Complementary Oncology: Adjunctive Methods in the Treatment of Cancer

Complementary and Alternative Medicine in Cancer Pain Management: A Systematic Review
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A glaring flaw in Dr. Remedies applied for symptom relief are not consistent with his definition of unproven remedies as cure-oriented and lacking data. Furthermore, most complementary therapies used for pain and other symptom control are often well supported by data. There are, for example, numerous articles in the medical literature describing the physiologic and psychological benefits of massage therapy, acupuncture, music and art therapies, tai chi, meditation, yoga, relaxation therapies, and so on.

Moreover, the NIH, including the National Cancer Institute, is now backing several studies designed to evaluate complementary as well as alternative or unproven therapies. More typically, fear is followed by efforts to deal with the problem, and those efforts most often take the form of seeking recommended mainstream treatment. But surely we all recognize these fears as virtually universal reactions to the diagnosis itself, following which most patients elect to receive mainstream care.

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Wein states, conventional physicians see patients as deluded when they rely on unproven therapies to alter the course of cancer, what label should we attach to people who believe that mainstream oncologic care can alter the course of pancreatic and some other cancers? The popularity of alternative medicine may be a biting criticism of mainstream medicine, but it is often and equally an opportunity for patients to participate in their own care; to exert some control over their lives and well-being.

We skate on very thin ice when we criticize or attach psychiatric labels to patients who seek unproven methods. Oncology care too often remains imperfect. Wein cites Cassileth as noting that there are few questionable methods for curable illnesses. Yoga is an ancient healing system, inclusive of various asanas or poses with breathing techniques and meditation to assist in the movement and balancing of life force energy or prana.

Though a lot of evidence supports use of yoga as an adjunct treatment for cancer patients and survivors yet studies on Yoga contributing in improvement of pain scores are scant. Individual experiences of patients suffering from cancer have reported that Yoga helped them survive cancer better with strength, hope and vitality. As chemotherapy and radiation therapy pose tremendous stress and emotional burden on the patient complementary therapies like yoga can generate a feeling of well-being for the patient and promote the fighting capabilities.

Eshe et al. The deep, relaxing breathing often emphasized in yoga in cancer therapy also increases the current of oxygen-rich blood to the cells, delivering vital nutrients to tired cells and further clearing out toxins.

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For those recovering from surgery, such as that for breast cancer, yoga can help restore motion and flexibility in a gentle, balanced manner. Buffart et al.

Complementary or alternative medicine in cancer care – myths and realities

Out of the records screened, 16 full text research papers on RCTs were included in the review and only four such RCTs evaluated pain as one of the physical outcomes and only one RCT reported a decrease in cancer pain after yoga. The other three studies reported no significant difference between yoga and control group. However two out of the four studies discussed in this extensive review of Buffart et al.

However, several reviews and meta-analysis suggest that yoga contribute to improvement in sleep, mood and QoL, depression, emotional function and anxiety. Recent studies of women cancer survivors of breast cancer, suggest that yoga may help improve several aspects of QoL. However ACS does not comment about effects of yoga on cancer pain. Another meta-analysis conducted by Lin et al. However interpretation of results on effects of yoga on physical health demonstrates that there was no significant difference between cancer patients in control group or yoga treated group.

The author also agrees that because of limited number of studies, effects of yoga on physical health remains unclear. Therefore, at present a lot of studies are providing preliminary support for the feasibility and efficacy of yoga interventions and mindfulness based stress reduction for cancer patients but evidence for contribution of yoga in relieving cancer pain remains scant.

Further studies, systematic reviews and meta-analysis are required to comment on effects of yoga in cancer pain. Tai chi also helps to balance the yin and yang principles, the feminine and masculine life force energies. Eshe reports that regular practice of tai chi promotes wellness of the mind, body and spirit, and can assist in decreasing the severity of side effects of cancer and chemotherapy.

Results demonstrated that Tai chi significantly improved the functional capacity including the aerobic capacity, muscle strength and flexibility as well as QoL as compared to psychological support therapy which could only improve flexibility.

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Zeng Y. Cancer, Unproven Therapies, and Magic. Patient Educ. You can meditate on your own for a few minutes once or twice a day or you can take a class with an instructor. Andrews recognition, , known

Lee et al. A systematic review by Lee et al. Another systematic review evaluating role of Tai chi on breast cancer patients reports that evidence does not support tai chi to be more effective CAM therapy than walking exercise, psychological support therapy or spiritual growth therapy standard control procedures. Three RCTs in this review compared tai chi with the standard control procedures in QoL and psychological health but failed to demonstrate any significant difference between the various procedures adopted.

In contrast to the RCTs the four non-randomized controlled trials included in the extensive review did show some beneficial effects of Tai chi for breast cancer patients but all the studies had high risk of bias as assessed by the Cochrane criteria. Yet another systematic review by Lee et al.

