Complementary Treatments and Therapies

I believe that we can improve on the treatments offered by conventional medicine. In particular, I believe a healthy lifestyle with the best possible food, plenty of aerobic and resistance exercise, good sleep, and freedom from excessive stress. Beyond that are naturopathic therapies and supplements which might help against the cancer, or especially against the side effects of the cancer or the drugs.

Several papers at this year's ASCO meeting dealt with such complementary therapies, which apparently can improve both the cancer outcome and the patient's quality of life. These are scienfific studies by serious researchers at well-known medical centers, with the papers approved by ASCO's review committee. One of those, a study at MD Anderson, determined that as many as 54% of patients use complementary or alternative medicine in some form. (9091). None of studies below are specific for myeloma patients, but they might to be applicable to anyone in cancer treatment:

• Neuropathy:
  • A study of topical menthol for treatment of peripheral neuropathy concluded that two thirds of patients with long-term neuropathy experienced an improvement in pain and function. (9129). I'm thinking it would smell good too.
  • Another study, of electrostimulation with a machine called the MC5-A Calmare therapy device, seemed to show that it "appears to dramatically reduce pain in refractory CIPN (neuropathy) patients with no toxicity." (9029). For a few patients, pain was reduced to zero after ten daily treatments. Normally I would be skeptical of such a study with a specific machine, wondering about the objectivity of the authors. They do not report any conflicts, though, so maybe it's worth a try. But I wouldn't buy the machine - better to find a therapist who already has one.
  • There is no rule saying that a person in pain can't try both of these, along with the other naturopathic remedies that are out there.
  
  
• Fatigue:
  • Guarana is a plant native to the Amazon basin that has been used as a stimulant since pre-Columbian times. Patients in a Brazilian cancer center were given 50 mg of guarana extract twice daily, and the researchers reported "Guarana is an effective, cheap and nontoxic alternative for the treatment of fatigue in breast cancer patients receiving systemic chemotherapy." (9007).
  • Rochester researchers studied 410 survivors of many different cancers and found that "YOCAS yoga intervention significantly improves sleep quality, fatigue, and quality of life while reducing sleep medication use among survivors." (9013).
  • The Bangalore Institute of Oncology studied 66 metastatic breast cancer survivors and concluded "The results offer preliminary support for stress reduction benefits of yoga intervention. However larger randomized controlled trials are needed to validate these findings." This study even found that yoga increased the number of NK (natural killer) cells, suggesting a possible clinical benefit beyond just quality of life. (9099).
  
  
• Actual Therapy (this is probably not "complementary" but an interesting use of an inexpensive natural substance): Mistletoe extract. A consortium of cancer centers studied 44 patients with a variety of advanced solid tumors (breast, prostate, ...) using a combination of mistletoe extract (EMEX) with a drug called gemcitabine (GEM), concluding "The EMEX/GEM combination demonstrated limited toxicity, no alterations of GEM Cp during infusion of EMEX, clinical benefit in 48% of patients, good tolerability and excellent EMEX compliance. Addition of EMEX may allow for use of higher doses of GEM and increase the (minimum neutrophil count)." (2559). Note that the work was done with solid tumors and may have no application to myeloma.

(2559) NCCAM/NCI phase I study of mistletoe extract and gemcitabine in patients with advanced solid tumors.
(9007) Effect of guarana (Paullinia cupana) on fatigue in breast cancer patients undergoing systemic chemotherapy.
(9013) Effect of YOCAS yoga on sleep, fatigue, and quality of life: A URCC CCOP randomized, controlled clinical trial among 410 cancer survivors.
(9029) Pilot trial of a patient-specific cutaneous electrostimulation device (MC5-A Calmare) for chemotherapy-induced peripheral neuropathy.
(9091) The use of complementary and alternative medicine in patients seen in phase I clinical trials program.
(9099) Role of yoga in modulating fatigue, sleep disturbances, salivary cortisol, and immune measures in breast cancer survivors: A randomized controlled trial.
(9129) Treatment of chemotherapy-induced peripheral neuropathy (CIPN) with topical menthol: A phase I study.