Complementary Alternative Cancer Therapies-3

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Natural Strategies for Alleviating Cancer Symptoms
A range of complementary strategies are known to improve symptoms experienced by cancer patients.

Anxiety, Depression, and Stress. The use of aromatherapy and massage is effective in alleviating depression, anxiety, and stress in cancer patients and has a positive effect on quality of life (Cassileth BR et al 2004; Soden K et al 2004). Undergoing 30-minute massage sessions three times a week for five weeks reduces hostility and anger in cancer patients (Hernandez-Reif M et al 2004). In addition to massage, progressive muscle relaxation alleviates depression and anxiety in cancer patients (Hernandez-Reif M et al 2005).

The use of acupuncture, hypnosis, and exercise reduces stress and anxiety (Samuels N 2002; Stalpers LJ et al 2005; Thorsen L et al 2005).

Laughter and humor are also known to improve mood and combat depression in cancer patients (Bennett MP et al 2003; Christie W et al 2005; Takahashi K et al 2001). This improvement in mood is accompanied by quantifiable improvements in immune system and hormonal factors that influence overall well-being (Berk LS et al 2001; Christie W et al 2005; Takahashi K et al 2001).

Emotional support from a spouse reduces depression and improves quality of life in cancer patients (Ohara-Hirano Y et al 2004). Dietary supplementation with the amino acid L-carnitine in cancer patients has been effective in treating depression (Cruciani RA et al 2004).

Nausea and Vomiting. Acupuncture and finger acupressure are effective in overcoming treatment-induced nausea and vomiting (Collins KB et al 2004; Klein J et al 2004; Shin YH et al 2004). Electro-acupoint stimulation and hypnotherapy also reduce the frequency and intensity of nausea in cancer patients (Gan TJ et al 2004; Deng G et al 2004).

Poor Appetite/Cachexia. Advanced cancer is often accompanied by a condition of muscle wasting referred to as cachexia or catabolic wasting (Barber MD 2001; Brown TT et al 2003). Metabolic imbalances caused by the disease, which include the over-production of inflammatory factors, lead to the loss of appetite and the excessive breakdown of fat and muscle (Barber MD et al 2001). This wasting condition is associated with diminished quality of life and shorter survival (Barber MD 2001; Brown TT et al 2003).

Dietary supplementation with fish oils (omega-3 fatty acids) counteracts the inflammatory factors and reverses the weight loss associated with cachexia (Barber MD 2001; Brown TT et al 2003; Fearon KC et al 2003). Stabilization of this condition with fish oil supplements also leads to enhanced quality of life (Bruera E et al 2003; Burns CP et al 2004; Fearon KC et al 2003). For more information, refer to the chapter on Catabolic Wasting.

Lymphedema. Lymphedema, a condition characterized by excessive swelling and retention of water under the skin, often afflicts cancer patients, particularly after radiation therapy and surgery (Ashikaga T et al 2002; McNeely ML et al 2004).

Natural strategies known to be somewhat helpful in alleviating this condition include compression bandaging, which reduces the size of the swollen area, and manual massage of the draining lymph nodes, which may alleviate mild cases of lymphedema (McNeely ML et al 2004; Mortimer PS 1997). The use of selenium may improve the benefits of physical therapies such as massage and compression (Bruns F et al 2003).

Sexual Dysfunction. Cancer patients, in particular those with prostate cancer, often experience sexual dysfunction, or impotency, usually as a complication of their treatment (Burnett AL 2005; Jayne DG et al 2005; Turner SL et al 1999). Sexual dysfunction is also associated with surgery for bladder and colorectal cancer, and with chemotherapy agents that damage the ovaries (Jayne DG et al 2005; Molina JR et al 2005).

Sexual dysfunction in prostate cancer patients can be successfully managed by the use of Viagra® (Incrocci L et al 2003a; Incrocci L et al 2003b). However, some alternative therapies are also effective in managing sexual dysfunction.

Clinical studies have shown that oral supplements of L-glutamine and yohimbine, a plant extract, can improve erectile dysfunction (Lebret T et al 2002). Another dietary supplement known as ArginMax™, which contains a combination of ginseng, ginkgo, L-arginine, multivitamins, and minerals, improves erectile dysfunction (Ito T et al 1998, 2001). A nutritional supplement known as Kyo-Green® has also been shown to improve sexual dysfunction (Lau BH et al 2003).

