Journal of the Society for Integrative Oncology最新文献

With the survival rates for childhood cancer growing, studies point to both the challenges and possible opportunities for personal growth that children with cancer may experience throughout their life journey. Examined in this review, research on the spirituality of childhood cancer survivors has provided insight into their overall spiritual journeys, their strategies to promote well-being, and the dynamics of hope and meaning within their lives. In an area that is in the early stages of research, the qualitative and exploratory research of the spirituality of childhood cancer survivors also contributes to the generation of future hypotheses. Finally, future research in this area should provide us with an enhanced understanding of spiritual paradigms that will assist us in making provisions for optimal support of children and their families.

The use of music as a therapeutic tool in health and medicine dates back to ancient times. In modern Western medicine, music therapy has been available since the 1950s and is now often incorporated into conventional medicine care. Music therapy is a common modality that is used in hospital settings as part of complementary and integrative medicine programs. It is also a key therapeutic tool used within most integrative medicine programs at large cancer centers in the United States. When used in conjunction with conventional cancer treatments, music therapy has been found to help patients promote a better quality of life; better communicate their fear, sadness, or other feelings; and better manage stress, while alleviating physical pain and discomfort. In this article, we review the literature on the value of integrating music therapy in cancer care and describe the experience of music therapy at a large comprehensive cancer center and the benefits that patients with cancer obtain from this service.

This study evaluated whether expressive writing (EW) was an effective stress management intervention for breast cancer patients. Women were recruited at the end of neoadjuvant chemotherapy and assigned to write about their cancer experience (EW group; n = 24) or neutral topics (neutral writing [NW] group; n = 25). Women were asked to write for 20 minutes a day for a total of four writing sessions that were completed over a 7-day period. Participants were reassessed approximately 3 days before and 2 weeks after surgery. The intervention did not significantly decrease women's distress, perceived stress, sleep disturbance, or pain. There was some evidence that the EW group used more sleep medication at the presurgical assessment than the NW group. Social constraints moderated the effect of the intervention. Among women with high social constraints, the EW group reported lower average daily pain than the NW group. Among women with low social constraints, the EW group reported higher average daily pain than the NW group. EW was not broadly effective as a stress management intervention for women with breast cancer. These data do not support the use of EW as a presurgical mind-body complementary medicine program for this population.

The results of several studies on the use of massage therapies for cancer patients have been published in the peer-reviewed literature over the past 20 years. The current article provides a summary and critique of published studies in which patient-reported symptom ratings were assessed in relation to massage. Twenty-two studies are discussed. Most studies were on Swedish massage, followed by aromatherapy massage, foot reflexology, and acupressure. Symptoms assessed as outcomes included pain, fatigue, anxiety, nausea, and depression. Study designs included uncontrolled observational studies, crossover designs, and quasiexperimental and randomized controlled studies. Several studies included methodologic limitations such as small sample sizes, lack of blinded assessment, lack of accounting for subject attrition in statistical analyses, and other limitations. The results of the studies reviewed are mixed and vary as a function of several study characteristics. The most consistent symptom reduction was anxiety reduction. Additional well-designed studies are needed. Several recommendations are offered for future studies.

Michael Gearin-Tosh was an English professor at Oxford University who was diagnosed with multiple myeloma in 1994. He rejected conventional chemotherapeutic approaches and turned to a variety of alternative cancer treatments, particularly those involving nutritional supplements and dietary change. In 2002, Dr. Gearin-Tosh published a book, Living Proof: A Medical Mutiny, recounting his experiences. The book gained significant public and media attention. One chapter was written by Carmen Wheatley, an advocate of alternative cancer treatments. In distinction to Dr. Gearin-Tosh's personal story, Dr. Wheatley makes general claims about cancer treatment that are supposedly based on the research literature. This appears to provide scientific validation for a highly unconventional program of cancer care. However, the scientific case made for alternative cancer treatments in Living Proof does not bear serious examination. There are numerous inaccuracies, omissions, and misrepresentations. Many important claims are either entirely unsubstantiated or not supported by the literature cited. In conclusion, a highly publicized book gives the impression that alternative cancer treatments are supported by scientific research. It also suggests that little progress has been made in the conventional treatment of myeloma. This is highly misleading and may lead to cancer patients rejecting effective treatments.

Active hexose correlated compound (AHCC), a Basidiomycotina extract, is a well-tolerated nutritional supplement with no reported adverse effects. It has demonstrated potential antitumor activity and immune modulator activity. However, there is no current information regarding its metabolism and the potential for drug-drug interactions for AHCC in combination with chemotherapy. The objective of this study was to characterize AHCC hepatic metabolism, specifically involving the potential for drug interactions with selected chemotherapy agents. High-throughput cytochrome P-450 (CYP450) metabolism inhibition experiments were conducted in vitro evaluating CYP450 3A4, 2C8, 2C9, and 2D6 followed by an evaluation of AHCC as a substrate of these same isoenzymes. An ex vivo model of cryopreserved human hepatocytes was used to evaluate the CYP450 metabolism induction potential of AHCC for CYP450 3A4, 2C8/2C9, and 2D6. No inhibition of CYP450 activity was observed in presence of AHCC; however, AHCC was a substrate of CYP450 2D6. The CYP450 induction metabolism assays indicate that AHCC is an inducer of CYP450 2D6. AHCC does have the potential for drug-drug interactions involving CYP450 2D6, such as doxorubicin or ondansetron; however, the overall data suggest that AHCC would be safe to administer with most other chemotherapy agents that are not metabolized via the CYP450 2D6 pathway.

The primary purpose of this survey was to assess the interest and concerns of a group of cancer researchers regarding complementary and alternative medicine (CAM) research issues. These issues include cancer researchers' perceptions of the most promising areas of cancer CAM research, their needs for support, the perceived obstacles to carrying out research objectives in the emerging field of cancer CAM research, and their level of interest in research collaboration with CAM practitioners. A cross-sectional survey of a convenience sample of cancer researchers interested in CAM was conducted. Three hundred twenty-one respondents completed the survey, and 298 of them had participated in cancer research. About 85% of the respondents had participated in cancer CAM research. For all CAM categories, the percentage of respondents who would like to conduct research was greater than the percentage of those who have already done so. About two-thirds of the respondents rated research in pharmacologic and biologic treatments and nutritional therapeutics for cancer treatment and symptom/side-effect management as high-priority areas. The obstacle considered to be the most significant by the greatest percentage of the respondents (26.7%) was the lack of success in receiving research funds. This was also the most frequently encountered obstacle. The assistance that was considered to be very useful by the greatest percentage of respondents was support for developmental research or pilot projects, indicated by more than four-fifths (85.4%) of the respondents. More than 83% of respondents expressed some interest in or willingness to establish research collaboration with a CAM practitioner. The results from this survey indicate that many cancer CAM researchers have shared interests, needs, perceived obstacles, and desired research opportunities. These factors and other forces are likely to lead to further growth in the numbers and activity of cancer CAM researchers. If this occurs, then it will become even more important for the National Cancer Institute and other organizations to study the development and changes in this emerging research field.