Significance of Kampo medicine in cancer supportive care“1st International Symposium on Kampo Medicine”

Abstract

Kampo medicine is a traditional Japanese medicine that is increasingly integrated in modern medicine. Next to hundreds of years of experience, basic research on single herbs and their combinations support its use in a modern context. With standardized herbal prescriptions, we now have non-interventional and randomized controlled trials of Kampo medicines supporting their traditionally known effects. The Japan Society for Oriental Medicine celebrated the first 20 years of the activities of the Evidence-Based Medicine (EBM) Committee in June 2021 [1]. Among the activities of the EBM Committee, Evidence Reports of Kampo Treatment contain randomized controlled trials (RCTs) and meta-analyses, including RCTs on cancer supportive care. Supportive care has always been a stronghold of Kampo medicine and leads to a more complete standard treatment especially for cancer patients. The first presentation is “Significance of Kampo Medicine for Cancer Supportive Care: Overview.” Cancer supportive care includes all measures to prevent or ameliorate side effects of any treatments including anticancer agents, with physical, mental, social, and spiritual care (survivorship). In modern cancer care, Kampo medicines are especially helpful in the management of refractory symptoms such as general malaise/fatigue, anorexia, cachexia, and peripheral neuropathy [2]. Action mechanisms of each Kampo formula and its components have been elucidated by basic research. In this symposium, we will learn and discuss state-ofthe art progress in basic and clinical research in the field of cancer supportive care. In addition to the reports on the Japanese situation, we will listen to German viewpoints on this theme. The second presentation is “Roles of Kampo Medicine for Chemotherapy-Related Adverse Events.” While the development of recent cancer treatments progresses, it is often experienced that continuation of cancer treatment becomes difficult due to individual differences, general condition, underlying diseases, and various therapy-related adverse events such as mucositis, diarrhea and immunosuppression. Therefore, the development of cancer treatments comes with the battle against their side effects. Advances in supportive care improve the outcome of cancer therapies. In recent years, the application of traditional Japanese medicine, “Kampo medicine,” to cancer supportive care has attracted attention to improve the results of cancer treatment and the quality of medical care [3]. Especially the Kampo formulas called “Hozai” have been reported to improve nutritional and immune status. In addition, their effects on both mind and body are recognized. This presentation overviews the clinical role and potential of Kampo medicine in the latest cancer treatments. The third presentation is “The Importance and Requirement of Evidence-Based Medicine to Expand the Use of Kampo Medicine.” Cancer treatment is one of the major projects in the world. In recent years, chemotherapy, surgical treatment, radiation and immune checkpoint therapy have been used for the treatment of cancer patients. In association with these treatments, the number of cancer survivors has increased. On the other hand — with long-time treatment — the number of patients suffering from side effects is increasing, and the importance of cancer supportive care is being emphasized. The effects of Kampo medicine are never just a sum of each effect induced by its various ingredients. Owing to the development of liquid chromatography–mass spectrometry (LC/MS/HPLC) and a variety of molecular biology tools, we are now able to examine profiles of particular effective ingredients included in Japanese Kampo medicines and select for those [4]. We now are investigating the effects of Kampo medicines on ameliorating adverse effects by analyzing targets in cancer patients and several effective compounds in Kampo medicines. The fourth presentation is “German Viewpoints on Kampo Medicine in Supportive Care for Cancer Patients.” The main task of medicine has always been to prevent disease or to support the healing process. The endpoint was the well-being of the patient. This has changed with the advent of diagnostic tools where outcome can be measured. In case of infection, leucocyte values have to normalize, Helicobacter pylori should be eradicated and tumor size should reduce or — in the best case — respond completely. However, we all know that invisibility to the CT scan does not mean the absence of tumor cells. Kampo medicine — like all traditional medicines — gives us the sensibility and the means to assess and to support the well-being Received: 20 May 2022 Accepted: 25 May 2022