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Markowitsch SD, Vakhrusheva O, Schupp P, Akele Y, Kitanovic J, Slade KS, Efferth T, Thomas A, Tsaur I, Mager R, Haferkamp A, Juengel E. Shikonin Inhibits Cell Growth of Sunitinib-Resistant Renal Cell Carcinoma by Activating the Necrosome Complex and Inhibiting the AKT/mTOR Signaling Pathway. Cancers (Basel) 2022; 14:cancers14051114. [PMID: 35267423 PMCID: PMC8909272 DOI: 10.3390/cancers14051114] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
Therapy resistance remains a major challenge in treating advanced renal cell carcinoma (RCC), making more effective treatment strategies crucial. Shikonin (SHI) from traditional Chinese medicine has exhibited antitumor properties in several tumor entities. We, therefore, currently investigated SHI's impact on progressive growth and metastatic behavior in therapy-sensitive (parental) and therapy-resistant Caki-1, 786-O, KTCTL-26, and A498 RCC cells. Tumor cell growth, proliferation, clonogenic capacity, cell cycle phase distribution, induction of cell death (apoptosis and necroptosis), and the expression and activity of regulating and signaling proteins were evaluated. Moreover, the adhesion and chemotactic activity of the RCC cells after exposure to SHI were investigated. SHI significantly inhibited the growth, proliferation, and clone formation in parental and sunitinib-resistant RCC cells by G2/M phase arrest through down-regulation of cell cycle activating proteins. Furthermore, SHI induced apoptosis and necroptosis by activating necrosome complex proteins. Concomitantly, SHI impaired the AKT/mTOR pathway. Adhesion and motility were cell line specifically affected by SHI. Thus, SHI may hold promise as an additive option in treating patients with advanced and therapy-resistant RCC.
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Affiliation(s)
- Sascha D. Markowitsch
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Olesya Vakhrusheva
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Patricia Schupp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Yasminn Akele
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Jovana Kitanovic
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Kimberly S. Slade
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Thomas Efferth
- Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University Mainz, 55128 Mainz, Germany;
| | - Anita Thomas
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Igor Tsaur
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - René Mager
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
| | - Eva Juengel
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.D.M.); (O.V.); (P.S.); (Y.A.); (J.K.); (K.S.S.); (A.T.); (I.T.); (R.M.); (A.H.)
- Correspondence: ; Tel.: +49-6131-17-5433; Fax: +49-6131-17-4410
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Markowitsch SD, Juetter KM, Schupp P, Hauschulte K, Vakhrusheva O, Slade KS, Thomas A, Tsaur I, Cinatl J, Michaelis M, Efferth T, Haferkamp A, Juengel E. Shikonin Reduces Growth of Docetaxel-Resistant Prostate Cancer Cells Mainly through Necroptosis. Cancers (Basel) 2021; 13:882. [PMID: 33672520 PMCID: PMC7923752 DOI: 10.3390/cancers13040882] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
The prognosis for advanced prostate carcinoma (PCa) remains poor due to development of therapy resistance, and new treatment options are needed. Shikonin (SHI) from Traditional Chinese Medicine has induced antitumor effects in diverse tumor entities, but data related to PCa are scarce. Therefore, the parental (=sensitive) and docetaxel (DX)-resistant PCa cell lines, PC3, DU145, LNCaP, and 22Rv1 were exposed to SHI [0.1-1.5 μM], and tumor cell growth, proliferation, cell cycling, cell death (apoptosis, necrosis, and necroptosis), and metabolic activity were evaluated. Correspondingly, the expression of regulating proteins was assessed. Exposure to SHI time- and dose-dependently inhibited tumor cell growth and proliferation in parental and DX-resistant PCa cells, accompanied by cell cycle arrest in the G2/M or S phase and modulation of cell cycle regulating proteins. SHI induced apoptosis and more dominantly necroptosis in both parental and DX-resistant PCa cells. This was shown by enhanced pRIP1 and pRIP3 expression and returned growth if applying the necroptosis inhibitor necrostatin-1. No SHI-induced alteration in metabolic activity of the PCa cells was detected. The significant antitumor effects induced by SHI to parental and DX-resistant PCa cells make the addition of SHI to standard therapy a promising treatment strategy for patients with advanced PCa.
