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Sun T, Wang T, Xia F, Xia L, Sun X, Jiang H, Xu P, Li P. Family Members' Perspectives on Integrative Chinese-Western Medicine in Cancer Care. J Multidiscip Healthc 2025; 18:2361-2373. [PMID: 40321884 PMCID: PMC12047228 DOI: 10.2147/jmdh.s509065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 03/21/2025] [Indexed: 05/08/2025] Open
Abstract
Purpose Family members play a central supporting role in cancer patient management. This study aimed to assess the knowledge, attitudes, and practices (KAP) of cancer patients' family members regarding the use of integrative Chinese-Western medicine in cancer treatment. Proper knowledge is necessary for informed decision-making and providing adequate care and support. Methods This cross-sectional study was conducted between August 2022 and December 2022 and included family members of cancer patients. Results A total of 493 questionnaires were collected. The mean score of knowledge, attitudes, and practices were 5.87 ± 3.63 (possible range: 0-12), 59.90 ± 9.45 (possible range: 16-80), and 21.73 ± 3.27 (possible range: 6-30), respectively. Junior college (university programs lasting 2-3 years) or above (OR=2.87, 95% CI: 1.41-5.88, P=0.004), had family members attending Chinese Medicine/Integrated Chinese and Western Medicine departments (OR=1.94, 95% CI: 1.17-3.24, P=0.011), and possessed knowledge of TCM (OR=2.90, 95% CI: 1.76-4.79, P<0.001) were linked to good knowledge. Knowledge (OR=1.96, 95% CI: 1.23-3.11, P=0.005) and family members attending Chinese Medicine/Integrated Chinese and Western Medicine departments (OR=2.10, 95% CI: 1.27-3.47, P=0.004) were linked to positive attitudes. Attitude (OR=5.65, 95% CI: 3.57-8.93, P<0.001) was linked to positive practices. Conclusion The family members of cancer patients showed limited knowledge and moderate attitudes and practices. Efforts should be made to address the benefits of integrative Chinese-Western medicine and provide more access to education and resources related to TCM. Although research would be necessary, the present study could provide hints regarding the combination of modern and traditional medicine in other countries.
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Affiliation(s)
- Ting Sun
- Graduate School, Anhui University of Chinese Medicine, Hefei, Anhui, 230012, People’s Republic of China
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, People’s Republic of China
| | - Ting Wang
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, People’s Republic of China
| | - Fan Xia
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, 230031, People’s Republic of China
| | - Lin Xia
- Department of Internal Medicine-Oncology, Hefei BOE Hospital, Hefei, 230000, People’s Republic of China
| | - Xin Sun
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, People’s Republic of China
| | - Haili Jiang
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, People’s Republic of China
| | - Panlin Xu
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, People’s Republic of China
| | - Ping Li
- Graduate School, Anhui University of Chinese Medicine, Hefei, Anhui, 230012, People’s Republic of China
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Zhang Y, Dai Y, Kang D, Yu Q, Zhou X, Tian X, Chen Q, Chen Y, Liu F, Shi Q. Who is Seeking Traditional Chinese Medicine (TCM) for Cancer? Insights from a Large Cohort in a Rehabilitation Clinic. Patient Prefer Adherence 2025; 19:883-896. [PMID: 40190445 PMCID: PMC11972600 DOI: 10.2147/ppa.s509263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Accepted: 03/22/2025] [Indexed: 04/09/2025] Open
Abstract
Purpose Traditional Chinese Medicine (TCM) is widely used in cancer care, yet its utilization features are not well understood. By providing a comprehensive overview of the demographic and clinical characteristics, symptom burden, HRQoL, and TCM constitution of cancer patients seeking TCM treatment, we aim to offer insights into the integration of TCM into cancer care. Patients and Methods The questionnaire collected data on demographic and clinical characteristics, the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM), the EuroQol-5Dimensions-5Levels (EQ-5D-5L), and the simplified version of the Constitution in Chinese Medicine Questionnaire (CCMQ). A descriptive analysis was conducted to profile the patients' status and expectations of TCM. Chi-square or Fisher exact tests were employed to compare the distribution of TCM constitutional types across different cancer diagnoses. Results Among 3047 eligible patients, 2796 (median age 55) completed the questionnaire and were subsequently included in the analysis. The cohort was predominantly female (56.5%), with lung cancer being the most common primary diagnosis (25.2%). Furthermore, 86.7% of the patients presented with a good performance status (ECOG-PS ≤ 1). The main reasons patients sought TCM treatment were to alleviate cancer-related symptoms (59.4%) and enhance immune function (55.4%). The most prevalent symptoms (scored 1-10 on a 0-10 scale) were fatigue (81.1%), followed by disturbed sleep (81.0%), and dry mouth (78.2%). The mean and median EQ-5D-5L utility scores were 0.81 and 0.89, respectively. About 83.4% of cancer patients exhibited a deviation in TCM constitution, with Yang-deficiency being particularly common among them. Conclusion This study highlights the symptom burden, HRQoL, TCM constitution, and characteristics of patients who pursue TCM treatment. It advances our understanding of TCM's role in cancer rehabilitation by shedding light on target population potential needs of care. The findings provide a foundation for developing evidence-based strategies to enhance TCM application in clinical settings, optimize resource allocation, and improve rehabilitation outcomes for cancer patients.
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Affiliation(s)
- Yong Zhang
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yiding Dai
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dan Kang
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qingsong Yu
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, People’s Republic of China
| | - Xiangxi Zhou
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xin Tian
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qiulong Chen
- Graduate School, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Yi Chen
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
| | - Fang Liu
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
| | - Qiuling Shi
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
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Wu J, Ge Y, Zhu G, Gao R, Zhu X, Zhang Y, Li J. Combination of Compound Kushen injection with first-line treatment versus first-line treatment alone for advanced colorectal cancer: a study protocol for a multicenter, openlabel, randomized controlled trial. BMC Complement Med Ther 2024; 24:429. [PMID: 39741233 DOI: 10.1186/s12906-024-04725-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 12/06/2024] [Indexed: 01/02/2025] Open
Abstract
BACKGROUND The treatment of advanced colorectal cancer (CRC) has progressed slowly, with chemotherapy combined with targeted therapy being the first-line treatment for the disease, but the improvement in efficacy is not satisfactory. Compound Kushen injection (CKI) is one of the representative drugs of anti-cancer Chinese herbal injection drugs, which has been widely used in the adjunct treatment of cancer in China. The aim of this trial is to evaluate the efficacy and safety of CKI combined with first-line treatment of advanced CRC. METHODS This is a multicenter, randomized, open-label controlled clinical trial in which 320 patients with advanced CRC will be randomly assigned to the treatment group or the control group in a 1:1 ratio. Both groups will receive at least 4 cycles of first-line therapy (FOLFOX/FOLFIRI/CAPEOX ± cetuximab/bevacizumab) in 14-21 day cycles, and the experimental group will receive additional CKI with a cumulative dose of 200 ml per cycle. Patients who achieve a complete response, partial response, or stable disease after 4-6 months will receive maintenance therapy until disease progression or another endpoint event, such as toxicity or death, occurs.. Follow-up will occur every 3 months until death or loss to follow-up. The primary outcome of this study will be progression-free survival (PFS). Secondary outcomes will be overall survival (OS), 1-year OS rate, 1-year PFS rate, objective response rate,disease control rate, symptoms and quality of life evaluation. Safety outcomes will be incidence of adverse events. DISCUSSION This study will be the first randomized controlled trial to investigate the efficacy and safety of CKI when combined with first-line treatment in the treatment of advanced CRC, with PFS as the primary outcome. It aims to clarify the clinical advantages and therapeutic effect of CKI in the treatment of advanced CRC. To identify the benefit population of CKI in the treatment of patients with advanced CRC, an enrichment design based on biomarkers will be utilized. Metabolomics and gut microbiota analysis will be conducted on biological samples to explore the metabolic and gut microbiota differences associated with the efficacy of CKI, guiding further research into its mechanism of action. TRIAL REGISTRATION ClinicalTrials.govNCT05894694. Registered on 4 August 2023.
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Affiliation(s)
- Jingyuan Wu
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yuansha Ge
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Guanghui Zhu
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China
| | - Ruike Gao
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China
| | - Xiaoyu Zhu
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China
| | - Ying Zhang
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China.
| | - Jie Li
- Oncology Department, Guang'anmen Hospital, China, Academy of Chinese Medical Sciences, Beixian Pavilion, No.5, Xicheng District, Beijing, China.
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Choi S, Karki Kunwor S, Im H, Choi D, Hwang J, Ahmed M, Han D. Traditional and Complementary Medicine Use among Cancer Patients in Asian Countries: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:3130. [PMID: 39335102 PMCID: PMC11429845 DOI: 10.3390/cancers16183130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/31/2024] [Accepted: 09/03/2024] [Indexed: 09/30/2024] Open
Abstract
Globally, cancer patients frequently use T&CM during their treatment for various reasons. The primary concerns regarding the use of T&CM among cancer patients are the potential risks associated with interactions between pharmaceuticals and T&CM, as well as the risk of noncompliance with conventional cancer treatments. Despite the higher prevalence of T&CM use in Asia, driven by cultural, historical, and resource-related factors, no prior review has tried to estimate the prevalence and influencing factors of T&CM use and disclosure among cancer patients in this region. This study aims to examine the prevalence and disclosure rates of T&CM use among cancer patients in Asia to assess various factors influencing its use across different cancer treatment settings in Asia. Systematic research on T&CM use was conducted using four databases (PubMed, EMBASE, Web of Science, and CINAHAL) from inception to January 2023. Quality was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS). A random effects model was used to estimate the pooled prevalence of T&CM use, and data analysis was performed using Stata Version 16.0. Among the 4849 records retrieved, 41 eligible studies conducted in 14 Asian countries were included, involving a total of 14,976 participants. The pooled prevalence of T&CM use was 49.3%, ranging from 24.0% to 94.8%, and the disclosure rate of T&CM use was 38.2% (11.9% to 82.5%). The most commonly used T&CM modalities were herbal medicines and traditional medicine. Females were 22.0% more likely to use T&CM than males. A subgroup analysis revealed the highest prevalence of T&CM use was found in studies conducted in East Asia (62.4%) and those covered by both national and private insurance (55.8%). The disclosure rate of T&CM use to physicians remains low. Moreover, the factors influencing this disclosure are still insufficiently explored. Since the disclosure of T&CM use is a crucial indicator of patient safety and the quality of cancer treatment prognosis, future research should focus on identifying the determinants of non-disclosure.
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Affiliation(s)
- Soojeung Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul 04763, Republic of Korea; (S.C.); (H.I.)
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Sangita Karki Kunwor
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul 04763, Republic of Korea; (S.C.); (H.I.)
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
| | - Hyeabin Im
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul 04763, Republic of Korea; (S.C.); (H.I.)
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
| | - Dain Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul 04763, Republic of Korea; (S.C.); (H.I.)
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
| | - Junghye Hwang
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
- Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Mansoor Ahmed
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
- School of Public Health, Dow University of Health Sciences, Karachi 75330, Pakistan
| | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul 04763, Republic of Korea; (S.C.); (H.I.)
- Institute of Health Services Management, Hanyang University, Seoul 04763, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
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Wu J, Ma X, Wang X, Zhu G, Wang H, Li J. Efficacy and safety of compound kushen injection for treating advanced colorectal cancer: A protocol for a systematic review and meta-analysis. Heliyon 2024; 10:e26981. [PMID: 38463847 PMCID: PMC10923683 DOI: 10.1016/j.heliyon.2024.e26981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 01/22/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Compound Kushen Injection (CKI) is a traditional Chinese medicine extracted from Sophora flavescens Aiton and Heterosmilax japonica Kunth. Widely utilized in China for the comprehensive treatment of colorectal cancer (CRC), this study aims to systematically assess the efficacy and safety of CKI when combined with chemotherapy for the treatment of advanced CRC, based on available data. Methods Randomized controlled trials investigating the efficacy and safety of CKI combined with chemotherapy in the treatment of advanced CRC will be comprehensively searched from databases, including PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang, Chinese Biomedicine Database Searches, Chinese Clinical Trial Registry, and ClinicalTrials.gov until November 2022. Two independent reviewers will screen the studies, assess the risk of bias, and extract data in duplicate. The ROB2 tool will be employed to assess the quality of included studies. Stata 16 will be used for data analysis, and publication bias will be assessed using funnel plots and Egger's test. The quality of evidence will be evaluated according to GRADE, and trial sequence analysis (TSA) will be utilized to calculate the final total sample size required for the meta-analysis. The results of this systematic review will be published in a peer-reviewed journal. The proposed review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022380106). Discussion This systematic review will integrate current evidence on CKI in advanced CRC and analyze the clinical efficacy and safety of CKI combined with different chemotherapy regimens, providing valuable guidance on the use of CKI in CRC patients.
