1
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Chan WJJ, Adiwidjaja J, McLachlan AJ, Boddy AV, Harnett JE. Interactions between natural products and cancer treatments: underlying mechanisms and clinical importance. Cancer Chemother Pharmacol 2023; 91:103-119. [PMID: 36707434 PMCID: PMC9905199 DOI: 10.1007/s00280-023-04504-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023]
Abstract
Natural products, also referred to as dietary supplements, complementary and alternative medicines, and health or food supplements are widely used by people living with cancer. These products are predominantly self-selected and taken concurrently with cancer treatments with the intention of improving quality of life, immune function and reducing cancer symptoms and treatment side effects. Concerns have been raised that concurrent use may lead to interactions resulting in adverse effects and unintended treatment outcomes. This review provides an overview of the mechanisms by which these interactions can occur and the current evidence about specific clinically important natural product-drug interactions. Clinical studies investigating pharmacokinetic interactions provide evidence that negative treatment outcomes may occur when Hypericum perforatum, Grapefruit, Schisandra sphenanthera, Curcuma longa or Hydrastis canadensis are taken concurrently with common cancer treatments. Conversely, pharmacodynamic interactions between Hangeshashinto (TJ-14) and some cancer treatments have been shown to reduce the side effects of diarrhoea and oral mucositis. In summary, research in this area is limited and requires further investigation.
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Affiliation(s)
- Wai-Jo Jocelin Chan
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jeffry Adiwidjaja
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Andrew J McLachlan
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Alan V Boddy
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia
| | - Joanna E Harnett
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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2
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Kim D, Sung SH, Shin S, Park M. The effect of cancer on traditional, complementary and alternative medicine utilization in Korea: a fixed effect analysis using Korea Health Panel data. BMC Complement Med Ther 2022; 22:137. [PMID: 35585580 PMCID: PMC9118572 DOI: 10.1186/s12906-022-03614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer-related incidence and mortality rates are rapidly increasing worldwide. However, no studies have examined the effect of cancer as a single factor on the use of traditional, complementary, and alternative medicine (T&CAM). We aimed to determine the effect of cancer occurrence on T&CAM utilization using Korea Health Panel (KHP) data. METHODS We analyzed longitudinal data (49,380 observations) derived from 12,975 Korean adult participants with complete KHP data from 2011 to 2014 and 2016, and divided them into two groups based on cancer diagnosis. A panel multinomial logit model was used to assess whether the participants used T&CAM or conventional medicine or both in outpatient settings. Additionally, a negative binomial regression model was used to examine the effect of cancer on the number of outpatient visits for T&CAM. RESULTS In total, 25.54% of the study participants in the cancer group used T&CAM, which was higher than that in the non-cancer group (18.37%, p < 0.0001). A panel multinomial logistic regression analysis using KHP data showed that cancer occurrence was significantly more likely to be associated with 'Using both Korean medicine and conventional medicine' (Coef. = 0.80, p = 0.017) and 'Not using Korean medicine but using conventional medicine' (Coef. = 0.85, p = 0.008) than 'Not using Korean medicine and conventional medicine.' A panel negative binomial regression showed a significant effect of cancer on increasing the number of T&CAM outpatient visits (Coef. = 0.11, p = 0.040). CONCLUSIONS Our findings showed that cancer occurrence within an individual led to the simultaneous use of conventional medicine and T&CAM. In addition, the occurrence of cancer significantly increased the number of T&CAM outpatient visits among participants already using T&CAM. It was also found that T&CAM has been utilized more often by the most vulnerable people, such as medical beneficiaries and those with a low level of education.
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Affiliation(s)
- Dongsu Kim
- College of Oriental Medicine, Dongshin University, Naju, Jeollanam-do, 58245, South Korea
| | - Soo-Hyun Sung
- Department of Policy Development, National Institute of Korean Medicine Development, Junggu, Seoul, 04561, South Korea
| | - Seungwon Shin
- National Agency for Korean Medicine Innovative Technologies Development, National Institute of Korean Medicine Development, Junggu, Seoul, 04561, South Korea
| | - Minjung Park
- National Agency for Korean Medicine Innovative Technologies Development, National Institute of Korean Medicine Development, Junggu, Seoul, 04561, South Korea.
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3
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Vogel J, Zomorodbakhsch B, Stauch T, Josfeld L, Hübner J. The role of the general practitioner in cancer care in general and with respect to complementary and alternative medicine for patients with cancer. Eur J Cancer Care (Engl) 2021; 31:e13533. [PMID: 34708899 DOI: 10.1111/ecc.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/10/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cancer patients often use complementary and alternative medicine (CAM). The aim of this study was to assess the expectations of cancer patients towards their general practitioner (GP) regarding information on and offers of CAM procedures. METHODS A standardised anonymous questionnaire was developed and handed out to cancer patients in GP practices and oncology clinics in Germany. RESULTS One hundred and eighty questionnaires were evaluable. For 88.1% of the patients, it was important that their GP regularly receives information on cancer therapy. Only a minority consulted with the GP regarding diagnosis and therapy of the cancer (32.4%) or approached him about side effects of the therapy (46.9%). About one fifth of the GPs offered CAM. Before the cancer diagnosis, only 7% of the patients received a CAM offer from the GP; after the diagnosis, it was 14%. A large majority wanted the GP to offer more complementary (70.9%) and alternative (54.3%) medicine. CONCLUSION Our survey points to a clear mismatch of supply and demand regarding CAM for cancer patients in the primary care sector. Training for GPs on scientific evidence of as well as communication skills on CAM will be indispensable in the future to optimise the care of cancer patients by GPs.
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Affiliation(s)
- Johanna Vogel
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | | | - Thomas Stauch
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Lena Josfeld
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Hübner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
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4
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Balogh LC, Matthews TW, Schrag C, Elebro KA. Clinical outcomes of head and neck cancer patients who refuse curative therapy in pursuit of alternative medicine. Laryngoscope Investig Otolaryngol 2021; 6:991-998. [PMID: 34667841 PMCID: PMC8513431 DOI: 10.1002/lio2.636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND We investigated the alarming trend of curable head and neck cancer (HNC) patients forgoing conventional treatment to pursue alternative medicine (AM). METHODS A prospectively maintained database identified HNC patients with ≥12 weeks from diagnosis to treatment initiation between 2012 and 2017. Reasons for delay were categorized and clinical stages and outcomes of AM patients were assessed through chart review by December 2019. RESULTS Among 1462 patients with primary HNC, 68 patients (4.7%) were confirmed to delay initiation of potentially curative treatment, and 19 of these patients (28%) delayed treatment to pursue AM. Eleven of 19 AM patients transitioned from curative intent to palliation while exploring AM. Continued treatment rejection was common and outcomes corresponded to patients' degree of treatment adherence. CONCLUSIONS AM caused treatment delay and poor outcomes in potentially curable HNC. Improved knowledge among physicians regarding AM and complementary approaches is urgently needed to improve patient counseling. LEVEL OF EVIDENCE Level 2c outcomes research.