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Affiliation(s)
- Sascha D. Markowitsch
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Kira M. Juetter
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Patricia Schupp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Kristine Hauschulte
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Olesya Vakhrusheva
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Kimberly Sue Slade
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Anita Thomas
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Igor Tsaur
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Jindrich Cinatl
- Institute of Medical Virology, Goethe-University, 60596 Frankfurt, Germany;
| | - Martin Michaelis
- Industrial Biotechnology Centre and School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK;
| | - Thomas Efferth
- Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University Mainz, Staudingerweg 5, 55128 Mainz, Germany;
| | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
| | - Eva Juengel
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (K.M.J.); (P.S.); (K.H.); (O.V.); (K.S.S.); (A.T.); (I.T.); (A.H.)
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Tangkiatkumjai M, Boardman H, Walker DM. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther 2020; 20:363. [PMID: 33228697 PMCID: PMC7686746 DOI: 10.1186/s12906-020-03157-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. METHODS A literature search was performed on Pubmed, ScienceDirect and EMBASE. KEYWORDS 'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. RESULTS 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). CONCLUSIONS Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.
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Affiliation(s)
- Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand
| | - Helen Boardman
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, UK
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Markowitsch SD, Schupp P, Lauckner J, Vakhrusheva O, Slade KS, Mager R, Efferth T, Haferkamp A, Juengel E. Artesunate Inhibits Growth of Sunitinib-Resistant Renal Cell Carcinoma Cells through Cell Cycle Arrest and Induction of Ferroptosis. Cancers (Basel) 2020; 12:cancers12113150. [PMID: 33121039 PMCID: PMC7692972 DOI: 10.3390/cancers12113150] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/22/2020] [Accepted: 10/24/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Renal cell carcinoma (RCC) is the most common kidney malignancy. Due to development of therapy resistance, efficacy of conventional drugs such as sunitinib is limited. Artesunate (ART), a drug originating from Traditional Chinese Medicine, has exhibited anti-tumor effects in several non-urologic tumors. ART inhibited growth, reduced metastatic properties, and curtailed metabolism in sunitinib-sensitive and sunitinib–resistant RCC cells. In three of four tested cell lines, ART’s growth inhibitory effects were accompanied by cell cycle arrest and modulation of cell cycle regulating proteins. In a fourth cell line, KTCTL-26, ART evoked ferroptosis, an iron-dependent cell death, and exhibited stronger anti-tumor effects than in the other cell lines. The regulatory protein, p53, was only detectable in the KTCTL-26 cells, possibly making p53 a predictive marker of cancer that may respond better to ART. ART, therefore, may hold promise as an additive therapy option for selected patients with advanced or therapy-resistant RCC. Abstract Although innovative therapeutic concepts have led to better treatment of advanced renal cell carcinoma (RCC), efficacy is still limited due to the tumor developing resistance to applied drugs. Artesunate (ART) has demonstrated anti-tumor effects in different tumor entities. This study was designed to investigate the impact of ART (1–100 µM) on the sunitinib-resistant RCC cell lines, Caki-1, 786-O, KTCTL26, and A-498. Therapy-sensitive (parental) and untreated cells served as controls. ART’s impact on tumor cell growth, proliferation, clonogenic growth, apoptosis, necrosis, ferroptosis, and metabolic activity was evaluated. Cell cycle distribution, the expression of cell cycle regulating proteins, p53, and the occurrence of reactive oxygen species (ROS) were investigated. ART significantly increased cytotoxicity and inhibited proliferation and clonogenic growth in both parental and sunitinib-resistant RCC cells. In Caki-1, 786-O, and A-498 cell lines growth inhibition was associated with G0/G1 phase arrest and distinct modulation of cell cycle regulating proteins. KTCTL-26 cells were mainly affected by ART through ROS generation, ferroptosis, and decreased metabolism. p53 exclusively appeared in the KTCTL-26 cells, indicating that p53 might be predictive for ART-dependent ferroptosis. Thus, ART may hold promise for treating selected patients with advanced and even therapy-resistant RCC.
