Background. No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). Methods. MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. Results. Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for “current use” of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. Conclusions. The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.

https://journals.sagepub.com/doi/pdf/10.1177/1534735411423920

How Many Cancer Patients Use Complementary and Alternative Medicine: A Systematic Review and Metaanalysis

The use of ultra-diluted natural products in the management of disease and treatment of cancer has generated a lot of interest and controversy. We conducted an in vitro study to determine if products prescribed by a clinic in India have any effect on breast cancer cell lines. We studied four ultra-diluted remedies (Carcinosin, Phytolacca, Conium and Thuja) against two human breast adenocarcinoma cell lines (MCF-7 and MDA-MB-231) and a cell line derived from immortalized normal human mammary epithelial cells (HMLE). The remedies exerted preferential cytotoxic effects against the two breast cancer cell lines, causing cell cycle delay/arrest and apoptosis. These effects were accompanied by altered expression of the cell cycle regulatory proteins, including downregulation of phosphorylated Rb and upregulation of the CDK inhibitor p27, which were likely responsible for the cell cycle delay/arrest as well as induction of the apoptotic cascade that manifested in the activation of caspase 7 and cleavage of PARP in the treated cells. The findings demonstrate biological activity of these natural products when presented at ultra-diluted doses. Further in-depth studies with additional cell lines and animal models are warranted to explore the clinical applicability of these agents.

/pdf/cytotoxic-effects-of-ultra-diluted-remedies-on-breast-cancer-3ev0ti72ie.pdf

Cytotoxic effects of ultra-diluted remedies on breast cancer cells.

Exploring frontiers: use of complementary and alternative medicine among patients with early-stage breast cancer.

Complementary medicines, including homeopathy, are used by many patients with cancer, usually alongside with conventional treatment. However, the molecular mechanisms underneath the anti-cancer effect, if any, of these medicines have still remained unexplored. To this end we attempted to evaluate the efficacy of calcarea carbonica, a homeopathic medicine, as an anti-cancer agent and to delineate the detail molecular mechanism(s) underlying calcerea carbonica-induced tumor regression. To investigate and delineate the underlying mechanisms of calcarea carbonica-induced tumor regression, Trypan blue dye-exclusion test, flow cytometric, Western blot and reverse transcriptase-PCR techniques were employed. Further, siRNA transfections and inhibitor studies were used to validate the involvement of p53 pathway in calcarea carbonica-induced apoptosis in cancer cells. Interestingly, although calcarea carbonica administration to Ehrlich’s ascites carcinoma (EAC)- and Sarcoma-180 (S-180)-bearing Swiss albino mice resulted in 30-35% tumor cell apoptosis, it failed to induce any significant cell death in ex vivo conditions. These results prompted us to examine whether calcarea carbonica employs the immuno-modulatory circuit in asserting its anti-tumor effects. Calcarea carbonica prevented tumor-induced loss of effector T cell repertoire, reversed type-2 cytokine bias and attenuated tumor-induced inhibition of T cell proliferation in tumor-bearing host. To confirm the role of immune system in calcarea carbonica-induced cancer cell death, a battery of cancer cells were co-cultured with calcarea carbonica-primed T cells. Our results indicated a "two-step" mechanism of the induction of apoptosis in tumor cells by calcarea carbonica i.e., (1) activation of the immune system of the host; and (2) induction of cancer cell apoptosis via immuno-modulatory circuit in p53-dependent manner by down-regulating Bcl-2:Bax ratio. Bax up-regulation resulted in mitochondrial transmembrane potential loss and cytochrome c release followed by activation of caspase cascade. Knocking out of p53 by RNA-interference inhibited calcarea carbonica-induced apoptosis thereby confirming the contribution of p53. These observations delineate the significance of immuno-modulatory circuit during calcarea carbonica-mediated tumor apoptosis. The molecular mechanism identified may serve as a platform for involving calcarea carbonica into immunotherapeutic strategies for effective tumor regression.

/pdf/calcarea-carbonica-induces-apoptosis-in-cancer-cells-in-p53-37wia4zdo7.pdf

Calcarea carbonica induces apoptosis in cancer cells in p53-dependent manner via an immuno-modulatory circuit

Anti-proliferative effects of homeopathic medicines on human kidney, colon and breast cancer cells

L’objectif de l’etude etait d’estimer, de decrire et d’evaluer la frequence et les raisons de l’utilisation de medecine complementaire chez des patients atteints de cancer suivis dans un service de cancerologie francais. Un questionnaire anonyme a ete mis a la disposition de patients volontaires en surveillance ou en cours de traitement dans un service de cancerologie. L’etude descriptive porte sur 207 questionnaires au total. Sur les 195 exploitables, 34 % des patients ont recours a la medecine complementaire. L’homeopathie (42 %), les plantes (27 %) et les vitamines (18 %) sont les substances les plus utilisees. L’acupuncture (22 %) et les massages (15 %) sont les techniques les plus representees. Aucun profil type de l’utilisateur de medecine complementaire n’a ete mis en evidence. La principale raison de cette utilisation n’etait pas de guerir le cancer mais de soulager les effets secondaires du traitement conventionnel (66 %). Plus de la moitie des utilisateurs (57 %) ne revelaient pas cette utilisation au cancerologue parce que cette question n’avait jamais ete abordee en consultation. Un patient sur trois atteints de cancer utilise la medecine complementaire pendant et apres le traitement de sa maladie. La medecine complementaire doit beneficier au meme titre que la medecine conventionnelle d’etudes scientifiques evaluant ses eventuels benefices, toxicites et interactions avec le traitement conventionnel afin que l’oncologue puisse en avertir l’utilisateur. Cette information au patient ne peut qu’ameliorer la relation de confiance instauree entre le cancerologue et son patient.

Stéphanie Träger-Maury

Papers

Utilisation de médecine complémentaire chez les patients atteints de cancer dans un service de cancérologie français