Abstract
As high-cost pharmaceutical immunotherapies take center stage in this year’s medical oncology meetings, it is appropriate for Integrative Cancer Therapies to devote some attention to immunotherapeutics derived from traditional herbal medicine. This issue contains 2 issues on preparations derived from anticancer, immunomodulatory fungi. The first is polysaccharide K, often known as PSK or Krestin, derived from the mushroom Trametes versicolor, also known as Coriolus versicolor. Heidi Fritz and her colleagues at the Canadian College of Naturopathic Medicine present a systematic review of studies on PSK, including 6 randomized trials. Outcomes included immune parameters, performance-related variables, and survival. This fungal constituent, which is sold as a cancer medication in Japan, certainly deserves further research. Adding lower cost natural products to our immunotherapeutic repertoire certainly has the potential to assist in the ballooning cost of cancer treatments.
Daniel Sliva of the Methodist Research Institute is well known for his research on the reishi mushroom, Ganoderma lucidum. Numerous preclinical and clinical studies point to a variety of anticancer activities, with immunomodulatory activity emerging as being of particular interest. Sliva suggests a systematic translational research program to bring this natural product to clinical use. He also emphasizes the importance of using preclinically evaluated, standardized, and biologically active extracts in alternative treatments—a worthwhile reminder for clinical use of all types of natural products.
Nasopharyngeal cancer is a major problem in Asia. Traditional Chinese herbal medicine has thus developed a number of therapeutic formulas for its treatment. Cho Seung-Hun and colleagues from Kyung-Hee University in Seoul, Korea have reviewed randomized studies on treatment of nasopharyngeal cancer with combined conventional and herbal therapy. Interesting results based on 22 studies include improvements in tumor response to treatment and suggestions of decrease in rates of distant metastases. Well-designed trials delineating specific, optimized herbal formulas have the potential to significantly improve treatment of this widespread cancer.
Rates of thyroid cancer are increasing, and with them, the need to attend to treatment side effects and quality of life variables for thyroid cancer articles. Yoo Hwa-Seung and colleagues at Dunsan Oriental Hospital in Daejeon, Korea present a small randomized study exploring the use of acupuncture in thyroid cancer patients undergoing radiation treatment. Treatment side effects for which acupuncture may have some benefit for these patients include quality of life and anorexia.
For many patients, a cancer diagnosis will trigger a new search for meaning in life. Sheila Garland and colleagues at the University of Pennsylvania explore the predictors of the need to find meaning in the cancer experience in the context of patients who are contemplating whether to attend teaching sessions for mindfulness-based stress reduction (MBSR). Patients who are interested in MBSR endorse personal search for meaning at higher rates than those who are not. Anxiety and identification of non-white racial/ethnic status both predict search for meaning. These data may be useful in helping to counsel patients on which types of stress reduction might be most attractive for them to explore, as well as raising questions of how to remove barriers to participation in MBSR classes.
Weight loss and weight gain are major issues for many cancer patients. Recent concerns about the effect of overweight on prognosis in some cancers has added a new dimension to the traditional concerns about patients with advanced cancers contending with anorexia and cachexia. Ann Klassen of Drexel University in Pennsylvania and colleagues present a qualitative study of the perceptions of clinical care providers on weight issues in cancer survivors. Many cancer survivors, especially those with comorbidities, are interested in losing weight. Providers are concerned with developing resources and capacity in the healthcare system to help patients address their concerns with weight.
Developing an acupuncture treatment for a clinical trial involves specification of variables such as specification of points to be used, needle type and length, depth of needling, and frequency of treatment as well as justification for these based on traditional Chinese medicine theory and literature review. How well are these characteristics of treatment specified in clinical trial reports of acupuncture? Suzanne Grant of the University of Western Sydney and colleagues examine this question using studies of acupuncture for cancer-related fatigue, cautioning us that without further standardization of reporting of these characteristics, progress in the field may be slowed.
Celastrus orbiculatus is an herbal treatment in traditional Chinese medicine that has previously been observed to have antimetastatic properties. Zhu Yaodong and colleagues at Yangzhou University examine an extract of this species to determine whether it affects the epithelial-mesenchymal transition (EMT) in gastric cancer cells, an important step in the initiation of cancer metastasis. Like many other herbal medicines, their research shows that this species inhibits more than just a single target, with both targets related to EMT and NF-κB/Snail signaling in its repertoire. Celastrus orbiculatus has now escaped from garden use in the United States, and become an invasive weed that adversely effects natural plant communities. Botanists trying to preserve the native vegetation of the eastern United States can only hope that this discovery of anticancer properties leads to commercialization and widespread collection of this weedy species from these communities, with its eventual eradication there!
Most pain medications in conventional Western treatment are taken orally or by injection. Only a few are applied externally, although the transdermal use of narcotics for cancer pain has greatly expanded in the past few years. Practitioners of traditional Chinese medicine at Tianjin University Hospital, however, have also been exploring the use of ointments in cancer pain control, as reported in an article by Jia Yingjie and colleagues. This article used an animal model of visceral pain to determine the mode of action of a formula used clinically, Hua-Jian-Ba-Du. This effective formula appears to regulate inflammation and neurotransmitters.