Complementary Therapies for Mesothelioma | Mesothelioma Applied Research Foundation

Complementary Therapies for Mesothelioma presented by Kathleen Wesa, MD, of Memorial Sloan-Kettering Cancer Center at the Mesothelioma Applied Research Foundation's conference in New York, NY on September 28, 2012. www.curemeso.org

Complementary Therapies for Mesothelioma | Mesothelioma Applied Research Foundation from Mesothelioma Applied Research Foundation

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• 1. Integrative Oncology: Complementary Therapies for MesotheliomaMesothelioma Applied Research Foundation New York, NY September 28, 2012 Kathleen Wesa, MD Integrative Medicine Service Memorial Sloan-Kettering Cancer Center New York, USA
• 2. Alternative vs ComplementaryAlternative Therapies• Promoted for use instead of mainstream treatment for cancer & other serious illnesses• Usually biologically invasive• Costly; potentially harmfulComplementary Therapies• Used WITH mainstream care for serious illnesses• Non-invasive• Inexpensive; safe; evidence-based
• 3. Seven Signs of Voodoo Medicine & Science1. Proponent pitches claim directly to media.2. Claims a powerful establishment is suppressing his work.3. The effect is at the very limit of detection.4. Evidence is anecdotal.5. He works in isolation.6. Says a belief is credible because it has endured for decades or centuries.7. Proposes new laws of nature to explain how it works. From “Seven Signs of Voodoo Science” by Robert Park, physicist, 2003.
• 4. Integrative OncologyCombines the best ofcomplementary and mainstream care
• 5. Complementary Therapiescontrol many symptoms experienced by patients and by people generally • Pain • Hot flashes • Sexual dysfunction • Urinary problems • Fatigue • Xerostomia (dry mouth) • Anxiety, depression, stress • Osteoarthritis • Neuropathy
• 6. 2- Fitness/Physical Activity Essential per data on activity and cancer outcome
• 7. When will we treat physical activity as a legitimate medicaltherapy… even though it does not come in a pill? Church T, Blair SN. Br J Sports Med 2008 Oct 16. 8
• 8. Summary of Exercise-Induced ChangesINCREASED DECREASED• Muscle mass, • Nausea strength & power • Body fat• CV fitness • Fatigue• Max walk distance • Symptom Experience• Immune system • Duration of capacity hospitalization• Physical functional • HR ability • SBP• Flexibility • Psychological &• QOL emotional stress• Hemoglobin • Depression & anxiety
• 9. ACS/ASCM Physical Activity Recommendations for Cancer Survivors• 30+ minutes of moderate to vigorous physical activity, above usual activities, on 5+ days/ wk• 45 to 60 minutes physical activity is preferable• If sedentary, begin with 10 minutes fitness and add 10-15% each wk, total 30 min continuous/5 days per wkACSM New Guidelines Presented at ASCO June 6, 2010
• 10. 3-Nutrition Recommendations
• 11. WCRF/AICR Recommendations1-Be as lean as possible w/o 5-Alcoholic Drinks being underweight • ≤ 2 drinks/day for men and2-Limit consumption of ≤ 1/day for women energy-dense foods• Avoid sugary drinks 6-Preservation,Processing, Preparation3- Plant Foods • Limit salt, avoid moldy cereals• 5+ servings of non-starchy veg and fruits every day 7-Dietary Supplements • Meet nutritional needs through4-Animal Foods diet alone• Limit intake of red meat • Dietary Supplements not and avoid processed meat recommended for cancer prevention
• 12. Dietary Supplements? 13
• 13. Or Substitution?
• 14. 4- Botanicals and Nutritional Supplements• 28+ BILLION dollars are spent each year in the USA on vitamins and nutritional supplements• Antioxidants are highly marketed and are of uncertain benefit, can interact directly with cancer treatments• Wheat grass, Gogi, Noni, AÇAI, Pomegranate, Mangostin, EGCG/green tea, resveratrol, Vitamin A, C and E, selenium
• 15. Herbs and Other Botanicals Benefits and Problems• Faulty Assumptions Natural = safe; Long-term use = effective• Botanicals are unrefined pharmaceuticals• OK for general public, probably not for many cancer patients• Concerns: contamination, toxicity, standardization, bioavailability, proper doses, and adverse herb-drug interactions• Vitamin D may provide benefits aside from osteoporosis prevention and bone health, studies are in progress
• 16. Web site about herbs, botanicals, vitamins, etc.www.mskcc.org/aboutherbs
• 17. Astragalus• Used in TCM for lung ailments• Modern scientific studies show potent immunostimulating effects and cytostatic activities• Chinese herbal medicine containing Astragalus can increase effectiveness and reduce side effects of chemotherapy (McCulloch M. J Clin Oncol. 2006., Taixiang W. Cochrane Database Syst Rev. 2005)• May affect the function of immunosuppressant drugs (Chu DT. J Clin Lab Immunol. 1988)
• 18. Application in Cancer Patients• Pain• Xerostomia (dry mouth)• Neuropathy• Nausea• Fatigue• Hot flashes• Stress/Depression• Bowel Irregularity• Lymphedema
• 19. Acupuncture Needles
• 20. 26
• 21. 6-Types of Mind-Body practices• Meditation- includes mantra, mindfulness and relaxation techniques• Yoga• Tai Chi and Qi-Gong• Hypnosis• Guided Imagery• Breath Awareness• Music Therapy
• 22. Massage Therapy
• 23. Symptom scores before and immediately after massage therapy N=1,290Mean symptom score (0 - 10) 8 7 6 5 4 3 2 1 0 Pain (n=625) Fatigue (n=819) Stress (n=786) Nausea (n=222) Depression (n=378) Pre-treatment Post-treatmentCassileth BR, Vickers AJ. Massage therapy for symptom control: outcome study at amajor cancer center. J Pain Symptom Manage 2004; 28:244-249
• 24. Complementary Medicine at the NIH• Website for Office of Cancer Complementary and Alternative Medicine www.cancer.gov/cam• National Center for Complementary and Alternative Medicine http://nccam.nih.gov
• 25. Summary Eat food Not too much Mostly plants Be physically active every day Discuss all botanical/supplement useAcupuncture can benefit many symptomsDon’t forget the Mind-body interventions
• 26. Thank you for your attention!