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Affiliation(s)
- Lauren C. Balogh
- Foothills Medical Centre, Alberta Health ServicesCalgaryCanada
- Section of Plastic and Reconstructive Surgery, Department of SurgeryUniversity of Calgary Cumming School of MedicineCalgaryCanada
| | - T. Wayne Matthews
- Foothills Medical Centre, Alberta Health ServicesCalgaryCanada
- Section of Otolaryngology Head & Neck Surgery, Department of SurgeryUniversity of Calgary Cumming School of MedicineCalgaryCanada
- Ohlson Research Initiative, Arnie Charbonneau Research InstituteUniversity of Calgary Cumming School of MedicineCalgaryCanada
| | - Christiaan Schrag
- Foothills Medical Centre, Alberta Health ServicesCalgaryCanada
- Section of Plastic and Reconstructive Surgery, Department of SurgeryUniversity of Calgary Cumming School of MedicineCalgaryCanada
| | - Karin A. Elebro
- Foothills Medical Centre, Alberta Health ServicesCalgaryCanada
- Section of Plastic and Reconstructive Surgery, Department of SurgeryUniversity of Calgary Cumming School of MedicineCalgaryCanada
- Department of Plastic and Reconstructive SurgerySkåne University HospitalMalmöSweden
- Division of Surgery, Department of Clinical Sciences MalmöLund UniversityMalmöSweden
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5
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Guo Q, Chen Q, Xue CC, Lin Zhang A, Coyle ME. Chinese Medicine Syndromes and Stages of Early Breast Cancer: Hierarchical Cluster Analysis and Implication for Clinical Practice. J Altern Complement Med 2021; 27:904-914. [PMID: 34076505 DOI: 10.1089/acm.2021.0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Chinese medicine (CM) has been widely used for women's health, including those with early breast cancer. Contemporary literature varies in descriptions of the CM syndromes that are critical for determining CM treatment options for breast cancer patients. However, the corresponding syndromes have not been standardized to align with the conventional medicine treatment stages. This review aimed to address this knowledge gap to enhance the quality and consistency of CM interventions for early breast cancer patients. Methods: In total, eight Chinese and English language databases were searched, and textbooks and clinical care documents were gathered. Sources were classified according to five treatment stages: preoperative, postoperative, chemotherapy, radiation therapy, and endocrine therapy. Descriptive statistics were used to examine the syndromes, and hierarchical cluster analysis was conducted to investigate clusters of signs and symptoms. Results: The CM syndrome of dual deficiency of qi and Blood was one of the most common syndromes across all treatment stages, whereas lack of strength and lassitude were the most common clinical presentations throughout all stages, except the preoperative stage. Cluster analyses identify three or four syndromes in each treatment stage. Cluster results for the preoperative stage were: Blood stasis, Liver depression and qi stagnation, and Kidney yin deficiency. Dual deficiency of qi and Blood existed at different stages except for the preoperative stage. In the postoperative stage and chemotherapy stages, some symptoms were categorized into clusters that related to the Spleen and Stomach. Syndromes such as yin deficiency with fire toxin and yin deficiency with fluid depletion were unique to the radiation therapy stage. Clusters for endocrine therapy stage included the dual deficiency of Spleen and Kidney, Liver depression and qi stagnation, and Kidney yin deficiency. Conclusions: Systematic review of the contemporary literature for early breast cancer revealed that the most frequently seen CM syndromes and cluster results have some similarities but some important distinctions. Clinical data are needed to confirm whether the syndromes described in contemporary literature reflect those seen in women with early breast cancer.
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Affiliation(s)
- Qianqian Guo
- China-Australia International Research Centre for Chinese Medicine, Royal Melbourne of Institute of Technology University, Melbourne, Australia.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qianjun Chen
- China-Australia International Research Centre for Chinese Medicine, Royal Melbourne of Institute of Technology University, Melbourne, Australia.,Breast Department, Guangdong Provincial Hospital of Chinese Medicine and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- China-Australia International Research Centre for Chinese Medicine, Royal Melbourne of Institute of Technology University, Melbourne, Australia.,Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Anthony Lin Zhang
- China-Australia International Research Centre for Chinese Medicine, Royal Melbourne of Institute of Technology University, Melbourne, Australia
| | - Meaghan E Coyle
- China-Australia International Research Centre for Chinese Medicine, Royal Melbourne of Institute of Technology University, Melbourne, Australia
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6
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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9963038. [PMID: 34055029 PMCID: PMC8149249 DOI: 10.1155/2021/9963038] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 05/08/2021] [Indexed: 12/24/2022]
Abstract
Background Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.
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Hunter J, Grant S, Delaney GP, Templeman K, Ussher J, Parton C, Kellett A, Smith C. Barriers and Facilitators to Integrative Oncology Services in Australia: A Changed Mind Set Required. J Altern Complement Med 2021; 27:S89-S98. [PMID: 33788601 DOI: 10.1089/acm.2020.0299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: This study aimed to explore barriers and facilitators to integrative oncology (IO) service provision and access in Australia. Design: The study design was mixed method with two substudies: a cross-sectional national cancer service survey of public and private sectors; and focus group interviews and an online survey of cancer survivors. Triangulation analysis of qualitative and quantitative data was used to identify and interrogate meta-themes. Subjects: The cancer service response rate was 93.2% (n = 275/295); 71/275 (25.8%) provided IO. Thirty-three cancer survivors from Anglo-European, Arabic, Vietnamese, and Chinese backgrounds were interviewed, and 121 survivors answered the online survey. Results: IO gaps were substantial, with no services in many regions and cities; a lack of diversity and availability of therapeutic options, including culturally appropriate services; and a mismatch between the high use of natural health products by survivors and types of IO services provided. Two overlapping meta-themes were identified: "barriers and facilitators" and "peoples and institutions"; each with four subthemes, respectively, "access/provision, affordability/funding, information/evidence, and culture/values" and "cancer survivors, healthcare professionals, organizations, and policies." While affordability/funding was the greatest barrier to survivors and providers, solutions varied (e.g., building a stronger evidence-base, business model advice) and often conflicted (e.g., public verses private sector funding). The most insidious barrier was professional/corporate cultures and values that influenced hospital policies (or lack thereof), conceptions of evidence and the therapeutic alliance. Survivors called for a change of mindset in the culture of medicine and value-based health care. Conclusions: The barriers and facilitators to IO services were more complex than building the evidence-base and demonstrating value to justify funding. To achieve a better alignment of patients' preferences with service provision, providers require more guidance on clinical governance, business models, local service gaps, and interprofessional collaboration. National strategies and funding models are needed to ensure appropriate, equitable IO service provision.
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Affiliation(s)
- Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Geoff P Delaney
- South-Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, Australia.,Cancer Services, South Western Sydney Local Health District, Liverpool, Australia
| | - Kate Templeman
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Andrew Kellett
- School of Medicine, Western Sydney University, Penrith, Australia
| | - Caroline Smith
- NICM Health Research Institute, Western Sydney University, Penrith, Australia.,Graduate Research School, Western Sydney University, Penrith, Australia
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8
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Rossi C, Maggiore C, Rossi MM, Filippone A, Guarino D, Di Micco A, Forcina L, Magno S. A Model of an Integrative Approach to Breast Cancer Patients. Integr Cancer Ther 2021; 20:15347354211040826. [PMID: 34670415 PMCID: PMC8543635 DOI: 10.1177/15347354211040826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/09/2021] [Accepted: 08/03/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Breast cancer (BC) survivors have physical and psychological needs that require convincing responses by health care providers. The quality of life issue and clinical unmet needs are among the main reasons pushing a number of patients toward "natural" therapies that are often misleading and alternative to mainstream cancer care. Integrative Oncology (IO) tries to respond to many of those needs, by combining lifestyle counseling, body-mind activities, and complementary evidence-informed therapies with anticancer standard treatments. METHODS In our model at Fondazione Policlinico Gemelli (FPG), every woman diagnosed with a BC waiting for surgery or candidate to neoadjuvant chemotherapy undergoes a preliminary psycho-oncological distress evaluation and a brief lifestyle interview. Anthropometric measurements, body composition analysis, and individual levels of physical activity are recorded. Patients are given evidence based recommendations about the advisable diet and physical activity in a prehabilitation setting. A physician provides patients with information about integrative care plans to treat symptoms related to the disease or its treatments. Therapeutic approaches include acupuncture, mindfulness-based protocols, qigong, massage therapy, and classes of music/art therapy. RESULTS Between September 2018 and February 2020, the Center for Integrative Oncology at FPG has carried out 1249 lifestyle counseling sessions, 1780 acupuncture treatments, 1340 physiotherapy sessions, 3261 psycho-oncological consultations, 218 herbal medicine counseling sessions. Moreover, 90 BC patients completed the mindfulness based stress reduction (MBSR) protocol and 970 patients participated in qigong, art therapy, and music therapy classes. CONCLUSIONS Our integrative approach aims to achieve a person-centered medicine by improving symptoms management, adherence to oncological protocols, and eventually overall quality of life.
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Affiliation(s)
- Cristina Rossi
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Maggiore
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Maddalena Rossi
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessio Filippone
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Donatella Guarino
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annalisa Di Micco
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luana Forcina
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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9
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Finding the value in oncology massage: A mixed-method study of cancer services and survivors in Australia. ADVANCES IN INTEGRATIVE MEDICINE 2020. [DOI: 10.1016/j.aimed.2020.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Caughey L, Sanjida S, Obermair A, Janda M. The use of CAM products, practices, and practitioners by long-term endometrial cancer survivors in Australia. Support Care Cancer 2020; 28:5479-5489. [DOI: 10.1007/s00520-020-05404-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 03/06/2020] [Indexed: 12/22/2022]
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Grant SJ, Hunter J, Seely D, Balneaves LG, Rossi E, Bao T. Integrative Oncology: International Perspectives. Integr Cancer Ther 2019; 18:1534735418823266. [PMID: 30791736 PMCID: PMC7240876 DOI: 10.1177/1534735418823266] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Interest in integrative oncology (IO) is growing globally. Patients with cancer are actively using traditional complementary and integrative medicine (TCIM) as part of their cancer and survivorship care. Published studies from around the world report increasing use of TCIM by people living with cancer. This article summarizes the presentations that took place during a symposium titled, "Integrative Oncology: International Perspectives" at the International Research Congress on Integrative Medicine and Health in Baltimore, 2018. The purpose of the presentations was to examine whether cancer services across a variety of geographical regions, including Australia, Canada, the United States, and the European Union, were actively responding to cancer survivors' demand for TCIM. The presenters highlighted utilization rates and both facilitators and barriers to the provision of IO services in their respective countries and regions. The audience discussion following the presentations drew out many noteworthy perspectives.
