes of anticancer compounds, their plant source(s) and the molecular pathway(s) targeted by them. In addition to the antioxidative and antiproliferative potentials of anticancer plant derivatives, this study emphasizes on their EMT-inhibition potential and other ‘anticancer related’ properties. The EMT is highlighted as a phenomenon of choice for targeting cancer due to its role in the induction of metastasis and drug resistance. Different phytochemicals in pre-clinical or clinical trials, with promising chemopreventive/anticancer activities have been enlisted and the plant compounds showing synergistic anticancer activity in combination with the existing drugs have been discussed. The review also unravels the need of carrying out pan-signalome studies for identifying the cardinal pathways modulated by phytomedicine(s), as in many cases, the molecular pathway(s) has/have been randomly studied.
Conclusion
This review systematically compiles the studies regarding the impact of various plant derivatives in different cancers and oncogenic processes, as tested in diverse experimental model systems. Availability of more comprehensive information on anticancer phyto-constituents, their relative abundance in crude drugs, pathways/molecules targeted by phytomedicines, their long-term toxicity data and information regarding their safe use under the combinatorial settings, would open greater avenues of their utilization in future against this dreaded disease.
Graphical Abstract
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14
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Mohamed A, Karima S, Nadia O. Contextualization and validation of the questionnaire ABCAM (Attitudes and Beliefs about Complementary and Alternative Medicine) in cancer patients in Morocco. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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15
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Casà C, Dinapoli L, Marconi E, Chiesa S, Cornacchione P, Beghella Bartoli F, Bracci S, Salvati A, Scalise S, Colloca GF, Chieffo DPR, Gambacorta MA, Valentini V, Tagliaferri L. Integration of art and technology in personalized radiation oncology care: Experiences, evidence, and perspectives. Front Public Health 2023; 11:1056307. [PMID: 36755901 PMCID: PMC9901799 DOI: 10.3389/fpubh.2023.1056307] [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] [Received: 09/28/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Cancer diagnoses expose patients to traumatic stress, sudden changes in daily life, changes in the body and autonomy, with even long-term consequences, and in some cases, to come to terms with the end-of-life. Furthermore, rising survival rates underline that the need for interventions for emotional wellbeing is in growing demand by patients and survivors. Cancer patients frequently have compliance problems, difficulties during treatment, stress, or challenges in implementing healthy behaviors. This scenario was highlighted during the COVID-19 emergency. These issues often do not reach the clinical attention of dedicated professionals and could also become a source of stress or burnout for professionals. So, these consequences are evident on individual, interpersonal, and health system levels. Oncology services have increasingly sought to provide value-based health care, considering resources invested, with implications for service delivery and related financing mechanisms. Value-based health care can improve patient outcomes, often revealed by patient outcome measures while seeking balance with economical budgets. The paper aims to show the Gemelli Advanced Radiation Therapy (ART) experience of personalizing the patients' care pathway through interventions based on technologies and art, the personalized approach to cancer patients and their role as "co-stars" in treatment care. The paper describes the vision, experiences, and evidence that have guided clinical choices involving patients and professionals in a co-constructed therapeutic pathway. We will explore this approach by describing: the various initiatives already implemented and prospects, with particular attention to the economic sustainability of the paths proposed to patients; the several pathways of personalized care, both from the patient's and healthcare professional perspective, that put the person's experience at the Gemelli ART Center. The patient's satisfaction with the treatment and economic outcomes have been considered. The experiences and future perspectives described in the manuscript will focus on the value of people's experiences and patient satisfaction indicators, patients, staff, and the healthcare organization.
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Affiliation(s)
- Calogero Casà
- UOC di Radioterapia Oncologica, Fatebenefratelli Isola Tiberina, Gemelli Isola, Rome, Italy
| | - Loredana Dinapoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Elisa Marconi
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,*Correspondence: Elisa Marconi ✉
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizia Cornacchione
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Beghella Bartoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Serena Bracci
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessandra Salvati
- Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara Scalise
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giuseppe Ferdinando Colloca
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Scienze della Salute della Donna, del Bambino e di Sanità Pubblica Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tagliaferri
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
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Miladinia M, Jahangiri M, Kennedy AB, Fagerström C, Tuvesson H, Safavi SS, Maniati M, Javaherforooshzadeh F, Karimpourian H. Determining massage dose-response to improve cancer-related symptom cluster of pain, fatigue, and sleep disturbance: A 7-arm randomized trial in palliative cancer care. Palliat Med 2023; 37:108-119. [PMID: 36226676 DOI: 10.1177/02692163221129158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The efficacy of various massage doses in palliative cancer care settings is still debated, and no specific protocol is available. AIM Evaluating response to various massage doses for symptom cluster of pain-fatigue-sleep. DESIGN A 7-arm randomized-controlled trial with weekly massage for 4 weeks depending on the prescribed dose (15-, 30-, or 60-min; 2× or 3×/week) and a 4-week follow-up. The intensities of pain, fatigue, and sleep disturbance were measured using a 0-10 scale at nine-timepoint; baseline, weekly during the intervention, and the follow-up period. Then, the mean scores of the three symptoms were calculated as the symptom cluster intensity at each timepoint. IRCT.ir IRCT20150302021307N5. SETTING/PARTICIPANTS Adults with cancer (n = 273) who reported all three symptoms at three oncology centers in Iran. RESULTS The odds of clinical improvement (at least 30% reduction in symptom cluster intensity from baseline) increased with dose-escalation significantly [(OR = 17.37; 95% CI = 3.87-77.90 for 60-min doses); (OR = 11.71; 95% CI = 2.60-52.69, for 30-min doses); (OR = 4.36; 95% CI = 0.94-20.32, for 15-min doses)]. The effect durability was significantly shorter at 15-min doses compared to 30- and 60-min doses. The odds of improvement for doses 3×/week was not significant compared to doses 2×/week (OR = 12.27 vs OR = 8.34); however, the effect durability for doses 3×/week was significantly higher. CONCLUSIONS The findings indicated that dose-escalation increases the efficacy of massage for the pain-fatigue-sleep symptom cluster. Although the 60-min doses were found to be more effective, the 30-min doses can be considered more practical because they are less costly and time-consuming. Our findings can be helpful to develop massage guidelines in palliative care settings. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT20150302021307N5.
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Affiliation(s)
- Mojtaba Miladinia
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Nursing, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Jahangiri
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ann Blair Kennedy
- Department of Biomedical Sciences, University of South Carolina, School of Medicine Greenville, Greenville, SC, USA.,Department of Family Medicine, Prisma Health, Greenville, SC, USA
| | - Cecilia Fagerström
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.,Department of Research, Region Kalmar County, Kalmar, Sweden
| | - Hanna Tuvesson
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Shadi Sadat Safavi
- School of Healthcare & Social Practice, Unitec Institute of Technology, Auckland, New Zealand
| | - Mahmood Maniati
- School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Javaherforooshzadeh
- Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Karimpourian
- Department of Medical Oncology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mallaiah S, Narayanan S, Wagner R, Cohen C, Christie AJ, Bruera E, Lopez G, Cohen L. Yoga Therapy in Cancer Care via Telehealth During the COVID-19 Pandemic. Integr Cancer Ther 2022; 21:15347354221141094. [PMID: 36510480 PMCID: PMC9749058 DOI: 10.1177/15347354221141094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Yoga is an evidence-based mind-body practice known to improve physical and mental health in cancer patients. We report on the processes and patient-reported outcomes of one-on-one yoga therapy (YT) consultations delivered via telehealth. METHODS For patients completing a YT consultation between March 2020 and October 2021, we examined demographics, reasons for referral, and self-reported symptom burden before and after one YT session using the Edmonton Symptom Assessment Scale (ESAS). Changes in ESAS symptom and subscale scores [physical distress (PHS), psychological distress (PSS), and global distress (GDS)] were evaluated by Wilcoxon signed-rank test. Descriptive statistics summarized the data. RESULTS Ninety-seven initial YT consults were completed, with data evaluated for 95 patient encounters. The majority were women (83.2%) and white (75.8%), The mean age for females was 54.0 and for males was 53.4; the most common diagnosis was breast cancer (48%), 32.6% had metastatic disease, and nearly half (48.4%) were employed full-time. Mental health (43.0%) was the most common reason for referral, followed by fatigue (13.2%) and sleep disturbances (11.7%). The highest symptoms at baseline were sleep disturbance (4.3), followed by anxiety (3.7) and fatigue (3.5). YT lead to clinically and statistically significant reductions in PHS (mean change = -3.1, P < .001) and GDS (mean change = -5.1, P < .001) and significant reductions in PSS (mean change = -1.6, P < .001). Examination of specific symptom scores revealed clinically and statistically significant reductions in anxiety (mean change score -1.34, P < .001) and fatigue (mean change score -1.22, P < .001). Exploratory analyses of patients scoring ≥1 for specific symptoms pre-YT revealed clinically and statistically significant improvements in almost all symptoms and those scoring ≥4 pre-YT. CONCLUSIONS As part of an integrative oncology outpatient consultation service, a single YT intervention delivered via telehealth contributed to a significant improvement in global, physical, and psychosocial distress. Additional research is warranted to explore the long-term sustainability of the improvement in symptoms.