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Complementary methods are playing an increasingly important role in these treatment of cancer. Resulting benefits are a higher quality of life, reduced instance. Buy Complementary Oncology: Adjunctive Methods in the Treatment of Cancer: Read 1 Kindle Store Reviews - elexanonde.ml

On search of various databases we could not find individual studies, systematic reviews or meta-analysis evaluating effects of tai chi specifically on cancer pain, hence at present it is difficult to assess the role of Tai chi on cancer pain though evidence supports its positive role in improving QoL and psychological health of cancer patients.

It is the induction of a trance-like state to facilitate relaxation and enhance suggestibility for treating conditions and introduce behavioural changes. It is not uncommon to see patients fearing a sense of helplessness and a loss of control over his or her own life due to cancer. Hypnosis helps patient cope more effectively with cancer. Liossi et al. Research supports that hypnosis can reduce anticipatory nausea and vomiting. Anticipatory nausea and vomiting occur prior to chemotherapy when previous exposure to chemotherapy has already caused nausea and vomiting but hypnosis had less effects on nausea and vomiting that happened after the chemotherapy dose is given.

A prospective, randomized study of 39 advanced-stage Stage III or IV cancer patients with malignant bone disease who received weekly sessions of supportive attention or a hypnosis intervention. Nash et al.

A systematic review of 27 papers comprising of RCTs, observational studies, retrospective questionnaires and 24 case studies for use of hypnotherapy to treat symptoms of terminally ill adult cancer patients concludes that quality of research done is not adequate and further research is required to understand the role of hypnotherapy in terminal cancer patients.

A review concluded that four of five RCTs found hypnosis plus cognitive behavioural techniques reduced pain intensity and severity compared with the control in patients with acute procedure related pain and oral mucositis pain related to bone marrow transplant. Various studies and reviews have reported that hypnotherapy may be helpful to reduce procedure related pain viz. The review also cautions use of hypnosis by an expert only as this form of CAM may be associate with short term fatigue, anxiety, confusion, fainting or rarely serious reactions also stupor, chronic psychological problems, seizures and therefore screening of vulnerable individuals is recommended for this therapy.

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A systematic review for effectiveness of hypnosis and procedure related pain and distress in pediatric cancer patients reveals that though hypnosis has potential as a clinically valuable intervention in such patients yet further research is required as various studies had lot of methodological limitations. Therefore at present evidence supports use of hypnotherapy for various procedure related pain in pediatric and adult cancer patients but evidence for use of hypnotherapy for chronic cancer pain is inconclusive.

This is the controlled use of plant essences, applied either to the skin through massage, added to baths or inhaled with steaming water. It has been shown that the aromatic oils reached the lymph system by means of blood circulation and provided recovery by means of intercellular fluids. A Cochrane systematic review concluded that aromatherapy have beneficial short-term effects on well-being in cancer patients.

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Many people fear that massage may spread the tumour to various other areas as it shall increase the blood supply to which Horrigan opines that surface massage will not make the cancer grow due an increased blood supply,[ 48 ] nor make the cancer spread, nor interfere with chemotherapy or radiotherapy, nor cure cancer by natural means. However aroma therapists advise not to use unresearched oils or unfamiliar oils.

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There is no evidence that either essential oils or aromatherapy has caused cancer in humans. Lavender and citrus oils of a good quality are also useful for relieving stress. Essential oils have been helpful when used during radiotherapy to help reduce or prevent deep burning and scarring. There is no evidence of any interaction of any essential oils with cytotoxic chemotherapeutic agents therefore cancer patients may be given a trial of aromatherapy for nausea and vomiting due to chemotherapy. A systematic review of 18 clinical trials reveal that aromatherapy has short term benefits on depression, anxiety and overall well-being, improved sleep and better pain control.

The neurotransmitters suggest inhibition of glutamate binding and GABA augmentation. Linalool is the main component of lavender oil and it inhibits glutamate binding in rats and augments gamma-aminobutyric acid GABA action. Surveys carried out in the UK showed that Repeated exposure to lavender and tea tree oils by topical administration was shown in one study to be associated with reversible prepubertal gynecomastia, therefore patients with estrogen-dependant tumors should exercise caution.

Research reports that music therapy can help decrease the nausea and vomiting in patients undergoing radiotherapy and chemotherapy. Music therapy can affect stress hormone levels and improve brain waves and brain circulation. Another review on quantitative literature on music based interventions in palliative cancer care reports that available evidence supports that music-based interventions may have a positive impact on cancer pain, anxiety, mood disturbance, and QoL in cancer patients.

The review also reports that no evidence was found on the effect of music for pain or anxiety. Therefore at present mixed results of use of music therapy for cancer pain exists and high quality evidence for its use is awaited. The TENS unit delivers low-voltage electrical stimulation to leads which are placed over the skin on or near the painful sites. The efficacy of TENS in chronic cancer patients has shown mixed results. Certain limitations of TENS therapy are that electrodes should not be placed on certain parts of the body, such as near eyes, on front of neck, open wounds or infections, near tumors, in pregnant women, or on genitals.