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Affiliation(s)
- Jingyuan Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- Graduate College, Beijing University of Traditional Chinese Medicine, Beijing, 100029, China
| | - Xinyi Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Xinmiao Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Guanghui Zhu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- Graduate College, Beijing University of Traditional Chinese Medicine, Beijing, 100029, China
| | - Heping Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Jie Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
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Youn B, Cha J, Cho S, Jeong S, Kim H, Ko S. Perception, attitudes, knowledge of using complementary and alternative medicine for cancer patients among healthcare professionals: A mixed-methods systematic review. Cancer Med 2023; 12:19149-19162. [PMID: 37676102 PMCID: PMC10557909 DOI: 10.1002/cam4.6499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND With the rapid increase in the prevalence of cancer worldwide, the utilization of complementary and alternative medicine (CAM) has increased among cancer patients. This review aimed to understand the perception, attitudes, and knowledge of healthcare professionals toward using CAM for cancer patients. METHODS A mixed-methods systematic review was undertaken in four databases. Inclusion criteria were primary studies reporting perception, attitudes, and knowledge of healthcare professionals for using CAM for cancer patients were eligible. A mixed-methods convergent synthesis was carried out, and the findings were subjected to a GRADE-CERQual assessment of confidence. RESULTS Forty-two studies were chosen. The majority of the studies were quantitative and had less than 100 participants. Most publications were from European countries, and oncology was the highest among the specialties. The review found the following themes: feasibility of having negative adverse effects, low expectations of using CAM among HCPs, potential positive effects of using CAM, specific CAM training may be helpful, no concrete regulations to promote CAM practice, and poor physician-patient communication. CONCLUSIONS Nurses had more positive views than other professions; oncologists were concerned regarding herb-drug interactions; integration of CAM into the healthcare system was favorable; HCPs felt the need to participate in specific CAM training; and HCPs agreed that CAM education should be provided more regularly. Future studies should explore the studies views of cancer patients and details of in-depth evidence of CAM in oncology settings.
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Affiliation(s)
- Bo‐Young Youn
- Department of Preventive Medicine, College of Korean MedicineKyung Hee UniversitySeoulSouth Korea
| | - Jie‐Won Cha
- Department of Applied Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Sungsu Cho
- Department of Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - So‐Mi Jeong
- Department of Clinical Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Hyo‐Jung Kim
- Department of Clinical Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Seong‐Gyu Ko
- Department of Preventive Medicine, College of Korean MedicineKyung Hee UniversitySeoulSouth Korea
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Geng X, Wang Z, Feng L, Gu Y, Wang R, Yao Q, Xu Y, Wu J, Jiang Z, Chen K, Hu W, Tang D, Huo J, Li L, Bu Q, Zhao S, Zhang B, Cheng H. Efficacy and safety of Xian-Lian-Jie-Du optimization decoction as an adjuvant treatment for prevention of recurrence in patients with stage IIIB/IIIC colon cancer: study protocol for a multicentre, randomized controlled trial. BMC Complement Med Ther 2023; 23:239. [PMID: 37461034 PMCID: PMC10351122 DOI: 10.1186/s12906-023-04052-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Colon cancer remains one of the most prevalent cancers worldwide. Unfortunately, there are no recognized and effective therapeutic strategies to prevent tumor recurrence after radical resection and chemotherapy, and the disease-free survival (DFS) in patients with stage IIIB or IIIC disease remains unsatisfactory. Xian-Lian-Jie-Du optimization decoction (XLJDOD) is a Chinese herbal medicine (CHM) empirical prescription, which has been validated experimentally and clinically that could inhibit the progression of colorectal cancer and ameliorate the symptoms. The purpose of this study is to evaluate the efficacy and safety of XLJDOD in prevention of recurrence of colon cancer. METHODS This study is a multi-center, double-blind, randomized, placebo-controlled trial conducted at 13 hospitals of China. Following the completion of surgery and adjuvant 5- fluorouracil-based chemotherapy, a total of 730 subjects with stage IIIB or IIIC colon cancer will be randomized in a 1:1 ratio to an intervention group (n = 365; XLJDOD compound granule) and a control group (n = 365; Placebo). Patients will receive 6-month treatments and be followed up with 3 monthly assessments for 2 years. The primary outcome is 2-year DFS rate and the secondary outcomes are 1, 2-year relapse rate (RR), overall survival (OS) and quality of life (QoL). Safety outcomes such as adverse events will be also assessed. A small number of subgroup analysis will be carried out to explore the heterogeneity of effects of XLJDOD. DISCUSSION The outcomes from this randomized controlled trial will provide objective evidences to evaluate XLJDOD's role as an adjuvant treatment in colon cancer. TRIAL REGISTRATION www. CLINICALTRIALS gov , identifier: NCT05709249. Registered on 31 Jan 2023.
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Affiliation(s)
- Xuechen Geng
- The First Clinical Medical College, Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziqiang Wang
- Department of General Surgery, Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Li Feng
- Traditional Chinese Medicine Department, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yanhong Gu
- Department of Oncology and Cancer Rehabilitation Centre, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Renjie Wang
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qinghua Yao
- Department of Integrated Chinese and Western Medicine, Institute of Basic Medicine and Cancer (IBMC), The Cancer HospitalUniversity of Chinese Academy of Sciences (Zhejiang Cancer Hospital)Chinese Academy of Sciences, Hangzhou, China
| | - Yangxian Xu
- Department of General Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianyu Wu
- No. 2 Surgery Department, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong, China
| | - Zhiwei Jiang
- Department of General Surgery, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Kai Chen
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wenwei Hu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Dongxin Tang
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Jiege Huo
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Sichuan Center of Technology Innovation for Real World Data, West China Hospital, Sichuan University, Chengdu, China
| | - Qianqian Bu
- The First Clinical Medical College, Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shuoqi Zhao
- The First Clinical Medical College, Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bei Zhang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
- Department of TCM, Sun Yat-Sen University Cancer Center, Guangzhou, China.
| | - Haibo Cheng
- The First Clinical Medical College, Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, Nanjing University of Chinese Medicine, Nanjing, China.
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Chen KW, Chung KP, Hsu CH. The intention of utilization and experience toward traditional Chinese medicine among breast cancer patients in the early and late stages: a qualitative study. BMC Complement Med Ther 2023; 23:226. [PMID: 37420247 DOI: 10.1186/s12906-023-04054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/24/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND In Taiwan, breast cancer patients usually take conventional medicine and traditional Chinese medicine simultaneously. The utilization of traditional Chinese medicine among breast cancer patients at various stages has not been examined. This study aims to compare the intention of utilization and experience toward traditional Chinese medicine among early- and late-stage breast cancer patients. METHOD This qualitative research collected data from breast cancer patients through focus groups interview by convenience sampling. Conducted in 2 branches of Taipei City Hospital, a public hospital managed by the Taipei City government. Breast cancer patients > 20 years old and had used TCM for breast cancer therapy for at least 3 months were included in the interview. A semi-structured interview guide was adopted in each focus group interview. In the following data analysis, stages I and II were considered early-stage, and stages III and IV were late-stage. For analyzing the data and reporting the results, we used qualitative content analysis as the approach for data analysis, assisted by NVivo 12. Categories and subcategories were identified through content analysis. RESULTS Twelve and seven early- and late-stage breast cancer patients were included in this study, respectively. The side effects were the main intention of utilizing traditional Chinese medicine. Improving side effects and constitution was the main benefit for patients in both stages. Additionally, early-stage breast cancer patients used traditional Chinese medicine to prevent recurrence or metastasis. Late-stage breast cancer patients responded more frequently to the use of traditional Chinese medicine due to the side effects of western medicine. However, some of their symptoms were not fully relieved. CONCLUSIONS Breast cancer staging may influence the intention and utilization of traditional Chinese medicine. Health policymakers should consider the results of this research and the evidence-based illustrations to establish guidelines for integrating traditional Chinese medicine among various stages of breast cancer to improve the outcome and quality of care for cancer patients.
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Affiliation(s)
- Kai-Wei Chen
- Institute of Health Policy and Management, National Taiwan University, 17 Xuzhou Road, Zhongzheng District, Taipei City, 100, Taiwan
- Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, 100 Kunming Street, Wanhua District, Taipei City, 108, Taiwan
| | - Kuo-Piao Chung
- Institute of Health Policy and Management, National Taiwan University, 17 Xuzhou Road, Zhongzheng District, Taipei City, 100, Taiwan.
| | - Chung-Hua Hsu
- Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, 100 Kunming Street, Wanhua District, Taipei City, 108, Taiwan
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Park SB, Yoon JH, Kim EH, Jin H, Yoon SW. Traditional herbal medicine for anorexia in patients with cancer: a systematic review and meta-analysis of randomized controlled trials. Front Pharmacol 2023; 14:1203137. [PMID: 37441530 PMCID: PMC10333490 DOI: 10.3389/fphar.2023.1203137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Background: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of traditional herbal medicine (THM) for improving anorexia in patients with cancer. Methods: We searched for randomized controlled trials (RCTs) that evaluated orally administered THM for cancer-related anorexia using 10 databases from the inception to 1 August 2021. The primary outcome was an improvement in anorexia, measured with the total effective rate (TER) or visual analog scale (VAS). The secondary outcomes were the changes in body weight, the Karnofsky performance scale, acylated ghrelin, and adverse events. We used the Cochrane risk of bias assessment tool and the Grading of Recommendations Assessment, Development, and Evaluation method to assess the quality of the studies and the quality of the evidence. Results: A total of 26 RCTs were included, of which 23 were subjected to quantitative analysis. THM showed a significant improvement in anorexia measured with the TER [risk ratio (RR) 1.12, 95% confidence intervals (CI) 1.04-1.20] than appetite stimulants with moderate quality evidence and in the Karnofsky performance scale (RR 1.38, 95% CI 1.12-1.70) with low quality evidence but not in body weight gain (RR 0.98, 95% CI 0.80-1.20). THM showed a significant improvement in anorexia measured with the TER (RR 1.74, 95% CI 1.23-2.48) compared with usual care with low-quality evidence but did not significantly improve the VAS score (mean difference 0.72, 95% CI 0.00-1.43) or the level of acylated ghrelin (mean difference 0.94, 95% CI 1.08-2.97). There were no serious adverse events. Conclusion: This review suggests that THM may be considered a safe alternative therapeutic option for improving anorexia in patients with cancer. Nonetheless, more rigorous RCTs are needed due to methodological limitations. Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier CRD42021276508.
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Affiliation(s)
- Su Bin Park
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jee-Hyun Yoon
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Eun Hye Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Hayun Jin
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seong Woo Yoon
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
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Zhao Q, Guo R, Fan Z, Hu L, Hu Z, Liu Y. Medical Conditions and Preference of Traditional Chinese Medicine: Results from the China Healthcare Improvement Evaluation Survey. Patient Prefer Adherence 2023; 17:227-237. [PMID: 36718438 PMCID: PMC9883991 DOI: 10.2147/ppa.s398644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/14/2023] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Although complementary and alternative medicine (CAM) is used around the world, there has been a lack of comprehensive understanding of major factors affecting patients' decision to use CAM. This study aimed to describe the preferences of Chinese patients regarding what conditions they will use Traditional Chinese Medicine (TCM) for and to determine the factors associated with these preferences. PATIENTS AND METHODS This study used data from the China Healthcare Improvement Evaluation Survey in January 2021, a national cross-sectional survey conducted at 163 hospitals across 31 provinces. A convenient sampling method was used to conduct the patient satisfaction survey, and 28,993 patients in an ambulatory setting constituted our study sample on TCM use. A multiple-choice question regarding TCM listed nine medical conditions and asked the patient about what condition he/she and his/her family members would use TCM. In addition to descriptive statistics, we used a binary logistic regression model to investigate factors affecting the likelihood of patients' decision to use TCM for multiple conditions. RESULTS The majority of the surveyed patients (76.3%) would use TCM for the purpose of disease prevention, and more than half (67.3%) for multiple medical/health conditions, 34.0% for dealing with chronic diseases, 33.0% for common symptoms, 26.9% for rehabilitation, and 26.3% for sleeping disorder. Female and older patients, as well as patients with a higher education level, urban residency, and higher family income, were found to be associated with a higher probability of using TCM for multiple conditions than their counterparts (odd ratios [OR]>1, P<0.05). CONCLUSION This study reveals a preference for TCM in a large sample of Chinese patients, especially used for prevention. Generally, patients with a higher socioeconomic status had a more positive attitude toward TCM.