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Affiliation(s)
- Smitha Mallaiah
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Santhosshi Narayanan
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA,S. Narayanan, Department of Palliative, Rehabilitation, and Integrative Medicine, Unit 1414, The University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Houston, TX 77030, USA.
| | - Richard Wagner
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chiara Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriel Lopez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Tagliaferri L, Dinapoli L, Casà C, Colloca GF, Marazzi F, Cornacchione P, Mazzarella C, Masiello V, Chiesa S, Beghella Bartoli F, Marconi E, D'Oria M, Cesario A, Chieffo DPR, Valentini V, Gambacorta MA. Art and digital technologies to support resilience during the oncological journey: The Art4ART project. Tech Innov Patient Support Radiat Oncol 2022; 24:101-106. [PMID: 36387778 PMCID: PMC9641049 DOI: 10.1016/j.tipsro.2022.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/15/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Digital technologies can be useful in welcoming patients using the beauty of art. Cancer patients typically need to be supported in their treatment pathway. Digital entertainment can become a resilience-enhancing strategy. Art4ART project offers an art-based digital supporting patients’ resilience. Art4ART offers a research platform about the role of humanities as cure.
Introduction New digital technologies can become a tool for welcoming the patient through the artistic dimension. Cancer patients, in particular, need support that accompanies and supports them throughout their treatment. Materials and methods The Art4ART project consist in the structural proposal to cancer patients of a web-based digital platform containing several forms of art as video-entertainments; a multimedia immersive room; an art-based welcoming of the patients with several original paintings; an environment with a peacefulness vertical garden; a reconceptualization of the chemotherapy-infusion seats. Data regarding patients’ preference and choices will be stored and analysed also using artificial intelligence (AI) algorithm to measure and predict impact indicators regarding clinical outcomes (survival and toxicity), psychological indicators. Moreover, the same digital platform will contribute to a better organization of the activities. Discussion Through the systematic acquisition of patient preferences and through integration with other clinical parameters, it will be possible to measure the clinical, psychological, organisational, and social impact of the newly implemented Art4ART project. The use of digital technology leads us to apply the reversal of viewpoint from therapeutic acts to patient-centred care.
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Integrative Approaches to the Treatment of Cancer. Cancers (Basel) 2022; 14:cancers14235933. [PMID: 36497414 PMCID: PMC9740147 DOI: 10.3390/cancers14235933] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
A significant proportion of cancer patients use forms of complementary medicine or therapies. An integrative approach to cancer management combines conventional medicine with evidence-based complementary medicines/therapies and lifestyle interventions, for the treatment and prevention of disease and the optimisation of health. Its basis is a holistic one; to treat the whole person, not just the disease. It makes use of adjunct technologies which may assist the clinician in diagnosis of early carcinogenesis and monitoring of treatment effectiveness. Many factors contribute to the development of cancer including some which are largely modifiable by the patient and which oncologists may be in a position to advise on, such as stress, poor nutrition, lack of physical activity, poor sleep, and Vitamin D deficiency. An integrative approach to addressing these factors may contribute to better overall health of the patient and better outcomes. Evidence-based complementary medicine approaches include the use of supplements, herbal medicine, various practices that reduce stress, and physical therapies. Individualised to the patient, these can also help address the symptoms and signs associated with cancer and its orthodox treatment.
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Predictors of herbal medicine use among cancer patients. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04451-x. [DOI: 10.1007/s00432-022-04451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
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Kim JH, Oh KH, Shin HY, Jun JK. How cancer patients get fake cancer information: From TV to YouTube, a qualitative study focusing on fenbendazole scandle. Front Oncol 2022; 12:942045. [PMID: 36387110 PMCID: PMC9650234 DOI: 10.3389/fonc.2022.942045] [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: 05/12/2022] [Accepted: 10/12/2022] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Korean society has faced challenges in communicating with cancer patients about false information related to complementary alternative medicine. As the situation has become severe with the 2020 fenbendazole scandal, the demand for reliable information from health authorities has increased. OBJECTIVES This study aimed to examine patients' acquisition patterns and perception of false information by presenting empirical evidence to help health authorities enable effective preemptive responses in the cancer communication context. METHOD We conducted a focus group interview with 21 lung cancer patients who were informed about fenbendazole based on a semi-structured questionnaire with three categories: 1) acquisition channel of the general cancer information and the false information, 2) quality of obtained information, and 3) perception toward it. The interviewees, comprising 13 men and eight women, were aged 50 or older. Participants' current stages of cancer were stages one, three, and four and there were seven people in each stage. RESULTS 1) Acquisition channel: Participants had their first encounter with false information through the TV, while the channels to obtain general cancer information were through Internet communities or portal sites. YouTube was a second channel to actively search for information regardless of the information type. 2) Information quality: participants had only fragmented information through media. 3) Perception: Most patients had a negative attitude toward complementary and alternative medicine information such as fenbendazole. They perceive that it needs to be verified by experts and filtered according to their arbitrary criteria. They had vague expectations based on a hope for "what if" at the same time. CONCLUSIONS Despite the complex media environment, traditional or legacy media is an important channel to encounter information. YouTube is independent of other media as an "active" information-seeking channel. Patients required the appropriate intervention of experts and governments because they perceived that they had obtained irrational and unreliable information from the media. Suggestions are made about how health authorities can construct an effective communication system focusing on the user to prevent patients from getting false cancer information.
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Affiliation(s)
- Jee Hyun Kim
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Kyoung Hee Oh
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Hye Young Shin
- Department of Nursing, Gangseo University, Seoul, South Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
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22
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Bell JG, McHale J, Elliott JO, Heaton W. The impact of art therapy on anxiety and hope in patients with gynecologic cancer undergoing chemotherapy. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Complementary and Integrative Approaches to Cancer: A Pilot Survey of Attitudes and Habits among Cancer Patients in Italy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2923967. [PMID: 35958921 PMCID: PMC9359845 DOI: 10.1155/2022/2923967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/27/2022] [Indexed: 02/03/2023]
Abstract
Background. Cancer patients are among the main consumers of traditional, complementary, integrative, and alternative medicine (TCIM) such as natural products (herbals, integrators, etc.) and mind and body practices (yoga, acupuncture, etc.). Methods. A questionnaire on TCIM was submitted to 415 Italian cancer patients. The questionnaire consisted of three sections: (i) biographical and clinical information; (ii) use of natural substances; and (iii) use of mind-body practices. Results. 406 patients completed the questionnaire. The prevalence of TCIM use was 72.3%. Of them, 75.6% started to use TCIM after a tumor diagnosis. The main reasons for using TCIM were to mitigate side effects (65.0%), to regain physical and mental balance (35.9%), to relieve pain (18.3%), and to improve the efficacy of cancer therapy (16.0%). 44.7% of patients taking natural products used them during conventional therapies (chemotherapy, radiotherapy, etc.), and in 67.5% of cases without consulting a doctor. As a consequence, only about 50% of patients taking natural substances used these compounds appropriately, and the most common errors were related with the purpose of reducing the side effects of the therapy (52.3%) and for boosting immune system (32.1%). Conclusions. There is an impelling need to provide patients with scientifically validated information to raise awareness about the benefits and risks of using TCIM.
