Abstract
We begin this issue by announcing good news. As of January 2013, Integrative Cancer Therapies will move to publishing 6 issues per year instead of quarterly publication. This is a significant move for the journal, and for the growing field of integrative oncology. We will now be able to accommodate more research articles, reviews, and educational features, including the Integrative Tumor Board. To help with the increased editorial workload, we very pleased to welcome a new associate editor to our staff, Dr Peiying Yang, assistant professor in the Integrative Medicine Program at M.D. Anderson Cancer Center. We encourage our readers to submit manuscripts and to suggest Integrative Cancer Therapies to colleagues as a place to publish new research. We look forward to bringing our readers an expanded selection of articles on all aspects of integrative oncology.
Recent weeks have seen publication of some good news for patients as well. A large randomized study has observed a statistically significant 8% reduction in cancer cases in the study arm randomized to take a commercially available multivitamin. 1 This study was conducted in a sample of middle-aged and older physicians, as part of the Physicians Health Study. The 8% reduction applied only to overall cancer incidence; reductions in risk for specific cancers were not significant, and a protective effect was lacking for early prostate cancer. This was a well-done study that maintained good adherence to the study medications over a long dosing period.
While an 8% decrease in cancer incidence may not sound very exciting, when we view it in terms of the overall US population, it is more interesting than one might think. Figures for cancer incidence in 2011 in the United States showed that there were 848 170 new cancer diagnoses. 2 About half of these (51%) were in men. If we calculate 8% of the total number of new cancer cases, we find that this is 67 853 cases, or 34 605 cases in men (4% of all cancers). The total 2010 cost of treating cancer in the United States was $124.6 billion. 3 Calculating 4% of this total for the costs that could be saved if men were diagnosed with these cancers, we find that an approximate $4.9 billion in health care costs could be saved. The authors point out in the discussion of this article that a better result has been achieved with this single multivitamin that contains a large variety of vitamins and minerals in small, balanced doses, than in previous trials of single vitamins or antioxidants given in large doses. And this result was obtained in a population that was fairly well nourished.
Another piece of good news is that this study was published in JAMA, the Journal of the American Medical Association. Practitioners of integrative medicine have often noticed that the large journals appear to be reluctant to publish positive studies on integrative and complementary therapies and that positive articles that are published often receive little notice in the popular press. For instance, Bairati et al published a well-known and widely cited study in the Journal of the National Cancer Institute in 2005 regarding a study that found a negative effect of antioxidant vitamins given during radiotherapy on second primary head and neck cancers. 4 Later studies by this group also noted increased mortality. These studies received much notice in the press. However, a reanalysis of the study data that found that almost all of the excess recurrence and mortality occurred in patients who smoked during radiation therapy was published in the International Journal of Cancer, 5 arguably a less prominent periodical than the original article. It received almost no notice by the press. Happily for the new multivitamin study, we are now seeing a case where a positive result was published in a major journal; it did receive significant notice in the mainstream media. We do need to note that in our local Chicago Tribune newspaper, the page after the story on this article was a full-page advertisement reinforcing the study findings by the multivitamin manufacturer, which is a major pharmaceutical company.
Of course, we do not regard a daily multivitamin as a solution to the problem of cancer in the United States or elsewhere. Reducing obesity, increasing exercise, improving fruit and vegetable consumption, as well as other lifestyle prevention factors are actually of much greater importance. Tailored supplementation that addresses specific risk factors, such as elevated inflammation or blood glucose, also has a role to play, especially in patients who are not optimally healthy. But we are pleased to see simple interventions that can help even a little to bring down the out-of-control cancer rates in the US population.
We hope to continue bringing good news to our readers as we move into the New Year.