Integrative Cancer Therapies最新文献

Breast cancer is the most prevalent form of cancer in women. Despite significant advances in conventional treatment, additional safer complementary treatment options are needed. Recently, ozone therapy has been considered as a type of medical adjunctive treatment that could inhibit cancer cell survival and reduce chemoresistance. However, only a few studies have been conducted on its use in breast cancer, and the optimal dosage and time of administration are unknown. Currently, preclinical studies suggest that ozone alone or in combination with chemotherapy is an effective method for inhibiting breast cancer cell growth. However, rather than investigating the effects of ozone as an antitumor therapy, current clinical trials have generally assessed its effect as an adjunctive therapy for reducing chemotherapy-induced side effects, increasing oxygen tension, normalizing blood flow, restoring blood lymphocytes more rapidly, and reducing fatigue symptoms. In this article, the use of ozone as a medical adjunctive treatment for breast cancer and its role in integrative therapy are summarized and discussed.

Background: Cancer is a chronic condition associated with a substantial symptom burden, which can impair recovery after treatment. Investigating interventions with potential to improve self-reported disease and/or treatment effects-known as patient-reported outcomes (PROs)-is paramount to inform cancer care. The objective of this study was to evaluate the effects of a yoga therapy (YT) intervention on key PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life [QoL]) among adults after treatment for cancer.

Methods: Data from 20 adults (M_age = 55.74 years, 85% female; M_{time since diagnosis} = 2.83 years) who had completed treatment for cancer were analyzed for this study. In this single-subject exploratory experimental study, the YT intervention comprised a 1:1 YT session (ie, 1 participant with 1 yoga therapist) followed by 6 weekly small (ie, 2-3 participants) group YT sessions. Group sessions were facilitated by the same yoga therapist who delivered participants' 1:1 session to ensure an in-depth personalized approach. PROs were assessed before (ie, pre-intervention) and after the 1:1 YT session (ie, during the intervention), as well as after the last group YT session (ie, post-intervention). Hierarchical linear modeling was used to analyze the data.

Results: Participants showed improvements in cancer-related fatigue, state anxiety, trait anxiety, perceived cognitive impairments, impacts of perceived cognitive impairments on QoL, and 1 dimension of QoL (ie, functional wellbeing) over time. Notably, cancer-related fatigue and state anxiety increased immediately after the 1:1 session, but showed greater improvements over time afterward (ie, during the intervention phase). No changes were observed for the remaining PROs.

Conclusion: Although results require confirmation in future trials, this study highlights the importance of continuing to investigate YT as an intervention to enhance important PROs (ie, cancer-related fatigue and state anxiety) after treatment for cancer. More research is needed to identify additional beneficial effects and factors that influence participants' responses to 1:1 and group YT (ie, moderators and mediators).

Registration number: ISRCTN64763228.

Date of registration: December 12, 2021. This trial was registered retrospectively.

Url of trial registry record: https://www.isrctn.com/ISRCTN64763228.

Published protocol: Brunet, J., Wurz, A., Hussien, J., Pitman, A., Conte, E., Ennis, J. K., . . . & Seely, D. (2022). Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integrative Cancer Therapies, 21, 15347354221075576.

Background: Many patients diagnosed with cancer use complementary and integrative healthcare (CIH) approaches to manage their cancer- and treatment-related symptoms and improve their well-being. Evidence suggests that counseling on CIH can improve health outcomes and decrease healthcare costs by increasing patient activation. This qualitative study explores the experiences of cancer patients who underwent interprofessional counseling on CIH to gain insights into how these patients were able to integrate recommended CIH measures into their daily lives while undergoing conventional cancer treatment.

Methods: Forty semi-structured interviews were conducted with cancer patients participating in the CCC-Integrativ study and its process evaluation. The interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis following Kuckartz and Rädiker. A purposeful sampling strategy was used to achieve a balanced sample regarding gender, age, cancer diagnosis, and treatment approach.

