Transcript Alternative Medicine

Alternative Medicine
Members
Peter Frechette, Stephanie Galanie, Kevin Gu,
Anna Hung, Sarah Kim, Kelsey Merrick, Krupa
Nataraj, Jessica Nooralian, Chetan Pasrija, Mihir
Patel, Jessica Stevens, Vivian Wang, Albert Zhou
Mentor
Dr. Mark Kantor
Librarian
Bob Garber
What is CAM?
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Complementary and Alternative
Medicine1
 practices and products that are not
presently considered to be part of
conventional medicine
 e.g. acupuncture, herbal and dietary
supplements, yoga/meditation, chiropractic
medicine, visualization
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Our focus: herbal supplements
CAM usage in Cancer
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CAM is used primarily to1
 alleviate symptoms
 speed up recovery
 create therapeutic relief
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Herbal supplements are thought to be
beneficial in combating certain types of
tumors1
More scientific evidence/research
needed1
Research Question
CAM use and efficacy
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Most common CAMs
Efficacy
Purpose
 treatment
 symptom control
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in vitro effects
Research Question
Communication and Information
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Patient disclosure
Physician influence
Available information
Literature Review
Cancer and CAM
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Most common cancers: prostrate, breast,
lung, and colon and rectal2,3
Few new drugs for cancer prevention4
36% of adults use some form of CAM7
Natural substances have been shown to
help cancer patients
Echinacea, ginseng, ginkgo biloba, and
garlic supplements are the most
commonly used herbal supplements6
Eastern v. Western medicine
Literature Review
Patients, Health Professionals, and CAM
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Lack of patient-physician
communication10-16
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Health professionals have mixed
opinions12, 17
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Many factors affect patients’ perceptions
of CAM 13, 14,18-24
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Patients use CAM for a variety of
reasons22, 23, 25
Literature Review
Specific Cancers and CAM
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General trends in CAM use for breast
cancer treatment26-30
Side effects from breast cancer treatment
include menopausal symptoms and
nausea
Specific CAM for specific cancers10, 31-41
Methodology
Preliminary Considerations
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Limitations and Assumptions
 Only dietary supplements
 CAM use prevalent among cancer patients
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Confounding Variables
 Different hospital settings
 Varied physician knowledge
 Patient demographics
Methodology
Data Collection: Survey and Interview
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Focus groups
Question Types
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Type of CAM used
Physician-patient relationship
Perceived efficacy
Reasons for use
Survey Analysis
 Patient and physician opinion on CAM
Methodology
Data Collection: Laboratory Research
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Choose one specific CAM
Extracted and purified at a local lab
Efficacy of extraction tested on cancer
cell line
Analysis
 Actual efficacy compared to perceived
efficacy
Timeline to Success
Fall 2007
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Outline draft proposal
Assign sections and editors
Find contacts
Research funding and surveying
Meet with librarian
Timeline to Success
Spring 2008
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Thesis proposal
Obtain IRB approval for survey
Create website
Find lab
Timeline to Success
Fall 2008
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Administer surveys
Outline thesis
Draft literature review for thesis
Fall colloquia
Begin lab research
Timeline to Success
Spring 2009
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Finish survey and lab data collection
Organize data
Draft Chapters 1, 2 and 3 of thesis
Undergraduate Research Day
Timeline to Success
Fall 2009
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Complete data analysis
Draft Chapters 4 and 5
Draft presentation for thesis conference
5 experts for conference panel
Timeline to Success
Spring 2010
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Submit final team information
Finish thesis
Thesis Conference
Submit final thesis for publication
Graduate!!! (and get our Gems
citations! )
References
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4.
CAMBasics [Internet]: NCCAM; c2007 [cited 2007 October 31]. Available from: http://nccam.nih.gov/health/whatiscam/.
Bettelheim A. Cancer treatments. CQ Researcher [Internet]. [revised 1998 9/11/1998;cited 9/14/2007];8(34).
Cancer of the Colon and Rectum [Internet]; c2007 [cited 2007 October/8]. Available from: http://www.seer.cancer.gov/statfacts/html/colorect.html.
