Abstract
We recently attended the Annual Meeting of the Society for Integrative Oncology, held in Houston, Texas. The concluding article in this issue contains a meeting report, as well as the 10 top-ranked abstracts that were presented at the conference. Readers will find some of these abstracts particularly interesting. The abstract by Joshua Bauml and colleagues concerns a study of acupuncture in which expectation of response to acupuncture was evaluated as part of the analysis of sham acupuncture received by the study’s control group. They observed that patients with a high expectation of benefit had a good response to sham acupuncture, whereas those who had a low expectation of benefit did not. However, both patients with high and low expectations of benefit experienced good results from true acupuncture. This is a significant insight into sham acupuncture, which deserves more study. Readers may wonder, as we did, whether similar mechanisms are relevant to other types of placebo, and the implications of this observation for complementary and alternative medicine research. We were also pleased to note that one of the top-ranked abstracts, concerning the Measure Yourself Concerns and Wellbeing test, is being published as a full article in this issue.
Holger Cramer and colleagues at the University of Duisburg-Essen begin this issue with a systematic review of 13 randomized trials of hypnosis in breast cancer. Hypnosis has long been used to assist patients in surgical recovery and in treatment of a variety of diseases. This review examines its role in breast biopsy, radiotherapy, hot flashes, and other outcomes. Extending the role of this noninvasive intervention with good clinical trials is a very worthwhile effort and has the potential to relieve many aspects of distress in cancer patients.
Shirley Fong and colleagues at the University of Hong Kong and other Hong Kong research institutes have examined the potential of tai chi qigong as a supportive treatment in nasopharyngeal cancer, a common cancer in Asia. Patients with this cancer often experience head, neck and shoulder impairments due to conventional treatments. These disturb sleep and have other adverse impacts on quality of life. This randomized trial examined impacts on range of motion, mouth opening capacity (a common problem in head and neck cancers), and sleep, demonstrating that this ancient system of movement has relevant impacts in the very modern treatment of a serious and widespread cancer.
The new movement toward patient-centered care, along with the need for documentation of quality care in the clinic is resulting in the emergence of interest in psychometric instruments that measure patients’ own perceptions of their health. One of these is the Measure Yourself Concerns and Wellbeing. This instrument allows patients to specify their own concerns and quantify their severity, rather than choosing from a prespecified list of concerns. Rachel Joliffe and colleagues at Penny Brohn Cancer Care validated this instrument using the FACIT-SpEx (Functional Assessment of Chronic Illness Therapy–Spiritual Wellbeing–Expanded) questionnaire and measures of responsiveness to change. We should expect to see more work on instruments of this type, which will play an important role in many health care systems in the near future.
Valerie Lee and colleagues at Columbia University questioned hepatocellular carcinoma patients at their university hospital about their use of dietary supplements. Hepatocellular carcinoma, while common in Asia, is much less common in the United States, making this an interesting subpopulation. Many herbal medicines appear to affect hepatic metabolism, and this make supplement use a particular concern. This study also examined survival in relation to supplement use, which makes its findings of special value.
Carolyn Eyles and colleagues at the University of Southampton carried out a mixed methods study of mindfulness-based stress reduction (MBSR) in metastatic breast cancer patients. This study explored feasibility of a MBSR course for breast cancer, and patient reactions to the course. The data this study offers on recruitment, commitment, attendance, and benefits to patients deserve attention by those interested in research on MBSR as well as on its clinical use. Time commitment in particular proved to be an area of some concern.
Abidemi Akindele of the University of Lagos and colleagues tested the Nigerian phytomedicine DAS-77 for anticancer activity. This interesting phytomedicine is composed of the barks of mango and papaya. It is known to possess antidiarrheal, gastroprotective, antimicrobial and antioxidant activity. This study used in vivo testing to determine the effects of different extracts of this preparation on solid and blood tumors.
Annona muricata, or soursop, is well known to contain anticancer phytochemicals, the annonaceous acetogenins. Under another name, Graviola, this herbal medicine is receiving substantial attention as an alternative cancer treatment, although clinical trials are lacking. Little work has been done on the effects of soursop on prostate cancer. George Asare and colleagues examine the effects of extracts of this species in both in vitro and in vivo models, including examination of both genetic expression and anatomic effects.
Jye-Hornq Wu and colleagues at National Chung Hsing University College of Forestry examine the effect of the phytochemical ferruginol in causing apoptosis in lung cancer cells. Ferruginol is an important phytochemical constituent of the tree species Cryptomeria japonica. This tree, also known as Japanese cedar, occurs not only in Asia, but is also planted as an ornamental species in the United States and other temperate countries. It is a conifer and is valued for construction in Japan and in Taiwan in addition to being known for anticancer properties. In addition to the investigation of apoptosis in this study, the authors provide in vivo data on subcutaneous implanted lung tumors.
Yibin Feng and colleagues at the University of Hong Kong examine a multicomponent herbal prescription known as Gegen Qinlian, consisting of 4 herbs commonly used in traditional Chinese medicine. The authors cite case reports in the literature of patients experiencing prolonged survival or tumor regression using this formula without conventional therapies. They provide data on the effects of the extract on renal cell carcinoma cells, noting that there is very little in the way of preclinical data on this intriguing herbal combination.
With the initiation of our 14th year of publication, we wish a happy and productive New Year to all our readers.