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Relation T, Ndumele A, Bhattacharyya O, Fisher JL, Li Y, Obeng-Gyasi S, Eskander MF, Tsung A, Oppong BA. Surgery Refusal Among Black and Hispanic Women with Non-Metastatic Breast Cancer. Ann Surg Oncol 2022; 29:6634-6643. [PMID: 35513589 DOI: 10.1245/s10434-022-11832-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/15/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies have shown a lower receipt of treatment among minority women with non-metastatic breast cancer. Those who refuse surgery have increased disease-specific mortality, contributing to disproportionately higher breast cancer mortality in non-Hispanic black (NHB) and Hispanic women. This study aimed to assess surgery refusal in these groups, identify factors associated with surgery refusal, and characterize the association between surgery refusal and survival. METHODS Surveillance, Epidemiology, and End Results (SEER) Program data from 2005 to 2015 for NHB and Hispanic women with a diagnosis of non-metastatic breast cancer (n = 113,987) was divided into data of those who underwent surgery and data of those who refused surgery. Sociodemographic and tumor clinical/pathologic differences were analyzed by multivariate logistic regression of predictors of surgery refusal and Cox-proportional hazard model of disease-specific mortality. RESULTS Of 799 patients who refused surgery, 562 were NHB and 237 were Hispanic. The percentage of patients refusing surgery increased from 0.6% in 2005 to 0.9% in 2015. The women who refused surgery were more likely to be older than 81 years, less likely to be married, and more likely to be uninsured or have Medicaid. The refusers presented with more advanced disease and more frequent estrogen receptor-positivity (ER+) and progesterone receptor-positivity (PR+) subtype on histology. Breast cancer-specific mortality increased significantly with surgery omission. Surgery refusal was independently associated with NHB race. CONCLUSION Surgery refusal among NHB and Hispanic women with potentially curable non-metastatic breast cancer is rising, especially among NHB women, women older than 60 years, single women, and women with a later stage of disease at diagnosis. Additional studies are needed to analyze qualitative data in these populations and their underlying health beliefs, communication needs, and possible use of alternative medicine.
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Affiliation(s)
- Theresa Relation
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Amara Ndumele
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Oindrila Bhattacharyya
- Department of Economics, Indiana University Purdue University, Indianapolis, IN, USA.,The William Tierney Center for Health Services Research, Regenstrief Institute, Inc, Indianapolis, IN, USA
| | - James L Fisher
- James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Yaming Li
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Mariam F Eskander
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Allan Tsung
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Bridget A Oppong
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA.
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Mohamed A, Karima S, Nadia O. The Use of Medicinal Plants Against Cancer: An Ethnobotanical Study in the Beni Mellal-Khenifra Region in Morocco. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Complementary and Alternative Medicine Use in Hospitalized Cancer Patients—Study from Silesia, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031600. [PMID: 35162621 PMCID: PMC8835686 DOI: 10.3390/ijerph19031600] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/16/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022]
Abstract
Background: The use of complementary and alternative medicine (CAM) is common amongst cancer patients. The aim of the study was to investigate the use of CAM, beliefs about CAM and the purpose of using it amongst Polish cancer patients. Methods: The study included 864 cancer patients (median 63 years old), who were individually interviewed. The questionnaire was designed specifically for this study. Results: Amongst 732 patients who declared that they heard about CAM, 342 patients (46.7%) had used CAM; 91% of these patients had used it as a complementary therapy and 9% had used it as an alternative therapy. Patients younger in age, highly educated, professionally active, with longer medical history, and at more advanced cancer stages have, statistically, used CAM more often; 66% of participants could not state what the health effect of CAM is. Patients received information about CAM from the internet, friends, family and other patients. Only 18% of patients discussed using CAM with a doctor. Conclusions: CAM was popular amongst Polish cancer patients, especially in younger, educated and professionally active patients with longer cancer history at advanced stage. Patients used CAM as a complementary therapy for strengthening immune system, improving morphological and biochemical test parameters, reducing the side effects of conventional therapy and improving their well-being.
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27
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Nakandi K, Mora D, Stub T, Kristoffersen AE. Conventional health care service utilization among cancer survivors that visit traditional and complementary providers in the Tromsø study: a cross-sectional study. BMC Health Serv Res 2022; 22:53. [PMID: 35016666 PMCID: PMC8751219 DOI: 10.1186/s12913-021-07445-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/21/2021] [Indexed: 11/11/2022] Open
Abstract
Background Traditional and complementary medicine (T&CM) is commonly used among cancer patients worldwide. Cancer patients in Norway mainly visit T&CM providers in addition to conventional health care services. It is not known how their utilization of T&CM providers influences their use of conventional health care services. The aim of this study was to investigate the difference between the utilization of conventional health care services among cancer survivors that visit T&CM providers and those that do not, and their associated factors. Method Health care service utilization data were obtained from cancer survivors 40 years and above participating in the Tromsø Study: Tromsø 7 conducted in 2015–2016. Data were collected from self-administered questionnaires. Pearson chi-square tests, Fisher exact tests, t-test, and logistic regression were used, with the significance level considered at p < 0.05. Results Of 1553 individuals, 10% (n = 155) reported visiting T&CM providers in the past 12 months. As both cancer survivors visiting and not visiting T&CM providers were frequent users of conventional health care, no significant differences were found in the overall use of conventional health care (98.1vs.94.5%, p = .056). Users of T&CM providers were however more likely to visit physiotherapists (40.1% vs 25%, p < .001), emergency rooms (29.2% vs 16.5%, p < .001), chiropractors (17% vs 6%, p < .001), and psychologist/psychiatrist (8.9% vs 3.4%, p < .001). They also had more frequent visits to conventional health care (11.45 vs 8.31 yearly visits, p = 0.014), particularly to general practitioners (5.21 visits vs. 3.94 visits, p = .002). Conclusion Results from this study show that visits to T&CM providers are associated with more visits to conventional health care services among cancer survivors. Further studies are needed to investigate the reasons for this high use behavior.
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Wells JC, Sidhu A, Ding K, Smoragiewicz M, Heng DYC, Shepherd FA, Ellis PM, Bradbury PA, Jonker DJ, Siu LL, Gelmon KA, Karapetis C, Shapiro J, Nott L, O’Callaghan CJ, Parulekar WR, Seymour L, Monzon JG. OUP accepted manuscript. Oncologist 2022; 27:e286-e293. [PMID: 35274718 PMCID: PMC8914495 DOI: 10.1093/oncolo/oyac020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 11/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background Complementary medicines (CM) are frequently used by patients with cancer. Controversy exists over the effectiveness and risk that CM may add to conventional cancer therapy. The incidence of CM use among patients enrolled in phase III clinical trials is unknown. Methods Medication lists from 6 international phase III clinical trials were retrospectively reviewed to identify patients using CM. Patients had metastatic breast, colorectal, or lung cancers. Quality of life, adverse events, overall survival, and progression-free survival were compared between CM users and non-users. Baseline differences between groups were adjusted with propensity score matching groups. Results Seven hundred and six of 3446 patients (20.5%) used at least one CM. CM use was highest among patients with breast cancer (35.6%). CM users had more favorable baseline prognostic factors (ECOG 0-1, non-smoking status, younger age, and fewer metastases). CM use was associated with lower rates of adverse events (50% vs. 62%, P = .002) and quality of life was similar between both groups. After adjustment with propensity score matching, CM use was also associated with longer overall survival in patients with lung cancer (adjusted hazard ratio 0.80, 95%CI, 0.68-0.94, P =.0054). However, several key control variables like EGFR status were not available. Conclusion One in 5 patients in phase III clinical trials report using CM. CM was not associated with worse cancer-specific outcomes. However, CM users had more favorable baseline prognostic factors, and likely other confounders that may have contributed to improved outcomes observed in the lung cohort. Physicians should monitor for CM use and potential interactions with clinical trial drugs.
