Subject: An Update on Complementary Therapies, Herbs, and Other Botanicals in Cancer Care
Location: Memorial Rockefeller Research Laboratories, 430 East 67th St., between 1st /York Ave.
Date: Tuesday, May 20, 2008.
Next session: Wednesday, August 6, 2008.
Presenters from Memorial Sloan Kettering’s Integrative Medicine Clinic: Gary E. Deng, MD, PhD, Associate Attending Physician and Kathleen Wesa, MD.
Location: 1429 First Avenue and 74th St. Phone: 212-639-4700
Clinic offers nutritional counseling, exercise, acupuncture, massage and mind-body therapies.
Report by Sara Messina, SHARE member
Dr. Deng showed a chart depicting CAM therapies for safety, efficiency, benefit/no benefit, helpful and do research to support/restrict for safety and efficiency.
He described the difference between alternative and complementary therapies.
Alternative therapy is used instead of mainstream treatment, relies on personal testimonials; with no scientific evidence, and no proven effectiveness. As an alternative therapy example, he cited use of Cesium Therapy to make your body alkaline; and that normal/vital cells are affected including the heart.
Then he said, “If the stomach is so acidic so why doesn’t everyone then get stomach cancer?”
Complementary therapy is used with mainstream medicine; has a good safety record, is supported by evidence and has favorable/ risk/benefit ratio. Examples given were Native American, Chinese Medicine, Ayurveda, naturopaths, homeopathy. They all share emphasis on balance and interaction; developed before modern bio medical science, shortage of supportive evidence derived from rigorous scientific research, use of natural products (e.g. aspirin from willow tree).
Different kinds of complimentary therapies were described: mind/body (e.g. meditation, hypnotherapy, biofeedback, yoga), touch therapy (Swedish massage, reflexology, Reiki, aromatherapy), movement (exercise and fitness, yoga, tai-chi), music/sound, acupuncture.
Benefits of acupuncture were discussed i.e. for pain relief.
Integrative approach is patient centered, prospective with emphasis on prevention, and holistic (mind, body, spirit) and importance of self-care. Take home message Integrative medicine helps reduce symptoms and empowers patients.
Dr. Deng spoke about acupuncture in cancer care with clinical evidence from multiple randomized trials showing its strongest for its ability to reduce acute and chronic pain; moderately strong for reducing nausea and vomiting and weak evidence for reducing hot flashes.
Dr. Wesa began her presentation about botanicals with these statistics:
WHO 80% of world’s population uses botanicals
CDC in 2004, 19% in US
Stone Survey 14% population and 6% RX were herbal supplements
Botanical Use among Cancer Patients:
50% of ovarian cancer patients; 13% women with breast cancer; and 22% Chinese women
1994 Fiche Act regulated dietary supplements- food, not drugs, so FDA did not require proof of efficacy; this is opposite of what is needed for pharmaceuticals.
Be mindful of what you are eating. Eat plant based diet 3-7 fruits/vegetables per day.
Memorial offers nutritional and supplemental counseling such as: Herb/drug interaction and evaluation, evidence based recommendation for healthful dietary guidance, expert advice for proper use of supplements.
Go to www. www.mskcc.org/aboutherbs
MSKCC policy is no herbs during cancer treatment or if on prescription meds.
Antioxidants. Hypothesis that antioxidants protect cancer cells; likely to increase cancer cells.
Botanicals - unrefined pharmaceuticals. Concerns: contamination, toxicity, standardization, bioavailability, proper doses and herb-drug interactions.
Example: St. Johns’ Wort and Valerian affect blood levels of prescription meds.
Look for USP label that contains ingredients and amount; tested for bioavailability. But USP label does not talk about efficacy. Only 2-3% carry consumer lab label.
MSKCC Research Center for Botanical Immunomodulators was established in 2005 and funded by NIH to investigate immune modulating botanicals. Core botanicals astragalus, Echinacea, maitake being studied by MSKCC, Weill Medical College, Lehman College, Institute of Chinese Medicine, and Chinese University of Hong Kong.
MD Andersen is doing studies on tumeric.
Discuss botanicals, vitamins, minerals and supplements with your oncologist.
Botanicals have risks and benefits. No botanicals during chemotherapy, radiation therapy. If you have a hormonal cancer, avoid hormonal botanicals
Some Questions and Answers
1. Vitamin D studies and osteoporosis trials going on with recommended dosage of 400 1,000 IU per day.
2. Acupressure is acupuncture light.
One man went up to Dr. Deng and said people came here and you gave a negative approach to use of botanicals. I went up to both doctors and identified myself as a Share advocate, and gave them our literature. I said that with the position that Memorial has taken, people will do it anyway and not tell their doctors that they are taking herbs.
There was information for the general cancer population who seemed to be there. However, it was disappointing as far as use of botanicals and herbs. This session was advertised as an Update on CAM and botanicals.
The part of the presentation that could be defined as an update is the work that Memorial and others are doing with astragalus, echinacea, mitake and tumeric.
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