Integrative Cancer Therapies最新文献

Background: Lung cancer is the most diagnosed cancer worldwide and is associated with various unmet supportive care needs. To address these needs, a 6-week virtual program called Inspire Now was developed, integrating yoga, education, and group support. The primary objective of this mixed-methods observational study was to evaluate the program's impact on quality of life (QOL). Secondary objectives included changes in participant-identified concerns, participants' qualitative experiences, and acceptability of virtual delivery.

Methods: Eligible participants included people with primary lung cancer enrolled in the program. Questionnaires were administered at baseline and program completion. QOL and patient-identified concerns were evaluated by within-person changes in Functional Assessment of Cancer Therapy - Lung (FACT-L) and Measure Yourself Concerns and Wellbeing (MYCaW). Qualitative experiences and feasibility of virtual delivery were obtained by MYCaW and an internally developed questionnaire. FACT-L and MYCaW were analyzed using paired t-tests, and qualitative data was evaluated by an inductive thematic analysis.

Results: Forty-five participants were enrolled and 31 were eligible for analysis. Most were female (87%), had stage IV disease (68%), and were on active treatment (74%). Significant improvements were observed in FACT-General and Lung scores (mean changes: +6.1, 95% CI 2.2- 10.0, P = .003; +5.9, 95% CI 1.1-10.7, P = .02, respectively). MYCaW concerns and overall wellbeing were significantly improved. Participants viewed the virtual format favorably. Emotional support and connection were the most valued aspects of the program.

Conclusions: A 6-week virtual program of yoga, education, and group support improved QOL, patient-specific concerns, and wellbeing for those with lung cancer.

Research on the relationship between integrative oncology (IO) programs and dispensing of chemotherapy agents and supportive care drugs, and hospitalization rates is limited. The present study examined these outcomes in chemotherapy-treated patients with cancer, comparing patients highly adherent to integrative care (high-AIC) to those with low adherence (low-AIC). Data from patients with cancer treated with taxane and/or platinum-based agents participating in an ongoing prospective, controlled pragmatic trial were examined retrospectively. Patients were referred to an IO consultation and weekly treatments at 3 medical centers in Northern Israel, with high-AIC defined as attending ≥4 sessions at 6 weeks; low-AIC, 0-3 sessions. Cancer-related parameters; dispensing of medication (chemotherapy agents, analgesics, anxiolytics and opioids); rates of hospitalizations and emergency room visits were analyzed using generalized linear regression models. Of 615 patients attending the IO consultation, 367 (59.7%) were high-AIC, with both groups having mostly similar baseline characteristics. Dispensing rates for taxanes (P = .336), platinum agents (P = .403), non-opioid analgesics (P = .201), and anxiolytics (P = .350), and number of emergency room visits were similar in both groups at 12 weeks. However, high-AIC patients had fewer dispensed opioid prescriptions (RR = 0.50, 95% CI = 0.30-0.85, P = .010); lower rates of hospitalization (OR = 0.59, 95% CI = 0.39-0.88, P = .010); and fewer hospitalization days (RR = 0.53, 95% CI = 0.31-0.90, P = .019). In conclusion, dispensing of chemotherapy drugs was similar between groups, though high-AIC patients used less opioids and had fewer hospitalizations at 12 weeks. Further research is needed with randomized and prospective studies exploring the relationship between adherence to IO care; adherence to chemotherapy; quality of life; opioid use; and hospitalization.

Chemoresistance is still an important factor affecting the efficacy of treatment in colorectal cancer (CRC) patients. Hypoxia is related to poor prognosis and treatment resistance in cancer. Relevant studies have shown that a hypoxic microenvironment can promote the polarization of M2 macrophages and thus promote tumor development. Previous research has found that bufalin has a wide range of antitumor effects, but whether bufalin can reverse tumor resistance by improving the hypoxic tumor microenvironment is still unclear. In present research, it was found that high expression of SRC-3 in CRC cells under hypoxic conditions promoted the polarization of M2 and caused chemotherapy resistance, while bufalin, a monomeric drug used in Chinese medicine, reduced the level of SRC-3 and HIF-1α, thereby reversing chemoresistance. In addition, overexpression of SRC-3 reduced the hypoxia-mitigating effect of bufalin on CRC cells to promote the polarization of M2. Bufalin also inhibits the polarization of M2 caused by hypoxic CRC cells. Therefore, bufalin has the potential to become a new adjuvant therapy that can be further explored in future studies on its treatment of CRC.

Screening for pulmonary nodules (PN) using low-dose CT has proven effective in reducing lung cancer (LC) mortality. However, current treatments relying on follow-up and surgical excision fail to fully address clinical needs. Pathological angiogenesis plays a pivotal role in supplying oxygen necessary for the progression of PN to LC. The interplay between hypoxia and angiogenesis establishes a vicious cycle, rendering anti-angiogenesis therapy alone insufficient to prevent PN to LC transformation. In traditional Chinese medicine (TCM), PN is referred to as "Feiji," which is mainly attributed to Qi and blood deficiency, correspondingly, the most commonly prescribed medicines are Astragalus membranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao (huang qi) (AR) and Angelica sinensis (Oliv.) Diels (dang gui) (ARS). Modern pharmacological studies have demonstrated that AR and ARS possess immune-enhancing, anti-tumor, anti-inflammatory, and anti-angiogenic properties. However, the precise mechanisms through which AR and ARS exert anti-angiogenic effects to delay PN progression to LC remain inadequately understood. This review explores the critical roles of hypoxia and angiogenesis in the transition from PN to LC. It emphasizes that, compared to therapies targeting angiogenic growth factors alone, AR, ARS, and their compound-based prescriptions offer additional benefits. These include ameliorating hypoxia by restoring blood composition, enhancing vascular structure, accelerating circulation, promoting vascular normalization, and blocking or inhibiting various pro-angiogenic expressions and receptor interactions. Collectively, these actions inhibit angiogenesis and delay the PN-to-LC transformation. Finally, this review summarizes recent advancements in related research, identifies existing limitations and gaps in knowledge, and proposes potential strategies and recommendations to address these challenges.