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Affiliation(s)
- Sascha D. Markowitsch
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - Patricia Schupp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - Julia Lauckner
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - Olesya Vakhrusheva
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - Kimberly S. Slade
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - René Mager
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - Thomas Efferth
- Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University Mainz, Staudingerweg 5, 55128 Mainz, Germany;
| | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
| | - Eva Juengel
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany; (S.D.M.); (P.S.); (J.L.); (O.V.); (K.S.S.); (R.M.); (A.H.)
- Correspondence: ; Tel.: +49-631-175-433; Fax: +49-6131-174-410
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Di Carlo A, Leveridge M, McGregor TB. Crowdfunding in urology: Canadian perspective. Can Urol Assoc J 2020; 15:E139-E143. [PMID: 32807287 DOI: 10.5489/cuaj.6572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Crowdfunding is becoming an increasingly used resource for patients to cover costs related to medical care. These costs can be related directly to treatments or indirectly to loss of income or travel-related costs. Little is known as to the extent of which crowdfunding is used for urological disease here in Canada. This study offers a first look at the prevalence of crowdfunding for urological disease and the factors surrounding its use. METHODS In January 2020, we queried the GoFundMe internal search engine for fundraising campaigns regarding urological ailments. Results were categorized according to the major organs of urological disease. RESULTS Crowdfunding campaigns are very prevalent within several areas of urology. Prostate cancer and chronic kidney disease represent the most frequent reason for campaigns. Fundraising goals and actual funds raised for malignant disease were significantly more than for benign disease. Interestingly, there was a significant portion of crowdfunding campaigns to cover costs for non-conventional treatments and transplant tourism. CONCLUSION Crowdfunding use to help cover direct and indirect costs of medical care is becoming increasingly apparent through several facets of medicine. This study shows that this statement holds true when looking at patients with urological disease in Canada. As urologists, we need to be aware of this trend, as it highlights the often-unforeseen financial burdens experienced by our patients.
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Affiliation(s)
- Alessia Di Carlo
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
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Rutz J, Maxeiner S, Justin S, Bachmeier B, Bernd A, Kippenberger S, Zöller N, Chun FKH, Blaheta RA. Low Dosed Curcumin Combined with Visible Light Exposure Inhibits Renal Cell Carcinoma Metastatic Behavior In Vitro. Cancers (Basel) 2020; 12:cancers12020302. [PMID: 32012894 PMCID: PMC7072295 DOI: 10.3390/cancers12020302] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/16/2020] [Accepted: 01/25/2020] [Indexed: 02/07/2023] Open
Abstract
Recent documentation shows that a curcumin-induced growth arrest of renal cell carcinoma (RCC) cells can be amplified by visible light. This study was designed to investigate whether this strategy may also contribute to blocking metastatic progression of RCC. Low dosed curcumin (0.2 µg/mL; 0.54 µM) was applied to A498, Caki1, or KTCTL-26 cells for 1 h, followed by exposure to visible light for 5 min (400–550 nm, 5500 lx). Adhesion to human vascular endothelial cells or immobilized collagen was then evaluated. The influence of curcumin on chemotaxis and migration was also investigated, as well as curcumin induced alterations of α and β integrin expression. Curcumin without light exposure or light exposure without curcumin induced no alterations, whereas curcumin plus light significantly inhibited RCC adhesion, migration, and chemotaxis. This was associated with a distinct reduction of α3, α5, β1, and β3 integrins in all cell lines. Separate blocking of each of these integrin subtypes led to significant modification of tumor cell adhesion and chemotactic behavior. Combining low dosed curcumin with light considerably suppressed RCC binding activity and chemotactic movement and was associated with lowered integrin α and β subtypes. Therefore, curcumin combined with visible light holds promise for inhibiting metastatic processes in RCC.
