Abstract
Our initial article concerns herbal therapies from ayurvedic medicine and is authored by Manjeshwar Baliga of Father Muller Medical College and his colleagues. They focus on classical drugs of ayurveda that have radioprotective effects on normal cells during radiation therapy. Due to the inadequate clinical benefit, toxicity, and cost of current radioprotectors, research in this area is certainly warranted.
A randomized study of the feasibility and acceptability of Tai Chi Chih was performed by Rebecca Campo of the Huntsman Cancer Institute and colleagues. This trial specifically targeted female senior cancer patients. The randomized design included a health education class as a control intervention. Insight into the feasibility, usefulness, and outcomes of control interventions in target populations, which this study provides, is one of the important results of feasibility studies that can sometimes be overlooked, so we are pleased to be able to provide this study.
Cognitive impairment after chemotherapy, often referred to as “chemo brain,” appears to be common but has little in the way of effective interventions. Jean Alvarez and her colleagues at the Applied Brain Research Foundation of Ohio present a controlled study of electroencephalogram biofeedback as a possible treatment for this condition, which is quite welcome as an innovative approach. Interestingly, we recently noted that a study presented in September of this year pointed to hormonal therapy as being more likely to cause cognitive impairment than chemotherapy in breast cancer patients. Whether this result is confirmed with larger studies remains to be seen, but the study certainly suggests that we need to learn more about both the origins and the treatments of this vexing condition.
Eran Ben Arye of Lin Medical Center in Haifa and his colleagues present a very intriguing article exploring the beliefs of complementary therapists, folk healers, and religious healers in the Arab community in northern Israel. Different classes of therapists have differing beliefs as to the curative potential of their therapies and the relationship of their therapies to the conventional medical system. This study shines an interesting light on the varieties of therapies accessed by this community during cancer treatment and suggests areas for more research.
Conjugated linoleic acid (CLA) is a compound found in dairy products and other sources that is a popular dietary supplement. In a randomized study in this issue by Elnaz Faramarzi of Tabriz University, Iran, and colleagues, CLA or placebo sunflower oil capsules were given to patients undergoing chemotherapy and radiotherapy for rectal cancer. Significant improvements in variables related to inflammation, angiogenesis, and tumor invasion were observed in the CLA group relative to the placebo group. This suggests that further work on CLA as a supportive agent during conventional treatment might be fruitful.
The psychosocial effects of cancer and its treatment are, of course, well known, and the correct measures to alleviate these are an active area of research. We present a case study of 2 patients by Holger Cramer of the University of Duisberg-Essen concerning a mind–body day clinic that has a multifaceted program centered on mindfulness-based stress reduction, yoga, nutrition, naturopathy, and cognitive restructuring. Case studies, and descriptions of comprehensive clinic programs, are helpful for our field in a quite different way from randomized trials. They explain models for potential future clinical work and suggest outcomes that might be seen for comprehensive interventions that could be studied in later clinical trial designs. Since most integrative oncology clinics do rely on multidisciplinary interventions, they also provide valuable perspectives and models for practicing clinicians.
Erin Sweet and colleagues from Bastyr University contribute a provocative literature review on adverse events associated with use of complementary and alternative medicine substances, such as dietary supplements, during conventional treatment for ovarian cancer. The search for adverse events is coupled with a literature search on herbal mediators of cytochrome P450 (CYP450) activity, which is, of course, of major interest when supplements are taken with chemotherapeutic agents due to the possibility of adverse interactions. The results of the search for adverse events are quite surprising in light of current concerns about CYP450-based interactions, but we will leave readers to discover these for themselves. The search for CYP450-active agents is more predictable, but the authors’ findings about adverse events lead them to suggest a more rigorous evaluation on the actual activity of these agents in human studies to balance the usual emphasis on laboratory evaluation.
Nontoxic means to enhance the cytotoxicity of chemotherapy agents to cancer cells are an important aim of integrative oncology. Garret Yount and colleagues at California Pacific Medical Center have applied infrasound at low pressure amplitudes to glioblastoma cells exposed to cisplatin. They find an enhancement of membrane permeabilization and of apoptosis in the cancer cells exposed simultaneously to infrasound and cisplatin. Research on ultrasound and shock waves for use in treatment is currently of significant importance. This study suggests that infrasound might also be explored for its therapeutic potentials.