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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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Alternative Medicine

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  1. 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

  2. What is CAM? • 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 • Our focus: herbal supplements

  3. CAM usage in Cancer • CAM is used primarily to1 • alleviate symptoms • speed up recovery • create therapeutic relief • Herbal supplements are thought to be beneficial in combating certain types of tumors1 • More scientific evidence/research needed1

  4. Research QuestionCAM use and efficacy • Most common CAMs • Efficacy • Purpose • treatment • symptom control • in vitro effects

  5. Research QuestionCommunication and Information • Patient disclosure • Physician influence • Available information

  6. Literature ReviewCancer and CAM • 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

  7. Literature ReviewPatients, Health Professionals, and CAM • Lack of patient-physician communication10-16 • Health professionals have mixed opinions12, 17 • Many factors affect patients’ perceptions of CAM 13, 14,18-24 • Patients use CAM for a variety of reasons22, 23, 25

  8. Literature ReviewSpecific Cancers and CAM • 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

  9. MethodologyPreliminary Considerations • Limitations and Assumptions • Only dietary supplements • CAM use prevalent among cancer patients • Confounding Variables • Different hospital settings • Varied physician knowledge • Patient demographics

  10. MethodologyData Collection: Survey and Interview Focus groups Question Types Type of CAM used Physician-patient relationship Perceived efficacy Reasons for use Survey Analysis Patient and physician opinion on CAM

  11. MethodologyData Collection: Laboratory Research 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

  12. Timeline to SuccessFall 2007 • Outline draft proposal • Assign sections and editors • Find contacts • Research funding and surveying • Meet with librarian

  13. Timeline to SuccessSpring 2008 • Thesis proposal • Obtain IRB approval for survey • Create website • Find lab

  14. Timeline to Success Fall 2008 • Administer surveys • Outline thesis • Draft literature review for thesis • Fall colloquia • Begin lab research

  15. Timeline to SuccessSpring 2009 • Finish survey and lab data collection • Organize data • Draft Chapters 1, 2 and 3 of thesis • Undergraduate Research Day

  16. Timeline to SuccessFall 2009 • Complete data analysis • Draft Chapters 4 and 5 • Draft presentation for thesis conference • 5 experts for conference panel

  17. Timeline to SuccessSpring 2010 • Submit final team information • Finish thesis • Thesis Conference • Submit final thesis for publication • Graduate!!! (and get our Gems citations! )

  18. References 1. CAMBasics [Internet]: NCCAM; c2007 [cited 2007 October 31]. Available from: http://nccam.nih.gov/health/whatiscam/. 2. Bettelheim A. Cancer treatments. CQ Researcher [Internet]. [revised 1998 9/11/1998;cited 9/14/2007];8(34). 3. Cancer of the Colon and Rectum [Internet]; c2007 [cited 2007 October/8]. Available from: http://www.seer.cancer.gov/statfacts/html/colorect.html. 4. Kelloff GJ, Sigman CC. Assessing intraepithelial neoplasia and drug safety in cancer-preventive drug development. Nat Rev Cancer 2007 Jul;7(7):508-18. 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.

  19. 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):1397-421. 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 Med Chem 1994 Jun 24;37(13):1971-6. 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 15;11(20):7490-8.

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