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Affiliation(s)
- Suzanne J Grant
- 1 Western Sydney University, Penrith, NSW, Australia.,2 Chris O'Brien Lifehouse Comprehensive Cancer Centre, Camperdown, NSW, Australia
| | - Jennifer Hunter
- 1 Western Sydney University, Penrith, NSW, Australia.,3 The University of Sydney, Australia
| | - Dugald Seely
- 4 Ottawa Integrative Cancer Centre, Ottawa, ON, Canada.,5 Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | | | - Elio Rossi
- 7 Coordinating Center of Complementary Medicine-Local Health Unit Tuscany North West, Lucca, Italy
| | - Ting Bao
- 8 Memorial Sloan Kettering Cancer Center, NY, USA
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12
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Jones E, Nissen L, McCarthy A, Steadman K, Windsor C. Exploring the Use of Complementary and Alternative Medicine in Cancer Patients. Integr Cancer Ther 2019; 18:1534735419846986. [PMID: 31072149 PMCID: PMC7242794 DOI: 10.1177/1534735419846986] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In Australia, it is estimated that around 17% to 87% of cancer patients have used
one form of complementary therapy during their cancer treatment. There are
numerous reasons and contributing factors for cancer patients to consider using
complementary and alternative medicine (CAM). CAM information and products are
readily available. However, the level of evidence to support the benefits of use
in the cancer setting is limited, and the associated adverse effects and
interactions with conventional medicine may not be fully studied. Besides, not
all health professionals favor the concept of integrative health approaches, or
have the confidence in dealing with CAM due to a lack of knowledge and
standardization of practices. A thematic review of the literature was performed
on the main contributing factors to cancer patients’ use of CAM, as well as the
current issues that may be encountered by the patients and health
professionals.
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Affiliation(s)
- Ellen Jones
- 1 Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Lisa Nissen
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Carol Windsor
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
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13
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Jones E, Nissen L, McCarthy A, Steadman K, Windsor C. Exploring the Use of Complementary and Alternative Medicine in Cancer Patients. Integr Cancer Ther 2019; 18:1534735419854134. [PMID: 31170844 PMCID: PMC6557018 DOI: 10.1177/1534735419854134] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In Australia, it is estimated that around 17% to 87% of cancer patients have used one form of complementary therapy during their cancer treatment. There are numerous reasons and contributing factors for cancer patients to consider using complementary and alternative medicine (CAM). CAM information and products are readily available. However, the level of evidence to support the benefits of use in the cancer setting is limited, and the associated adverse effects and interactions with conventional medicine may not be fully studied. Besides, not all health professionals favor the concept of integrative health approaches, or have the confidence in dealing with CAM due to a lack of knowledge and standardization of practices. A thematic review of the literature was performed on the main contributing factors to cancer patients’ use of CAM, as well as the current issues that may be encountered by the patients and health professionals.
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Affiliation(s)
- Ellen Jones
- 1 Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Lisa Nissen
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | - Carol Windsor
- 2 Queensland University of Technology, Brisbane, Queensland, Australia
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14
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Therapeutic and preventive properties of honey and its bioactive compounds in cancer: an evidence-based review. Nutr Res Rev 2019; 33:50-76. [PMID: 31791437 DOI: 10.1017/s0954422419000192] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Despite the much improved therapeutic approaches for cancer treatment that have been developed over the past 50 years, cancer remains a major cause of mortality globally. Considerable epidemiological and experimental evidence has demonstrated an association between ingestion of food and nutrients with either an increased risk for cancer or its prevention. There is rising interest in exploring agents derived from natural products for chemoprevention or for therapeutic purposes. Honey is rich in nutritional and non-nutritional bioactive compounds, as well as in natural antioxidants, and its potential beneficial function in human health is becoming more evident. A large number of studies have addressed the anti-cancer effects of different types of honey and their phenolic compounds using in vitro and in vivo cancer models. The reported findings affirm that honey is an agent able to modulate oxidative stress and has anti-proliferative, pro-apoptotic, anti-inflammatory, immune-modulatory and anti-metastatic properties. However, despite its reported anti-cancer activities, very few clinical studies have been undertaken. In the present review, we summarise the findings from different experimental approaches, including in vitro cell cultures, preclinical animal models and clinical studies, and provide an overview of the bioactive profile and bioavailability of the most commonly studied honey types, with special emphasis on the chemopreventive and therapeutic properties of honey and its major phenolic compounds in cancer. The implications of these findings as well as the future prospects of utilising honey to fight cancer will be discussed.
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Delaney LJ, Manley SJ. Complementary and alternative therapy use in a regional radiation oncology treatment centre: Can staff knowledge, views, confidence and documentation be improved? J Med Radiat Sci 2019; 66:191-199. [PMID: 31393077 PMCID: PMC6745355 DOI: 10.1002/jmrs.344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/20/2019] [Accepted: 06/19/2019] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Complementary and alternative therapies (CATs) are widely used by cancer patients but are infrequently disclosed and documented. This study aimed to improve radiation therapy staff knowledge, confidence, views and documentation of radiation oncology patients' use of CATs. METHOD Participants completed a baseline questionnaire regarding their knowledge, confidence, views and documentation relating to patients' CAT use. An intervention was undertaken whereby participants attended an educational session and a CAT screening tool was implemented simultaneously. Participants immediately completed a post-intervention questionnaire and later a 6-month follow-up questionnaire. A patient record audit was conducted to measure the documentation of CAT use pre- and post-intervention. RESULTS From baseline to post-intervention, there was a statistically significant shift in staff knowledge and confidence (P = 0.001-0.01). The observed shift was sustained over a 6-month period, (P = 0.453-1.00). Participants' perceived views of CATs did not change as a result of the intervention (P = 0.261-1.000). The post-intervention audit compared to the baseline audit yielded a statistically significant increase in documentation. There was an increase in CAT use mentioned in patient records from 14% (15/108) to 40% (35/88) (P < 0.001). CONCLUSIONS The implementation of a screening tool and staff education increased radiation therapy staff knowledge of CATs and increased staff confidence when discussing CAT use with patients. Documentation of CATs in the patient record increased post-intervention. These changes positively affected radiation therapy staff understanding the use of CATs by cancer patients.