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Affiliation(s)
- Qi Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Ran Guo
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Zixuan Fan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Linlin Hu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Zhimin Hu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
- Correspondence: Yuanli Liu, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdansantiao, Dongcheng District, Beijing, 100730, People’s Republic of China, Email
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Association between Oral Chinese Herbal Medicine and Recurrence and Metastasis in Patients with Stages II and III Colorectal Cancer: A Cohort Study in China. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8529395. [DOI: 10.1155/2022/8529395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022]
Abstract
Background. To evaluate the associations between long-term oral Chinese herbal medicines (CHMs) and recurrence and metastasis (R&M) in patients with stage II and III colorectal cancer (CRC). Furthermore, we aimed to determine the correlation between different syndrome patterns and prognosis and summarized the regularities among CHMs prescriptions, providing reference for clinical practice. Methods. An ambispective cohort study was conducted. All CRC patients who sought evaluation and treatment at Xiyuan Hospital and Beijing Cancer Hospital from August 2014 to August 2016 were included. In this study, “whether patients voluntarily take CHMs” was taken as the exposure factor, and the exposure degree was “the duration of CHM use.” Stratification was performed according to the duration of TCM use to determine the relationship with R&M of CRC. The primary outcome was disease-free survival. Patients who had R&M of CRC after taking CHMs for ≥6 months were defined as “worst patients.” R software was used for statistical analysis. The Kaplan–Meier method and Cox regression analysis were used to determine the prognosis. IBM SPSS was used to model a priori association rules; drug use rules were analyzed on this basis. Results. A total of 186 patients with stage II and III CRC after radical resection were enrolled. All patients reached the study endpoint by August 2021. The difference in disease-free survival between the two groups was most significant when the cutoff value for CHMs was 18 months (
). Multivariate analysis showed that 18 CHMs were independent protective factors for R&M of CRC (
, HR = 0.20, 95% CI = 0.08–0.53). The ratio of Pi (spleen) and Shen (kidney) deficiency in the worst cases was higher than patients without R&M (
). Sijunzi and Liuwei Dihuang decoctions were the most frequently used prescriptions in the anti-R&M phase. Conclusion. CHMs complying with the “Jianpi Bushen” principle may attenuate the risk of R&M in patients with stage II and III CRC. Pi (spleen) and Shen (kidney) deficiency in patients receiving TCM intervention for the first time within 6 months of radical resection may be associated with a higher CRC R&M rate. Further research is warranted to validate these findings and elucidate underlying biological mechanisms.
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CHEN H, SHI L, SHI Z, XIA Y, WANG D. Factors influencing physician's behavioral intention to use Traditional Chinese Medicine to treat coronavirus disease 2019 based on the theory of planned behavior. J TRADIT CHIN MED 2022; 42:633-6400. [PMID: 35848981 PMCID: PMC9924696 DOI: 10.19852/j.cnki.jtcm.20220607.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To explore the factors influencing physicians' intentions to use Traditional Chinese Medicine (TCM) to treat coronavirus disease 2019 (COVID-19). METHODS A cross-sectional, self-report online survey was conducted from March 16, 2020, to April 2, 2020, in China. Participants were recruited through convenience and snowball sampling. Data were collected by using a self-designed questionnaire based on the Theory of Planned Behavior. Structural equation modeling was used for data analysis. RESULTS A total of 494 physicians were enrolled in this study. Overall, the model explained 75.4% and 75.5% of the total variance in intention and attitude, respectively. Specifically, attitudes (β = 0.467, P < 0.001), past behavior (β = 0.384, P < 0.05), subjective norms (SN) (β = 0.177, P < 0.001), and perceived behavioral control (PBC) (β = 0.133, P < 0.05) significantly affected physicians' intention to use TCM. Cognition (β = 0.606, P < 0.001) and PBC (β = 0.569, P < 0.01) significantly influenced physicians' attitudes toward using TCM. SN (β = 0.064, P = 0.263) was not a factor affecting attitude. CONCLUSION Physicians' intention to use TCM was significantly associated with attitude, past behavior, PBC, and SN. The findings may not only be useful for understanding the influencing factors and paths of physicians' intention to use TCM to treat COVID-19 but also provide a reference for health authorities and policymakers to promote physicians to utilize TCM.
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Affiliation(s)
- Huang CHEN
- 1 General Office, the People’s Government of Guangdong Province, Guangzhou 510045, China
- 2 the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China
| | - Lushaobo SHI
- 2 the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China
- 3 School of Health Management, Southern Medical University, Guangzhou 510515, China
| | - Zengping SHI
- 2 the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China
- 3 School of Health Management, Southern Medical University, Guangzhou 510515, China
| | - Yi XIA
- 2 the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China
- 3 School of Health Management, Southern Medical University, Guangzhou 510515, China
- XIA Yi, School of Health Management, Southern Medical University, Guangzhou 510515, China; the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China.
| | - Dong WANG
- 2 the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China
- 3 School of Health Management, Southern Medical University, Guangzhou 510515, China
- WANG Dong, School of Health Management, Southern Medical University, Guangzhou 510515, China; the Public Health Service System Construction Research Foundation of Guangzhou, Guangzhou 510515, China. , Telephone: +86-20-61647576
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Mao JJ, Pillai GG, Andrade CJ, Ligibel JA, Basu P, Cohen L, Khan IA, Mustian KM, Puthiyedath R, Dhiman KS, Lao L, Ghelman R, Cáceres Guido P, Lopez G, Gallego-Perez DF, Salicrup LA. Integrative oncology: Addressing the global challenges of cancer prevention and treatment. CA Cancer J Clin 2022; 72:144-164. [PMID: 34751943 DOI: 10.3322/caac.21706] [Citation(s) in RCA: 191] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 12/15/2022] Open
Abstract
The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.
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Affiliation(s)
- Jun J Mao
- Bendheim Integrative Medicine Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Geetha Gopalakrishna Pillai
- Traditional, Complementary and Integrative Medicine Unit, Service Delivery and Safety Department, World Health Organization, Geneva, Switzerland
| | | | - Jennifer A Ligibel
- Leonard P. Zakim Center for Integrative Therapies and Healthy Living, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Partha Basu
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Lorenzo Cohen
- Integrative Medicine Program, Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ikhlas A Khan
- National Center for Natural Products Research, University of Mississippi, Jackson, Mississippi
| | - Karen M Mustian
- Wilmot Cancer Institute, Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | | | | | - Lixing Lao
- Virginia University of Integrative Medicine, Fairfax, Virginia
| | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health, University of São Paulo, São Paulo, Brazil
| | - Paulo Cáceres Guido
- Pharmacokinetics and Research in Clinical Pharmacology and Integrative Medicine Group, Garrahan Pediatric Hospital, Buenos Aires, Argentina
- Traditional, Complementary, and Integrative Medicine Network of the Americas, São Paulo, Brazil
| | - Gabriel Lopez
- Integrative Medicine Program, Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel F Gallego-Perez
- Traditional, Complementary, and Integrative Medicine Network of the Americas, São Paulo, Brazil
- Boston University School of Public Health, Boston, Massachusetts
| | - Luis Alejandro Salicrup
- Center for Global Health and Office of Cancer Complementary and Alternative Medicine, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Zhu Y, Yu J, Zhang K, Feng Y, Guo K, Sun L, Ruan S. Network Pharmacology Analysis to Explore the Pharmacological Mechanism of Effective Chinese Medicines in Treating Metastatic Colorectal Cancer using Meta-Analysis Approach. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 49:1839-1870. [PMID: 34781857 DOI: 10.1142/s0192415x21500877] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The role of traditional Chinese medicine (TCM) on treatment of metastatic colorectal cancer (mCRC) remains controversial, and its active components and potential targets are still unclear. This study mainly aimed to assess the efficacy and safety of TCM in mCRC treatment through meta-analysis and explore the effective components and potential targets based on the network pharmacology method. We systematically searched PubMed, EMBASE, Cochrane, CBM, WanFang, and CNKI database for randomized controlled trials (RCTs) comparing the treatment of mCRC patients with and without TCM. A meta-analysis using RevMan 5.4 was conducted. In total, 25 clinical trials were analyzed, and the result demonstrated that TCM was closely correlated with the improved OS (HR: 0.63; 95% CI: 0.52-0.76; [Formula: see text] < 0.00001) and PFS (HR: 0.73; 95% CI: 0.61-0.88; [Formula: see text] = 0.0010). Then, high-frequency Chinese herbs from the prescriptions extracted from the trails included in the OS meta-analysis were counted to construct a core-effective prescription. The TCMSP database was used to retrieve the active chemical components and predict herb targets. The Genecards, OMIM, Disgenet, DrugBank, and TTD database were searched for colorectal cancer targets. R-package was used to construct the Component-Target (C-T) network based on the intersection genes. Further, we extracted hub genes from C-T network and performed functional enrichment and pathway analysis. Finally, the C-T network showed 120 herb and disease co-target genes, and the most important top 10 active components were: Quercetin, Luteolin, Wogonin, Kaempferol, Nobiletin, Baicalein, Licochalcone A, Naringenin, Isorhamnetin, and Acacetin. The first 20 hub genes were extracted: CDKN1A, CDK1, CDK2, E2F1, CDK4, PCNA, RB1, CCNA2, MAPK3, CCND1, CCNB1, JUN, MAPK1, RELA, FOS, MAPK8, STAT3, MAPK14, NR3C1, and MYC. Thus, effective Chinese herb components may inhibit the mCRC by targeting multiple biological processes of the above hub genes.
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Affiliation(s)
- Ying Zhu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, P. R. China
| | - Jieru Yu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, P. R. China
| | - Kai Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou 310053, P. R. China
| | - Yuqian Feng
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, P. R. China
| | - Kaibo Guo
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, P. R. China
| | - Leitao Sun
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou 310053, P. R. China
| | - Shanming Ruan
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou 310053, P. R. China
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Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9963038. [PMID: 34055029 PMCID: PMC8149249 DOI: 10.1155/2021/9963038] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 05/08/2021] [Indexed: 12/24/2022]
Abstract
Background Although herbal medicines are used by patients with cancer in multiple oncology care settings, the magnitude of herbal medicine use in this context remains unclear. The purpose of this review was to establish the prevalence of herbal medicine use among patients with cancer, across various geographical settings and patient characteristics (age and gender categories). Methods Electronic databases that were searched for data published, from January 2000 to January 2020, were Medline (PubMed), Google Scholar, Embase, and African Index Medicus. Eligible studies reporting prevalence estimates of herbal medicine use amongst cancer patients were pooled using random-effects meta-analyses. Studies were grouped by World Bank region and income groups. Subgroup and meta-regression analyses were performed to explore source of heterogeneity. Results In total, 155 studies with data for 809,065 participants (53.95% female) met the inclusion criteria. Overall, the pooled prevalence of the use of herbal medicine among patients with cancer was 22% (95% confidence interval (CI): 18%–25%), with the highest prevalence estimates for Africa (40%, 95% CI: 23%–58%) and Asia (28%, 95% CI: 21%–35%). The pooled prevalence estimate was higher across low- and middle-income countries (32%, 95% CI: 23%–42%) and lower across high-income countries (17%, 95% CI: 14%–21%). Higher pooled prevalence estimates were found for adult patients with cancer (22%, 95% CI: 19%–26%) compared with children with cancer (18%, 95% CI: 11%–27%) and for female patients (27%, 95% CI: 19%–35%) compared with males (17%, 95% CI: 1%–47%). Conclusion Herbal medicine is used by a large percentage of patients with cancer use. The findings of this review highlight the need for herbal medicine to be integrated in cancer care.
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Case series and review of Ayurvedic medication induced liver injury. BMC Complement Med Ther 2021; 21:91. [PMID: 33714265 PMCID: PMC7956115 DOI: 10.1186/s12906-021-03251-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/16/2021] [Indexed: 02/08/2023] Open
Abstract
Background Complementary and alternative medicine use among Americans is prevalent. Originating in India, Ayurvedic medicine use in the United States has grown 57% since 2002. CAM accounts for a significant proportion of drug induced liver injury in India and China, but there have been only three reports of drug induced liver injury from Ayurvedic medications in the U.S. We report three cases of suspected Ayurvedic medication associated liver injury seen at a Southern California community hospital and review literature of Ayurvedic medication induced liver injury. Case presentations Three patients presented with acute hepatocellular injury and jaundice after taking Ayurvedic supplements for 90–120 days. First patient took Giloy Kwath consisting solely of Tinospora cordifolia. Second patient took Manjishthadi Kwatham and Aragwadhi Kwatham, which contained 52 and 10 individual plant extracts, respectively. Third patient took Kanchnar Guggulu, containing 10 individual plant extracts. Aminotransferase activities decreased 50% in < 30 days and all 3 patients made a full recovery. Roussel Uclaf Causality Assessment Method (RUCAM) scores were 7–8, indicating probable causality. These products all contained ingredients in other Ayurvedic and traditional Chinese medicines with previously reported associations with drug induced liver injury. Conclusions These patients highlight the risk of drug induced liver injury from Ayurvedic medications and the complexity of determining causality. There is a need for a platform like LiverTox.gov to catalog Ayurvedic ingredients causing liver damage. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03251-z.