Hair Loss. A mushroom extract, originally concocted for use as an immune system booster, improves alopecia (hair loss), a condition associated with the use of conventional cancer treatments (Ahn WS et al 2004). Animal studies have also shown that supplementing with the antioxidant N-acetylcysteine can also protect against hair loss during conventional cancer treatments (D'Agostini F et al 1998).

Fatigue. In addition to relieving stress, dietary supplementation with the amino acid L-carnitine reduces fatigue, which can be a symptom of the cancer or a side effect of conventional treatment (Cruciani RA et al 2004). The use of L-carnitine during chemotherapy with doxorubicin has been proposed as an adjuvant therapy since 1985 (de Leonardis V et al 1985).

Acupuncture has also demonstrated effectiveness in alleviating cancer fatigue (Cohen AJ et al 2005). Cancer-related fatigue responds to a combined regimen of massage, foot soaking, and reflexology (Kohara H et al 2004). In addition, breathing exercises, conducted with the help of a healthcare provider, improves fatigue in patients recovering from stem cell transplantation (Kim SD et al 2005).

Natural Strategies for Counteracting Adverse Effects from Conventional Cancer Treatment

Nutritional supplements known to counteract some of the negative side effects of conventional treatments are summarized in Table 2. In addition to these nutrients, physical and psychological therapies—including acupuncture, breathing exercises, massage and aromatherapy—can also improve these negative side effects (Fellowes D et al 2004; Kim SD et al 2005; Samuels N 2002). For more information, refer to the chapters on Cancer Surgery, Cancer Chemotherapy, and Cancer Radiation Therapy.


Clinical Trials

Numerous ongoing clinical studies are assessing the merits of different CAM therapies for cancer. Cancer patients can opt to participate in these studies or simply monitor their outcomes. The specific details and findings of these studies are subject to constant change and therefore are not provided here. Up-to-date information on ongoing clinical trials can be obtained from the National Center for Complementary and Alternative Medicine (NCCAM) at the following address:

NCCAM
National Institutes of Health
Bethesda, MD 20892
Email: info@nccam.nih.gov.
Website: http://nccam.nih.gov/clinicaltrials/

For More Information
Cancer patients who suffer from the aforementioned manifestations may wish to read the following chapters and design a program that addresses the full range of their cancer concerns:

1)Cancer Chemotherapy

2)Cancer Radiation Therapy

3)Cancer Surgery

4)Cancer Vaccines and Immunotherapies

5)Catabolic Wasting
Anemia, Leukopenia, and Thrombocytopenia
Immune System Enhancement.


Life Extension Foundation Recommendations
Cancer patients should consult their physicians before using any complementary alternative therapies while undergoing conventional medical treatment.

Different doses of the same nutritional supplement may be required for different applications of complementary alternative cancer therapies, such as preventing cancer, inhibiting tumor spread, enhancing/suppressing the immune system, alleviating cancer symptoms, and counteracting the side effects of conventional treatment. Cancer patients who wish to adopt a CAM approach should refer to the appropriate chapter or consult an integrative practitioner for definitive advice on appropriate doses of the nutritional supplements discussed in this chapter.

Safety Caveats
Patients should consult physicians who are qualified integrative practitioners experienced in the field of nutritional oncology.

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Proton-Pump Inhibitor Use Linked to Increased Risk for Hospital-Acquired Pneumonia

Proton-pump cheap cialis use is linked to increased risk for hospital-acquired pneumonia, according to the results of a large, hospital-based pharmacoepidemiologic cohort study reported in the May 27 issue of the Journal of the American Medical Association.

"The use of acid-suppressive medication has been steadily increasing, particularly in the inpatient setting, despite lack of an accepted indication in the majority of these patients," write Shoshana J. Herzig, MD, from Beth Israel Deaconess Medical Center in Boston, Massachusetts, and colleagues. "Recent data in the outpatient setting suggest an increased risk for community-acquired pneumonia in current users of acid-suppressive medication (both proton-pump inhibitors and histamine₂ receptor antagonists)."