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Affiliation(s)
- Lisa J. Delaney
- Department of Radiation OncologyNorth Coast Cancer InstituteLismoreNew South WalesAustralia
| | - Stephen J. Manley
- Department of Radiation OncologyNorth Coast Cancer InstituteLismoreNew South WalesAustralia
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16
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Mwaka AD, Mangi SP, Okuku FM. Use of traditional and complementary medicines by cancer patients at a national cancer referral facility in a low-income country. Eur J Cancer Care (Engl) 2019; 28:e13158. [PMID: 31441575 DOI: 10.1111/ecc.13158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/28/2019] [Accepted: 08/01/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe use of traditional and complementary medicines (T&CM) and associated factors among patients with cancer. METHODS We conducted a cross-sectional study at the Uganda Cancer Institute (UCI) involving patients with selected solid tumours. Independent variables included age, sex, marital status, cancer site and stage. Main outcome variables were use and disclosure of use of T&CM. RESULTS The majority of participants were women (n = 352; 81.9%). Breast cancer (n = 312; 71.9%) was the predominant cancer type. 55.4% of participants (n = 240) self-reported use of T&CM. Among them, 68.3% (140/205) reported using them to treat/cure cancer, 35.6% (72/202) for strengthening the immune system and 31.2% (63/202) for management of pain. Patients with advanced stage cancers were more likely to be users compared with those in stage one. The majority (81.9%, 195/238) of T&CM users did not disclose use to their healthcare professionals. The main reasons for nondisclosure included lack of inquiry by clinicians (79.6%, 117/147) and fear of disapproval and/or rebuke (11.6%, 17/147). CONCLUSION Use of T&CM by patients with cancer under biomedical care is common but often undisclosed to the healthcare professionals.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.,Cancer Awareness and Early Detection Coalition (CAEDCO), Kampala, Uganda
| | - Sabina Patrick Mangi
- Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda.,Tosamaganga Council Designated Hospital, Iringa, Tanzania
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17
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Hunter J, Smith C, Delaney GP, Templeman K, Grant S, Ussher JM. Coverage of cancer services in Australia and providers' views on service gaps: findings from a national cross-sectional survey. BMC Cancer 2019; 19:570. [PMID: 31185937 PMCID: PMC6560726 DOI: 10.1186/s12885-019-5649-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 04/26/2019] [Indexed: 01/02/2023] Open
Abstract
Background In response to the increasing cancer prevalence and the evolving health service landscape across the public and private health sectors in Australia, this study aimed to map cancer services and identify factors associated with service provision and important service gaps. Methods A prospective, cross-sectional survey was conducted throughout 2016. Extensive search strategies identified Government or privately-owned, hospital or community-based healthcare organisations with dedicated cancer services. One nominated staff member from each organisation answered a purpose specific online/paper questionnaire. Descriptive statistics, standardised rates, and single level and multilevel multinomial logistic regression were used to analyse the data. Analysis was augmented with a qualitative descriptive analysis of open-ended questions. Results From the 295 eligible organisations with a cancer service in Australia, 93.2% participated in the survey. After adjusting for remoteness, for-profit companies were significantly more likely than Government operated services to provide only one or two types of cancer services (e.g. radiotherapy) in a limited range of settings (e.g. day hospital with no in-patient or home care) (p < 0.001) and less likely to provide comprehensive cancer services (p < 0.001). After adjusting for ownership and the respondent’s role in the organisation, respondents located in remote regions of Australia were more likely to identify cancer services that are dependent upon specialist medical practitioners as the most important service gaps in their region (p = 0.003). Despite 76.0% of organisations across Australia offering some type of supportive care or survivorship services, providers identified this group of services as the most pressing service gaps in major cities, rural and remote regions alike (standardised rate: 47.9% (95%CI: 43.6–57.4%); p < .000). This included the need for improved integration, outreach and affordability. Conclusions The broad range of cancer services, settings and ownership identified by this survey highlights the complexity of the Australian healthcare system that cancer survivors must navigate and the challenges of providing comprehensive cancer care particularly in rural and remote regions. Whilst the significant role of supportive care and survivorship services are increasingly being recognised, the findings from this survey support calls for innovative service models and funding mechanisms that expand the focus from preventing and treating cancer to supporting cancer survivors throughout the cancer continuum and promoting the delivery of integrated and equitable cancer care across the public and private sectors. Electronic supplementary material The online version of this article (10.1186/s12885-019-5649-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Caroline Smith
- NICM Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Geoff P Delaney
- South-Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Cancer Services, South Western Sydney Local Health District, Sydney, NSW, Australia.,Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Kate Templeman
- NICM Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Strawberry tree honey as a new potential functional food. Part 2: Strawberry tree honey increases ROS generation by suppressing Nrf2-ARE and NF-кB signaling pathways and decreases metabolic phenotypes and metastatic activity in colon cancer cells. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.04.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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19
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Liew AC, Peh KK, Tan BS, Zhao W, Tangiisuran B. Evaluation of chemotherapy-induced toxicity and health-related quality of life amongst early-stage breast cancer patients receiving Chinese herbal medicine in Malaysia. Support Care Cancer 2019; 27:4515-4524. [PMID: 30911917 DOI: 10.1007/s00520-019-04724-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 03/01/2019] [Indexed: 11/12/2022]
Abstract
PURPOSE This observational study aimed to compare the outcome and health-related quality of life (HRQOL) amongst breast cancer patients using Chinese herbal medicine (CHM) and those not using CHM during chemotherapy. METHODS A prospective, non-randomised longitudinal study was conducted in two government integrated hospitals over an 8-month period. Early-stage breast cancer patients who were (1) either already using complementary and alternative medicine (CAM) or not and (2) who were on a regime of 5-fluorouracil, epirubicin, and cyclophosphamide were included in the study. Patients who agreed to receive CHM were assigned to receive individualised CHM prescriptions deemed suitable for the individual at a particular time. Those who were not willing to take Chinese herbal medicines (CHM) were assigned to the non-CHM control group. Blood profile and chemotherapy-induced AE were recorded whilst HRQOL assessment was done using the EORTC QLQ-C30 questionnaire on first, third, and sixth cycles. RESULTS Forty-seven patients [32 female vs. 1 male, p = 0.31; mean year of age: 52.2(SD = 7.6), p = 0.28)}] were recruited during the study period. Demographics of both groups were comparable. Fifty percent of respondents reported using some kind of CAM before chemotherapy. Diet supplements (40.6%) were the most common CAM used by the respondents. The study showed that patients using CHM had significantly less fatigue (p = 0.012), nausea (p = 0.04), and anorexia (p = 0.005) during chemotherapy. There were no significant differences in patients' HRQOL (p = 0.79). There were no AEs reported during the study. CONCLUSION The use of CHM as an adjunct treatment with conventional chemotherapy have been shown to reduce fatigue, nausea, and anorexia in breast cancer patients but did not reduce chemotherapy-associated hematologic toxicity. The sample size of this study was not powered to assess the significance of HRQOL between two groups of patients.
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Affiliation(s)
- Ai Ch'i Liew
- Clinical Research Centre, Hospital Seberang Jaya, Jalan Tun Hussein Oon, 13700, Perai, Penang, Malaysia.
| | - Kok-Khiang Peh
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Penang, Malaysia
| | - Boon Seang Tan
- Department of Clinical Oncology and Radiotherapy, Penang General Hospital, Jalan Residensi, 10990, George Town, Penang, Malaysia
| | - Wei Zhao
- Traditional Chinese Medicine Oncology Physician, Guang'anmen Hospital (of Traditional Chinese Medicine), Beijing, No. 5, Bei Xian Ge, Xuan Wu District, Beijing, 100053, China
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20
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The Perspective of Cancer Patients on the Use of Complementary Medicine. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.89916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Smith CA, Hunter J, Delaney GP, Ussher JM, Templeman K, Grant S, Oyston E. Integrative oncology and complementary medicine cancer services in Australia: findings from a national cross-sectional survey. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:289. [PMID: 30373631 PMCID: PMC6206936 DOI: 10.1186/s12906-018-2357-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/19/2018] [Indexed: 01/01/2023]
Abstract
Background Individuals living with and beyond a cancer diagnosis are increasingly using complementary therapies and medicines (CM) to enhance the effectiveness of cancer treatment, manage treatment-related side effects, improve quality-of-life, and promote self-efficacy. In response to the increasing use and demand for CM by cancer patients, interest in the implementation of Integrative Oncology (IO) services that provide CM alongside conventional cancer care in Australia and abroad has developed. The extent that cancer services in Australia are integrating CM is uncertain. Thus, the aim of this study was to identify IO services in Australia and explore barriers and facilitators to IO service provision. Methods A national, cross-sectional survey of healthcare organisations was conducted in 2016. Organisations in the public and private sectors, including not-for-profit organisations that provided cancer care in hospital or community setting, were included. Results A response rate of 93.2% was achieved (n = 275/295). Seventy-one organisations (25.8%) across all states/territories, except the Northern Territory, offered IO albeit in a limited amount by many. Most common IO services included massage, psychological-wellbeing, and movement modalities in hospital outpatient or inpatient settings. There were only a few instances where biological-based complementary medicine (CM) therapies were prescribed. Funding was often mixed, including patient contributions, philanthropy, funding by the organisation, and volunteer practitioners. Of the 204 non-IO providers, 80.9% had never provided any IO service. Overwhelmingly, the most common barrier to IO was a lack of funding, followed by uncertainty about patient demand, choice of services, and establishing such services. Less-common barriers were a lack of evidence, and support from oncologists or management. More funding, education and training, and building the evidence-base for CM were the most commonly suggested solutions. Conclusion IO is increasingly being provided in Australia, although service provision remains limited or non-existent in many areas. Mismatches appear to exist between low IO service provision, CM evidence, and high CM use by cancer patients. Greater strategic planning and policy guidance is indicated to ensure the appropriate provision of, and equitable access to IO services for all Australian cancer survivors. Electronic supplementary material The online version of this article (10.1186/s12906-018-2357-8) contains supplementary material, which is available to authorized users.