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17
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Xia Y, Shi LSB, Chang JH, Miao HZ, Wang D. Impact of the COVID-19 pandemic on intention to use traditional Chinese medicine: A cross-sectional study based on the theory of planned behavior. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:219-225. [PMID: 33547011 PMCID: PMC7826027 DOI: 10.1016/j.joim.2021.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/11/2020] [Indexed: 12/11/2022]
Abstract
Objective Coronavirus disease 2019 (COVID-19) has become an increasingly severe public health emergency. Although traditional Chinese medicine (TCM) has helped to combat COVID-19, public perception of TCM remains controversial. We used the theory of planned behavior (TPB) to identify factors that affect the intention to use TCM. Methods A cross-sectional web-based survey of 10,824 individuals from the general public was conducted between March 16 and April 2, 2020. The participants were recruited using a snowball sampling method. Data were collected using a self-administered questionnaire, based on the TPB. The questionnaire consisted of demographic characteristics and TPB structures. Structural equation modeling was used to identify predictors of intention. Results The results indicated the model explained 77.5% and 71.9% of intention and attitude variance. Intention to use TCM had the strongest relationship with attitude (P < 0.001), followed by past behavior (P < 0.001), subjective norms (P < 0.001) and perceived behavioral control (P < 0.001). Attitudes toward TCM were significantly affected by perceived behavioral control (P < 0.001), subjective norms (P < 0.001) and cognition of TCM (P < 0.001). Conclusion Attitude is a key factor in determining the intention to use TCM, followed by past behaviors, subjective norms and perceived behavioral control. Our results offer important implications for health policy makers to promote the use of TCM.
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Affiliation(s)
- Yi Xia
- School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong Province, China; School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Lu-Shao-Bo Shi
- School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Jing-Hui Chang
- School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Hua-Zhang Miao
- School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
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18
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Yang G, Zhang H, Xu Y, Zhao A, Shu P, Wang W, Zhang H, Wang T, Yang Y. Basic Characteristics, Status, and Challenges of Integrative Oncology in China. Integr Cancer Ther 2021; 20:15347354211063504. [PMID: 34866448 PMCID: PMC8652177 DOI: 10.1177/15347354211063504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Integrative oncology has developed for about 20 years in some countries; however, integrative oncology is still a relative new term for most China's oncologists. Thus, it is essential to summarize the experience and expertise, share details of differing existing models and discuss future perspectives to help define and guide practice in integrative oncology in China. This study presents a summary of the basic characteristics, status, and challenges of integrative oncology in China, and also reports on China's integrative physicians' service delivery, clinical practice and research patterns of integrative oncology by an online national survey, including 405 oncologists. It is easy for cancer patients to access to integrative therapies in China. Public funding is sufficient for integrative oncology in China, and services are often provided through general hospitals and academic hospitals. Most (95.3%) of oncologists showed a positive attitude toward the development of integrative oncology. More than half (55.6%) of the oncologists worried about the influence on integrative oncology of COVID-19, especially for routine treatment, follow-up and holding seminars. We found that integrative oncology in China has swiftly developed in recent years. However, we suggest that standard diagnosis and treatment patterns and national professional guidelines should be set up as soon as possible.
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Affiliation(s)
- Geliang Yang
- Department of Medicine, Shanghai Clinical Research Center, Shanghai, China
| | - Huiqing Zhang
- Department of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yun Xu
- Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Aiguang Zhao
- Department of Oncology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peng Shu
- Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wei Wang
- Chongqing University Cancer Hospital, Chongqing, China
| | - Haibo Zhang
- Department of Oncology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Tingting Wang
- The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, China
| | - Yufei Yang
- Department of Oncology Diagnosis and Treatment, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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Nwachukwu K, Rhoads E, Meek S, Bardi M. Back to nature: herbal treatment, environmental enrichment, and social play can protect against unpredictable chronic stress in Long-Evans rats (Rattus norvegicus). Psychopharmacology (Berl) 2021; 238:2999-3012. [PMID: 34333673 PMCID: PMC8325775 DOI: 10.1007/s00213-021-05917-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/30/2021] [Indexed: 11/03/2022]
Abstract
The importance of integrative biobehavioral responses to complex challenges cannot be overlooked. In this study, the synergetic effects of icariin (a flavonoid present in the plant Epimedium brevicornum), natural enrichment (NaEn), and play behavior were investigated. Rats (n = 60) were assigned to standard housing or NaEn; these two groups were subsequently divided into controls, rats receiving icariin treatments, and rats receiving icariin and allowed to play with an individual from another cage. All rats were exposed to unpredictable mild stressors for 4 weeks. At the end of the treatment, a Forced Swim Task (FST) was conducted to assess emotional regulation during an inescapable acute challenge. Biological samples were collected weekly and before and after the FST to monitor endocrine changes. Corticosterone (CORT), dehydroepiandrosterone (DHEA), and testosterone (T) were assayed. We found that icariin had a significant effect on DHEA/CORT ratios and T levels. NaEn also had a significant effect on both CORT and DHEA, but not on T levels. Play did not appear to be significantly related to the endocrine changes. The strongest positive effects on emotional resilience were observed in NaEn rats that also received icariin. Our results confirmed that using multiple channels to stimulate adaptive responses can be effective in increasing the ability of an organism to face uncertainty. Considering how quickly our life can change due to unpredictable events, our data is instrumental to a better comprehension of the many aspects of integrative biobehavioral responses.
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Affiliation(s)
- Kiana Nwachukwu
- grid.262455.20000 0001 2205 6070Department of Psychology and Neuroscience, Randolph-Macon College, Ashland, VA 23005 USA
| | - Elizabeth Rhoads
- grid.262455.20000 0001 2205 6070Department of Psychology and Neuroscience, Randolph-Macon College, Ashland, VA 23005 USA
| | - Sarah Meek
- grid.262455.20000 0001 2205 6070Department of Psychology and Neuroscience, Randolph-Macon College, Ashland, VA 23005 USA
| | - Massimo Bardi
- Department of Psychology and Neuroscience, Randolph-Macon College, Ashland, VA, 23005, USA. .,134D Copley Science Center, Randolph-Macon College, Ashland, VA, 23005, USA.
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Pandey L, Pasricha R, Joseph D, Ahuja R, Yanthan Y, Garg PK, Gupta M. Use of complementary and alternative medicine among patients with cancer in a sub-Himalayan state in India: An exploratory study. J Ayurveda Integr Med 2021; 12:126-130. [PMID: 33637425 PMCID: PMC8039360 DOI: 10.1016/j.jaim.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/21/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) is widespread among cancer patients in India. OBJECTIVE The present study elucidated usage patterns of CAM and the factors responsible for its adoption among the patients with cancer, and the therapeutic impact of CAM. MATERIALS AND METHODS This was a questionnaire-based study, conducted among patients with cancer in a tertiary care hospital in a sub-Himalayan city. Data were analyzed using statistical methods. RESULTS A total of 2614 patients with cancer were included. Almost half of the patients (n = 1208, 46.2%) reported to have been treated with CAM. Breast cancer (n = 274, 23.0%) was most prevalent with majority at advanced stages. Ayurveda (n = 428, 35.9%) Yoga/Naturopathy (n = 381, 32.0%) Homeopathy (n = 143, 12.0%) and Unani (n = 71, 5.9%) were used commonly. Among CAM users, 85.0% (n = 1012) of patients used CAM as the sole method of treatment, while 58.9% (n = 702) patients reported initial symptomatic benefit. CONCLUSION Using CAM benefitted a significant number of patients with cancer. However, there is an urgent need to integrate CAM with modern system of medicine.
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Affiliation(s)
- Laxman Pandey
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Rajesh Pasricha
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India.
| | - Deepa Joseph
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Rachit Ahuja
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Yanpothung Yanthan
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Pankaj Kumar Garg
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
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Guiné RPF, Florença SG, Barroca MJ, Anjos O. The Link between the Consumer and the Innovations in Food Product Development. Foods 2020; 9:E1317. [PMID: 32962007 PMCID: PMC7554954 DOI: 10.3390/foods9091317] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/20/2022] Open
Abstract
New lifestyles, higher incomes and better consumer awareness are increasing the demand for a year-round supply of innovative food products. In past decades, important developments have been achieved in areas related to food and the food industry. This review shows that factors influencing performance in new product development (NPD) are dynamic and continuously guiding project development. The data obtained by direct involvement of consumers can impact positively successful product development and enhance the company's financial performance. The study of consumer behaviour and attitudes towards new foods encompasses multiple aspects, such as preference, choice, desire to eat certain foods, buying intentions and frequency of consumption. Additionally, both the consumers' willingness to purchase and the willingness to pay a premium are important in NPD, launching and success.
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Affiliation(s)
- Raquel P. F. Guiné
- Research Centre for Natural Resources, Environment and Society (CERNAS), Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal;
| | - Sofia G. Florença
- Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4150-180 Porto, Portugal;
| | - Maria João Barroca
- Polytechnic Institute of Coimbra, Coimbra College of Agriculture, Bencanta, 3045-601 Coimbra, Portugal
- Department Chemistry, Molecular Physical-Chemistry R&D Unit, University of Coimbra, 3004-535 Coimbra, Portugal
| | - Ofélia Anjos
- Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal;
- CEF, Forest Research Centre, School of Agriculture, University of Lisbon, 1349-017 Lisbon, Portugal
- CBP-BI, Plant Biotechnology Centre of Beira Interior, 6001-909 Castelo Branco, Portugal
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Effectiveness and Safety Evaluation of Chinese Medicine in Treatment of Metastatic Colorectal Cancer after Chemotherapy Failure: Protocol of a Prospective Multicenter Cohort Study. Chin J Integr Med 2020; 27:674-679. [PMID: 32820453 DOI: 10.1007/s11655-020-3420-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC. OBJECTIVE To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy. METHODS The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals among Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score. DISCUSSION This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622 on ClinicalTrials.gov).
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A Survey on Perceptions of Complementary and Alternative Medicine among Undergraduates in China. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9091051. [PMID: 32082398 PMCID: PMC7011398 DOI: 10.1155/2020/9091051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/05/2019] [Indexed: 12/25/2022]
Abstract
In recent years, complementary and alternative medicine (CAM) is more widely known and used globally. This study was the first to investigate undergraduates' attitude toward CAM, and influencing factors and barriers for students to use CAM. Students of five different grades in six universities of China were selected for this study from February to May 2019. First, the participants were divided into two groups based on their majors and fulfilled a previously validated 10-item CAM Health Belief Questionnaire (CHBQ) to evaluate their attitudes toward CAM. Second, the chi-square test was used to analyze the differences between the groups, and correlation analysis was conducted to investigate the relationship of the data between the two groups. Third, we used frequency analysis to identify the types that students wanted to study and the barriers to use CAM. The overall mean score of the CHBQ was 48.87 ± 8.594, which was higher than that in other countries. The students in lower grades had a stronger desire to learn CAM than those in higher grades (89% vs 83%, p < 0.05). “Too time-consuming and bad tastes,” “Western medicine was enough,” and “lack of relevant knowledge” were found to be the main interruptions for students to use CAM. 82.3% of students wanted CAM to be incorporated into the curriculum and desired to learn more about CAM. 72.3% of the students who had never learned CAM wanted to know more about CAM. 55.5% of the students were willing to recommend CAM. Most undergraduates desired to learn more about CAM. It is necessary to introduce or integrate CAM courses into the present curriculum, and it should be started in the lower grades. We hope this study can provide evidence for the authority in China to make appropriate changes and integrate CAM into the college curriculum.
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Nootim P, Kapol N, Bunchuailua W, Poompruek P, Tungsukruthai P. Current state of cancer patient care incorporating Thai traditional medicine in Thailand: A qualitative study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 18:41-45. [PMID: 31889658 DOI: 10.1016/j.joim.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess the current state of cancer treatment incorporating Thai traditional medicine (TTM) and to identify problems in the system, by using the health system framework of the World Health Organization. METHODS A qualitative study was conducted by interviewing three groups of people involved in the healthcare system. The groups were constructed via purposive sampling of patients with cancer, caregivers and service providers. The study groups included 37 individuals from five TTM hospitals. In-depth interviews were conducted from October 2017 to March 2018. The interview questions were developed based on the six building blocks of a health system framework. Free form answers from participants were analyzed and interpreted to develop the study conclusions. RESULTS All five TTM hospitals provided treatment to patients with cancer based on provincial public health policy. The policy allows patients with cancer to obtain TTM services in outpatient and inpatient departments and via home visits; most patients used outpatient services. The TTM services were primarily provided by TTM practitioners and included massage, herbal steam, herbal compress and meditation. Herbal medicines were widely used and included Benja-amarit, an anticancer formulation made from Wat Khampramong and Phytoplex. The problems included poor acceptance of TTM practitioners by other healthcare practitioners, lack of experience among TTM practitioners in treating patients with cancer, lack of herbal medicine research trials, contamination in herbal medicine preparations and absence of practical treatment guidelines. CONCLUSION TTM is an alternative treatment modality for patients with cancer and is supported by a national policy in Thailand. To increase accountability to patients and other practitioners, TTM treatments should be refined to rely on scientific principles and practitioners of TTM should receive academic training. Practical treatment guidelines need to be established and thoroughly disseminated to TTM practitioners.