The goal of this prospective study was to evaluate the association between acid-suppressive medication and hospital-acquired pneumonia. The study cohort consisted of all patients who were admitted to a large, urban academic medical center in Boston, Massachusetts, from January 2004 through December 2007, who were 18 years or older and hospitalized for 3 or more days without being admitted to the intensive care unit.

Any order for a proton-pump cialis or histamine₂ receptor antagonist was considered as use of acid-suppressive medication. Potentially confounding factors were controlled through traditional and propensity-matched multivariable logistic regression. The primary endpoint of the study was the incidence of hospital-acquired pneumonia, defined with codes from the International Classification of Diseases, Ninth Revision, Clinical Modification, in patients using vs not using acid-suppressive medication.

Of 63,878 admissions in the final cohort, hospital-acquired pneumonia developed in 2219 admissions (3.5%). In more than half of admissions (52%), acid-suppressive medication was ordered (27,236 received proton-pump inhibitors and 7548 received histamine₂ receptor antagonists). Most of these medications (89%) were ordered within 48 hours of admission.

Compared with patients not exposed to acid-suppressive medications, those who were exposed had a higher unadjusted incidence of hospital-acquired pneumonia (4.9% vs 2.0%; odds ratio, 2.6; 95% confidence interval [CI], 2.3 - 2.8).

In the group exposed to acid-suppressive medication, the adjusted odds ratio of hospital-acquired pneumonia was 1.3 (95% CI, 1.1 - 1.4), based on multivariable logistic regression. Findings were identical with use of matched propensity-score analyses. Although the association was significant for proton-pump inhibitors (odds ratio, 1.3; 95% CI, 1.1 - 1.4), it was not significant for histamine₂ receptor antagonists (odds ratio, 1.2; 95% CI, 0.98 - 1.4).

"In this large, hospital-based pharmacoepidemiologic cohort, acid-suppressive medication use was associated with 30% increased odds of hospital-acquired pneumonia," the study authors write. "In subset analyses, statistically significant risk was demonstrated only for proton-pump inhibitor use."

Limitations of this study include inability to determine the potential benefits of acid-suppressive medication in preventing gastrointestinal tract bleeding, concerns regarding the validity of International Classification of Diseases, Ninth Revision, Clinical Modification, coding, and lack of information on the temporal association between use of acid-suppressive medication and diagnosis of hospital-acquired pneumonia. Other limitations include possible unmeasured confounders and insufficient power to exclude a small but increased risk associated with histamine₂ receptor antagonists.

"These results occur in the context of an increasing body of literature suggesting an association between acid-suppressive medication and pneumonia," the study authors conclude. "Further scrutiny is warranted regarding inpatient prescribing practices of these medications."

The study authors have disclosed no relevant financial relationships. Dr. Herzig was funded by the Health Resources and Services Administration of the Department of Health and Human Services to support the Harvard Medical School Fellowship in General Medicine and Primary Care. The study contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services.

JAMA. 2009;301:2120-2128.

Clinical Context

Proton-pump inhibitors are widely used, in part because they are perceived to have a very good safety profile. However, some research has suggested that this class of medications may reduce the threshold for community-acquired pneumonia. In a case-control analysis by Sarkar and colleagues, the overall use of proton-pump inhibitors did not significantly affect the rates of community-acquired pneumonia or pneumonia requiring hospitalization. However, the study results, which were published in the September 16, 2008, issue of the Annals of Internal Medicine, also found that the adjusted hazard ratio for community-acquired pneumonia associated with starting a proton-pump inhibitor within the last 2 days was 6.53. The risk for pneumonia remained elevated in the first month after the initiation of proton-pump inhibitor therapy.

The current study uses a large database to examine whether the use of acid-suppressive medications affect the rate of hospital-acquired pneumonia.