Results: Most patients with cancer reported largely implementing the CIH recommendations. Participants acknowledged the efficacy of CIH recommendations in managing their symptoms. They felt strengthened and empowered to actively take part in their healthcare decisions. However, the patients encountered obstacles in incorporating the recommended CIH applications into their daily routines. These challenges encompassed the effort required for treatment application (e.g., baths, compresses), limitations imposed by the cancer disease (e.g., fatigue, pain), difficulties acquiring necessary materials, associated costs, and lack of infrastructure for CIH. Facilitators of CIH implementation included the availability of easily manageable CIH measures (e.g., herbal teas), informative materials on their application, distribution of samples, family support, and a high level of self-efficacy. The patient-centered approach and strong patient-provider partnership within the counseling context were perceived as empowering. Participants expressed a desire for a consistent point of contact to address their CIH concerns.

Conclusions: The findings underscore the benefits of CIH counseling for cancer patients' symptom management and overall well-being. Healthcare professionals providing CIH counseling to patients with cancer may recognize the barriers identified to better support their patients in the regular use of CIH.

Hyperthermia, the raising of tumor temperature (≥39°C), holds great promise as an adjuvant treatment for cancer therapy. This review focuses on 2 key aspects of hyperthermia: its molecular and cellular effects and its impact on the immune system. Hyperthermia has profound effects on critical biological processes. Increased temperatures inhibit DNA repair enzymes, making cancer cells more sensitive to chemotherapy and radiation. Elevated temperatures also induce cell cycle arrest and trigger apoptotic pathways. Furthermore, hyperthermia modifies the expression of heat shock proteins, which play vital roles in cancer therapy, including enhancing immune responses. Hyperthermic treatments also have a significant impact on the body's immune response against tumors, potentially improving the efficacy of immune checkpoint inhibitors. Mild systemic hyperthermia (39°C-41°C) mimics fever, activating immune cells and raising metabolic rates. Intense heat above 50°C can release tumor antigens, enhancing immune reactions. Using photothermal nanoparticles for targeted heating and drug delivery can also modulate the immune response. Hyperthermia emerges as a cost-effective and well-tolerated adjuvant therapy when integrated with immunotherapy. This comprehensive review serves as a valuable resource for the selection of patient-specific treatments and the guidance of future experimental studies.

Objective: To compare the effects between telerehabilitation and in-person rehabilitation on physical function, pain and quality of life in patients with breast cancer after surgery.

Design: Randomized, controlled, and parallel study that involved post-surgical oncological breast surgery patients who were female and aged between 18 and 70 years. The study was conducted in an outpatient environment, and the participants were randomized using a computer system. Population was divided into 2 groups: G1 (n = 20), who received face-to-face care, and G2 (n = 24), who received telerehabilitation. Participants were followed for 15 and 45 days postoperatively. The study's primary outcomes were based on 44 patients (n = 44). Values of changes in quality of life, range of motion (ROM), muscle strength, and upper limb functionality were compared for both groups during the 15 to 45 day postoperative.

Results: Both groups exhibited progressive improvements in range of motion, muscle strength, functionality, and quality of life over time (15- and 45-days post-operatively [PO]), indicating a positive response to treatment. Patients in G2 demonstrated more significant improvements in range of motion and muscle strength, as well as better functionality and quality of life compared to G1, particularly after 45 days PO. Additionally, G2 exhibited a more significant reduction in fatigue after 45 days PO.

Conclusions: Telerehabilitation is a viable option with good usability, and has been shown to produce results similar to in-person physiotherapy in most cases, and even superior in some. Long-term intervention studies are needed for the development of telerehabilitation.

Background: The global burden of cancer continues to rise and complementary and alternative medicine (CAM) is attracting a lot of interest. However, quality of online information on CAM, particularly on platforms like YouTube, remains questionable. This study aimed to create a comprehensive assessment tool to assess the quality of CAM-related YouTube videos, crucial for informed decision-making in oncology.

Methods: The assessment tool was developed by adapting existing criteria for website content analysis to video rating. A YouTube search was conducted using German-language terms related to CAM ("complementary medicine (CM) for cancer" and "alternative medicine (AM) for cancer"). In total 25 videos were assessed based on the defined criteria and assigned to five different types of providers (journalism, healthcare organization, hospital or health insurance, independent person, non-medical organization). Statistical analysis was conducted using IBM SPSS Statistics 27.