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Affiliation(s)
- Preecha Nootim
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Mueang, Nonthaburi 11000, Thailand; Faculty of Pharmacy, Silpakorn University, Mueang, Nakhon Pathom 73000, Thailand
| | - Nattiya Kapol
- Department of Community Pharmacy, Faculty of Pharmacy, Silpakorn University, Mueang, Nakhon Pathom 73000, Thailand.
| | - Waranee Bunchuailua
- Department of Community Pharmacy, Faculty of Pharmacy, Silpakorn University, Mueang, Nakhon Pathom 73000, Thailand
| | - Panoopat Poompruek
- Department of Community Pharmacy, Faculty of Pharmacy, Silpakorn University, Mueang, Nakhon Pathom 73000, Thailand
| | - Parankul Tungsukruthai
- Chulabhorn International College of Medicine, Thammasat University, Khlong Luang, Pathum Thani 12120, Thailand
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Wong W, Chen BZ, Lee AKY, Chan AHC, Wu JCY, Lin Z. Chinese Herbal Medicine Effectively Prolongs the Overall Survival of Pancreatic Cancer Patients: A Case Series. Integr Cancer Ther 2019; 18:1534735419828836. [PMID: 30791742 PMCID: PMC6432679 DOI: 10.1177/1534735419828836] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background and Aims: Pancreatic cancer has the lowest survival rate of all cancers (4%), and it accounts for 1.9% of new cancer cases in Hong Kong. Combined treatment with Chinese herbal medicine (CHM) and Western medicine has yielded promising results, leading to improved prognosis and overall survival. This retrospective case series aimed to illustrate the improved survival and quality of life outcomes of pancreatic cancer patients administered CHM based on traditional Chinese medicine theory. Methods: To investigate the effectiveness of CHM in prolonging overall survival, 182 patients diagnosed with pancreatic cancer who received CHM treatment were observed from 2005 to 2015. Results: One hundred eighty-two pancreatic cancer patients were treated with CHM; 21 patients died. The mean and median survival of these patients were 29.6 and 15.2 months, respectively; the 1-year survival rate was 76% (range = 4 months to 9 years). These results are better than those reported in patients treated with Western medicine, suggesting the need for further study of CHM. Conclusion: A superior clinical outcome may be obtained with CHM treatment. The case series illustrates the potential benefits and safety issues of CHM in pancreatic cancer patients that could be relevant for developing strategies to increase individualization of pancreatic cancer treatment and improve survival. This study may facilitate interprofessional communication and improved clinical management of pancreatic cancer patients.
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Affiliation(s)
- Wendy Wong
- 1 The Chinese University of Hong Kong, Shatin New Town, Hong Kong
| | - Bing Zhong Chen
- 1 The Chinese University of Hong Kong, Shatin New Town, Hong Kong
| | | | | | | | - Zhixiu Lin
- 1 The Chinese University of Hong Kong, Shatin New Town, Hong Kong
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Kam W, Zhang ZJ, Bäärnhielm S. Traditional Chinese Medicine Explanatory Models of Depressive Disorders: A Qualitative Study. Cult Med Psychiatry 2019; 43:387-403. [PMID: 30963358 DOI: 10.1007/s11013-019-09628-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Traditional Chinese medicine (TCM) is an alternative medical system utilised by many Chinese. However, the knowledge of TCM concepts of depression is limited amongst clinicians with training in Western biomedicine. The purpose of this study was to obtain a better understanding of the conceptualisation of depression from a group of TCM practitioners. Semi-structured interviews in Chinese were carried out with 10 TCM practitioners in Hong Kong. A case description of major depression disorder (MDD) was used as a basis. Interview texts were transcribed, translated and analysed using qualitative content analysis. Most informants identified the case as a depression pattern, a term that lacked clear definition and standardised criteria. The mechanism of disease for MDD symptoms were regarded to be liver-qi dysregulation and an imbalance of yin and yang. The TCM practitioners implemented individualised diagnosis, treatment, and a holistic concept without clear distinction between the mind and the body. This contrasted with the biomedical tradition of separating psychologisation and somatisation. The meanings given to the concept of depression did not correspond with current DSM or ICD definitions, and the TCM normativity can result in variations in explanatory models.
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Affiliation(s)
- Wan Kam
- Transcultural Centre, North Stockholm Psychiatric Clinic, Stockholm, Sweden
| | - Zhang-Jin Zhang
- The University of Hong Kong School of Chinese Medicine, 10 Sassoon Road, Pokfulam, Hong Kong, China
| | - Sofie Bäärnhielm
- Transcultural Centre, North Stockholm Psychiatric Clinic, Stockholm, Sweden. .,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Aw JYH, Yiengprugsawan VS, Gong CH. Utilization of Traditional Chinese Medicine Practitioners in Later Life in Mainland China. Geriatrics (Basel) 2019; 4:E49. [PMID: 31450713 PMCID: PMC6787663 DOI: 10.3390/geriatrics4030049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 11/17/2022] Open
Abstract
Mainland China is one of the world's most rapidly aging countries, and yet there is very limited literature on traditional Chinese medicine (TCM) use in older individuals. This study aimed to determine the national and provincial prevalence of TCM practitioner utilization in later life and associated factors. We used World Health Organization China Study on Global Aging and Adult Health Wave 1 data to determine descriptive statistics of the study population of participants aged 50 years and over. Multivariate logistic regression was conducted controlling for sociodemographic and health factors. A total of 14% of participants utilized a TCM practitioner, and the prevalence of utilization varied significantly by locality. Utilization was more likely in participants living in rural areas [adjusted odds ratio (OR) = 12.96; p < 0.001], Hubei (OR = 7.17; p < 0.001), or Shandong provinces (OR = 4.21; p < 0.001) and being diagnosed with chronic lung disease (OR = 1.97; p = 0.005). Hence, rurality, provincial influence, and chronic lung diseases are significant factors associated with TCM practitioner utilization among older individuals in China. These findings may inform policy for preservation and development of TCM nationally as well as its sustainability in an increasingly aging society.
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Affiliation(s)
- Jessica Yi Han Aw
- Centre for Research on Ageing Health and Wellbeing (CRAHW), Research School of Population Health, The Australian National University, Canberra ACT 2601, Australia.
| | - Vasoontara Sbirakos Yiengprugsawan
- Centre for Research on Ageing Health and Wellbeing (CRAHW), Research School of Population Health, The Australian National University, Canberra ACT 2601, Australia
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales Business School, Kensington NSW2033, Australia
| | - Cathy Honge Gong
- Centre for Research on Ageing Health and Wellbeing (CRAHW), Research School of Population Health, The Australian National University, Canberra ACT 2601, Australia
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales Business School, Kensington NSW2033, Australia
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Ung COL, Harnett JE, Hu H, Desselle SP. Barriers to pharmacists adopting professional responsibilities that support the appropriate and safe use of dietary supplements in the United States: Perspectives of key stakeholders. Am J Health Syst Pharm 2019; 76:980-990. [DOI: 10.1093/ajhp/zxz079] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Joanna E Harnett
- University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, New South Wales, Australia, and Australian Centre in Complementary and Integrative Medicine, University of Technology Sydney, New South Wales, Australia
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
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Use of complementary and alternative medicine and quality of life of cancer patients who received chemotherapy in Turkey. Complement Ther Med 2019; 44:143-150. [PMID: 31126547 DOI: 10.1016/j.ctim.2019.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the frequency of use of CAM therapies among cancer patients, the types of CAM therapies they used, the demographic and clinical factors affecting their tendency to use CAM therapies, and the difference between quality of life of CAM user and non-user patients. DESIGN This cross-sectional study was carried out between March and June 2016 in an education and research hospital located in Mugla, Turkey. A CAM use questionnaire, the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30 version 3.0) and the Nightingale Symptom Assessment Scale (N-SAS) were administered to 211 patients. RESULTS Among all the participating patients, 46.4% were CAM users. The most commonly used CAM therapy was herbal products. The rate of CAM use was higher among the patients with a low education level (P = 0.004). No statistically significant difference was found between the quality-of-life scores of the CAM user and non-user patients. CONCLUSION Almost half of the cancer patients used CAM therapy, with the most commonly used CAM therapy being herbal products. Doctors/nurses should assess patients in terms of the CAM therapies they use to determine their possible side effects and drug interactions. Further research should be performed to determine the relationship between CAM therapy and quality of life.
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Sun L, UI Ain Q, Gao YS, Khan GJ, Yuan ST, Roy D. Effect of Marsdenia tenacissima extract on G2/M cell cycle arrest by upregulating 14-3-3σ and downregulating c-myc in vitro and in vivo. CHINESE HERBAL MEDICINES 2019. [DOI: 10.1016/j.chmed.2019.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Xu Y, Mao JJ, Sun L, Yang L, Li J, Hao Y, Li H, Hou W, Chu Y, Bai Y, Jia X, Wang J, Shen L, Zhang Y, Wang J, Liu J, Yang Y. Association Between Use of Traditional Chinese Medicine Herbal Therapy and Survival Outcomes in Patients With Stage II and III Colorectal Cancer: A Multicenter Prospective Cohort Study. J Natl Cancer Inst Monogr 2018; 2017:4617830. [PMID: 29140496 DOI: 10.1093/jncimonographs/lgx015] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 08/16/2017] [Indexed: 12/28/2022] Open
Abstract
Background Chinese cancer patients often use Traditional Chinese Medicine (TCM) herbal medicine during or after active cancer treatments. However, little is known about how TCM herbal medicine impacts cancer outcomes. This study aimed to evaluate the association between TCM herbal therapy and survival outcomes in patients with stage II or III colorectal cancer. Methods We conducted an eight-center prospective cohort study in China among patients who had undergone radical resection for stage II and III colorectal cancer. All patients received comprehensive conventional treatments according to National Comprehensive Cancer Network (NCCN) guidelines, and follow-up visits were conducted over five years. We defined high exposure as a patient's use of TCM individualized herbs for more than one year, ascertained via clinical interviews. The primary outcome was disease-free survival (DFS), with overall survival (OS) as a secondary outcome. Results Between April 2007 and February 2009, we enrolled 312 patients into the cohort; 166 (53.2%) met the definition of high exposure to TCM herbs. Adjusting for covariates, high exposure to TCM was associated with both better DFS (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = 0.39 to 0.98) and OS (HR = 0.31, 95% CI = 0.14 to 0.68). In subgroup exploratory analysis, the effects demonstrated that the differences in outcomes were statistically significant in patients who had received chemotherapy. Conclusion Longer duration of TCM herbal use is associated with improved survival outcomes in stage II and III colorectal cancer patients in China. More research is needed to evaluate the effects and underlying mechanisms of herbal medicine on colorectal cancer outcomes.
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Affiliation(s)
- Yun Xu
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Jun J Mao
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Lingyun Sun
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Lin Yang
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Jie Li
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Yingxu Hao
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Huashan Li
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Wei Hou
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Yuping Chu
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Bai
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoqiang Jia
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Jinwan Wang
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Lin Shen
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Zhang
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Jianbin Wang
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Jianping Liu
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
| | - Yufei Yang
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Internal Oncology Department, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China; Gastroenterology Department, Peking University of Cancer Hospital and Beijing Cancer Hospital, Beijing, China; Integrative Traditional Chinese Medicine and Western Medicine Department, China-Japan Friendship Hospital, Beijing, China; Oncology Department, Guanganmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China; Oncology Department, Beijing Chaoyang Hospital of Capital Medical University, Beijing China; Gastroenterology Department, No. 1 Hospital of Peking University, Beijing, China; Epidemiology Department, Beijing University of Chinese Medicine, Beijing, China
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Sun L, Mao JJ, Vertosick E, Seluzicki C, Yang Y. Evaluating Cancer Patients' Expectations and Barriers Toward Traditional Chinese Medicine Utilization in China: A Patient-Support Group-Based Cross-Sectional Survey. Integr Cancer Ther 2018; 17:885-893. [PMID: 29888609 PMCID: PMC6142069 DOI: 10.1177/1534735418777117] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: Traditional Chinese medicine (TCM) is widely used among
Chinese cancer patients. However, little is known about Chinese patients’
expectations and barriers toward using TCM for cancer. Methods: We
conducted a cross-sectional survey within a patient-support group, the Beijing
Anti-Cancer Association. We measured the outcome, Chinese cancer survivors’
expectations and barriers toward TCM utilization, using a modified version of
ABCAM (Attitudes and Beliefs towards Complementary and Alternative Medicine),
the ABTCM (Attitudes and Beliefs towards Traditional Chinese Medicine). We used
multivariate models to evaluate the impact of socioeconomic status and clinical
factors on their expectations and barriers (including treatment concerns and
logistical challenges domain) toward TCM. Results: Among 590
participants, most patients expected TCM to boost their immune system (96%),
improve their physical health (96%), and reduce symptoms (94%). Many had
logistical challenges (difficulty decocting herbs (58%) and finding a good TCM
physician (55%)). A few were concerned that TCM might interfere with
conventional treatments (7.6%), and that many TCM treatments are not based on
scientific research (9.1%). In the multivariable regression model, age ≤60 years
was independently associated with higher expectation score (P =
.031). Age ≤60 years (coefficient 5.0, P = .003) and localized
disease (coefficient 9.5, P = .001) were both associated with
higher treatment concerns. Active employment status (coefficient 9.0,
P = .008) and localized disease (coefficient 7.5,
P = .030) were related to more logistical challenges.