Kelloff GJ, Sigman CC. Assessing intraepithelial neoplasia and drug safety in cancer-preventive drug development. Nat Rev Cancer 2007 Jul;7(7):50818.
5. Fabrega H,Jr. Medical validity in eastern and western traditions. Perspect Biol Med 2002 Summer;45(3):395-415.
6. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC. Trends in alternative medicine use in the united states, 1990-1997:
Results of a follow-up national survey. JAMA 1998 Nov 11;280(18):1569-75.
7. Szabo L. What's new in the battle against cancer ? USA TodayJune 4. LIFE:7D.
8. Hök J, Wachtler C, Falkenberg T, Tishelman C. Using narrative analysis to understand the combined use of complementary therapies and bio-medically
oriented health care. Social Science & Medicine 2007 10;65(8):1642-53.
9. Jones S, DePrimo S, Whitfield M, Brooks J. Resveratrol-induced gene expression profiles in human prostate cancer cells. Cancer Epidemiol Biomarkers
Prev 2005 March 1;14(3):596-604.
10. Hyun-Na Koo. Mountain grown ginseng induces apoptosis in HL-60 cells and its mechanism have little relation with TNF-α production. Am J Chin Med
2007;35(1):169-82.
11. Kemper KJ, Gardiner P, Gobble J, Woods C. Expertise about herbs and dietary supplements among diverse health professionals. BMC Complement
Altern Med 2006 Apr 28;6:15.
12. Kwan D, Hirschkorn K, Boon H. U.S. and canadian pharmacists' attitudes, knowledge, and professional practice behaviors toward dietary supplements:
A systematic review. BMC Complement Altern Med 2006 Sep 19;6:31.
13. Lerner IJ, Kennedy BJ. The prevalence of questionable methods of cancer treatment in the united states. CA Cancer J Clin 1992 May 1;42(3):181-91.
14. Boon HS, Olatunde F, Zick SM. Trends in complementary/alternative medicine use by breast cancer survivors: Comparing survey data from 1998 and
2005. BMC Womens Health 2007 Mar 30.
15. ICR, AARP, and NCCAM. Complementary and alternative medicine: What people 50 and older are using and discussing with their physicians.
Washington, DC: AARP; 2007.
16. Molassiotis A, Browall M, Milovics L, Panteli V, Patiraki E, Fernandez-Ortega P. Complementary and alternative medicine use in patients with
gynecological cancers in europe. Int J Gynecol Cancer 2006 Jan-Feb;16 Suppl 1:219-24.
17. Tovey P, Broom A. Oncologists’ and specialist cancer nurses’ approaches to complementary and alternative medicine and their impact on patient
action. Social Science & Medicine 2007 6;64(12):2550-64.
18. Chiu L, Balneaves L, Barroetavena MC, Doll R, and Leis A. Use of complementary and alternative medicine by chinese individuals living with cancer in
british columbia. Journal of Complementary and Integrative Medicine 2006;2(1):Article 2.
19. Jones RAJ, Taylor AG, Bourguignon C, Steeves R, Fraser G, Lippert M, Theodorescu D, Mathews H, Kilbridge KL. Complementary and alternative
medicine modality use and beliefs among african american prostate cancer survivors. Oncol Nurs Forum 2007 03;34(2):359-64.
20. Malik IA, Gopalan S. Use of CAM results in delay in seeking medical advice for breast cancer. Eur J Epidemiol 2003;18(8):817-22.
References
21. Malik IA, Khan NA, Khan W. Use of unconventional methods of therapy by cancer patients in pakistan. Eur J Epidemiol 2000 Feb.;16(2):155-60.
22. Adler SR. Complementary and alternative medicine use among women with breast cancer. Med Anthropol Q 1999 Jun;13(2):214-22.
23. Sparber A. Use of complementary medicine by adult patients participating in cancer clinical trials. Oncol Nurs Forum 2000 May2000;27(4):623,624,
625, 626, 627, 628, 629, 630.
24. Vapiwala N, Mick R, Hampshire MK, Metz JM, Denittis AS. Patient initiation of complementary and alternative medical therapies (CAM) following cancer
diagnosis. Cancer Journal 2006;12(6):467-74.