Results: Interrater reliability analysis showed an Intraclass Correlation Coefficient (ICC) of .91, indicating good to excellent agreement. The average video result was of poor quality, with none of the videos meeting all criteria. The videos achieved a mean rating of 38.2 points (SD: 6.5 points; possible range: 20-60 points). Journalism-based videos showed the most views per days, particularly surpassing those from hospitals or health insurance providers (Kruskal-Wallis-Test: z = 3.14, P = .02). However, there was no statistically significant correlation between video quality and the type of provider or interaction indices. Videos retrieved under the search term "CM" generally scored higher in quality than those under "AM" (Mann-Whitney U test: U = 39.5, P = .04). Nonetheless, "CM" videos were less frequently viewed (Mann-Whitney U test: U = 31.0, P = .01).

Conclusion: This study, the first of its kind focusing on CAM in cancer care emphasized the challenges in identifying credible sources on social media platforms such as YouTube. The developed assessment tool offers a more detailed evaluation method for health-related videos but requires further refinement and testing. Collaboration between healthcare and media entities is suggested to improve the dissemination of reliable information on platforms like YouTube.

Context: Salvia miltiorrhiza (SM) is a commonly used herb in traditional Chinese medicine (TCM) and has been used in the treatment of pancreatic cancer to relieve the symptom of "blood stasis and toxin accumulation." Tanshinones (Tan), the main lipophilic constituents extracted from the roots and rhizomes of SM, have been reported to possess anticancer functions in several cancers. But the mechanism of how the active components work in pancreatic cancer still need to be clarified.

Objective: In this study, we aimed to investigate the therapeutic potential of Tan in pancreatic cancer and elucidate the underlying mechanisms.

Materials and methods: The viabilities of PANC-1 and Bxpc-3 cells were determined by MTT assay, after treatment with various concentrations of Tan. The apoptotic cells were quantified by annexin V-FITC/PI staining and DAPI staining assays. The expression of relative proteins was used western blotting. Tumor growth was assessed by subcutaneously inoculating cells into C57BL/6 mice.

Results: Our experiments discovered that Tan effectively suppressed pancreatic cancer cell proliferation and promoted apoptosis. Mechanistically, we propose that Tan enhances intracellular ROS levels by activating the AKT/FOXO3/SOD2 signaling pathway, ultimately leading to apoptosis in pancreatic cancer cells. In vivo assay showed the antitumor effect of Tan.

Conclusion: Tan, a natural compound from Salvia miltiorrhiza, was found to effectively suppress pancreatic cancer cell proliferation and promote apoptosis both in vitro and in vivo. Mechanistically, we propose a positive feedback loop mechanism. These findings provide valuable insights into the molecular pathways driving pancreatic cancer progression.

Purpose: Allogeneic hematopoietic stem cell transplantation (HSCT) can have a long-term impact on patients' sexual functioning and consequently, their relationship satisfaction. This study aimed to examine the feasibility and acceptability of a 5-session psychosexual intervention for HSCT survivors and their partners.

Methods: To be eligible patients were required to be more than 3 months post-allogeneic HSCT. The intervention comprised 2 components: (1) A psychosexual education session exploring medical/behavioral treatment options for sexual dysfunction, delivered by a specialist nurse; (2) A 4-session Emotionally-Focused Therapy-based relationship education program for couples delivered by a clinical psychologist. Measures assessing relationship quality, sexual functioning, anxiety, and depression were administered pre- and post-intervention. Feasibility was measured via participation rate, adherence and compliance with completing main measures. Acceptability of the intervention was assessed via patient/partner satisfaction surveys.

Results: Eight of 85 (9.4%) eligible patients and their partners participated in the study. Reasons for declining participation included: feeling uncomfortable due to sensitive nature of intervention; did not have any relationship/sexual function issues; and experiencing ongoing medical issues. Six of 8 couples (75%) attended at least 4 intervention sessions and 5 of 8 (62.5%) completed the main study measures post-intervention. Four couples reported that sexual satisfaction and relationship satisfaction was somewhat or much better post-intervention; 1 reported no change.

Conclusion: Feasibility criteria were not met, with low enrolment rate, however the intervention was deemed acceptable. Couples who participated adhered to the intervention and considered it beneficial. Further strategies to identify and manage sexual concerns are required.