Conclusion: Age and cancer stage were related to Chinese cancer
patients’ perceived expectations and barriers toward TCM use. Understanding
these attitudes is important for reshaping the role that TCM plays in China’s
patient-centered comprehensive cancer care model.
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Affiliation(s)
- Lingyun Sun
- 1 Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,2 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jun J Mao
- 2 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Yufei Yang
- 1 Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Zhang H, Yang G, Zhang W, Gu W, Su Y, Ling C. Characteristic Analysis of Complementary and Alternative Medicine in Randomized Controlled Trials of Oncology: A Comparison of Published Studies. Integr Cancer Ther 2018; 17:551-557. [PMID: 28627237 PMCID: PMC6041924 DOI: 10.1177/1534735417696722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 12/30/2016] [Accepted: 01/27/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) has been widely used by cancer patients and oncologists in the past decades. The present study aimed to examine and compare the characteristics and registration status of published studies in a sample of recently published CAM randomized controlled trial (RCT) reports of oncology in leading journals of 3 categories: general and internal medicine (GIM), clinical oncology (CO), and CAM. METHODS Articles published in the top 5 journals of the 3 categories from 2006 to 2015 were searched in PubMed. Basic characteristics, registration information, impact factor, and citations were identified and extracted from the included RCTs. Data were summarized by frequency, mean, and median and compared using χ2 test and Kruskal-Wallis H test. RESULTS A total of 59 RCTs were included; among them, 34 (58%) could be identified with a registration number. GIM journals (15) enjoyed the highest average number of citations per article, followed by CO (12) and CAM (3) journals ( P < .0001). ClinicalTrials.gov was the most popular registry for these RCTs. Of the RCTs registered in ClinicalTrials.gov , 24% (4/17) of the published studies in CO journals put their results in the registry; however, no study in GIM and CAM journals put the result in the registry ( P = .372). CONCLUSION The top GIM, CO, and CAM journals rarely published CAM RCTs of oncology from 2006 to 2015, and the CAM articles of oncology were less cited. However, there was a clear improvement in the trial registration rate over the past decades.
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Affiliation(s)
- Huiqing Zhang
- Changhai Hospital of Traditional Chinese
Medicine, Second Military Medical University, Shanghai, China
| | - Geliang Yang
- Changhai Hospital of Traditional Chinese
Medicine, Second Military Medical University, Shanghai, China
| | - Wei Zhang
- Department of Urology, Changhai
Hospital, Second Military Medical University, Shanghai, China
| | - Wei Gu
- Changhai Hospital of Traditional Chinese
Medicine, Second Military Medical University, Shanghai, China
| | - Yonghua Su
- Changhai Hospital of Traditional Chinese
Medicine, Second Military Medical University, Shanghai, China
| | - Changquan Ling
- Changhai Hospital of Traditional Chinese
Medicine, Second Military Medical University, Shanghai, China
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Yang G, Zhang H, Gan Z, Fan Y, Gu W, Ling C. Discrepant Views of Oncologists and Cancer Patients on Complementary and Alternative Medicine in a Chinese General Hospital. Integr Cancer Ther 2018; 17:451-457. [PMID: 28870099 PMCID: PMC6041901 DOI: 10.1177/1534735417725579] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/14/2017] [Accepted: 07/03/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. METHODS Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. RESULTS A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P < .001) on CAM communications. Both oncologists and patients expected that CAM could improve the immune system. They both agreed that oncologists usually discouraged their patients from using CAM. Regarding the effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. CONCLUSION China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.
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Affiliation(s)
- Geliang Yang
- Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Huiqing Zhang
- Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Zheng Gan
- Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Yifu Fan
- Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Wei Gu
- Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Changquan Ling
- Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
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Sun L, Fahey P, Zhu X, Ng W, Chen ZP, Qiu Y, Lai H, Lin J, Lin L. A Cohort Study to Examine the Use of Chinese Herbal Medicine in Combination With Conventional Therapies for Patients With Hepatocellular Carcinoma in China. Integr Cancer Ther 2018; 17:902-911. [PMID: 29775121 PMCID: PMC6142107 DOI: 10.1177/1534735418775819] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background. Hepatocellular carcinoma (HCC) is one of the major
malignancies associated with high mortality rates. Chinese herbal medicine (CHM)
alone, or in combination with conventional therapies (CT), has been widely used
for patients with HCC in China. This study aims to explore how integrative
therapy (IT) through the combination of CHM and CT affects the survival of
patients with intermediate-advanced HCC. Methods. A retrospective
cohort study was performed at the First Affiliated Hospital of Guangzhou
University of Chinese Medicine, Guangzhou, China. Data of consecutive patients
diagnosed with intermediate-advanced HCC and a specific traditional Chinese
medicine diagnostic pattern between January 2006 and December 2013 were
retrieved from the electronic medical record system at the hospital. Patients
were divided into 3 groups based on the therapies used, that is, IT, CHM alone,
and CT alone, and the survival times of these patients was compared.
Results. A total of 328 patients were included in this study.
Median follow-up period was 26.4 months (95% confidence interval [CI] =
22.7-38.9). Median overall survival was 11.0 months for IT, 8.6 months for CHM,
and 9.4 months for CT groups (P < .001). The adjusted hazard
ratio (HR) of death for the IT group was 0.55 (95% CI = 0.38-0.79,
P = .001) relative to the CT group and 0.68 (95% CI =
0.52-0.90, P = .007) relative to the CHM group, after adjusting
for the factors that impact prognosis. Stratified analysis shows that IT can
significantly lower the risk of death, especially for patients with good
performance status (PS) and Child-Pugh class A. Conclusions. It was
indicated that the integrative approach with combination of CHM and CT might
improve survival for patients with intermediate-advanced HCC, especially for
patients with good PS and Child-Pugh class A. However, a randomized controlled
trial is warranted for a conclusive statement.
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Affiliation(s)
- Lingling Sun
- 1 Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Paul Fahey
- 2 Western Sydney University, Campbelltown, New South Wales, Australia
| | - Xiaoshu Zhu
- 2 Western Sydney University, Campbelltown, New South Wales, Australia
| | - Weng Ng
- 3 South West Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Zhuo Ping Chen
- 1 Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Yiwen Qiu
- 1 Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Hezheng Lai
- 2 Western Sydney University, Campbelltown, New South Wales, Australia
| | - Jietao Lin
- 1 Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Lizhu Lin
- 1 Guangzhou University of Chinese Medicine First Affiliated Hospital, Guangzhou, Guangdong, China
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Shen HS, Wen SH. Effect of early use of Chinese herbal products on mortality rate in patients with lung cancer. JOURNAL OF ETHNOPHARMACOLOGY 2018; 211:1-8. [PMID: 28942131 DOI: 10.1016/j.jep.2017.09.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 09/05/2017] [Accepted: 09/18/2017] [Indexed: 05/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Patients with lung cancer are frequently treated with Western medical treatments. Recently, patients have begun to use Chinese medicine to strengthen the immune system and alleviate side effects. AIM OF THE STUDY We aimed to evaluate the association between mortality rate and early use of Chinese herbal products (CHPs) among patients with lung cancer. MATERIALS AND METHODS We conducted a retrospective cohort study based on the National Health Insurance Research Database, Taiwan Cancer Registry, and Cause of Death Data. Patients with newly diagnosed lung cancer between 2002 and 2010 were classified as either the CHP (n = 422) or the non-CHP group (n = 2828) based on whether they used CHP within 3 months after first diagnosis of lung cancer. A robust Cox regression model was used to examine the hazard ratio (HR) of death for propensity score (PS) matching samples. RESULTS After PS matching, average survival time of the CHP group was significantly longer than that of the non-CHP group. The adjusted HR (0.82; 95% CI: 0.73-0.92) in the CHP group was lower than the non-CHP group. Stratified by clinical cancer stages, CHP group had longer survival time in stage 3 subgroup. When the exposure period of CHP use was changed from 3 to 6 months, results remained similar (HR = 0.85; 95% CI: 0.76-0.95). CONCLUSION Results indicated that patients with lung cancer who used CHP within 3 months after first diagnosis had a lower hazard of death than non-CHP users, especially for stage 3 lung cancer. Further experimental studies are needed to examine the causal relationship.
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Affiliation(s)
- Hsuan-Shu Shen
- Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shu-Hui Wen
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan.
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Xu R, Yu X, Hao J, Wang L, Pan H, Han G, Xu J, Zhang Y, Yang S, Chen J, Ying J, Dai G, Li M, Begic D, Lu B, Shen L. Efficacy and safety of weekly nab-paclitaxel plus gemcitabine in Chinese patients with metastatic adenocarcinoma of the pancreas: a phase II study. BMC Cancer 2017; 17:885. [PMID: 29273007 PMCID: PMC5740894 DOI: 10.1186/s12885-017-3887-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 12/08/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This phase II bridging study assessed the safety and efficacy of nab-paclitaxel/gemcitabine (Metastatic Pancreatic Adenocarcinoma Clinical Trial [MPACT] regimen) in Chinese patients with metastatic pancreatic cancer (MPC). METHODS This 3-part sequential study evaluated nab-paclitaxel 125 mg/m2 plus gemcitabine 1000 mg/m2 on days 1, 8, and 15 every 4 weeks. Part 1 evaluated safety. Part 2 evaluated efficacy using Simon's optimal 2-stage design: if >2 responses were observed in Stage 1 (n = 28), 54 additional patients would be enrolled in Stage 2. If >9 responses were observed, the study was complete. Otherwise, nab-paclitaxel/gemcitabine would be compared with gemcitabine alone in Part 3. The primary endpoint was overall response rate (ORR). Secondary endpoints included duration of response (DOR), overall survival (OS), and safety. RESULTS Eighty-three patients were treated. The prespecified primary endpoint was met: the independently assessed ORR in Stages 1 + 2 was 35% (95% CI, 24.8-46.2); therefore, Part 3 was not initiated. The median DOR was 8.9 months (95% CI, 6.01-8.94). The median OS and progression-free survival were 9.2 (95% CI, 7.6-11.1) and 5.5 (95% CI, 5.29-7.16) months, respectively. The 12-month OS rate was 30%. In an updated analysis, the median OS was 9.3 months and the 12-month OS rate was 32%. Longer OS was observed in patients with baseline neutrophil-to-lymphocyte ratio ≤ 5 vs > 5. The most common grade ≥ 3 adverse events were leukopenia (35%), neutropenia (34%), anemia (15%), thrombocytopenia (10%), and fatigue (13%). Grade 3 peripheral neuropathy occurred in 7% of patients (no grade 4 reported). CONCLUSIONS The MPACT regimen of nab-paclitaxel/gemcitabine is efficacious in Chinese patients with MPC. No new safety signals were observed. TRIAL REGISTRATION NCT02135822 , May 8, 2014.
