Can­cer: Al­ter­na­tive ther­a­pies are pop­u­lar but risky

Tehran Times - - HEALTH -

Two new stud­ies, pre­sented at the Eu­ro­pean So­ci­ety for Med­i­cal On­col­ogy 2018 Congress, show that peo­ple with sar­coma of­ten take com­ple­men­tary and al­ter­na­tive medicine with lit­tle re­gard for the po­ten­tial risks or ways in which they may in­ter­act with con­ven­tional can­cer treat­ment.

Vi­ta­min and herb sup­ple­ments could be risky when added to can­cer treat­ment.

Sar­coma is a rare can­cer that af­fects con­nec­tive tis­sue and ac­counts for 1 per­cent of all can­cer cases.

In the United States, around 15,000 peo­ple find out that they have sar­coma each year.

Re­cently, re­searchers from Univer­sity Hospi­tal Mannheim in Ger­many zoomed in on this form of can­cer to in­ves­ti­gate whether peo­ple who have it use any com­ple­men­tary or al­ter­na­tive medicines (CAMs).

Prof. Peter Ho­hen­berger su­per­vised the team.

An­other study that was led by Dr. Au­drey Belle­soeur — of the Univer­sity Paris Descartes in France — com­ple­ments these find­ings by ex­am­in­ing the drug-to-drug in­ter­ac­tions be­tween CAMs and con­ven­tional can­cer treat­ment, such as chemo­ther­apy or ty­ro­sine ki­nase in­hibitors.

Both of these stud­ies were pre­sented at the Eu­ro­pean So­ci­ety for Med­i­cal On­col­ogy 2018 Congress, held in Mu­nich, Ger­many.

Al­ter­na­tive ther­a­pies ‘not without risk’

In the first study, Prof. Ho­hen­berger and team sur­veyed 152 peo­ple who had been di­ag­nosed with sar­coma, gas­troin­testi­nal stro­mal tu­mors (GIST), and desmoid tu­mors — which are both types of sar­coma — over the 4 months be­tween Jan­uary and April 2018.

The sur­vey re­vealed that 51 per­cent of the study par­tic­i­pants had used CAMs in their lives. These al­ter­na­tive medicines and prac­tices in­cluded: tak­ing vi­ta­min sup­ple­ments, min­er­als, or heal­ing herbs; prac­tic­ing home­opa­thy, acupunc­ture, med­i­ta­tion, yoga, or tai chi; and eat­ing ei­ther a ke­to­genic or a ve­gan diet.

Im­por­tantly, their sur­vey re­vealed that 15 per­cent of the par­tic­i­pants used CAMs to com­ple­ment can­cer ther­apy af­ter they were di­ag­nosed with sar­coma. Forty-four of the vol­un­teers were not in­ter­ested in CAMs be­fore re­ceiv­ing the di­ag­no­sis.

A new study looks at the pa­tients’ prospects and their treat­ment ad­her­ence.

Prof. Ho­hen­berger sums up the find­ings, claim­ing, “What we found is that vi­ta­mins and min­er­als are very pop­u­lar but pa­tients take them specif­i­cally rather than us­ing mul­ti­vi­ta­min sup­ple­ments. Vi­ta­min D is in the lead­ing po­si­tion, fol­lowed by se­le­nium plus zinc, vi­ta­min C, and in­ter­est in vi­ta­min B-17 is emerg­ing.”

Also, the sur­vey demon­strated that few peo­ple were con­cerned about the po­ten­tial health risks of these prac­tices. While 60 per­cent of those who were sur­veyed ad­mit­ted that they had in­suf­fi­cient in­for­ma­tion on the safety of CAMs, these par­tic­i­pants were very lit­tle pre­oc­cu­pied with the risks.

“When we looked at the sources of in­for­ma­tion on non-con­ven­tional prac­tices,” con­tin­ues Prof. Ho­hen­berger, “on­col­o­gists rep­re­sented only 7 [per­cent]. In our study, pa­tients men­tioned repet­i­tively that they were pos­i­tively sur­prised about our in­ter­est in their use of CAMs.”

