Abstract
This issue begins with a meta-analysis on one of the most widespread of integrative cancer therapies, massage. Massage is traditionally used to relieve pain, and this analysis by Sabina Lim and colleagues at Kyung-Hee University in Seoul, Korea, seeks to determine whether massage is effective for cancer pain. Meta-analyses evaluate studies based on various scales used to measure risk of bias due to poor trial design. This study used both a risk-of-bias tool developed by the Cochrane Collaboration and one developed by the Physiotherapy Evidence Database group, called the PEDro scale. This scale is being used to evaluate studies in fields such as physical therapy and occupational therapy, and we are pleased to see it being rigorously applied to massage studies. One of the interesting findings of this analysis concerns the helpfulness of foot reflexology, an alternative massage technique.
A continuing controversy in the field of integrative oncology is the usefulness of dietary and supplemental antioxidants for cancer patients. Gyeongyeon Hong and colleagues at Tom Baker Cancer Center in Calgary, Canada, explored this question from an interesting perspective: they collected policies and guidelines on antioxidant use from cancer hospitals in North America and evaluated them relative to the research literature on antioxidants. They also evaluated how the policies were developed. Communicating information on antioxidants to both patients and hospital staff is a continuing challenge that practitioners would do well to consider.
Dianne Groll and Marian Luktar-Flude of Queen’s University, Kingston, Canada, have evaluated the literature on neurofeedback, a noninvasive form of brain training that may be useful for cancer patients affected by long-term cognitive impairment. Most of the work in this area has been with populations other than cancer patients, but these authors have explored the ability of neurofeedback methods to alleviate both cognitive impairments and fatigue, both of which are relevant in cancer. Their results suggest that further research on this method may provide new options for cancer patients.
Research on the benefits of exercise for cancer patients continues to point to new ways in which it may contribute to the well-being of cancer patients. Morton Quist and colleagues at University Hospitals Centre for Health Research in Copenhagen, Denmark, report on a phase II study of a multimodal group exercise intervention for lung cancer patients with stage III or IV disease. Physical and functional capacity, anxiety, emotional well-being, health-related quality of life, and ability to adhere to an exercise program were the important variables measured in this study; all are highly relevant for this population.
This issue features 2 articles on the use of complementary and alternative therapies by cancer patients in Australia. The first, by Aimee Sullivan of Prince of Wales Hospital, Randwick, Australia, concerns English-speaking patients at a regional cancer center. Of the patients surveyed at this center, 68% reported using some type of complementary and alternative therapy. Not disclosing use of these therapies to their physicians was common. In an interesting contrast, Jon Adams and colleagues at the University of Technology Sydney in Sydney, Australia, examined use of complementary and alternative medicine among Indigenous Australians with cancer who were being treated at large hospitals in Queensland. Among this group, only 18.7% reported using complementary and alternative therapies, with only 2.8% reporting visits to indigenous practitioners. The contrasting practices among these 2 groups emphasize the need for cultural sensitivity in dealing with complementary and alternative medicine use in ethnically mixed populations.
Objective measures for distress in cancer patients would be a helpful research tool. David Lipschitz and colleagues at the University of Utah in Salt Lake City, Utah, explored the use of salivary oxytocin in a study of mind-body interventions. Oxytocin is associated with affiliation, calm and a sense of well-being. The study compared mindfulness meditation, mind-body bridging and sleep hygiene education for their effects on sleep and variables such as mindfulness and self-compassion, with salivary oxytocin used as an objective measure.
Herbal medicine has many anticancer functions in traditional Chinese medicine. One of the functions that we do not so readily think of is pain relief. Lon-Teng-Tong-Luo is a traditional Chinese formula containing 7 herbs, which is applied in cancer pain relief as a medicated gel. We seldom think of treating something like bone cancer pain with a medicated gel, much less an herbal medicated gel, but Juyong Yang and colleagues at Longhua Hospital in Shanghai studied just such an application using a rat model of bone cancer pain. They explored the nature of its pain-relieving effects through its impact on neuronal pain receptors, mediated by interleukin 17-A in the spinal cord.
Zhenfeng Hong and colleagues at Fujian University in Fuzhou, China, examined molecular mechanisms the anticancer properties of an alkaloid extract of Rubus alceifolius, a plant used for treatment of liver disease in traditional Chinese medicine. They used cell cultures and mouse models of hepatocellular carcinoma, the sixth most common malignancy globally. The hedgehog pathway was their particular interest, and they noted reduction of the matrix metalloproteinases. These important enzymes have roles in cell proliferation, migration, differentiation, angiogenesis, and apoptosis, making them a highly significant target for development of anticancer therapeutics.
Finally, with deep sadness we note the passing of Jeremy Geffen as this issue goes to press. Jeremy was a pioneer in integrative oncology, author of The Journey Through Cancer, 1 and an architect of The Seven Levels of Healing, a personally designed oncology support system. Jeremy was also an explorer of the world’s healing traditions, incorporating them into his work and his life. He will be missed by patients and colleagues alike.