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22
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Establishing an integrative oncology service in the Australian healthcare setting—the Chris O’Brien Lifehouse Hospital experience. Support Care Cancer 2018; 27:2069-2076. [DOI: 10.1007/s00520-018-4460-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022]
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23
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Hall H, Leach MJ, Brosnan C, Cant R, Collins M. Registered Nurses' communication about patients' use of complementary therapies: A national survey. PATIENT EDUCATION AND COUNSELING 2018; 101:1403-1409. [PMID: 29550294 DOI: 10.1016/j.pec.2018.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 03/04/2018] [Accepted: 03/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To identify communication patterns of Registered Nurses regarding patients' use of complementary therapies. METHODS A cross-sectional online survey conducted in 2017 recruited Australian Registered Nurses working in any area of nursing. RESULTS Responses of 614 Registered Nurses were analysed. Patient-initiated discussion of complementary therapies were common for 77% of nurses; nurse-initiated discussions were perceived by 73% (sometimes/almost always/always). Nurses' personal use of complementary therapies predicted discussion with patients and education-based, oncology, or aged care/rehabilitation nurses were most likely to initiate dialogue. Many (55%) did not 'recommend' a particular therapy, although 12% 'almost always/always' did so. Four out of five nurses (84%) documented patients' use and communicated with medical/nursing colleagues about this use. Conversely, 61% 'never' or 'almost never' communicated with a complementary therapy practitioner. CONCLUSION Nurses working in Australia often discuss complementary therapies, however they rarely specifically recommend their use. Their workplace environment and clinical context influenced nurses' willingness to communicate about complementary therapy use. PRACTICE IMPLICATIONS EVIDENCE: suggests the need for policy development to promote communication between mainstream healthcare providers and complementary therapy practitioners to support the delivery of safe, high quality patient care.
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Affiliation(s)
- Helen Hall
- Nursing & Midwifery, Monash University, Frankston, Vic, Australia; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia.
| | - Matthew J Leach
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia; Department of Rural Health. University of South Australia, Australia
| | - Caragh Brosnan
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia; School of Humanities and Social Science, University of Newcastle, Australia
| | - Robyn Cant
- Nursing & Midwifery, Monash University, Frankston, Vic, Australia
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Hunter J, Ussher J, Parton C, Kellett A, Smith C, Delaney G, Oyston E. Australian integrative oncology services: a mixed-method study exploring the views of cancer survivors. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:153. [PMID: 29743054 PMCID: PMC5944107 DOI: 10.1186/s12906-018-2209-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/17/2018] [Indexed: 12/22/2022]
Abstract
Background The significant use of traditional and complementary medicine (T&CM) by cancer survivors is well documented. The aim of this study was to explore cancer survivors’ views on integrating T&CM services with conventional cancer care. Method A mixed-method study design with an emphasis on qualitative methodology was used to conduct and analyse four focus group interviews and an on-line survey. Purposive sampling recruited 33 cancer survivors and caregivers from Arabic, Vietnamese, Chinese and Anglo-European Australian backgrounds who participated in one of four focus group interviews, and 121 cancer survivors who responded to an on-line survey. The inductive thematic analysis was augmented with a descriptive statistical analysis. Results Most participants had used T&CM therapies or consulted T&CM practitioners as an adjuvant during and/or after their initial cancer treatment. Two themes emerged: ‘positive perceptions and experiences’ and ‘barriers and unmet needs’. Participants emphasised that T&CM was not a ‘luxury item’, rather it was considered important for managing side effects and comorbidities, rehabilitation and quality of life. A wide range of complex, interrelated barriers and solutions to IO service provision and access were identified. Structural barriers included inadequate service provision, medical practitioner attitudes, logistical constraints and funding. Personal barriers were influenced by the severity of impairment and disability; attitudes, beliefs and knowledge about T&CM; and available resources (e.g. finances, time, transport). Unmet need and inequitable access was exacerbated by geographical location, ethnicity and ability to pay. There was a mismatch between where participants were accessing T&CM services and their preference for IO service delivery. Participants perceived hospital-based IO services availability to have several benefits, including the T&CM practitioners having more expert knowledge about cancer care, the convenience of co-locating oncology services, and potentially lower out-of-pocket costs. Conclusion Patients’ use, preferences and needs for T&CM services in the oncology setting are important for informing service provision. Inequitable, unmet need reflected the increasing demand and expectation from patients for their oncology teams to be well informed about the benefits, risks and indications for T&CM use, and for the public and private health sectors to formally integrate and fund IO services. Electronic supplementary material The online version of this article (10.1186/s12906-018-2209-6) contains supplementary material, which is available to authorized users.
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Qureshi M, Zelinski E, Carlson LE. Cancer and Complementary Therapies: Current Trends in Survivors' Interest and Use. Integr Cancer Ther 2018; 17:844-853. [PMID: 29629606 PMCID: PMC6142098 DOI: 10.1177/1534735418762496] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background. Cancer survivors use complementary therapies (CTs)
for a variety of reasons; however, with interest and use reportedly on the rise
and a widening range of products and practices available, there is a need to
establish trends in and drivers of interest. We aimed to determine (1)
frequencies of use, level of interest, and barriers for 30 specific CTs and (2)
whether physical symptoms, perceived stress (PS), or spiritual well-being were
related to interest levels. Method. A total of 212 cancer
outpatients were surveyed at the Tom Baker Cancer Centre in Calgary, Canada.
Results. Overall, up to 75% of survivors already used some
form of CTs since their diagnosis. The most highly used were the following:
vitamins B12 and D, multivitamins, calcium, and breathing and relaxation
exercises. Those who had not used CTs indicated highest interest in massage,
vitamin B12, breathing and relaxation, mindfulness-based stress reduction, and
antioxidants. The most frequently reported barriers for all CTs were not knowing
enough about what a therapy was and not having enough evidence on whether it
worked. High PS predicted higher interest for all CTs, but spirituality was not
significantly related to any. Physical symptoms, anxiety, and depression were
significant predictors of interest for some CTs. Conclusion.
These findings provide a blueprint for future clinical efficacy trials and
highlight the need for clinical practice guidelines.
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Affiliation(s)
| | - Erin Zelinski
- 3 Alberta Health Services-Cancer Care, Calgary, AB, Canada
| | - Linda E Carlson
- 1 University of Calgary, Calgary, AB, Canada.,2 Tom Baker Cancer Centre, Calgary, AB, Canada.,3 Alberta Health Services-Cancer Care, Calgary, AB, Canada
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Smith PJ, Clavarino AM, Long JE, Steadman KJ. The Use of a Brochure to Enable CAM-with-Chemotherapy Patient Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:814-819. [PMID: 26932309 DOI: 10.1007/s13187-016-1011-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The majority of cancer patients receiving chemotherapy will consider taking complementary and alternative medicine (CAM) during their treatment. As biologically-active CAM may detrimentally interfere with chemotherapy treatment, cancer patients require evidence-based information on chemotherapy-CAM integration consequences. This study aimed to assess if the availability of a purpose-designed brochure within a cancer service aided doctors' discussions with their patients on CAM use and helped patients understand the effects of CAM during their chemotherapy treatment. Cancer care doctors consulting in an adult day unit completed a structured post-intervention feedback survey form (n = 17), and cancer patients receiving chemotherapy treatment were provided the brochure and completed the local health service consumer testing feedback form (n = 30). All cancer care doctors perceived a need for the brochure and recommended the brochure to their patients. All doctors thought the brochure made it easier for them to discuss CAM with their patients, and 59 % believed that it saved them time during patient consultations. Ninety percent of cancer patients reported the brochure had enough information to answer their CAM questions, and all patients thought the information was easy to read and understand. An evidence-based CAM-with-chemotherapy patient brochure was perceived to have enabled cancer care doctors to discuss CAM with their patients and to have answered patients' CAM questions.
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Affiliation(s)
- Peter J Smith
- School of Pharmacy, The University of Queensland, Brisbane, Qld, 4072, Australia.
- Sunshine Coast Cancer Care Services, Nambour General Hospital, Nambour, Qld, 4560, Australia.
| | | | - Jeremy E Long
- Sunshine Coast Cancer Care Services, Nambour General Hospital, Nambour, Qld, 4560, Australia
| | - Kathryn J Steadman
- School of Pharmacy, The University of Queensland, Brisbane, Qld, 4072, Australia
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Hamilton K, Marietti V. A qualitative investigation of Australian psychologists' perceptions about complementary and alternative medicine for use in clinical practice. Complement Ther Clin Pract 2017; 29:105-110. [PMID: 29122247 DOI: 10.1016/j.ctcp.2017.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/04/2017] [Accepted: 09/05/2017] [Indexed: 11/16/2022]
Abstract
This study explored psychologists' knowledge of, attitude toward, and experience with complementary and alternative medicine (CAM) use for clinical purposes. Using a qualitative design, 18 Australian psychologists participated in a semi-structured interview. Psychologists had some understanding about CAM; yet, there was a mismatch between their perceived and actual knowledge. While psychologists were, in general, open toward using CAM with clients they were also sceptical. Attitudes did not overly influence psychologists' views about using CAM in practice, rather adhering to the scientist-practitioner model and embracing a client-centred approach affected their beliefs. Different views emerged as guiding psychologists' use of CAM; however, the codes of conduct played a major role in informing psychologists' use in clinical practice. Psychologists appear open to the idea to use some forms of CAM to enhance client care; yet, they experience unique difficulties such as ethical constraints that may prevent their actual use of CAM for clinical purposes.