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Affiliation(s)
| | - Aven Sidhu
- Fraser Health and Veralife Health Centre, Surrey, BC, Canada
| | - Keyue Ding
- Canadian Cancer Trials Group, Kingston, ON, Canada
| | | | - Daniel Y C Heng
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
| | - Frances A Shepherd
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Peter M Ellis
- Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - Penelope A Bradbury
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | | - Lillian L Siu
- Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | | | | | - Jose G Monzon
- Corresponding author: Jose G. Monzon, Department of Medical Oncology, Tom Baker Cancer Center, University of Calgary, 1331 29 St NW, Calgary, AB, Canada T2N 4N2. Tel: +1 403 521 3688;
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Fernando SS, Paige EK, Dendle C, Weinkove R, Kong DCM, Omond P, Routledge DJ, Szer J, Blyth CC. Consensus guidelines for improving patients' understanding of invasive fungal disease and related risk prevention in the haematology/oncology setting, 2021. Intern Med J 2021; 51 Suppl 7:220-233. [PMID: 34937138 DOI: 10.1111/imj.15593] [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: 01/04/2023]
Abstract
Patients with invasive fungal disease (IFD) are at significant risk of morbidity and mortality. A productive partnership between patients, their carers/families, and the multidisciplinary team managing the infection and any underlying conditions, is essential. Sharing information and addressing knowledge gaps are required to ensure those at risk of IFD avoid infection, while those with suspected or confirmed infection optimise their therapy and avoid toxicities. This new addition to the Australian and New Zealand consensus guidelines for the management of IFD and antifungal use in the haematology/oncology setting outlines the key information needs of patients and their carers/families. It specifically addresses risk factor reduction, antifungal agents and adherence, and the risks and benefits of complementary and alternative therapies. Knowledge gaps are also identified to help inform the future research agenda.
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Affiliation(s)
| | - Emma K Paige
- Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
| | - Claire Dendle
- Infection and Immunity Service, Monash Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robert Weinkove
- Wellington Blood and Cancer Centre, Capital and Coast District Health Board, Wellington, New Zealand.,Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand
| | - David C M Kong
- Pharmacy Department, Ballarat Health Service, Ballarat, Victoria, Australia.,Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.,National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Paul Omond
- National Centre for Infections in Cancer, Melbourne, Victoria, Australia.,Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - David J Routledge
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jeff Szer
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Department of Paediatric Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.,Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Perth, Western Australia, Australia
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Effects of yoga in men with prostate cancer on quality of life and immune response: a pilot randomized controlled trial. Prostate Cancer Prostatic Dis 2021; 25:531-538. [PMID: 34815548 PMCID: PMC9124736 DOI: 10.1038/s41391-021-00470-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
Abstract
Background Diagnosis and treatment of prostate cancer is associated with anxiety, fear, and depression in up to one-third of men. Yoga improves health-related quality of life (QoL) in patients with several types of cancer, but evidence of its efficacy in enhancing QoL is lacking in prostate cancer. Methods In this randomized controlled study, 29 men newly diagnosed with localized prostate cancer were randomized to yoga for 6 weeks (n = 14) or standard-of-care (n = 15) before radical prostatectomy. The primary outcome was self-reported QoL, assessed by the Expanded Prostate Index Composite (EPIC), Functional Assessment of Cancer Therapy-Prostate (FACT-P), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT–F), Functional Assessment of Cancer Therapy-General (FACT-G) at baseline, preoperatively, and 6 weeks postoperatively. Secondary outcomes were changes in immune cell status and cytokine levels with yoga. Results The greatest benefit of yoga on QoL was seen in EPIC-sexual (mean difference, 8.5 points), FACIT-F (6.3 points), FACT-Functional wellbeing (8.6 points), FACT-physical wellbeing (5.5 points), and FACT-Social wellbeing (14.6 points). The yoga group showed increased numbers of circulating CD4+ and CD8+ T-cells, more production of interferon-gamma by natural killer cells, and increased Fc receptor III expression in natural killer cells. The yoga group also showed decreased numbers of regulatory T-cells, myeloid-derived suppressor cells, indicating antitumor activity, and reduction in inflammatory cytokine levels (granulocyte colony-stimulating factor [0.55 (0.05–1.05), p = 0.03], monocyte chemoattractant protein [0.22 (0.01–0.43), p = 0.04], and FMS-like tyrosine kinase-3 ligand [0.91 (−0.01, 1.82), p = 0.053]. Conclusions Perioperative yoga exercise improved QoL, promoted an immune response, and attenuated inflammation in men with prostate cancer. Yoga is feasible in this setting and has benefits that require further investigation. Trial registration clinicaltrials.org (NCT02620033).
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Sleep disturbance in cancer patients referred to an ambulatory integrative oncology consultation. Support Care Cancer 2021; 30:2417-2425. [PMID: 34762218 DOI: 10.1007/s00520-021-06668-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Sleep disturbance (SD) is highly prevalent in oncology and negatively affects quality of life and mortality. Evidence supports the use of integrative oncology (IO) practices to treat SD, but there is limited published data on the characteristics of SD and factors associated with SD in IO. We determined the prevalence, severity, and factors associated with SD among cancer patients seen in an ambulatory IO consultation. METHODS Patients with cancer referred for initial outpatient IO consultation in 2017 were eligible. Patient demographics, clinical characteristics, and patient-reported outcomes (Edmonton Symptom Assessment Scale (ESAS), Measure Yourself Concerns and Wellbeing (MYCaW), PROMIS-10) were retrospectively reviewed. RESULTS One thousand five hundred twenty patients were included in the analysis. The majority (70%) were women with breast cancer (42%). Nine hundred seventy-one (64%) patients reported significant SD with ESAS Sleep ≥ 4, yet only 11% expressed poor sleep as their primary or secondary concern for the IO consultation. The median SD (IQR) was 5 (3,7). ESAS scores for fatigue (adjusted OR 1.16; CI 1.07-1.26, p < 0.001), pain (adjusted OR 1.07; CI 1.00-1.15, p < 0.05), hot flashes (adjusted OR 1.14; CI 1.07-1.22, p < 0.001), well-being (adjusted OR 1.33; CI 1.22-1.46, p < 0.001), and psychological distress score (anxiety and depression) (adjusted OR 1.16; CI 1.01-1.11, p < 0.01) were independently associated with SD in multivariate analysis. Acupuncture was the most frequent intervention prescribed, 175 (35%). Other modalities included oncology massage (15%), health psychology (5%), and meditation (1%). CONCLUSIONS Although 64% of patients seeking IO consultation reported clinically significant SD, only 11% were seeking integrative approaches for managing SD. ESAS fatigue, hot flashes, well-being, and psychological symptoms were significantly associated with SD.
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Rizzo G, Goggi S, Giampieri F, Baroni L. A review of mushrooms in human nutrition and health. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2020.12.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Use of complementary traditional phytotherapy to manage cancer in Morocco: A decade-long review of ethnopharmacological studies. J Herb Med 2021. [DOI: 10.1016/j.hermed.2021.100494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Butler TW, Hande K, Ryan M, Raman R, McDowell MR, Cones B, Jackson HJ, Cortez M, Murphy BA. Cannabidiol: Knowledge, Beliefs, and Experiences of Patients With Cancer. Clin J Oncol Nurs 2021; 25:405-412. [PMID: 34269337 DOI: 10.1188/21.cjon.405-412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cannabidiol (CBD) is purported to work for a variety of therapeutic indications. Interest in CBD products has significantly increased as patients with cancer seek ways to improve symptom control and quality of life. OBJECTIVES The purpose of this study was to explore patients' knowledge of and experience with CBD. METHODS A panel of oncology nurse practitioners, an oncologist, and oncology pharmacy specialists developed a survey to capture information about patient knowledge and use of CBD. The initial survey was pilot tested and further refined, resulting in the final item survey. The final survey was administered to 100 participants undergoing or having completed cancer treatment and being followed in a supportive oncology care clinic at a large academic medical center. FINDINGS Most patients learned about CBD through a family member or friend. The majority of patients had never tried CBD. The most common reported indications were pain, anxiety, and nausea. Of those who had not tried CBD, the most common reasons included lack of knowledge about CBD and providers not recommending CBD.