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Affiliation(s)
- Ruihua Xu
- Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060 China
| | - Xianjun Yu
- Fudan University Shanghai Cancer Center, No 270, Dongan Road, Shanghai, 200032 China
| | - Jihui Hao
- Tianjin Cancer Hospital, Huan-Hu-Xi Road, Tianjin, 300060 China
| | - Liwei Wang
- Renji Hospital, Shanghai Jiaotong University, 160 Pujian Lu, Shanghai, 200127 China
| | - Hongming Pan
- Sir Run Run Shaw Hospital, Zhejiang University, 3 East Qingchun Road, Hangzhou City, 310016 China
| | - Guohong Han
- Xijing Hospital, W Rd, Xi’an, Changle, 127 China
| | - Jianming Xu
- 307 Hospital of the People’s Liberation Army, Beijing, 100021 China
| | - Yanqiao Zhang
- Harbin Medical University Cancer Hospital, Haping Road No.150, Harbin, China
| | - Shujun Yang
- Henan Cancer Hospital, Zhengzhou, 450003 China
| | - Jia Chen
- Jiangsu Provincial Tumor Hospital, 300 Guangzhou Road, Nanjing, 210029 China
| | - Jieer Ying
- Zhejiang Cancer Hospital, 38 Guangji Road, Banshan Bridge, Hangzhou City, 310022 China
| | - Guanghai Dai
- Chinese People’s Liberation Army General Hospital No.28, Fuxing Road, Beijing, China
| | | | | | - Brian Lu
- Celgene Corporation, Summit, NJ USA
| | - Lin Shen
- Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142 China
- Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142 China
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Sun L, Yang Y, Vertosick E, Jo S, Sun G, Mao JJ. Do Perceived Needs Affect Willingness to Use Traditional Chinese Medicine for Survivorship Care Among Chinese Cancer Survivors? A Cross-Sectional Survey. J Glob Oncol 2017; 3:692-700. [PMID: 29244994 PMCID: PMC5735974 DOI: 10.1200/jgo.2016.007955] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose We aimed to quantify Chinese cancer survivors' perceived needs for survivorship care and to evaluate whether these needs could impact their willingness to use traditional Chinese medicine (TCM). Methods We conducted a cross-sectional survey with members of the Beijing Anti-Cancer Association in China. We measured perceived needs with the seven-item Brief Chinese Cancer Survivorship Needs Scale that assesses psychological, functional, nutritional, social, body image, pain, and symptom needs. The outcome variable was willingness to use TCM for survivorship care. We performed multivariable logistic regression analyses to evaluate whether perceived needs are associated with willingness. Results A total of 600 patients were invited, with a response rate of 81%. The mean (standard deviation) score of the perceived needs scale (0 to 10) was 4.4 (2.2), with the majority of participants endorsing nutritional (72%), symptom (65%), and psychological (54%) needs. Among survivors, 387 (80%; 95% CI, 76% to 83%) were willing to use TCM for survivorship care. In multivariable analysis, a higher perceived needs score (adjusted odds ratio [OR], 1.33; 95% CI, 1.14 to 1.56; P < .001) was associated with greater willingness to use TCM. Specifically, nutritional (OR, 3.17; 95% CI, 1.79 to 5.62; P < .001) and symptom needs (OR, 3.15; 95% CI, 1.79 to 5.55; P < .001) had the strongest relationship. Conclusion A higher level of perceived needs, especially in the areas of nutrition and symptoms, was associated with greater willingness to use TCM for survivorship care.
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Affiliation(s)
- Lingyun Sun
- Lingyun Sun, Emily Vertosick, and Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, NY; Lingyun Sun, Yufei Yang, and SungHwa Jo, China Academy of Chinese Medical Science, and Guilan Sun, Beijing Anti-Cancer Association, Beijing, China
| | - Yufei Yang
- Lingyun Sun, Emily Vertosick, and Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, NY; Lingyun Sun, Yufei Yang, and SungHwa Jo, China Academy of Chinese Medical Science, and Guilan Sun, Beijing Anti-Cancer Association, Beijing, China
| | - Emily Vertosick
- Lingyun Sun, Emily Vertosick, and Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, NY; Lingyun Sun, Yufei Yang, and SungHwa Jo, China Academy of Chinese Medical Science, and Guilan Sun, Beijing Anti-Cancer Association, Beijing, China
| | - SungHwa Jo
- Lingyun Sun, Emily Vertosick, and Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, NY; Lingyun Sun, Yufei Yang, and SungHwa Jo, China Academy of Chinese Medical Science, and Guilan Sun, Beijing Anti-Cancer Association, Beijing, China
| | - Guilan Sun
- Lingyun Sun, Emily Vertosick, and Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, NY; Lingyun Sun, Yufei Yang, and SungHwa Jo, China Academy of Chinese Medical Science, and Guilan Sun, Beijing Anti-Cancer Association, Beijing, China
| | - Jun J. Mao
- Lingyun Sun, Emily Vertosick, and Jun J. Mao, Memorial Sloan Kettering Cancer Center, New York, NY; Lingyun Sun, Yufei Yang, and SungHwa Jo, China Academy of Chinese Medical Science, and Guilan Sun, Beijing Anti-Cancer Association, Beijing, China
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Yang G, Lee R, Zhang H, Gu W, Yang P, Ling C. National survey of China's oncologists' knowledge, attitudes, and clinical practice patterns on complementary and alternative medicine. Oncotarget 2017; 8:13440-13449. [PMID: 28088780 PMCID: PMC5355110 DOI: 10.18632/oncotarget.14560] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 12/30/2016] [Indexed: 01/26/2023] Open
Abstract
It is common for cancer patients to use complementary and alternative medicine (CAM). This study was designed to explore China's oncologists’ knowledge, attitudes and clinical practices regarding CAM use by their patients. An online survey was conducted of China's oncologists. Among 11,270 participants who completed the online survey, 6,007 (53.3%) were identified as oncologists. Most were men (75.2%), with a mean age of 33.4 (standard deviation: 6.5) years. The 6,007 oncologists discussed with 36.5% of their patients about CAM. Most of them (75.6%) did not want to initiate discussions due to lack of knowledge on CAM. Oncologists estimated that 40.0% of their patients used CAM treatments. Oncologists reported that 28.7% of their patients underwent anticancer therapy with the concurrent use of CAM. Four out of five of the responding oncologists self-reported inadequate knowledge and only 22.0% reported receiving professional education on CAM. Nearly half (44.9%) of the oncologists believed CAM treatment was effective for symptoms and treatment of cancer. Physician factors associated with initiating discussions with patients about CAM use included sex, age (≥ 33 years), medical license for traditional Chinese medicine, enough knowledge and professional education experience. China's oncologists infrequently discussed with their patients about CAM due to lack of knowledge. Most of the oncologists did not encourage CAM use.
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Affiliation(s)
- Geliang Yang
- Department of Integrative Oncology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Richard Lee
- Department of Medicine, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Huiqing Zhang
- Department of Integrative Oncology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wei Gu
- Department of Integrative Oncology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Peiying Yang
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Changquan Ling
- Department of Integrative Oncology, Changhai Hospital, Second Military Medical University, Shanghai, China
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Hua M, Fan J, Dong H, Sherer R. Integrating traditional Chinese medicine into Chinese medical education reform: issues and challenges. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:126-127. [PMID: 28412722 PMCID: PMC5420456 DOI: 10.5116/ijme.58e3.c489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 04/04/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Miao Hua
- Department of Anthropology, University of Chicago, Chicago, Illinois, USA
| | - Jingyi Fan
- Department of Pediatrics, Zhongnan Hospital, Wuhan, China
| | - Hongmei Dong
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Renslow Sherer
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
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Fan J, Hua M, Dong H, Sherer R. Reforming Medical Education in China: A Traditional Chinese Medicine Perspective. MEDEDPUBLISH 2017; 6:32. [PMID: 38406449 PMCID: PMC10885235 DOI: 10.15694/mep.2017.000032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Introduction: While the Chinese medical education system is undergoing comprehensive reform, traditional forms of Chinese medicines (TCM) continue to be a unique and indispensable part of health care system. However, few studies have explored how various forms of TCM are incorporated with biomedicine in clinical practice. Purpose: To explore clinicians' professional and extraprofessional experience with TCM and to assess whether their medical education has prepared them for clinical work that requires drawing on knowledge of TCM. Methods: Surveys were distributed in 2013 to 18 clinicians, 33 undergraduates and 60 post-graduate students. The survey combined forced-choice and open-ended questions assessing personal and professional experiences with TCM. Mixed qualitative and quantitative methods were used to investigate trends in open-ended survey responses. Results: The majority of clinicians (89%), post-graduate students (60%) and undergraduate students (67%) have personally used TCM treatments. The vast majority of all three groups indicated that they would continue to recommend TCM to patients. Respondents expressed an overall positive attitude towards their extraprofessional experience with TCM whereas their professional experience with TCM was mixed. Conclusion: The extraprofessional and professional experiences of clinicians and students with various types of TCM for a diverse array of indications reveal the sustained clinical presence of TCM. The survey reveals the importance of more training in applying TCM, especially in a clinical setting, and imminent hurdles that must be overcome in implementing clinical training reforms.
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Use of Chinese herbal medicine therapies in comprehensive hospitals in central China: A parallel survey in cancer patients and clinicians. ACTA ACUST UNITED AC 2015; 35:808-814. [PMID: 26670429 DOI: 10.1007/s11596-015-1511-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 06/05/2015] [Indexed: 10/22/2022]
Abstract
Chinese herbal medicine (CHM), as the largest application category of traditional Chinese medicine (TCM), is widely accepted among cancer patients in China. Herbal slice (HS) and Chinese patent drug (CPD) are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were related to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did (20.41% vs. 5.37%). Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment (85.71% among clinicians and 94.07% among cancer patients), in comparison with directly killing tumor cells (24.49% among clinicians and 31.36% among patients). As for refusal reasons, imprecise efficacy was the unanimous (100%) reason for clinicians' rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients (33.33% vs. 15.81%). In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.
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Wu H, Wang K, Li G, Meng D, Han J, Wang G, Li YU. Effects of transcutaneous acupoint electrical stimulation on the imbalance of Th 1, Th 2, Th 17 and T reg cells following thoracotomy of patients with lung cancer. Exp Ther Med 2015; 11:495-502. [PMID: 26893636 DOI: 10.3892/etm.2015.2913] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 09/01/2015] [Indexed: 01/05/2023] Open
Abstract
An imbalance in the various T lymphocytes, including T-helper (Th)1, Th2 and Th17 cells, and regulatory T (Treg) cells, has been associated with immune dysfunction, and may occur following thoracotomy of patients with lung cancer. The use of transcutaneous acupoint electrical stimulation (TAES) has previously been demonstrated to exert immunoregulatory effects; therefore, the present study aimed to evaluate whether TAES was able to attenuate postoperative immune suppression in patients with lung cancer. Thoracic surgical patients with lung cancer (n=27) underwent TAES (frequency, 2/100 Hz; intensity, 4-12 mA) at the bilateral large intestine 4, pericardium 6, small intestine 3 and San Jiao 6 acupuncture points for 30 min, prior to incision, and at 20, 44, 68, 92 and 116 h following thoracotomy. The number of Th1, Th2, Th17 and Treg cells, and the protein and mRNA expression levels of related cytokines were measured by flow cytometry, ELISA and polymerase chain reaction, respectively. The balance of Th1, Th2, Th17 and Treg cells in the peripheral blood of patients with lung cancer was disrupted following thoracotomy. TAES administration increased the percentage of Th1 and Th17 cells, the protein expression levels of interleukin (IL)-2 and interferon-γ, the mRNA expression levels of T-bet and RAR-related orphan receptor-γt, and decreased the percentage of Th2 cells, IL-10 protein expression levels, and GATA binding protein 3 mRNA expression levels. The results of the present study demonstrated that TAES was able to partially attenuate the postoperative immune depression of patients with lung cancer, by regulating the balance of Th1, Th2, Th17 and Treg cells, and the expression levels of related cytokines and transcription factors; therefore, TAES may be considered to be a promising strategy for treating postoperative immune dysfunction in patients with lung cancer.
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Affiliation(s)
- Huaxing Wu
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang 150080, P.R. China; Department of Clinical Oncology, Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Kun Wang
- Department of Anesthesiology, Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Guixian Li
- Department of Mechanical Design and Theory, School of Mechatronics Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, P.R. China
| | - Dexin Meng
- Department of Clinical Oncology, Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Jiacheng Han
- Department of Clinical Oncology, Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Guonian Wang
- Department of Anesthesiology, Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Y U Li
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang 150080, P.R. China
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Poonthananiwatkul B, Howard RL, Williamson EM, Lim RHM. Cancer patients taking herbal medicines: A review of clinical purposes, associated factors, and perceptions of benefit or harm. JOURNAL OF ETHNOPHARMACOLOGY 2015; 175:58-66. [PMID: 26344852 DOI: 10.1016/j.jep.2015.08.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/18/2015] [Accepted: 08/30/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cancer patients in all cultures are high consumers of herbal medicines (HMs) usually as part of a regime consisting of several complementary and alternative medicine (CAM) modalities, but the type of patient, the reasons for choosing such HM-CAM regimes, and the benefits they perceive from taking them are poorly understood. There are also concerns that local information may be ignored due to language issues. This study investigates aspects of HM-CAM use in cancer patients using two different abstracting sources: Medline, which contains only peer-reviewed studies from SCI journals, and in order to explore whether further data may be available regionally, the Thai national databases of HM and CAM were searched as an example. MATERIALS AND METHODS The international and Thai language databases were searched separately to identify relevant studies, using key words chosen to include HM use in all traditions. Analysis of these was undertaken to identify socio-demographic and clinical factors, as well as sources of information, which may inform the decision to use HMs. RESULTS Medline yielded 5638 records, with 49 papers fitting the criteria for review. The Thai databases yielded 155, with none relevant for review. Factors associated with HM-CAM usage were: a younger age, higher education or economic status, multiple chemotherapy treatment, late stage of disease. The most common purposes for using HM-CAM cited by patients were to improve physical symptoms, support emotional health, stimulate the immune system, improve quality of life, and relieve side-effects of conventional treatment. CONCLUSIONS Several indicators were identified for cancer patients who are most likely to take HM-CAM. However, interpreting the clinical reasons why patients decide to use HM-CAM is hampered by a lack of standard terminology and thematic coding, because patients' own descriptions are too variable and overlapping for meaningful comparison. Nevertheless, fears that the results of local studies published regionally are being missed, at least in the case of Thailand, appeared to be unfounded.