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Affiliation(s)
- Kyra Hamilton
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia.
| | - Vanina Marietti
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia
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Guidance for establishing an integrative oncology service in the Australian healthcare setting—a discussion paper. Support Care Cancer 2017; 26:471-481. [DOI: 10.1007/s00520-017-3851-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 07/31/2017] [Indexed: 12/11/2022]
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Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:8434697. [PMID: 28912824 PMCID: PMC5587961 DOI: 10.1155/2017/8434697] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/24/2017] [Indexed: 12/18/2022]
Abstract
Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted.
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Allom V, Mullan B, Clifford A, Rebar A. Understanding supplement use: an application of temporal self-regulation theory. PSYCHOL HEALTH MED 2017; 23:178-188. [DOI: 10.1080/13548506.2017.1339893] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Vanessa Allom
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Barbara Mullan
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Allison Clifford
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Amanda Rebar
- School or Human, Health, and Social Sciences, Central Queensland University, Rockhampton, Australia
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Porter D, Cochrane S, Zhu X. Current Usage of Traditional Chinese Medicine for Breast Cancer-A Narrative Approach to the Experiences of Women with Breast Cancer in Australia-A Pilot Study. MEDICINES 2017; 4:medicines4020020. [PMID: 28930235 PMCID: PMC5590056 DOI: 10.3390/medicines4020020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 01/06/2023]
Abstract
Background: The use of Traditional Chinese Medicine (TCM) by breast cancer patients is growing. Few studies have examined the complexity of breast cancer survivors' attitudes, lived experiences, barriers, and perceptions in using TCM as part of their treatment journey. This article examines breast cancer survivors' experiences, perceptions of, and benefits (or not) in using TCM. Methods: Qualitative research, using semi-structured interviews, was the chosen methodology. Results: Participants used TCM as a form of self-help and as a complement, not an alternative, to standard care. Overall, 100% of the participants used acupuncture, 62% used Chinese herbal medicine, 23% used Qigong, and 23% used Chinese dietary therapy. Participants reported perceived outcomes and health benefits from TCM usage ranging from increased coping mechanisms, relieving stress and side-effects of standard treatment, the desire to be pro-active in the treatment journey, and to have a locus of control. Some cited the need to have "time-out" and the therapeutic relationship with the practitioner as being important. Conclusion: There is a clear need to understand breast cancer survivors' needs for physical and psychological support as they aim to regain control over their life through their experience of illness. More studies are needed to measure and evaluate these outcomes and to help identify breast cancer survivors' healthcare seeking behaviours, during and after the acute treatment stage that addresses their physical, emotional, and spiritual needs. These results aim to inform future research design and evaluate and develop support services that are patient-centred and focus on whole health outcomes, shared decision-making, and quality of life.
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Affiliation(s)
- Dianna Porter
- National Institute of Complementary Medicine, Western Sydney University, Penrith 2751, Australia.
| | - Suzanne Cochrane
- National Institute of Complementary Medicine, Western Sydney University, Penrith 2751, Australia.
| | - Xiaoshu Zhu
- School of Science and Health, Western Sydney University, Penrith 2751, Australia.
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Oyunchimeg B, Hwang JH, Ahmed M, Choi S, Han D. Complementary and alternative medicine use among patients with cancer in Mongolia: a National hospital survey. Altern Ther Health Med 2017; 17:58. [PMID: 28103860 PMCID: PMC5244576 DOI: 10.1186/s12906-017-1576-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 01/11/2017] [Indexed: 11/25/2022]
Abstract
Background Complementary and alternative medicine (CAM) use is popular in former Soviet Central Asian countries including Mongolia. However, no studies are available on CAM use among patients with cancer in countries of this region. The aim of this research is to describe the prevalence and patterns of CAM use by patients with cancer in Mongolia. Methods A cross-sectional study was conducted using data from 482 cancer patients attending the National Cancer Center in Mongolia from September 2015 to February 2016. The survey instrument included 25 questions regarding CAM used, factors associated with use of CAM, cancer-related characteristics, and participants’ socio-demographic profile. Results Among 482 respondents (response rate, 95.6%), 47.9% reported using one or more CAM modalities. Products of animal origin were the most popular modalities of CAM, followed by herbal products. Half of the users used CAM while receiving conventional treatment of cancer. Among users, only 29% discussed the CAM use with their doctors. Female gender, younger age, higher education, shorter disease duration, and prior use of CAM were significantly associated with CAM use. Conclusions CAM appears to be widely accepted by patients with cancer in Mongolia. The findings support the urgent need for further in-depth study into commonly used oral CAM products and their potential effects on health of patients with cancer in Mongolia. High prevalence of CAM use among cancer patients in our study warrants further studies in other countries of Central Asia.
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Abou-Rizk J, Alameddine M, Naja F. Prevalence and Characteristics of CAM Use among People Living with HIV and AIDS in Lebanon: Implications for Patient Care. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:5013132. [PMID: 28050191 PMCID: PMC5168459 DOI: 10.1155/2016/5013132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/07/2016] [Indexed: 01/25/2023]
Abstract
This study aimed to assess the prevalence and determinants of Complementary and Alternative Medicine (CAM) use among People Living with HIV and AIDS (PLWHA) in Lebanon and to identify related issues that may affect patient care. A cross-sectional survey design was used to interview 116 PLWHA in Beirut. The questionnaire addressed sociodemographic and disease characteristics as well as CAM use. The main outcome of the study was CAM use since diagnosis. Data analysis included descriptive statistics and logistic regression analyses. Overall, 46.6% of participants reported using one or more CAM therapies, with herbs and herbal products being the most commonly used (63%). A higher education level was associated with a 3-fold increase in the odds of CAM use. Among users, 20% used CAM as alternative to conventional treatment, 48% were not aware of CAM-drug interactions, 89% relied on nonhealth care sources for their choice of CAM, and 44% did not disclose CAM use to their physician. CAM use is prevalent among Lebanese PLWHA. Findings of this study highlighted the need to educate health care practitioners to have an open communication and a patient-centered approach discussing CAM use during routine care and to enhance awareness of PLWHA on safe use of CAM.
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Affiliation(s)
- Joana Abou-Rizk
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Mohamad Alameddine
- Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14, Dubai Healthcare City, P.O. Box 505055, Dubai, UAE
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, Beirut 1107 2020, Lebanon
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Albashtawy M, Gharaibeh H, Alhalaiqa F, Batiha AM, Freij M, Saifan A, Al-Awamreh K, Hamadneh S, Al-Kloub M, Khamaiseh A. The Health Belief Model's Impacts on the Use of Complementary and Alternative Medicine by Parents or Guardians of Children with Cancer. IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:708-9. [PMID: 27398349 PMCID: PMC4935720 DOI: pmid/27398349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | - Huda Gharaibeh
- Faculty of Nursing, Al al-Bayt University, Al-Mafraq, Jordan
| | | | | | - Mazen Freij
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Ahmad Saifan
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | | | | | - Manal Al-Kloub
- Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Barnes J, McLachlan AJ, Sherwin CM, Enioutina EY. Herbal medicines: challenges in the modern world. Part 1. Australia and New Zealand. Expert Rev Clin Pharmacol 2016; 9:905-15. [PMID: 27070431 DOI: 10.1586/17512433.2016.1171712] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
As in many developed countries, herbal medicines (HMs) are widely used in Australia and New Zealand (NZ). The popularity of HM continues to rise. Western, Asian and indigenous HMs are used, reflecting the cultural diversity of people in this region. HMs in Australia are regulated on a risk-based system with many HMs identified as being low risk. The legislation was reviewed in 2015 and proposals for change are under consideration. In NZ, it is recognised that current regulations for HMs and other natural health products (NHPs) do not adequately protect public health. NZ is entering a phase of regulatory change for this sector, and proposals for a 'light-touch' regulatory framework for NHPs are planned to be introduced into legislation during 2016.