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Affiliation(s)
- Jochen Rutz
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.M.); (S.J.); (F.K.-H.C.); (R.A.B.)
- Correspondence: ; Tel.: +49-69-6301-7109; Fax: +49-69-6301-7108
| | - Sebastian Maxeiner
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.M.); (S.J.); (F.K.-H.C.); (R.A.B.)
| | - Saira Justin
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.M.); (S.J.); (F.K.-H.C.); (R.A.B.)
| | - Beatrice Bachmeier
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilians-University, 80539 Munich, Germany;
| | - August Bernd
- Department of Dermatology, Venereology, and Allergology, Goethe-University, 60590 Frankfurt am Main, Germany; (A.B.); (S.K.); (N.Z.)
| | - Stefan Kippenberger
- Department of Dermatology, Venereology, and Allergology, Goethe-University, 60590 Frankfurt am Main, Germany; (A.B.); (S.K.); (N.Z.)
| | - Nadja Zöller
- Department of Dermatology, Venereology, and Allergology, Goethe-University, 60590 Frankfurt am Main, Germany; (A.B.); (S.K.); (N.Z.)
| | - Felix K.-H. Chun
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.M.); (S.J.); (F.K.-H.C.); (R.A.B.)
| | - Roman A. Blaheta
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.M.); (S.J.); (F.K.-H.C.); (R.A.B.)
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Schallock H, Bartmann B, Keinki C, Huebner J. Online information on oncologists' and non-medical practitioners' websites in Germany: A critical comparison. PATIENT EDUCATION AND COUNSELING 2019; 102:2038-2048. [PMID: 31147090 DOI: 10.1016/j.pec.2019.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To survey websites of oncologists and non-medical practitioners (NMPs) in Germany regarding range of treated symptoms, diagnostic tools and therapies offered to cancer patients as well as the quality of websites. METHODS Analysis of 98 websites of oncologists and NMPs was conducted between April and July 2018 with a standardized tool. RESULTS Range of diagnostic and therapeutic methods was high and differed between both groups. Many NMPs (65.3%) intended to support conventional therapy rather than to treat cancer. Most oncologists (85.7%) did not mention the role of complementary and alternative medicine (CAM). Texts on oncologists' websites, showed high complexity according to readability analysis using LIX score as opposed to those on NMPs websites that showed medium complexity. Only small difference of quality of websites between both groups could be detected. CONCLUSION Methods not acknowledged by evidence-based medicine as well as methods at risk for interaction with conventional cancer therapy but also treatment offers with potential benefits for cancer patients were found on NMPs websites. PRACTICE IMPLICATIONS As evidence-based CAM methods can be a useful support of cancer treatment, risk of herb drug interactions can be minimized by oncologists offering reasonable CAM.
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Affiliation(s)
- Henriette Schallock
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Berit Bartmann
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Christian Keinki
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Jutta Huebner
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
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Keene MR, Heslop IM, Sabesan SS, Glass BD. Complementary and alternative medicine use in cancer: A systematic review. Complement Ther Clin Pract 2019; 35:33-47. [PMID: 31003679 DOI: 10.1016/j.ctcp.2019.01.004] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE Complementary and alternative medicine (CAM) use in cancer is increasing. The purpose of this study was to systematically review the literature to determine demographic profiles and prevalence and reasons for use in cancer patients. METHODS In this systematic review, the databases OVID, PubMed, and Scopus were searched for studies on CAM use in cancer between 2009 and June 2018. RESULTS The results showed that an average of 51% of cancer patients used CAM. Common independent demographic characteristics associated with CAM use were younger, female cancer patients, having higher education, earning a higher income and having previously used CAM. Frequent reasons for use, grouped into themes were shown to be to influence their cancer and general health and to treat complications of the cancer or therapy. CONCLUSION The review provides an insight and will serve to better inform health professionals on how this population is using CAM.