25. Cui Y, Shu X, Gao Y, Wen W, Ruan Z, Jin F, Zheng W. Use of complementary and alternative medicine by chinese women with breast cancer. Breast
Cancer Res Treat 2004 06;85(3):263-70.
26. Lengacher CA, Bennett MP, Kip KE, Gonzalez L, Jacobsen P, Cox CE. Relief of symptoms, side effects, and psychological distress through use of
complementary and alternative medicine in women with breast cancer. Oncology Nursing Forum 2006;33(1):97.
27. Graft MC, Geller PA. Treating hot flashes in breast cancer survivors:A review of alternative treatments to hormone replacement therapy. Clin J Oncol
Nurs 2003;7(6):637-40.
28. Deniz G, Antoine C, Liebens F, Carly B, Pastijn A, Rozenberg S. Treatment of premature menopause in breast cancer patients. Acta Chir Belg 2007
Jun;107(3):263-6.
29. Antoine C, Liebens F, Carly B, Pastijn A, Rozenberg S. Safety of alternative treatments for menopausal symptoms after breast cancer: A qualitative
systematic review. Climacteric 2007 02;10(1):23-6.
30. O'Connell M. Holistic help for breast cancer. Natural Health 2007;37(7; 7):18-.
31. Carlsson M, Arman M, Backman M, Hamrin E. Coping in women with breast cancer in complementary and conventional care over 5 years measured by
the mental adjustment to cancer scale. Journal of Alternative & Complementary Medicine 2005 06;11(3):441-7.
32. Luk JM, Xiaoling Wang, Ping Liu, Kwong-Fai Wong, Kwong-Leung Chan, Yao Tong, Chi-Kin Hui, Lau GK, Sheung-Tat Fan. Traditional chinese herbal
medicines for treatment of liver fibrosis and cancer: From laboratory discovery to clinical evaluation. Liver International 2007 09;27(7):879-90.
33. Nelson PS, Montgomery B. Unconventional therapy for prostate cancer: Good, bad or questionable? Nat Rev Cancer 2003 Nov;3(11):845-58.
34. Aggarwal BB, Shishodia S. Molecular targets of dietary agents for prevention and therapy of cancer. Biochem Pharmacol 2006 May 14;71(10):1397421.
35. Huang X, Kojima-Yuasa A, Norikura T, Kennedy DO, Hasuma T, Matsui-Yuasa I. Mechanism of the anti-cancer activity of zizyphus jujuba in HepG2
cells. Am J Chin Med 2007;35(3):517-32.
36. Sullivan R, Smith JE, Rowan NJ. Medicinal mushrooms and cancer therapy: Translating a traditional practice into western medicine. Perspect Biol Med
2006 Spring;49(2):159-70.
37. Siddiqui IA, Saleem M, Adhami VM, Asim M, Mukhtar H. Tea beverage in chemoprevention and chemotherapy of prostate cancer. Acta Pharmacol Sin
2007 09;28(9):1392-408.
38. Volate SR, Davenport DM, Muga SJ, Wargovich MJ. Modulation of aberrant crypt foci and apoptosis by dietary herbal supplements (quercetin,
curcumin, silymarin, ginseng and rutin). Carcinogenesis 2005 Aug;26(8):1450-6.
39. Zhao GX, Miesbauer LR, Smith DL, McLaughlin JL. Asimin, asiminacin, and asiminecin: Novel highly cytotoxic asimicin isomers from asimina triloba. J
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40. Sengupta S, Toh S, Sellers L, Skepper J, Koolwijk P, Leung H, Yeung H, Wong RS, Sasisekharan R, Fan T. Modulating angiogenesis: The yin and the
yang in ginseng. Circulation 2004 September 7;110(10):1219-25.
41. Aggarwal B, Shishodia S, Takada Y, Banerjee S, Newman R, Bueso-Ramos C, Price J. Curcumin suppresses the paclitaxel-induced nuclear factor{kappa}B pathway in breast cancer cells and inhibits lung metastasis of human breast cancer in nude mice. Clin Cancer Res 2005 October
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