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Affiliation(s)
- Joanne Barnes
- a Faculty of Medical and Health Sciences , School of Pharmacy, University of Auckland , Auckland , New Zealand
| | - Andrew J McLachlan
- b Faculty of Pharmacy and Centre for Education and Research on Ageing , University of Sydney and Concord Hospital , Sydney , NSW , Australia.,c NHMRC Centre for Research Excellence in Medicines and Ageing , the University of Sydney , Sydney , Australia
| | - Catherine Mt Sherwin
- d Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.,e Department of Pharmacology and Toxicology , University of Utah , Salt Lake City , UT , USA
| | - Elena Y Enioutina
- d Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.,f Division of Microbiology and Immunology, the Department of Pathology , University of Utah School of Medicine , Salt Lake City , UT , USA
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Smith PJ, Clavarino AM, Long JE, Anstey CM, Steadman KJ. Complementary and alternative medicine use by patients receiving curative-intent chemotherapy. Asia Pac J Clin Oncol 2016; 12:265-74. [DOI: 10.1111/ajco.12490] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Peter J Smith
- School of Pharmacy; The University of Queensland; Brisbane Australia
- Sunshine Coast Cancer Care Services; Nambour General Hospital; Nambour Australia
| | | | - Jeremy E Long
- Sunshine Coast Cancer Care Services; Nambour General Hospital; Nambour Australia
- School of Medicine; The University of Queensland; Brisbane Australia
| | - Chris M Anstey
- Sunshine Coast Cancer Care Services; Nambour General Hospital; Nambour Australia
- School of Medicine; The University of Queensland; Brisbane Australia
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Poonthananiwatkul B, Howard RL, Williamson EM, Lim RHM. Cancer patients taking herbal medicines: A review of clinical purposes, associated factors, and perceptions of benefit or harm. JOURNAL OF ETHNOPHARMACOLOGY 2015; 175:58-66. [PMID: 26344852 DOI: 10.1016/j.jep.2015.08.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/18/2015] [Accepted: 08/30/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. MATERIALS AND METHODS The international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. RESULTS Medline yielded 5638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. CONCLUSIONS Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.
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Affiliation(s)
| | - Rachel L Howard
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
| | - Elizabeth M Williamson
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom.
| | - Rosemary H M Lim
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
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Mwaka AD, Okello ES, Orach CG. Barriers to biomedical care and use of traditional medicines for treatment of cervical cancer: an exploratory qualitative study in northern Uganda. Eur J Cancer Care (Engl) 2015; 24:503-13. [PMID: 24923866 PMCID: PMC4930140 DOI: 10.1111/ecc.12211] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2014] [Indexed: 11/27/2022]
Abstract
Use of traditional medicines for treatment of cancers has increased worldwide. We used a qualitative approach to explore barriers to biomedical care and reasons for use of traditional medicines for the treatment of cervical cancer in Gulu, northern Uganda. We carried out 24 focus group discussions involving men and women aged 18-59 years. We employed content analyses technique in data analysis. Traditional medicines were used mainly due to barriers to biomedical care for cervical cancer. The barriers included health system factors, for example long distances to health facilities and unavailability of medicines; health workers' factors, for example negative attitudes towards patients and demands for bribes; individual patient's factors, for example inability to pay for medical care; and socio-cultural beliefs about superiority of traditional medicines and perceived greater privacy in accessing traditional healers. Barriers to biomedical care and community beliefs in the effectiveness of traditional medicines encourage use of traditional medicines for treatment of cervical cancer but might hinder help-seeking at biomedical facilities. There is need for targeted culturally sensitive awareness campaign to promote effectiveness of modern medicine and to encourage cautious use of traditional medicines in the treatment of cervical cancer.
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Affiliation(s)
- A D Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala
| | - E S Okello
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala
| | - C G Orach
- Department of Community Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Adams J, Valery PC, Sibbritt D, Bernardes CM, Broom A, Garvey G. Use of Traditional Indigenous Medicine and Complementary Medicine Among Indigenous Cancer Patients in Queensland, Australia. Integr Cancer Ther 2015; 14:359-65. [DOI: 10.1177/1534735415583555] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background. The cancer toll on Indigenous Australians is alarming with overall cancer incidence and mortality rates higher and the 5-year survival rate lower for Indigenous Australians compared with non-Indigenous Australians. Meanwhile, a range of approaches to health and illness—including both complementary and alternative medicine (CAM) and traditional Indigenous medicine (TM)—are used by cancer patients. Little work has focused on Indigenous cancer patients with regard to CAM/TM use. This article reports findings from the first examination of the prevalence and profile of TM/CAM use and users among Indigenous Australians with cancer. Methods. A structured questionnaire was administered via face-to-face interviews to 248 Indigenous Australian cancer patients diagnosed with a range of cancer types. All received treatment and were recruited from 1 of 4 large hospitals located in Queensland, Australia. Results. A substantial percentage (18.7%) of Indigenous cancer patients use at least one TM/CAM for support with their care, including traditional Indigenous therapy use (2.8%), visiting a traditional Indigenous practitioner (2.8%), CAM use (10.7%), visiting a CAM practitioner (2.4%), and attending relaxation/meditation classes (4.0%). Having a higher level of educational attainment was positively associated with CAM practitioner consultations (P = .015). Women with breast cancer were more likely to attend relaxation/meditation classes (P = .019). Men with genital organ cancer were more likely to use traditional Indigenous therapies (P = .017) and/or CAM (P = .002). Conclusion. A substantial percentage of Indigenous Australians reported using TM/CAM for their cancer care, and there is a need to expand examination of this area of health care using large-scale studies focusing on in-depth specific cancer(s).
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Affiliation(s)
- Jon Adams
- University of Technology Sydney, Sydney, NSW, Australia
| | | | | | | | - Alex Broom
- University of New South Wales, Sydney, NSW, Australia
| | - Gail Garvey
- Charles Darwin University, Darwin, Northern Territory, Australia
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Sullivan A, Gilbar P, Curtain C. Complementary and Alternative Medicine Use in Cancer Patients in Rural Australia. Integr Cancer Ther 2015; 14:350-8. [DOI: 10.1177/1534735415580679] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim. Numerous studies have demonstrated the high prevalence of complementary and alternative medicine (CAM) use in metropolitan cancer cohorts but few have been conducted in regional and remote populations. This study aimed to investigate the trends and regional variations in CAM use by cancer patients at a regional cancer care center in Toowoomba, South East Queensland, Australia. Methods. All English-speaking adult cancer patients attending the regional cancer care center were invited to participate. Eligible patients were provided a self-administered questionnaire that was developed based on published surveys. Ethics approval was obtained. Results. Overall 142 patients completed the questionnaire and 68% were currently or had previously used at least one form of CAM. CAM users and nonusers did not differ significantly by region, age, gender, time since diagnosis, income, town size, treatment intent, or metastases. CAM users were more likely to have a higher level of education. Concurrent CAM use with conventional treatment was reported by approximately half of respondents. The most common reason for CAM use was “to improve general physical well-being.” The most common sources of CAM information were family (31%) and friends (29%). Disclosure of CAM use to either the general practitioner or specialist was reported by 46% and 33% of patients, respectively. The most common reason for nondisclosure was “doctor never asked.” Conclusion. This study supports previous research that CAM use is as common in regional and remote areas as metropolitan areas. Nondisclosure of CAM use to health professionals was common. Future research needs to focus on strategies to improve communication between patients and health professionals about the use of CAM.
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Affiliation(s)
- Aimee Sullivan
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Prince of Wales Hospital, Sydney, New South Wales, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Peter Gilbar
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Department of Medicine (Rural Clinical School), The University of Queensland, Toowoomba, Queensland, Australia
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Evaluation of a Patient CAM-with-Chemotherapy Educational Brochure. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:408430. [PMID: 25802538 PMCID: PMC4352944 DOI: 10.1155/2015/408430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/12/2015] [Indexed: 11/18/2022]
Abstract
Biologically active CAM may detrimentally interfere with chemotherapy treatment, so cancer patients require targeted, evidence-based information on chemotherapy-CAM integration consequences. The object of this study was to investigate the potential for medical doctor recommendation and patient acceptance of a purpose-designed patient educational brochure on the safe use of CAM with chemotherapy. Cancer care doctors (n = 17) were provided a draft version of a patient educational brochure developed by the authors and completed a structured feedback form. Cancer patients receiving treatment (n = 12) were provided with the brochure and completed the local health service consumer testing feedback form. All 17 doctors perceived a need for the brochure and all would recommend the brochure to their patients. Approximately 59% of the doctors indicated they would recommend the brochure to all patients receiving chemotherapy and 41% preferred that only patients using CAM or who enquired about CAM be given the brochure. Cancer patients receiving chemotherapy reported that the brochure information answered their questions and was easy to understand. This evidence-based CAM-chemotherapy patient brochure may be a useful adjunct for use by cancer care health professionals to educate patients on the potential dangers of biologically active CAM use with chemotherapy and to provide patients with safe CAM alternatives.