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Wolf CPJG, Rachow T, Ernst T, Hochhaus A, Zomorodbakhsch B, Foller S, Rengsberger M, Hartmann M, Huebner J. Complementary and alternative medicine (CAM) supplements in cancer outpatients: analyses of usage and of interaction risks with cancer treatment. J Cancer Res Clin Oncol 2021; 148:1123-1135. [PMID: 34228225 PMCID: PMC9016053 DOI: 10.1007/s00432-021-03675-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 11/25/2022]
Abstract
Purpose The aim of our study was to analyze the use of complementary and alternative medicine (CAM) supplements, identify possible predictors, and analyze and compile potential interactions of CAM supplements with conventional cancer therapy. Methods We included outpatient cancer patients treated at a German university hospital in March or April 2020. Information was obtained from questionnaires and patient records. CAM–drug interactions were identified based on literature research for each active ingredient of the supplements consumed by the patients. Results 37.4% of a total of 115 patients consumed CAM supplements. Potential interactions with conventional cancer treatment were identified in 51.2% of these patients. All types of CAM supplements were revealed to be a potential source for interactions: vitamins, minerals, food and plant extracts, and other processed CAM substances. Younger age (< 62 years) (p = 0.020, φc = 0.229) and duration of individual cancer history of more than 1 year (p = 0.006, φc = 0.264) were associated with increased likelihood of CAM supplement use. A wide range of different CAM supplement interactions were reviewed: effects of antioxidants, cytochrome (CYP) interactions, and specific agonistic or antagonistic effects with cancer treatment. Conclusion The interaction risks of conventional cancer therapy with over-the-counter CAM supplements seem to be underestimated. Supplements without medical indication, as well as overdoses, should be avoided, especially in cancer patients. To increase patient safety, physicians should address the risks of interactions in physician–patient communication, document the use of CAM supplements in patient records, and check for interactions.
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Affiliation(s)
- Clemens P J G Wolf
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Tobias Rachow
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Pneumologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Thomas Ernst
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Konservative Tagesklinik des UniversitätsTumorCentrums (UTC), Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | | | - Susan Foller
- Klinik für Urologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Matthias Rengsberger
- Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Michael Hartmann
- Apotheke des Universitätsklinikums, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Jutta Huebner
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Integrative Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9963038. [PMID: 34055029 PMCID: PMC8149249 DOI: 10.1155/2021/9963038] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 05/08/2021] [Indexed: 12/24/2022]
Abstract
Background Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.
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Tan PY, Anand SP, Chan DXH. Post-mastectomy pain syndrome: A timely review of its predisposing factors and current approaches to treatment. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211006419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Post-mastectomy pain syndrome (PMPS) has been reported to occur in 25–60% of patients following surgeries for breast cancer, the highest occurring cancer in women worldwide. There has been much research interest due to this high prevalence. However, there is still a lack of incorporation of PMPS prevention strategies in standard perioperative plans, and our understanding of this condition is still incomplete. Objectives: This narrative review discusses recent literature on modifiable risk factors, current approaches to prevention and treatment and potential directions for future treatment and research. Methods: A PubMed search with the relevant keywords was done for articles published in the last 10 years. Results: The incidence of PMPS can be reduced by early recognition and management of modifiable risk factors as well as the perioperative use of analgesics and regional nerve blocks. These also have a significant role in the management of established PMPS together with surgical interventions and physical therapy. Conclusions: PMPS is still poorly defined and hence underdiagnosed and undertreated at this point. Perioperative peripheral nerve blocks have a very promising role as preventive analgesia to reduce the risk of developing PMPS, but large-scale randomised controlled studies will need to be done to evaluate their comparative efficacy. There is a need to prioritise PMPS prevention as a standard inclusion into the perioperative plans of mastectomy patients.
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Affiliation(s)
- Pei Yu Tan
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore Health Services, Singapore
| | - Singh Prit Anand
- Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore Health Services, Singapore
| | - Diana Xin Hui Chan
- Division of Anaesthesiology and Perioperative Medicine, Department of Pain Medicine, Singapore General Hospital, Singapore Health Services, Singapore
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The use of complementary and integrative therapies as adjunct interventions during radiotherapy: a systematic review. Support Care Cancer 2021; 29:6201-6209. [PMID: 33822240 DOI: 10.1007/s00520-021-06173-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/21/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Literature supporting the efficacy of complementary and integrative medicine (CIM) alongside radiotherapy is fragmented with varying outcomes and levels of evidence. This review summarizes the available evidence on CIM used with radiotherapy in order to inform clinicians. METHODS A systematic literature review identified studies on the use of CIM during radiotherapy. Inclusion required the following criteria: the study was interventional, CIM therapy was for human patients with cancer, and CIM therapy was administered concurrently with radiotherapy. Data points of interest were collected from included studies. A subset was identified as high-quality using the Jadad scale. Fisher's exact test was used to assess the association between study results, outcome measured, and type of CIM. RESULTS Overall, 163 articles met inclusion. Of these, 68 (41.7%) were considered high-quality trials. Articles published per year increased over time (p < 0.01). Frequently identified therapies were biologically based therapies (47.9%), mind-body therapies (23.3%), and alternative medical systems (13.5%). Within the subset of high-quality trials, 60.0% of studies reported a favorable change with CIM while 40.0% reported no change. No studies reported an unfavorable change. Commonly assessed outcome types were patient-reported (41.1%) and provider-reported (21.5%). Rate of favorable change did not differ based on type of CIM (p = 0.90) or outcome measured (p = 0.24). CONCLUSIONS Concurrent CIM may reduce radiotherapy-induced toxicities and improve quality of life, suggesting that physicians should discuss CIM with patients receiving radiotherapy. This review provides a broad overview of investigations on CIM use during radiotherapy and can inform how radiation oncologists advise their patients about CIM.
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Dufter SA, Hübner J, Ahmadi E, Zomorodbakhsch B. Traits of cancer patients and CAM usage. J Cancer Res Clin Oncol 2021; 147:3685-3692. [PMID: 33811274 PMCID: PMC8557154 DOI: 10.1007/s00432-021-03605-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
Background The use of Complementary Alternative Medicine (CAM) Methods is increasing and therefore gaining importance also in conventional western medicine. Identifying personal traits to make out by whom and why CAM is used can help physicians in successful physician–patient interaction, and thus improve patient’s compliance and trust towards their physician. Patients and methods A questionnaire was passed on to cancer patients in an ambulant clinical and a rehabilitation setting. Multiple regression analyses were run to examine possible predictors for CAM use, such as gender, age, level of education, spirituality, attentiveness, self-efficacy and resilience. To differentiate within CAM users, two dependent variables were created: “holistic and mind–body methods”, such as Yoga, meditation or Homeopathy and “material based methods”, such as food supplements or vitamins. Results Higher level of education, younger age and religion-independent attentiveness were significant predictors for the use of “material based methods”. Female gender, higher education and religious spirituality were detected as significant predictors for “holistic and mind–body methods”. Conclusion This study is among the first to take a more detailed look at how numerous personal traits are associated with the use of CAM methods and differentiate between the applied methods. Our finding should be considered by conventional health care providers and could be integrated into a holistic assessment, to offer information about complementary medicine and meeting patients’ needs.
