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Oncology > Other Alternative Therapies > Flashcards

Other Alternative Therapies Flashcards

1
Q

What is anthroposophic medicine?

A

Developed by Rudolf Steiner and Ita Wagman; holistic medicine combining homeopathy, bot, nutrition, music, etc w/ conventional medicine

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2
Q

Which mistletoe preparations are available in NA?

A

Iscador, Helixor

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3
Q

What are the types of Iscador and where are they harvested from?

A

Q for quercus (=oak)
M for mali (=apple)
P for pinus (=pine)

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4
Q

What are the types of Helixor and where are they harvested from?

A

A for abies (=fir)
M for mali (=apple)
P for pinus (=pine)

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5
Q

Studies on Mistletoe have included…?

A

33 RCTs, 18 non-randomized trials, 18 prospective single-arm studies, 4 retrospective studies

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6
Q

Results of Mistletoe therapy have mostly been ____, but results have been questioned because ____?

A

positive; they’re of low quality

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7
Q

Why have few mistletoe trials been blinded?

A

Red reaction at he injection site is very common

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8
Q

What does the best evidence for Mistletoe exist for?

A

Improving QOL and tolerability of chemo and radiation (in N/V, fatigue, sleep, appetite, emotional well-being, difficulty concentrating)

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9
Q

The best study on mistletoe was ___ and showed ___

A

220 pt RCT w/ locally advanced or metastatic pancreatic comparing mistletoe and no treatment; better survival, better QOL, weight increased

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10
Q

Mistletoe cautions

A

Serious a/e

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11
Q

IV Vit C mechanism

A

Exact is unknown
Accepted current - interacts with iron to create h202 (low dose)
Direct cytotoxic effects on cancer cells (high dose)

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12
Q

Why is Vit C selectively toxic to cancer cells?

A

Cancer cells can’t produce enough calylase and glutathione peroxidase enzyme to convert H2O2 –> H20

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13
Q

Studies on Vit C have included…?

A

2 RCTs, 11 small pilot trials, retrospective cohort and case reports

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14
Q

IV C combined with gemcitabine in advanced pancreatic cancer showed…?

A
  • no difference but likely underestimated effects (n=9, + erlotinib)
  • Mitigated side effects, increased progression free and overall survival vs average in this pop (n=9)
  • Increased progression free and overall survival vs institutional average (n=14)
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15
Q

IV C w/ paclitaxel and carboplatin in ovarian cancer showed…?

A

May increased survival and time to relapse, decreased grade 1 and 2 toxicities (n=25)

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16
Q

IV C w/ CHASER regimen in Non-Hodkin’s lymphoma showed…?

A

No obvious a/e

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17
Q

IV C w/ temozolomide, surgery, and radiation, in glioblastoma showed…?

A

Possible increased survival (n=11)

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18
Q

IV C w/ platinum chemo in advanced NSCLC showed…?

A

Increased disease control and objective response vs historical control (n=14)

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19
Q

IV C w/ hyperthermia and supportive care in refractory NSCLC showed…?

A

Prolonged progression free and overall survival, QOL, compared to supportive (n=97) care

20
Q

IV C w/ FOLFOX or FOLFIRI in colorectal/ gastric cancer showed…?

A

Decreased all-grade and grade 3&4 marrow and GI toxicities, possible increase in objective response rate and disease control rate (n=36)

21
Q

IVC in various advanced cancers showed…?

A
  • w/ chemo (n=14), was safe and well tolerated, some showed unexpected transient stable dz, improved function
  • in cancers w/ unresponsive bone metastases, reduced pain and increased increased median survival (n=11)
22
Q

Which chemotherapy should Vitamin C be avoided with?

A

Bortezomib

23
Q

What dosing schedule should IV C be used in combo with chemo?

A

5 half-lives awy from chemotherapy

24
Q

How should IV C be combined with radiation therapy?

A

It should not; use after radiation is complete

25
Q

IV C A/E

A
  • Overall quite safe
  • self-limiting nausea, HA, lightheadedess, dry mouth
  • Falsely elevates blood sugar
  • Can chelate metals
26
Q

IV C cautions and CI

A
  • CI G6PD deficiency (over 15 g)
  • CI Renal insufficiency, hemodialysis, iron overload
  • Caution history of oxalate kidney stones
  • Caution fluid overload
27
Q

Essiac evidence for safety

A

Generally safe - Case reports, in vitro studies, 1 animal model

28
Q

Essiac evidence for effectiveness

A

No proven effects in human or animal studies, some in vitro

29
Q

Hoxsley formula safety

A

Tincture may worsen nausea and diarrhea, salve can cause burns
Avoid in estrogen sensitive cancers
May interfere with some chemo

30
Q

Hoxley formula efficacy

A

None proven in humans or animals, case reports invalid

31
Q

PolyMVA safety

A

Unknown

32
Q

PolyMVA efficacy

A

None proven (anecdotal reports), some animal evidence for antioxidant effect

33
Q

Shark cartilage safety

A

Human trials show safety at therapeutic doses

34
Q

Shark cartilage efficacy

A

Increased survival in multiple myeloma and renal cell (phase II)
No effect in well designed phase III trial

35
Q

Graviola safety

A

Lowered platets in rats, may cause Parkinson-like disease

36
Q

Graviola efficacy

A

No studies in human or animal cancers

37
Q

Amygdalin/ Laetril safety

A

a/e effect of cyanide poisoning, especially in oral forms

CI combination with amygdalin

38
Q

Amygdalin/ Laetril efficacy

A

Clinical trials and cochrane review concluded no benefit

39
Q

Blue Scorpion venom safety

A

No documented effects, but have not been assessed

40
Q

Blue scorpion venom (Escozine or Escozul) efficacy

A

No clinical trials on humans, some animal trials. Rejected by cuban govt.
chlorotoxin (CTX) may facilitate chemo entry into tumors
CTX as ‘tumour paint’

41
Q

Cannabis efficacy

A

Preclinical evidence about efficacy around cancer/ cancer tx side effects: N/V, anorexia, pain, insomnia
Animal studies with good results on advanced cancers, but none in humans

42
Q

Cannabis safety

A

Non-serious side effects more common, m/c dizziness

43
Q

Cesium chloride efficacy

A

No trials; some case reports

44
Q

Cesium chloride efficacy

A

Case reports suggest high toxicity, can cause hypokalemia

45
Q

Dichloroacetate efficacy

A

3 phase 1 trials
May have efficacy in brain cancer
No effect on advanced solid tumors

46
Q

Dichloroacetate safety

A

Peripheral neuropathies common

Oncology (7 decks)

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