Other Alternative Therapies Flashcards
What is anthroposophic medicine?
Developed by Rudolf Steiner and Ita Wagman; holistic medicine combining homeopathy, bot, nutrition, music, etc w/ conventional medicine
Which mistletoe preparations are available in NA?
Iscador, Helixor
What are the types of Iscador and where are they harvested from?
Q for quercus (=oak)
M for mali (=apple)
P for pinus (=pine)
What are the types of Helixor and where are they harvested from?
A for abies (=fir)
M for mali (=apple)
P for pinus (=pine)
Studies on Mistletoe have included…?
33 RCTs, 18 non-randomized trials, 18 prospective single-arm studies, 4 retrospective studies
Results of Mistletoe therapy have mostly been ____, but results have been questioned because ____?
positive; they’re of low quality
Why have few mistletoe trials been blinded?
Red reaction at he injection site is very common
What does the best evidence for Mistletoe exist for?
Improving QOL and tolerability of chemo and radiation (in N/V, fatigue, sleep, appetite, emotional well-being, difficulty concentrating)
The best study on mistletoe was ___ and showed ___
220 pt RCT w/ locally advanced or metastatic pancreatic comparing mistletoe and no treatment; better survival, better QOL, weight increased
Mistletoe cautions
Serious a/e
IV Vit C mechanism
Exact is unknown
Accepted current - interacts with iron to create h202 (low dose)
Direct cytotoxic effects on cancer cells (high dose)
Why is Vit C selectively toxic to cancer cells?
Cancer cells can’t produce enough calylase and glutathione peroxidase enzyme to convert H2O2 –> H20
Studies on Vit C have included…?
2 RCTs, 11 small pilot trials, retrospective cohort and case reports
IV C combined with gemcitabine in advanced pancreatic cancer showed…?
- no difference but likely underestimated effects (n=9, + erlotinib)
- Mitigated side effects, increased progression free and overall survival vs average in this pop (n=9)
- Increased progression free and overall survival vs institutional average (n=14)
IV C w/ paclitaxel and carboplatin in ovarian cancer showed…?
May increased survival and time to relapse, decreased grade 1 and 2 toxicities (n=25)
IV C w/ CHASER regimen in Non-Hodkin’s lymphoma showed…?
No obvious a/e
IV C w/ temozolomide, surgery, and radiation, in glioblastoma showed…?
Possible increased survival (n=11)
IV C w/ platinum chemo in advanced NSCLC showed…?
Increased disease control and objective response vs historical control (n=14)
IV C w/ hyperthermia and supportive care in refractory NSCLC showed…?
Prolonged progression free and overall survival, QOL, compared to supportive (n=97) care
IV C w/ FOLFOX or FOLFIRI in colorectal/ gastric cancer showed…?
Decreased all-grade and grade 3&4 marrow and GI toxicities, possible increase in objective response rate and disease control rate (n=36)
IVC in various advanced cancers showed…?
- w/ chemo (n=14), was safe and well tolerated, some showed unexpected transient stable dz, improved function
- in cancers w/ unresponsive bone metastases, reduced pain and increased increased median survival (n=11)
Which chemotherapy should Vitamin C be avoided with?
Bortezomib
What dosing schedule should IV C be used in combo with chemo?
5 half-lives awy from chemotherapy
How should IV C be combined with radiation therapy?
It should not; use after radiation is complete
IV C A/E
- Overall quite safe
- self-limiting nausea, HA, lightheadedess, dry mouth
- Falsely elevates blood sugar
- Can chelate metals
IV C cautions and CI
- CI G6PD deficiency (over 15 g)
- CI Renal insufficiency, hemodialysis, iron overload
- Caution history of oxalate kidney stones
- Caution fluid overload
Essiac evidence for safety
Generally safe - Case reports, in vitro studies, 1 animal model
Essiac evidence for effectiveness
No proven effects in human or animal studies, some in vitro
Hoxsley formula safety
Tincture may worsen nausea and diarrhea, salve can cause burns
Avoid in estrogen sensitive cancers
May interfere with some chemo
Hoxley formula efficacy
None proven in humans or animals, case reports invalid
PolyMVA safety
Unknown
PolyMVA efficacy
None proven (anecdotal reports), some animal evidence for antioxidant effect
Shark cartilage safety
Human trials show safety at therapeutic doses
Shark cartilage efficacy
Increased survival in multiple myeloma and renal cell (phase II)
No effect in well designed phase III trial
Graviola safety
Lowered platets in rats, may cause Parkinson-like disease
Graviola efficacy
No studies in human or animal cancers
Amygdalin/ Laetril safety
a/e effect of cyanide poisoning, especially in oral forms
CI combination with amygdalin
Amygdalin/ Laetril efficacy
Clinical trials and cochrane review concluded no benefit
Blue Scorpion venom safety
No documented effects, but have not been assessed
Blue scorpion venom (Escozine or Escozul) efficacy
No clinical trials on humans, some animal trials. Rejected by cuban govt.
chlorotoxin (CTX) may facilitate chemo entry into tumors
CTX as ‘tumour paint’
Cannabis efficacy
Preclinical evidence about efficacy around cancer/ cancer tx side effects: N/V, anorexia, pain, insomnia
Animal studies with good results on advanced cancers, but none in humans
Cannabis safety
Non-serious side effects more common, m/c dizziness
Cesium chloride efficacy
No trials; some case reports
Cesium chloride efficacy
Case reports suggest high toxicity, can cause hypokalemia
Dichloroacetate efficacy
3 phase 1 trials
May have efficacy in brain cancer
No effect on advanced solid tumors
Dichloroacetate safety
Peripheral neuropathies common