Study Highlights

• The study population consisted of inpatients from 1 Massachusetts medical center between 2004 and 2007. All study subjects were at least 18 years old and were hospitalized for at least 3 days.
• The main outcome of the study was the effect of the use of acid-suppressive therapy on the rate of hospital-acquired pneumonia, an outcome which was culled from hospital discharge codes. Acid-suppressive therapy could consist of either proton-pump inhibitors or histamine₂ receptor antagonists.
• The main result of the study was adjusted to account for 50 potential covariates.
• 63,878 patients provided data for study analysis. The median age was 54 years, and 37% were men. Approximately 70% of subjects were white.
• 52% of the entire study cohort received acid-suppressive therapy. Patients who received such therapy were more likely to receive a medicine service, have an emergent admission, and receive systemic steroids and anticoagulants vs patients who did not receive acid-suppressive therapy.
• Conversely, patients who received nonsteroidal anti-inflammatory drugs were less likely to receive acid-suppressive therapy.
• 83% of subjects receiving acid-suppressive therapy were prescribed proton-pump inhibitors, and 23% received histamine₂ receptor antagonists.
• Hospital-acquired pneumonia occurred in 3.5% of subjects, including 4.9% of those receiving acid-suppressive therapy and 2.0% of those not receiving such medications.
• The adjusted odds ratio for hospital-acquired pneumonia associated with the use of acid-suppressive therapy was significant at 1.3.
• The risk for aspiration pneumonia was particularly elevated with the use of acid-suppressive therapy.
• On subgroup analysis based on treatment type, only patients receiving proton-pump inhibitors experienced a higher risk for hospital-acquired pneumonia.
• An analysis that minimized characteristics between patients who did and did not receive acid-suppressive therapy failed to alter the main study outcome.
• Researchers performed an analysis of the timing of acid-suppressive medications, and initiation of this therapy within 48 hours of admission was associated with a significant increase in the risk for hospital-acquired pneumonia.

Clinical Implications

• A previous study found that although proton-pump inhibitor therapy did not affect the overall rate of community-acquired pneumonia or pneumonia causing hospitalization, recent initiation of proton-pump inhibitor therapy was associated with a higher risk for pneumonia.
• The current study suggests that proton-pump inhibitors significantly increase the risk for hospital-acquired pneumonia, particularly aspiration pneumonia.

Source : http://cme.medscape.com/viewarticle/703792?sssdmh=dm1.481051&src=nldne

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An erection occurs when blood is pumped to the penis which makes it hard allowing sexual intercourse. This action is impossible in some men because they experience penile dysfunction. More and more men in recent years have been admitting that this is a problem for them and asking for help. In Bothell Washington, a small company began research and subsequent development of a drug called cheap cialis to help men with their problem.

There are a group of drugs called PDE5 enzyme inhibitors and Cialis fits in to this. It was discovered by researchers that cyclic guanosine monophosphate (cGMP) was the key to achieving and sustaining an erection. Following sexual stimulation a chain reaction occurs in the tissue of the penis of a man that results in elevated levels of cGMP. With sufficient levels of cGMP, the penis can remain erect and the more cGMP the more robust is the erection.
Cialis works by blocking the enzyme PDE5 which is responsible for neutralization of cGMP. Because Cialis is very highly selective inhibitor of PDE5 it is very effective. Cialis on its own does not cause an erection, Cialis blocks the degradation of cGMP produced in reaction to sexual stimulation. It is important to understand that if you are not being sexually stimulated there is no cGMP to protect so Cialis remains in the background. This is why Cialis is so different from some other medications for the problem. There were many drugs for penile dysfunction before Cialis, which induced a chemical reaction instead of one which reacted to stimulation. It was found that this was one of the main complaints by couples who were taking other types of drugs and did not seem to be natural.

By blocking the enzyme PDE5 Cialis effectively causes the blood vessels in the penis to relax and allowing the blood to flow and enlarge this. By compressing the veins at the base of the penis the flow of blood from this is restricted and the erection is maintained. Following intercourse these veins relax allowing the blood to flow out as normal. Correctly used Cialis, means that sexual activity is as natural as not having to use it at all.Because Cialis is easily absorbed into the bloodstream it can be taken from 30 minutes up to 12 hours prior to sexual activity and Cialis is active for between 24 and 36 hours. According to the manufactures, because of its unique onset and duration periods, Cialis can be taken many hours before sexual activity is contemplated.