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Affiliation(s)
| | - Rachel L Howard
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
| | - Elizabeth M Williamson
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom.
| | - Rosemary H M Lim
- University of Reading School of Pharmacy, Whiteknights, Reading RG6 6AP, United Kingdom
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Lin QJ, Yang F, Jin C, Fu DL. Current status and progress of pancreatic cancer in China. World J Gastroenterol 2015; 21:7988-8003. [PMID: 26185370 PMCID: PMC4499341 DOI: 10.3748/wjg.v21.i26.7988] [Citation(s) in RCA: 206] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/31/2015] [Accepted: 04/16/2015] [Indexed: 02/06/2023] Open
Abstract
Cancer is currently one of the most important public health problems in the world. Pancreatic cancer is a fatal disease with poor prognosis. As in most other countries, the health burden of pancreatic cancer in China is increasing, with annual mortality rates almost equal to incidence rates. The increasing trend of pancreatic cancer incidence is more significant in the rural areas than in the urban areas. Annual diagnoses and deaths of pancreatic cancer in China are now beyond the number of cases in the United States. GLOBOCAN 2012 estimates that cases in China account for 19.45% (65727/337872) of all newly diagnosed pancreatic cancer and 19.27% (63662/330391) of all deaths from pancreatic cancer worldwide. The population's growing socioeconomic status contributes to the rapid increase of China's proportional contribution to global rates. Here, we present an overview of control programs for pancreatic cancer in China focusing on prevention, early diagnosis and treatment. In addition, we describe key epidemiological, demographic, and socioeconomic differences between China and developed countries. Facts including no nationwide screening program for pancreatic cancer, delay in early detection resulting in a late stage at presentation, lack of awareness of pancreatic cancer in the Chinese population, and low investment compared with other cancer types by government have led to backwardness in China's pancreatic cancer diagnosis and treatment. Finally, we suggest measures to improve health outcomes of pancreatic cancer patients in China.
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The Hepatoprotective Effect of Haoqin Qingdan Decoction against Liver Injury Induced by a Chemotherapeutic Drug Cyclophosphamide. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:978219. [PMID: 26101538 PMCID: PMC4460239 DOI: 10.1155/2015/978219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/29/2015] [Accepted: 05/03/2015] [Indexed: 11/18/2022]
Abstract
Haoqin Qingdan decoction (HQQD), a modern Chinese formula, has been widely used in Eastern Asia. Our study focuses on the hepatoprotective effect of HQQD against cyclophosphamide-induced hepatotoxicity. S180, a kind of ascites tumor cells, was used to establish S180-bearing mice, followed by the injection of cyclophosphamide (CP, 80 mg/kg) every other day for 5 times. HQQD was used intragastrically at the dose of 80 g/kg, 40 g/kg, and 20 g/kg twice a day for 12 days. HL-7702 hepatic cell line was incubated with HQQD-medicated serum. Then we detected the effects of HQQD on (i) tumor suppression; (ii) morphological examination; (iii) SOD, MDA, GSH, ALT, and AST; (iv) cleaved caspase-3 expression and (v) cellular viability. CP caused dramatic elevations of AST, ALT, and MDA, while HQQD notably attenuated these elevations. SOD and GSH were notably increased, which were efficiently attenuated by HQQD. CP injection significantly increased apoptosis by increasing cleaved caspase-3 expression, which was obviously inhibited by HQQD, accompanied by the improvement of cells viability. Histopathological examinations supported the above findings. Therefore, HQQD may protect liver tissue through attenuating oxidative stress and the caspase-3-dependent intrinsic apoptosis induced by CP, which suggests the potentially therapeutic effect of HQQD in the use of alkylating agent for cancer chemotherapy.
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47
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Li TF, Lin CC, Tsai HP, Hsu CH, Fu SL. Effects of Kuan-Sin-Yin decoction on immunomodulation and tumorigenesis in mouse tumor models. Altern Ther Health Med 2014; 14:488. [PMID: 25510204 PMCID: PMC4301833 DOI: 10.1186/1472-6882-14-488] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022]
Abstract
Background Complementary therapies are widely used among cancer patients. Kuan-Sin-Yin (KSY) decoction, a popular qi-promoting herbal medicine, was constituted with several herbs known to exhibit immunomodulating or anticancer activity. After combining these herbs as a compound formula, it is necessary to reassess the immunomodulation effects, the effects on tumor growth, and possible toxicity of KSY. Methods The anti-cancer effects of KSY in vivo were determined by measuring the tumor volumes, anticancer-associated cytokines (IFN-gamma, TNF-alpha, IL-2, and IL-12), accumulation of tumor infiltrating leukocytes (TILs), proliferation and apoptosis-related molecular markers (Ki-67, p53, p21, activated caspase 3, and cleaved PARP), and an in situ TUNEL assay. The body weight and serum chemistry of treated mice were also assessed. In vitro, the effects of KSY were evaluated using MTT assay, BrdU incorporation assay and cell growth curve. Results In vivo, KSY suppressed bladder or lung cancer growth but did not promote the production of cytokines nor increase the accumulation of TILs. The expression of p53 and p21 in KSY-treated mice were increased. The numbers of apoptotic tumor cells and the expression of apoptosis marker proteins (Caspase 3 and cleaved PARP) were not significantly elevated after KSY treatment. In vitro, the viability and proliferation of tumor cells, but not normal cells, were suppressed by KSY treatment. No significant toxicity was found in KSY-treated mice. Conclusions KSY suppressed the tumor growth in vivo and in vitro, which resulted from its cytostatic effects on cancer cells, rather than the induction of anti-cancer immunity. Under these experimental conditions, no apparent toxicity was observed. Electronic supplementary material The online version of this article (doi:10.1186/1472-6882-14-488) contains supplementary material, which is available to authorized users.
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Fan L, Strasser-Weippl K, Li JJ, St Louis J, Finkelstein DM, Yu KD, Chen WQ, Shao ZM, Goss PE. Breast cancer in China. Lancet Oncol 2014; 15:e279-89. [PMID: 24872111 DOI: 10.1016/s1470-2045(13)70567-9] [Citation(s) in RCA: 1087] [Impact Index Per Article: 98.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The health burden of cancer is increasing in China, with more than 1·6 million people being diagnosed and 1·2 million people dying of the disease each year. As in most other countries, breast cancer is now the most common cancer in Chinese women; cases in China account for 12·2% of all newly diagnosed breast cancers and 9·6% of all deaths from breast cancer worldwide. China's proportional contribution to global rates is increasing rapidly because of the population's rising socioeconomic status and unique reproductive patterns. In this Review we present an overview of present control measures for breast cancer across China, and emphasise epidemiological and socioeconomic diversities and disparities in access to care for various subpopulations. We describe demographic differences between China and high-income countries, and also within geographical and socioeconomic regions of China. These disparities between China and high-income countries include younger age at onset of breast cancer; the unique one-child policy; lower rates of provision and uptake for screening for breast cancer; delays in diagnosis that result in more advanced stage of disease at presentation; inadequate resources; and a lack of awareness about breast cancer in the Chinese population. Finally, we recommend key measures that could contribute to improved health outcomes for patients with breast cancer in China.
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Affiliation(s)
- Lei Fan
- International Breast Cancer Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Breast Surgery, Cancer Center and Cancer Institute, Fudan University, Shanghai, China
| | - Kathrin Strasser-Weippl
- International Breast Cancer Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Oncology, Hematology and Palliative Care, Wilhelminen Hospital, Vienna, Austria
| | - Jun-Jie Li
- International Breast Cancer Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Breast Surgery, Cancer Center and Cancer Institute, Fudan University, Shanghai, China
| | - Jessica St Louis
- International Breast Cancer Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dianne M Finkelstein
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ke-Da Yu
- Department of Breast Surgery, Cancer Center and Cancer Institute, Fudan University, Shanghai, China
| | - Wan-Qing Chen
- National Office for Cancer Prevention and Control, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhi-Ming Shao
- Department of Breast Surgery, Cancer Center and Cancer Institute, Fudan University, Shanghai, China
| | - Paul E Goss
- International Breast Cancer Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, Liedke PER, Pramesh CS, Badovinac-Crnjevic T, Sheikine Y, Chen Z, Qiao YL, Shao Z, Wu YL, Fan D, Chow LWC, Wang J, Zhang Q, Yu S, Shen G, He J, Purushotham A, Sullivan R, Badwe R, Banavali SD, Nair R, Kumar L, Parikh P, Subramanian S, Chaturvedi P, Iyer S, Shastri SS, Digumarti R, Soto-Perez-de-Celis E, Adilbay D, Semiglazov V, Orlov S, Kaidarova D, Tsimafeyeu I, Tatishchev S, Danishevskiy KD, Hurlbert M, Vail C, St Louis J, Chan A. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15:489-538. [PMID: 24731404 DOI: 10.1016/s1470-2045(14)70029-4] [Citation(s) in RCA: 331] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement.
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Affiliation(s)
- Paul E Goss
- Harvard Medical School, Boston, MA, USA; Avon Breast Cancer Center of Excellence, Massachusetts General Hospital, Boston, MA, USA.
| | | | - Brittany L Lee-Bychkovsky
- Harvard Medical School, Boston, MA, USA; Department of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA; International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Lei Fan
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Junjie Li
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Yanin Chavarri-Guerra
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pedro E R Liedke
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Oncologia Hospital de Clínicas de Porto Alegre and Instituto do Cancer Mãe de Deus, Porto Alegre, Rio Grande do Sul, Brazil
| | - C S Pramesh
- Department of Surgical Oncology/Clinical Research, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Tanja Badovinac-Crnjevic
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; University Hospital Zagreb, Department of Oncology, Zagreb, Croatia
| | - Yuri Sheikine
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Zhu Chen
- State Key Lab of Medical Genomics, Shanghai Institute of Hematology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You-lin Qiao
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiming Shao
- Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Daiming Fan
- Fourth Military Medical University, State Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, Xi'an, Shaanxi Province, China
| | - Louis W C Chow
- Organisation for Oncology and Translational Research, Hong Kong, China; UNIMED Medical Institute, Comprehensive Centre for Breast Diseases, Hong Kong, China
| | - Jun Wang
- Institute of Public Health Economics and Management, Central University of Finance and Economics, Beijing, China
| | - Qiong Zhang
- Department of Economics, School of Economics, Central University of Finance and Economics, Beijing, China
| | - Shiying Yu
- Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gordon Shen
- University of California, Berkeley, CA, USA; Cancer Institute & Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Arnie Purushotham
- King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK
| | - Richard Sullivan
- King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK; Institute of Cancer Policy, King's College London, Guy's Hospital, London, UK
| | - Rajendra Badwe
- Administration, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Shripad D Banavali
- Department of Medical and Pediatric Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Reena Nair
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Lalit Kumar
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Purvish Parikh
- Clinical Research and Education, BSES GH Municipal Hospital, Mumbai, India
| | | | - Pankaj Chaturvedi
- Department of Head and Neck Surgery, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Subramania Iyer
- Amrita Institute of Medical Sciences & Research Centre, Head & Neck/Plastic & Reconstructive Surgery, Kochi, Kerala, India
| | | | | | - Enrique Soto-Perez-de-Celis
- Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Dauren Adilbay
- Astana Oncology Center, Head and Neck Oncology, Astana, Kazakhstan
| | - Vladimir Semiglazov
- Reproductive System Tumors Department, NN Petrov Research Institute of Oncology, St Petersburg, Russia
| | - Sergey Orlov
- Department of Thoracic Oncology, Saint Petersburg Medical University, Saint Petersburg, Russia
| | | | - Ilya Tsimafeyeu
- Russian Society of Clinical Oncology, Kidney Cancer Research Bureau, Moscow, Russia
| | - Sergei Tatishchev
- Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
| | | | - Marc Hurlbert
- Avon Foundation Breast Cancer Crusade, New York, NY, USA
| | - Caroline Vail
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica St Louis
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Arlene Chan
- Breast Cancer Research Centre-Western Australia and Curtin University, Perth, WA, Australia
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Current understanding on antihepatocarcinoma effects of xiao chai hu tang and its constituents. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:529458. [PMID: 23853661 PMCID: PMC3703324 DOI: 10.1155/2013/529458] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/25/2013] [Accepted: 05/27/2013] [Indexed: 02/07/2023]
Abstract
Xiao Chai Hu Tang (XCHT), a compound formula originally recorded in an ancient Chinese medical book Shanghanlun, has been used to treat chronic liver diseases for a long period of time in China. Although extensive studies have been demonstrated the efficacy of this formula to treat chronic hepatitis, hepatic fibrosis, and hepatocarcinoma, how it works against these diseases still awaits full understanding. Here, we firstly present an overview arranging from the entire formula to mechanism studies of single herb in XCHT and their active components, from a new perspective of "separation study," and we tried our best to both detailedly and systematically organize the antihepatocarcinoma effects of it, hoping that the review will facilitate the strive on elucidating how XCHT elicits its antihepatocarcinoma role.
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