Chapter 7 Integrative Oncology

Question 1

The practice of health medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals and disciplines to achieve optimal health and healing

Answer 1

Integrative medicine

Question 2

4 main categories of complementary therapies

Answer 2

mind and body medicine (meditation, deep-breathing exercise, hypnotherapy, guided imagery, yoga, tai chi, qi gong and other spiritual practices)
Manipulative and body-based practices (massage, spinal manipulation)
energy-based therapies (reiki, healing touch and qi gong)
Natural products therapies (dietary interventions and supplements)

Question 3

4 main recommendations of the ACS for nutrition and physical activity

Answer 3

1. achieve and maintain a healthy weight throughout life
2. adopt a physically active lifestyle
3. choose a healthy diet with an emphasis on plant foods
4. if you drink alcoholic beverages, limit consumption

Question 4

Mechanisms for how obesity increases the risk of cancer

Answer 4

Fat secretes cytokines that promote inflammation
Excess in body fat may impair immunity
Obesity leads to insulin resistance
Fat produces estrogen which is relevant in the increased risk of post-menopausal ER+ breast CA and endometrial CA
Associated with a poorer prognosis in a number of malignancies

Question 5

Indicators of inflammation and need for anti-inflammatory diet

Answer 5

HgbA1c

hs CRP

Question 6

Difference in organic vs nonorganic produce

Answer 6

high in phytochemicals such as phenolic compounds and flavonoids

Question 7

AICR alcohol guidelines

Answer 7

2 for men
1 for women
per day

Question 8

35% of currently prescribed oncology drugs are metabolized this enzyme

Answer 8

CYP3A4 isoform of the hepatic cytochrome p450 enzyme system

Question 9

How does fish oil reduce inflammation

Answer 9

changes in membrane fluidity, cell signaling, and production of anti-inflammatory eicosanoids, which may slow cancer progression
May increase apoptosis by suppressing NF-kappa B

Question 10

Vitamin D MOA

Answer 10

hormone-like action that controls calcium, phosphorus, and bone metabolism

Question 11

Low 25-hydroxyvitamin D are associated with increased risk of which cancers

Answer 11

breast
prostate
colorectal
possibly others but data is inconclusive

Question 12

Safe recommendations for vitamin D level

Answer 12

40-80ng/mL

Question 13

Best source of vitamin D

Answer 13

ultraviolet light

also in eggs, fortified dairy, mushrooms, and fish

Question 14

Production of vitamin is impaired by these factors

Answer 14

age, obesity, pigmentation

Question 15

How much does 1000 IU dose of vitamin raise serum levels by?

Answer 15

10ng/mL

Question 16

Benefits of curcumin (turmeric)

Answer 16

potent anti-inflammatory effects
antioxidant effects
antibiotic effects
inhibits tumor initiation, promotion, invasion, angiogenesis and metastasis
acts as a chemosensitizer and radiosensitizer for some tumors

Question 17

Bioavailabity of curcumin

Answer 17

poor - stays in the GI tract and has local action on the mucosa
combined with black pepper (piperine) increases absorption
fat increases absorption

Question 18

The major catechin in green tea

Answer 18

EGCG (epigallocatechin)

Question 19

Green tea MOA against CA

Answer 19

pro-apoptotic effects
inhibition of NF-kappaB
antimetastatic and antioxidant effects

Question 20

Green Tea has a protective effect against which tumors

Answer 20

colon
prostate
esophagus
liver
stomach
lung
breast
pancreas
skin

Question 21

how do mushroom polysaccharides exert their antitumor action

Answer 21

activation of the hose immune response

Question 22

An intact T-cell immune system is essential for the anittumor acitivty of what nutraceutical

Answer 22

medicinal mushrooms

Question 23

Name 3 types of immune enhancing and anti-cancer edible mushrooms

Answer 23

grifola frondosa (maitake)
lentinus edodoes (shiitake)
flammulina velutipes (enokitake)

Question 24

Name 2 medicinal mushrooms takes as an infusion or capsule

Answer 24

ganoderma lucidum (reishi)
trametes or coriolus versicolor (turkey tail)

Question 25

White button mushroom contain this hydrazine derivative, which is deactivated by heating

Answer 25

agaritine

Question 26

Name 2 immunosuppressant hormones that are overproduced during stress by the sympathetic nervous system

Answer 26

epinephrine

cortisol

Question 27

Name benefits of acupuncture in cancer patients

Answer 27

help with symptoms of:
xerostomia following RT for HN CA
musculoskeletal complaints r/t aromatase inhibitor tx
hot flashes in both men and women with hormone ablation therapies and chemo-induced peripheral neuropathy
better salivary flow in pt undergoing RT for H/N CA