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Affiliation(s)
| | - Jutta Hübner
- Klinik Für Innere Medizin II, Am Klinikum 1, 07747, Jena, Germany
| | - Emadaldin Ahmadi
- Klinik Für Innere Medizin II, Am Klinikum 1, 07747, Jena, Germany
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Narayanan S, Lopez G, Powers-James C, Fellman BM, Chunduru A, Li Y, Bruera E, Cohen L. Integrative Oncology Consultations Delivered via Telehealth in 2020 and In-Person in 2019: Paradigm Shift During the COVID-19 World Pandemic. Integr Cancer Ther 2021; 20:1534735421999101. [PMID: 33655797 PMCID: PMC7934055 DOI: 10.1177/1534735421999101] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: The COVID-19 pandemic has catalyzed the use of mobile technologies to deliver health care. This new medical model has benefited integrative oncology (IO) consultations, where cancer patients are counseled about healthy lifestyle, non-pharmacological approaches for symptom management, and addressing questions around natural products and other integrative modalities. Here we report the feasibility of conducting IO physician consultations via telehealth in 2020 and compare patient characteristics to prior in-person consultations conducted in 2019. Methods: An integrated EHR-telemedicine platform was used for IO physician consultations. As in the prior in-person visits, patients completed pre-visit patient-reported outcome (PRO) assessments about common cancer symptoms [modified Edmonton Symptom Assessment Scale, (ESAS)], Measure Yourself Concerns and Wellbeing (MYCaW), and the PROMIS-10 to assess quality of life (QOL). Patient demographics, clinical characteristics, and PROs for new telehealth consultation in 2020 were compared to new in-person consultations in 2019 using t-tests, chi-squared tests, and -Wilcoxon rank-sum test. Results: We provided telehealth IO consultations to 509 new patients from April 21, 2020, to October 21, 2020, versus 842 new patients in-person during the same period in 2019. Most were female (77 % vs 73%); median age (56 vs 58), and the most frequent cancer type was breast (48% vs 39%). More patients were seeking counseling on herbs and supplements (12.9 vs 6.8%) and lifestyle (diet 22.7 vs 16.9% and exercise 5.2 vs 1.8%) in the 2020 cohort than 2019, respectively. The 2020 telehealth cohort had lower symptom management concerns compared to the 2019 in-person cohort (19.5 vs 33.1%). Conclusions: Delivering IO consultations using telehealth is feasible and meets patients’ needs. Compared to patients seen in-person during 2019, patients having telehealth IO consultations in 2020 reported lower symptom burden and more concerns about lifestyle and herbs and supplements. Additional research is warranted to explore the satisfaction and challenges among patients receiving telehealth IO care.
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Affiliation(s)
| | - Gabriel Lopez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Bryan M Fellman
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aditi Chunduru
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Use of complementary and alternative medicine among patients with cancer in a sub-Himalayan state in India: An exploratory study. J Ayurveda Integr Med 2021; 12:126-130. [PMID: 33637425 PMCID: PMC8039360 DOI: 10.1016/j.jaim.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/21/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background The use of complementary and alternative medicine (CAM) is widespread among cancer patients in India. Objective The present study elucidated usage patterns of CAM and the factors responsible for its adoption among the patients with cancer, and the therapeutic impact of CAM. Materials and methods This was a questionnaire-based study, conducted among patients with cancer in a tertiary care hospital in a sub-Himalayan city. Data were analyzed using statistical methods. Results A total of 2614 patients with cancer were included. Almost half of the patients (n = 1208, 46.2%) reported to have been treated with CAM. Breast cancer (n = 274, 23.0%) was most prevalent with majority at advanced stages. Ayurveda (n = 428, 35.9%) Yoga/Naturopathy (n = 381, 32.0%) Homeopathy (n = 143, 12.0%) and Unani (n = 71, 5.9%) were used commonly. Among CAM users, 85.0% (n = 1012) of patients used CAM as the sole method of treatment, while 58.9% (n = 702) patients reported initial symptomatic benefit. Conclusion Using CAM benefitted a significant number of patients with cancer. However, there is an urgent need to integrate CAM with modern system of medicine. CAM is widely used in India including in cancer patients. Almost half of the patients reported to have been treated with CAM. CAM needs integration with modern system of medicine.
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Joukar F, Mavaddati S, Mansour-Ghanaei F, Samadani AA. Gut Microbiota as a Positive Potential Therapeutic Factor in Carcinogenesis: an Overview of Microbiota-Targeted Therapy. J Gastrointest Cancer 2021; 51:363-378. [PMID: 31025167 DOI: 10.1007/s12029-019-00237-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cancer therapeutic methods comprising chemotherapy, radiotherapy, and surgery are so routine in cancer treatment. Remarkably, there are several personal features which affect the effectiveness of such treatments including nutrition, microbiome diversity, and physical activity which has distinct significant roles during and after therapies along with their bilateral connections. In this way, the ability of gut microbiota36 in modulating the efficacy of chemotherapeutic medications in cancer and other types of disorders is of great importance. In addition, the role of dietary, probiotic, and synthetically engineered bacteria in manipulating and optimizing the gut microbiota is of interest. Conspicuously, the correlation between the commensal microbiota and also host can regulate the physiological activities comprising the immunity system and inflammatory agents and it is scanned in the category of cancers. Bacterial species have been employed in cancer therapy; commensal microbes posse a key beneficial role in this field. Practically, the microbiota has this potential to accelerate and modulates a certain response by priming in order to release the pro-inflammatory agents. We would like to discuss these vital factors in this review as gut microbiota has the potential to be the main option for personalized cancer treatment strategies in the future. Meaning, this novel data present clinical promising feasibilities of modulating cancer therapy with using microbiota.
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Affiliation(s)
- Farahnaz Joukar
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Mavaddati
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Akbar Samadani
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran. .,Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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Lee RT, Kwon N, Wu J, To C, To S, Szmulewitz R, Tchekmedyian R, Holmes HM, Olopade OI, Stadler WM, Von Roenn J. Prevalence of potential interactions of medications, including herbs and supplements, before, during, and after chemotherapy in patients with breast and prostate cancer. Cancer 2021; 127:1827-1835. [PMID: 33524183 DOI: 10.1002/cncr.33324] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/07/2020] [Accepted: 10/20/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The use of herbs and supplements (HS) is common among patients with cancer, yet limited information exists about potential medication interactions (PMIs) with HS use around chemotherapy. METHODS Patients with breast or prostate cancer who had recently finished chemotherapy at 2 academic medical centers were surveyed by telephone. Interviewers inquired about all medications, including HS, before, during, and after chemotherapy. Micromedex, Lexicomp, and Natural Medicines Comprehensive Database interaction software programs were used to determine PMIs. RESULTS A total of 67 subjects (age range, 39-77 years) were evaluated in this study. Participants were primarily White patients (73%) with breast cancer (87%). The median number of medications was 11 (range, 2-28) during the entire study and was highest during chemotherapy (7; range, 2-22). Approximately four-fifths (84%) used HS. A total of 1747 PMIs were identified, and they represented 635 unique PMIs across all 3 timeframes, with most occurring during chemotherapy. Prescription-related PMIs (70%) were the most common type, and they were followed by HS-related (56%) and anticancer treatment-related PMIs (22%). Approximately half of the PMIs (54%) were categorized as moderate interactions, and more than one-third (38%) were categorized as major interactions. Patient use of HS increased from 51% during chemotherapy to 66% after chemotherapy, and this correlated with an increased prevalence of HS PMIs (46% to 60%). HS users were more likely to be at risk for a major PMI than non-HS users (92% vs 70%; P = .038). CONCLUSIONS The use of HS remains prevalent among patients with cancer and may place them at risk for PMIs both during chemotherapy and after the completion of treatment. LAY SUMMARY This study evaluates the risk of potential medication interactions for patients with breast or prostate cancer undergoing chemotherapy. The results show that patients often use herbs and supplements during treatment. Prescription medications are most often associated with medication interactions, which are followed by herb and supplement-related interactions. More than one-third of potential medication interactions are considered major. Patients should be educated about the risk of herb and supplement-related medication interactions during treatment.
