Abstract
Intravenous vitamin C has been attracting substantial attention in recent months, especially since the publication early this year of the results of studies at the University of Kansas on treatment of ovarian cancer with high-dose intravenous vitamin C. 1 We are thus especially pleased to publish in the current issue a systematic review of human studies on vitamin C, authored by a team based at the Canadian College of Natural Medicine under the leadership of Heidi Fritz. This review covers not only the small number of available randomized trials but also uncontrolled trials, observational studies, and case reports, giving us a thorough inventory of the interesting, though limited, information on this well-known alternative therapy.
Another area of continuing interest in integrative medicine is whether biobehavioral interventions are able to influence patient survival. While this question has been explored in multiple randomized trials and meta-analyses, a meta-analysis in this issue by Wang Debin and colleagues adds a new element to our thinking on this issue by calculating the effect of the length, or “dose” of the biobehavioral intervention. Certainly one would not expect an intervention consisting of a few hours of contact time with a therapist or group to have as much potential impact as one that lasted for weeks. Could length of the intervention influence survival outcomes? Debin and colleagues find intriguing suggestions that it may.
The great traditional medicine systems of Asia, such as traditional Chinese and Japanese medicine, have long been integrated with conventional pharmacological treatment of cancer. Korea has its own traditional medical system as well, with unique perspectives, contexts, and treatments. Korean practitioners have also been working to integrate this system with conventional cancer treatment as well as prevention. A review in this issue by Jong Soo Jeong and colleagues reviews progress in this area. A particularly interesting feature of this article is the inclusion of a table showing the molecular targets of a number of major herbal therapies used in Korean traditional medicine.
Intratumoral injection is an unusual means of applying herbal therapy. Nonetheless, it has been used in Europe with mistletoe extracts, which are widely popular as cancer treatments in that area. An article by Jan Axtner and colleagues discusses a case series of patients with pancreatic cancer who received this treatment, noting its safety and possible efficacy. Given the difficulty of treating pancreatic cancer with conventional therapies, we should always be open to rigorous evaluation of therapies that may offer new alternatives to patients, and this may be a relevant example.
A study from Brazil using a new approach to the old tradition of meditation also appears in this issue. Carlos Tosta and colleagues have developed a secular meditation method that relies on the concept of “prana,” which is a concept from Indian traditional medicine that is analogous to “qi” in traditional Chinese medicine. Pranic meditation relies on easy-to-learn techniques of concentration, breathing, and visualization. A pilot study with 75 Brazilian breast cancer patients in this issue suggests interesting effects on a variety of mental health measures.
Sarwat Sultana and colleagues have explored the immune surveillance and p53-stabilizing properties of 3 well-known herbs, fenugreek, bhringraj, and calendula, with a view toward using them to combat skin carcinogenesis. In the in vivo models used in the study, the authors were able to explore not only the obvious parameters of tumor growth and multiplicity but also a variety of other targets, including immune surveillance, effect on NF-κB, anti-inflammatory effects, and p53 stabilization. The multiple capabilities of these herbs are typical of what we are seeing with natural products and highlight the contrast of these products with activities of targeted therapies, which are currently demonstrating both efficacy and limitations. We feel that research in the multitargeted properties of traditional herbals is an important addition to our knowledge of cancer, its prevention, and its management, and we plan to publish more of it in the future.