The In­ter­net and other me­dia were the top sources of in­for­ma­tion for these re­spon­dents, with 43 per­cent turn­ing to them for ad­vice. Friends and heal­ing pro­fes­sion­als came sec­ond and third, re­spec­tively, with 15 per­cent and 14 per­cent of the re­spon­dents us­ing these sources.

“In sharp con­trast with this,” says Prof. Ho­hen­berger, “when it came to find­ing in­for­ma­tion on [the] side ef­fects of can­cer ther­a­pies or how to han­dle them, al­most half of [the] pa­tients asked their on­col­o­gist.”

Dr. Markus Jo­erger, from the Can­tonal Hospi­tal in St. Gallen, Switzer­land, com­ments on the sig­nif­i­cance of the re­sults, say­ing, “Pa­tients tend to be­lieve that sup­ple­ments or herbs are gen­er­ally safe, but they are not without risk.”

“In daily prac­tice, if you don’t know what your pa­tient is tak­ing as al­ter­na­tive medicine, the risk of drug-drug in­ter­ac­tions can sig­nif­i­cantly in­crease and have an im­pact on clin­i­cal out­comes.”

What are the risks of drug-drug in­ter­ac­tions?

Dr. Belle­soeur and her col­leagues’ re­view ad­dressed pre­cisely this risk of drug-to-drug in­ter­ac­tions. They re­viewed data on 202 pa­tients treated for sar­coma with chemo­ther­apy or ty­ro­sine ki­nase in­hibitor in 2014–2018.

Dur­ing this time, drug-to-drug in­ter­ac­tions oc­curred in 18 per­cent of the cases. The study’s lead au­thor re­ports on the find­ings.

“In our re­view, 29 [per­cent] of drug-drug in­ter­ac­tions re­quir­ing phar­ma­cist in­ter­ven­tions were as­so­ci­ated with com­ple­men­tary al­ter­na­tive medicines. Risks of in­ter­ac­tions with non-con­ven­tional drugs are the same as for other co-med­i­ca­tions: mainly in­creased tox­i­c­ity and loss of ef­fi­cacy of anti-can­cer treat­ments.”

“How­ever, we of­ten have less in­for­ma­tion on the com­po­si­tion of these prod­ucts and their risk of tox­i­c­ity or in­ter­ac­tion when used in com­bi­na­tion with other agents,” adds Dr. Belle­soeur.

Dr. Jo­erger also chimes on this sec­ond study, say­ing, “[P]atients are re­ceiv­ing more and more co-med­i­ca­tions but they are still not rou­tinely checked for drug­drug in­ter­ac­tions.”

“Med­i­cal re­view by a clin­i­cal phar­ma­cist,” he goes on to say, “can cer­tainly be an ef­fec­tive strat­egy to avoid or limit them as the study showed. How­ever,” he adds, “can­cer cen­ters must also in­vest in in­te­gra­tive medicine that com­bines med­i­cal an­ti­cancer treat­ments with non­con­ven­tional ther­a­pies. The av­er­age on­col­o­gist has poor knowl­edge of these al­ter­na­tive meth­ods; this is mostly due to a lack of stud­ies and data­bases in the field.”

In this re­gard, pre­vi­ous re­search pre­sented at the meet­ing ac­knowl­edges the ben­e­fits of ex­er­cise, mind­ful­ness pro­grammes, yoga, acupunc­ture, and hyp­no­sis as an ad­di­tion to con­ven­tional can­cer treat­ment.

How­ever, an­tiox­i­dant sup­ple­ments, herbs, min­er­als, vi­ta­mins, or phy­toe­stro­gens have not been linked with any pos­i­tive or harm­ful ef­fects.

Newspapers in English

Newspapers from Iran

© PressReader. All rights reserved.