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Affiliation(s)
- Richard T Lee
- Department of Medicine, University Hospitals and Case Western Reserve University, Cleveland, Ohio
| | - Nancy Kwon
- Section of Hematology/Oncology, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Jimin Wu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Connie To
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven To
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Russell Szmulewitz
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois
| | | | - Holly M Holmes
- Department of Internal Medicine, University of Texas, Houston, Texas
| | - Olufunmilayo I Olopade
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Walter M Stadler
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Jamie Von Roenn
- Section of Hematology/Oncology, Department of Medicine, Northwestern University, Chicago, Illinois
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Mohamed MR, Ramsdale E, Loh KP, Xu H, Patil A, Gilmore N, Obrecht S, Wells M, Nightingale G, Juba KM, Faller B, Onitilo A, Bradley T, Culakova E, Holmes H, Mohile SG. Association of Polypharmacy and Potentially Inappropriate Medications With Physical Functional Impairments in Older Adults With Cancer. J Natl Compr Canc Netw 2021; 19:267-274. [PMID: 33482631 PMCID: PMC8295406 DOI: 10.6004/jnccn.2020.7628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/23/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults with cancer, but their associations with physical function are not often studied. This study examined the associations of polypharmacy and PIMs with physical function in older adults with cancer, and determined the optimal cutoff value for the number of medications most strongly associated with physical functional impairment. METHODS This cross-sectional analysis used baseline data from a randomized study enrolling patients aged ≥70 years with advanced cancer starting a new systemic cancer treatment. We categorized PIM using 2015 American Geriatrics Society Beers Criteria. Three validated physical function measures were used to assess patient-reported impairments: activities of daily living (ADL) scale, instrumental activities of daily living (IADL) scale, and the Older Americans Resources and Services Physical Health (OARS PH) survey. Optimal cutoff value for number of medications was determined by the Youden index. Separate multivariate logistic regressions were then performed to examine associations of polypharmacy and PIMs with physical function measures. RESULTS Among 439 patients (mean age, 76.9 years), the Youden index identified ≥8 medications as the optimal cutoff value for polypharmacy; 43% were taking ≥8 medications and 62% were taking ≥1 PIMs. On multivariate analysis, taking ≥8 medications was associated with impairment in ADL (adjusted odds ratio [aOR], 1.64; 95% CI, 1.01-2.58) and OARS PH (aOR, 1.73; 95% CI, 1.01-2.98). PIMs were associated with impairments in IADL (aOR, 1.72; 95% CI, 1.09-2.73) and OARS PH (aOR, 1.97; 95% CI, 1.15-3.37). A cutoff of 5 medications was not associated with any of the physical function measures. CONCLUSIONS Physical function, an important component of outcomes for older adults with cancer, is cross-sectionally associated with polypharmacy (defined as ≥8 medications) and with PIMs. Future studies should evaluate the association of polypharmacy with functional outcomes in this population in a longitudinal fashion.
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Affiliation(s)
- Mostafa R Mohamed
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Erika Ramsdale
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Kah Poh Loh
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Huiwen Xu
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Amita Patil
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Nikesha Gilmore
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Spencer Obrecht
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Megan Wells
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Ginah Nightingale
- 2Department of Pharmacy Practice, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Katherine M Juba
- 3Department of Pharmacy, University of Rochester Medical Center, Rochester, New York
| | - Bryan Faller
- 4Missouri Baptist Medical Center, St. Louis, Missouri
| | | | - Thomas Bradley
- 6Zucker School of Medicine at Hofstra-Northwell, Lake Success, New York; and
| | - Eva Culakova
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Holly Holmes
- 7The University of Texas Health Science Center at Houston, Houston, Texas
| | - Supriya G Mohile
- 1James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
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Michalczyk K, Pawlik J, Czekawy I, Kozłowski M, Cymbaluk-Płoska A. Complementary Methods in Cancer Treatment-Cure or Curse? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E356. [PMID: 33466517 PMCID: PMC7796472 DOI: 10.3390/ijerph18010356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022]
Abstract
(1) Background: The prevalence of complementary and alternative methods (CAM) use among oncological patients has been rising constantly over the last few decades and a variety of both pharmacological and non-pharmacological methods have been developed. Many advertisements promise to relieve side effects of chemotherapy or even to cure the disease, thus encouraging patients to use CAM; (2) Methods: The objective of the study was to determine which patients' characteristics are associated with the use of complementary medicine during cancer treatment, their pattern of use, and if it has any association with its safety profile. This survey-based prospective multicenter study of 316 patients examined the use of complementary medicine among patients undergoing chemotherapy treatment in cancer centers in Poland between 2017 and 2019; (3) Results: The Chi2 analysis showed that patients' opinion regarding the safety of unconventional methods is related to the use of CAM (p = 0.00147). Moreover, patients' thinking that alternative medicine can replace traditional therapy was correlated with his/her education (p = 0.01198). Moreover, we performed univariate and multivariate analysis to determine factors associated with CAM use including sociodemographic and clinical characteristics. Finally, we conducted survival analysis of patients undergoing chemotherapy treatment with 42 months of follow-up time of our prospective study. Using Kaplan-Meier curves and log-rank analysis, we found no statistical difference in overall survival between the groups that used and did not use any form of CAM (p = 0.211); (4) Conclusions: CAM use is common among patients undergoing chemotherapy treatment and should be considered by medical teams as some agents may interact with chemotherapy drugs and affect their efficacy or cause adverse effects.
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Affiliation(s)
- Kaja Michalczyk
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (J.P.); (I.C.); (M.K.); (A.C.-P.)
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Gosain R, Gage-Bouchard E, Ambrosone C, Repasky E, Gandhi S. Stress reduction strategies in breast cancer: review of pharmacologic and non-pharmacologic based strategies. Semin Immunopathol 2020; 42:719-734. [PMID: 32948909 PMCID: PMC7704484 DOI: 10.1007/s00281-020-00815-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/30/2020] [Indexed: 12/24/2022]
Abstract
Breast cancer is the most common cancer diagnosed in women. It is associated with multiple symptoms in both patients and caregivers, such as stress, anxiety, depression, sleep disturbance, and fatigue. Stress appears to promote cancer progression via activation of the sympathetic nervous system releasing epinephrine and norepinephrine as well as activation of hypothalamic-pituitary-adrenal axis releasing cortisol. These stress hormones have been shown to promote the proliferation of cancer cells. This review focuses on stress-reducing strategies which may decrease cancer progression by abrogating these pathways, with a main focus on the β-adrenergic signaling pathway. Patients utilize both non-pharmacologic and pharmacologic strategies to reduce stress. Non-pharmacologic stress-reduction strategies include complementary and alternative medicine techniques, such as meditation, yoga, acupuncture, exercise, use of natural products, support groups and psychology counseling, herbal compounds, and multivitamins. Pharmacologic strategies include abrogating the β2-adrenergic receptor signaling pathway to antagonize epinephrine and norepinephrine action on tumor and immune cells. β-Blocker drugs may play a role in weakening the pro-migratory and pro-metastatic effects induced by stress hormones in cancer and strengthening the anti-tumor immune response. Preclinical models have shown that non-selective β1/2-blocker use is associated with a decrease in tumor growth and metastases and clinical studies have suggested their positive impact on decreasing breast cancer recurrence and mortality. Thus, non-pharmacological approaches, along with pharmacological therapies part of clinical trials are available to cancer patients to reduce stress, and have promise to break the cycle of cancer and stress.
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Affiliation(s)
- Rohit Gosain
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
- Department of Medicine, UPMC Hillman Cancer Center, Chautauqua, NY, USA.
| | - Elizabeth Gage-Bouchard
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Christine Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Elizabeth Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Shipra Gandhi
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Haron MH, Avula PhD B, Gurley PhD BJ, Chittiboyina PhD AG, Khan PhD IA, Khan PhD SI. Possible Herb-Drug Interaction Risk of Some Nutritional and Beauty Supplements on Antiretroviral Therapy in HIV Patients. J Diet Suppl 2020; 19:62-77. [PMID: 33200619 DOI: 10.1080/19390211.2020.1846658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study was carried out to assess the drug interaction potential of a variety of beauty and sports/nutritional supplements when co-administered with antiviral drug therapy, especially anti-HIV drugs. Ethanolic extracts of seven dietary supplements (two beauty products, three nutritional protein supplement products and two weight loss/body building products) were examined in human liver cells (HepG2 cells and primary hepatocytes) for their influence on the hepatic metabolism of five antiviral drugs (elvitegravir, rilpivirine, tenofovir, dolutegravir, and cobicistat), all of which are substrates for a key drug metabolizing enzyme CYP3A4. Our results showed that six of the seven supplements caused a 1.5 - 2 fold induction in PXR transcriptional activity in HepG2 cells. PXR regulates the expression of key drug metabolizing enzymes including CYP3A4. Follow up studies indicated a 1.5 - 3 fold induction in CYP3A4 enzyme activity in HepG2 cells treated with these supplements. We further investigated the effects of the supplement on the metabolism of above mentioned anti-viral drugs in HepG2 cells and primary hepatocytes. Of the five drugs, rilpivirine and dolutegravir metabolism was increased by up to 2-folds over the no supplement control by some of the supplements. Our findings indicate that concomitant consumption of these products with anti-HIV drugs may compromise the efficacy of antivirals therapy due to supplement-induced metabolism via induction of CYP3A4 activity.