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Abdel-Latif MMM. Chemoprevention of gastrointestinal cancers by natural honey. World J Pharmacol 2015; 4:160-167. [DOI: 10.5497/wjp.v4.i1.160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/03/2015] [Accepted: 01/20/2015] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal cancers are the most common human cancers in both men and women worldwide. Several epidemiological and experimental studies suggest a relationship between gastrointestinal cancers risk and dietary factors. Natural honey has been widely used in traditional medicine for many centuries to treat a wide range of ailments and complaints. Honey contains various components that exhibit wide activities including antibacterial, anti-inflammatory, antioxidant and anticancer properties. The anticancer effects of honey are mediated via diverse mechanisms, including inhibition of proliferation, induction of apoptosis, suppression of free radicals and modulation of inflammatory signalling pathways. The present review assesses the chemopreventive effects of natural honey and its components in the modulation of gastrointestinal cancers and its modes of action in the prevention of the development of gastrointestinal tumors. Honey can be an approach as a cancer-preventive strategy which merits further experimental and clinical research in the near future.
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Braun L, Harris J, Katris P, Cain M, Dhillon H, Koczwara B, Olver I, Robotin M. Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients. Asia Pac J Clin Oncol 2014; 10:289-96. [PMID: 25244342 DOI: 10.1111/ajco.12227] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2014] [Indexed: 11/30/2022]
Abstract
Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy.
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Affiliation(s)
- Lesley Braun
- National Institute of Complementary Medicine, University of Western Sydney, Sydney, New South Wales, Australia; Alfred Hospital, Melbourne, Victoria, Australia
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Savas P, Robertson A, Beatty L, Hookings E, McGee M, Marker J, McCaleb B, Bowen J, Richards A, Koczwara B. Patient preferences on the integration of complementary therapy with conventional cancer care. Asia Pac J Clin Oncol 2014; 12:e311-8. [DOI: 10.1111/ajco.12226] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Peter Savas
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer; Flinders Medical Centre and Flinders University; Bedford Park South Australia Australia
| | - Amanda Robertson
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer; Flinders Medical Centre and Flinders University; Bedford Park South Australia Australia
| | - Lisa Beatty
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer; Flinders Medical Centre and Flinders University; Bedford Park South Australia Australia
| | - Emily Hookings
- Faculty of Health Sciences; Flinders University; Bedford Park South Australia Australia
| | - Margaret McGee
- Dame Roma Mitchell Cancer Research Laboratories; University of Adelaide; Adelaide South Australia Australia
| | - Julie Marker
- Cancer Voices SA; Kensington Park South Australia Australia
| | - Belle McCaleb
- McCaleb Health Pty Ltd; St. Georges South Australia Australia
| | - Joanne Bowen
- School of Medical Sciences; University of Adelaide; Adelaide South Australia Australia
| | - Alison Richards
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer; Flinders Medical Centre and Flinders University; Bedford Park South Australia Australia
| | - Bogda Koczwara
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer; Flinders Medical Centre and Flinders University; Bedford Park South Australia Australia
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Edwards GV, Aherne NJ, Horsley PJ, Benjamin LC, McLachlan CS, McKay MJ, Shakespeare TP. Prevalence of complementary and alternative therapy use by cancer patients undergoing radiation therapy. Asia Pac J Clin Oncol 2014; 10:346-53. [DOI: 10.1111/ajco.12203] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Grace V Edwards
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
| | - Noel J Aherne
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
- Rural Clinical School Faculty of Medicine; University of New South Wales; Coffs Harbour New South Wales Australia
| | - Patrick J Horsley
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
| | - Linus C Benjamin
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
| | - Craig S McLachlan
- Rural Clinical School Faculty of Medicine; University of New South Wales; Coffs Harbour New South Wales Australia
| | - Michael J McKay
- Department of Radiation Oncology; North Coast Cancer Institute; Lismore New South Wales Australia
- Faculty of Medicine; University of Sydney; Sydney New South Wales Australia
| | - Thomas P Shakespeare
- Department of Radiation Oncology; North Coast Cancer Institute; Coffs Harbour New South Wales Australia
- Rural Clinical School Faculty of Medicine; University of New South Wales; Coffs Harbour New South Wales Australia
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Chitindingu E, George G, Gow J. A review of the integration of traditional, complementary and alternative medicine into the curriculum of South African medical schools. BMC MEDICAL EDUCATION 2014; 14:40. [PMID: 24575843 PMCID: PMC3939811 DOI: 10.1186/1472-6920-14-40] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 02/17/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND Traditional, complementary and alternative (TCAM) medicine is consumed by a large majority of the South African population. In the context of increasing overall demand for healthcare this paper investigates the extent to which South African medical schools have incorporated TCAM into their curriculum because of the increased legislative and policy interest in formally incorporating TCAM into the health care system since democracy in 1994. METHODS Heads of School from seven South African medical schools were surveyed telephonically. RESULTS One school was teaching both Traditional African Medicine (TM) and CAM, five were teaching either TM or CAM and another was not teaching any aspect of TCAM. CONCLUSIONS In conclusion, there is a paucity of curricula which incorporate TCAM. Medical schools have not responded to government policies or the contextual realities by incorporating TCAM into the curriculum for their students. South African medical schools need to review their curricula to increase their students' knowledge of TCAM given the demands of the population and the legislative realities.
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Affiliation(s)
- Ethel Chitindingu
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Gavin George
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Jeff Gow
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
- School of Commerce, University of Southern Queensland, Toowoomba, Australia
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Erejuwa OO, Sulaiman SA, Wahab MSA. Effects of honey and its mechanisms of action on the development and progression of cancer. Molecules 2014; 19:2497-522. [PMID: 24566317 PMCID: PMC6270987 DOI: 10.3390/molecules19022497] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/06/2014] [Accepted: 02/10/2014] [Indexed: 12/11/2022] Open
Abstract
Honey is a natural product known for its varied biological or pharmacological activities-ranging from anti-inflammatory, antioxidant, antibacterial, antihypertensive to hypoglycemic effects. This review article focuses on the role of honey in modulating the development and progression of tumors or cancers. It reviews available evidence (some of which is very recent) with regards to the antimetastatic, antiproliferative and anticancer effects of honey in various forms of cancer. These effects of honey have been thoroughly investigated in certain cancers such as breast, liver and colorectal cancer cell lines. In contrast, limited but promising data are available for other forms of cancers including prostate, bladder, endometrial, kidney, skin, cervical, oral and bone cancer cells. The article also underscores the various possible mechanisms by which honey may inhibit growth and proliferation of tumors or cancers. These include regulation of cell cycle, activation of mitochondrial pathway, induction of mitochondrial outer membrane permeabilization, induction of apoptosis, modulation of oxidative stress, amelioration of inflammation, modulation of insulin signaling and inhibition of angiogenesis. Honey is highly cytotoxic against tumor or cancer cells while it is non-cytotoxic to normal cells. The data indicate that honey can inhibit carcinogenesis by modulating the molecular processes of initiation, promotion, and progression stages. Thus, it may serve as a potential and promising anticancer agent which warrants further experimental and clinical studies.
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Affiliation(s)
- Omotayo O Erejuwa
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
| | - Siti A Sulaiman
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
| | - Mohd S Ab Wahab
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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Smith PJ, Clavarino A, Long J, Steadman KJ. Why do some cancer patients receiving chemotherapy choose to take complementary and alternative medicines and what are the risks? Asia Pac J Clin Oncol 2013; 10:1-10. [PMID: 23910177 DOI: 10.1111/ajco.12115] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2013] [Indexed: 12/21/2022]
Abstract
Complementary and alternative medicine (CAM) cover a broad and diverse group of treatments and products that do not tend to be widely used by conventional healthcare professions. CAM that is systemically absorbed is the most likely to interfere with concurrent chemotherapy and potentially cause harm to cancer patients. Patients receiving chemotherapy may be consuming CAM to treat cancer, to lessen chemotherapy side effects, for symptom management, or to treat conditions unrelated to their cancer. A small proportion of cancer patients decide to use CAM alone to treat cancer and delay conventional treatment. Cancer patients may be influenced in their CAM decision-making by others: practitioners, family, friends, spouse and even casual acquaintances met in waiting rooms and support groups. This influence may range from encouraging and supporting the patient's decision through to making the decisions for the patient. When tested in rigorous clinical trials, no CAM cancer treatments alone have shown benefit beyond placebo. With the exception of ginger to treat chemotherapy-induced nausea, there is no compelling evidence overriding risk to take complementary medicines for supportive care during chemotherapy treatment. There is, however, established evidence to use mind-body complementary therapies for supportive care during chemotherapy treatment.
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Affiliation(s)
- Peter J Smith
- School of Pharmacy, University of Queensland, Brisbane, Queensland, Australia; Sunshine Coast Cancer Care Services, Nambour General Hospital, Nambour, Queensland, Australia
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Kraft K. CAM for depression, anxiety, grief, and other symptoms in palliative care. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/1743291x12y.0000000020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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