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Affiliation(s)
- Martin R Keene
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia.
| | - Ian M Heslop
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
| | - Sabe S Sabesan
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
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Klein J, von dem Knesebeck O. Inequalities in health care utilization among migrants and non-migrants in Germany: a systematic review. Int J Equity Health 2018; 17:160. [PMID: 30382861 PMCID: PMC6211605 DOI: 10.1186/s12939-018-0876-z] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/18/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Despite the growing number of people with migrant background in Germany, a systematic review about their utilization of health care and differences to the non-migrant population is lacking. By covering various sectors of health care and migrant populations, the review aimed at giving a general overview and identifying special areas of potential intervention. METHODS A systematic review was conducted in PubMed database including records that were published until 1st of June 2017. Further criteria for eligibility were a publication in a peer-reviewed journal written in English or German language. The studies have to report quantitative and original data of a population residing in Germany. The appropriateness of the studies was judged by both authors. Studies were excluded if native controls were not originated from the same sample. Moreover, indicators of health care utilization have to assess individual behaviour like consultation or participation rates. 63 studies met the inclusion criteria for a qualitative synthesis of the findings. RESULTS The overall findings indicate a lower utilization among migrants, although the results vary in terms of health care sector, indicator of health care utilization and migrant population. For specialist care, medication use, therapist consultations and counselling, rehabilitation as well as disease prevention (early cancer detection, prevention programs for children and oral health check-ups) a lower utilization among people with migrant background was found. The lower usage was particularly shown for migrants of the 1st generation, people with two-sided migrant background, children/adolescents and women. Due to the methodological heterogeneity a meta-analysis was not feasible. As most of the studies were cross-sectional, no causal interpretations could be drawn. CONCLUSIONS The inequalities in utilization could not substantially be explained by differences in the socioeconomic status. Other reasons of lower utilization could be due to differences in need, preferences, information, language and formal access barriers (e.g. charges, waiting times, travel distances or lost wages). Different migrant-specific and migrant-sensitive strategies are relevant to address the problem for certain health care sectors and migrant populations. TRIAL REGISTRATION The review protocol was registered on PROSPERO ( CRD42014015162 ).
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Affiliation(s)
- Jens Klein
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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Complementary and alternative medicine in radiation oncology. Strahlenther Onkol 2017; 193:419-425. [DOI: 10.1007/s00066-017-1101-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 01/06/2017] [Indexed: 01/23/2023]
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Kessel KA, Lettner S, Kessel C, Bier H, Biedermann T, Friess H, Herrschbach P, Gschwend JE, Meyer B, Peschel C, Schmid R, Schwaiger M, Wolff KD, Combs SE. Use of Complementary and Alternative Medicine (CAM) as Part of the Oncological Treatment: Survey about Patients' Attitude towards CAM in a University-Based Oncology Center in Germany. PLoS One 2016; 11:e0165801. [PMID: 27812163 PMCID: PMC5094772 DOI: 10.1371/journal.pone.0165801] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 10/18/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM. METHODS We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting. RESULTS A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%). CONCLUSION Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.
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Affiliation(s)
- Kerstin A. Kessel
- Department of Radiation Oncology, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
- Institute for Innovative Radiotherapy (iRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany
- * E-mail:
| | - Sabrina Lettner
- Department of Radiation Oncology, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Carmen Kessel
- Department of Radiation Oncology, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
- Onkologisches Zentrum im RHCCC am Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Henning Bier
- Department of Otorhinolaryngology, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy Biederstein, Technical University of Munich (TUM), Biedersteiner Straße 29, Munich, Germany
| | - Helmut Friess
- Department of Surgery, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Peter Herrschbach
- Roman-Herzog-Krebszentrum Comprehensive Cancer Center (RHCCC), Technical University of Munich (TUM), Trogerstraße 26, Munich, Germany
| | - Jürgen E. Gschwend
- Department of Urology, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Christian Peschel
- 3rd Department of Internal Medicine, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Roland Schmid
- 2nd Department of Internal Medicine, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
| | - Stephanie E. Combs
- Department of Radiation Oncology, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
- Institute for Innovative Radiotherapy (iRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany
- Onkologisches Zentrum im RHCCC am Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Straße 22, Munich, Germany
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