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Affiliation(s)
- Mona H Haron
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Bharathi Avula PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Bill J Gurley PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Amar G Chittiboyina PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Ikhlas A Khan PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Shabana I Khan PhD
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, University, MS, USA
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Al-Ani LA, Kadir FA, Hashim NM, Julkapli NM, Seyfoddin A, Lu J, AlSaadi MA, Yehye WA. The impact of curcumin-graphene based nanoformulation on cellular interaction and redox-activated apoptosis: An in vitro colon cancer study. Heliyon 2020; 6:e05360. [PMID: 33163675 PMCID: PMC7609448 DOI: 10.1016/j.heliyon.2020.e05360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/03/2020] [Accepted: 10/23/2020] [Indexed: 12/21/2022] Open
Abstract
Natural plants derivatives have gained enormous merits in cancer therapy applications upon formulation with nanomaterials. Curcumin, as a popular research focus has acquired such improvements surpassing its disadvantageous low bioavailability. To this point, the available research data had confirmed the importance of nanomaterial type in orienting cellular response and provoking different toxicological and death mechanisms that may range from physical membrane damage to intracellular changes. This in turn underlines the poorly studied field of nanoformulation interaction with cells as the key determinant in toxicology outcomes. In this work, curcumin-AuNPs-reduced graphene oxide nanocomposite (CAG) was implemented as a model, to study the impact on cellular membrane integrity and the possible redox changes using colon cancer in vitro cell lines (HT-29 and SW-948), representing drug-responsive and resistant subtypes. Morphological and biochemical methods of transmission electron microscopy (TEM), apoptosis assay, reactive oxygen species (ROS) and antioxidants glutathione and superoxide dismutase (GSH and SOD) levels were examined with consideration to suitable protocols and vital optimizations. TEM micrographs proved endocytic uptake with succeeding cytoplasm deposition, which unlike other nanomaterials studied previously, conserved membrane integrity allowing intracellular cytotoxic mechanism. Apoptosis was confirmed with gold-standard morphological features observed in micrographs, while redox parameters revealed a time-dependent increase in ROS accompanied with regressive GSH and SOD levels. Collectively, this work demonstrates the success of graphene as a platform for curcumin intracellular delivery and cytotoxicity, and further highlights the importance of suitable in vitro methods to be used for nanomaterial validation.
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Affiliation(s)
- Lina A. Al-Ani
- Institute of Advanced Studies, Nanotechnology & Catalysis Research Centre (NANOCAT), University of Malaya, Kuala Lumpur, Malaysia
| | - Farkaad A. Kadir
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Najihah M. Hashim
- Department of Pharmaceutical Chemicals, Faculty of Pharmacy, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Natural Products and Drug Discovery (CENAR), University of Malaya, Kuala Lumpur, Malaysia
| | - Nurhidayatullaili M. Julkapli
- Institute of Advanced Studies, Nanotechnology & Catalysis Research Centre (NANOCAT), University of Malaya, Kuala Lumpur, Malaysia
| | - Ali Seyfoddin
- Drug Delivery Research Group, Auckland University of Technology, School of Science, Auckland, New Zealand
| | - Jun Lu
- School of Science, Faculty of Health & Environmental Sciences, Auckland University of Technology. Auckland, New Zealand
- College of Perfume and Aroma, Shanghai Institute of Technology, Shanghai, China
| | - Mohammed A. AlSaadi
- Institute of Advanced Studies, Nanotechnology & Catalysis Research Centre (NANOCAT), University of Malaya, Kuala Lumpur, Malaysia
- University of Malaya Centre for Ionic Liquids (UMCiL), University of Malaya, Kuala Lumpur, Malaysia
- National Chair of Materials Sciences and Metallurgy, University of Nizwa, Nizwa, Sultanate of Oman
| | - Wageeh A. Yehye
- Institute of Advanced Studies, Nanotechnology & Catalysis Research Centre (NANOCAT), University of Malaya, Kuala Lumpur, Malaysia
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49
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Stie M, Jensen LH, Delmar C, Nørgaard B. Open dialogue about complementary and alternative medicine (CAM) integrated in conventional oncology care, characteristics and impact. A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:2224-2234. [PMID: 32563705 DOI: 10.1016/j.pec.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To systematically review evidence on the characteristics, experiences and impact of an open dialogue about complementary and alternative medicine (CAM) integrated in oncology care. METHODS We searched MEDLINE, EMBASE, AMED, Scopus, ProQuest Dissertations and Thesis, Cochrane Central Register, clinicaltrials.gov, forskningsdatabase.dk and PROSPERO. Two reviewers screened title, abstract and full-text articles. Each study was appraised using the Critical Appraisal Skills Programme (CASP) and synthesized narratively. PROSPERO registration CRD42019112242. RESULTS We retrieved 4736 articles and included 5; 3 received 9 ½, 1 received 9, and 1 received 5 points on the CASP score. Predominately, the open dialogue was one or two individual, patient-centered, face-to-face consultations led by oncology physicians. In one study, it was a tele-phone consultation and in another it was structured counseling led by pharmacists. Integrated information and recommendations about CAM contributed to high level of satisfaction and improvement in concerns, quality of life and well-being. CONCLUSION Integration of open dialogue about CAM in oncology care including acknowledging patients' preferences, values, wishes and knowledge, and providing information about CAM expands the opportunities for improving patients' health, quality of life and well-being. PRACTICE IMPLICATIONS Open dialogue about CAM has potentials, but research on how it specifically helps patients, is needed.
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Affiliation(s)
- Mette Stie
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Lars Henrik Jensen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Charlotte Delmar
- Department of Nursing Science, Health Faculty, Aarhus University, Aarhus, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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50
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Yang J, Xu G, Yin Z, Cheng Y, Sun SM, Zheng Q, Chen J, Liang FR, Zhao L. Acupuncture for chronic cancer-related pain: a systematic review and network meta-analysis protocol. BMJ Open 2020; 10:e039087. [PMID: 33033027 PMCID: PMC7542929 DOI: 10.1136/bmjopen-2020-039087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Chronic cancer-related pain is one of the most common excruciating symptom that can be caused by the cancer (by the primary tumour or by metastases) or by its treatment (surgery, chemotherapy and radiotherapy). Although multiple clinical trials and systematic reviews have suggested that acupuncture could be effective in treating chronic cancer-related pain, the comparative efficacy and safety of these acupuncture methods remains unclear. We, therefore, performed this study to evaluate and rank the efficacy and safety of different acupuncture methods for chronic cancer-related pain. METHODS AND ANALYSIS Seven databases will be searched, including Cochrane Library, MEDLINE, Embase, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, the Chongqing VIP Chinese Science and Technology Periodical Database and Chinese Biomedical Literature Database (CBM) from their inception to March 2020. The primary outcome is the change of pain intensity. Bayesian network meta-analysis will be conducted using software R3.5.1. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation System (GRADE) to assess the quality of evidence. ETHICS AND DISSEMINATION Ethical approval is not required for literature-based studies. The results will be disseminated through peer-reviewed publication. PROSPERO REGISTRATION NUMBER CRD42020165747.
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Affiliation(s)
- Jiao Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Guixing Xu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zihan Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ying Cheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sheng Ming Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jiao Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fan-Rong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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