Ikeda E. Beatrix Collins Clare E. Alvaro Frank Marshall Glenn Garg Manohar L.

This cross-sectional study describes oxidative stress and antioxidant status in 54 pediatric oncology patients undergoing chemotherapy. Plasma 8-iso-prostaglandin-F2α (8-iso-PGF2α), vitamins A and E and β-carotene, and erythrocyte activities of superoxide dismutase and glutathione peroxidase levels were assessed. One-third of the patients (34%) had plasma 8-iso-PGF2α levels higher than the upper limit of the normal range (> 40 ng/mL). The majority (> 80%) had plasma levels of vitamins A and E and β-carotene within the normal range. Superoxide dismutase activity was lower than the reference range (< 2.4 U/mg Hb) in all patients, whereas erythrocyte glutathione peroxidase activity was lower than the reference range in 46%. Advanced-stage cancer was associated with increased lipid peroxidation but treatment-related factors or use of dietary supplements was not, suggesting that the oxidant-antioxidant balance may be disturbed in a large proportion of this group. Prospective studies would establish whether antioxidant supplementation plays a role in clinical treatment for pediatric oncology patients.

Hamilton Ann S. Cockburn Myles G. Chen Xinguang Deapen Dennis

The major objective of this study was to determine the prevalence and determinants of the use of complementary and alternative medicine (CAM) in cancer patients. A telephone survey was conducted of 443 racially diverse patients from Los Angeles County, with breast, colorectal, bladder, or ovarian cancer; patients were diagnosed in 1995 to 1996 and interviewed 4 to 5 years later. Univariate and multivariate analysis methods were used.At least one type of CAM was used by 57.9% of respondents. Vitamins/supplements/herbs were used by 33% of patients, whereas 30% relied on spiritual healing. Younger patients and those whose religious beliefs affected their decisions were more likely to use CAM. Most used CAM to improve quality of life and felt that these therapies were very effective.More research is needed to evaluate the effectiveness of CAM, especially including measures of quality of life.

Phipps Sean Dunavant Maggi Gray Elizabeth Rai Shesh N.

Children undergoing hematopoietic stem cell transplantation (HSCT) experience high levels of somatic and affective distress despite aggressive supportive care. We examined whether a massage intervention could reduce the distress experienced by children undergoing HSCT, while at the same time comparing the effects of massage provided by professional massage therapists versus that provided by parents. A total of 50 children undergoing HSCT were randomized to professional massage, parent massage, or a standard care group. Measures of somatic distress and mood disturbance obtained by patient, parent, and nurse reports represented the primary outcomes. Secondary outcomes involved the use of antinausea and narcotic pain medications, days spent in hospital, and days to engraftment.No significant differences were observed between the two massage interventions on the primary outcomes, nor were there significant differences between either massage group and standard care, although there were descriptive trends suggestive of benefit, some of which approached significance. Larger differences emerged on the outcomes of days in hospital and days to engraftment, pointing to the potential cost-benefits of a massage intervention in this setting. These findings should be appreciated in the context of a pilot study based on a small sample with an unbalanced design.

Willison Kevin D.

Many of the ideological orientations within the framework of primary health care (PHC) mirror orientations inherent in the practices of complementary and alternative medicine (CAM). Both seek improved outcomes for their clients, especially those with chronic disease, and both are oriented towards disease management, rehabilitation, and self-care to enhance health and wellness. With PHC reform in full swing in countries such as Canada, addressing its link to CAM is more important than ever. In fact, given the ideological similarities between these complex and evolving paradigms, PHC reforms have real potential to encourage CAM use even further. Since the prevalence of CAM use in cancer patients is well-documented, its link with PHC reform is an important and timely issue.

Augusto Feio Farias Rômulo Pajón González Raimundo Leyva Albert Aparecida Medeiros Maciel Maria da Cunha Pinto Ângelo Florêncio da Veiga Jr Valdir Pessoa Claudia Odorico Moraes Manoel

Chromatographic fractions of the medicinal plant Croton cajucara Benth. were studied in human promyelocytic leukemia HL-60 cells for antiproliferative and cell differentiation-inducing properties. The chromatographic fractions F26-30, F39-42 , F50-51, and F60-66, but not 19-nor-clerodane diterpene trans-dehydrocrotonin (t-DCTN) alone, inhibited cell proliferation based on IC50 values (the concentration that inhibits the 50% of cell proliferation) obtained using the 3-(4,5-dimethylthiazol-2-yl) diphenyltetrazolium bromide (MTT) assay. These fractions also inhibited 5-bromodeoxyuridine incorporation, indicating that the growth-inhibitory effect involved the inhibition of deoxyribonucleic acid synthesis. The same fractions induced morphologic changes and caused significant nitroblue tetrazoli-um reduction in HL-60 cells as well. In summary, the results of this study demonstrate that the chromatographic fractions of Croton cajucara contain substances differing from t-DCTN that inhibit cell proliferation and also induce cell differentiation in HL-60 cells.Further studies are warranted to define the contribution of each component to these pharmacologic activities of the fractions.

Wiwanitkit Viroj

The use of complementary and alternative medicine (CAM) is common in the general population, including patients with cancer. The main objective of this study was to determine the frequency of the use of CAM by patients with cancer in Thailand.During the year 2000, I performed an interview survey on 120 patients with cancer. Data were collected on prevalence and patterns of CAM use. Of the 120 patients (68 males and 52 females), 92 (76.7%) used CAM and 84 (70%) visited a CAM provider. The most commonly used CAM detected in the study was a ritual remedy from Buddhist temples (87 cases, 72.5%), followed by a novel regime, a biophysical approach (80 cases, 66.7%). Most patients used more than one CAM. The most common source of information on CAM was friends (80 cases, 66.7%).In conclusion, CAM is frequently used by patients with cancer in Thailand and their physicians need to be aware of this possibility. A similar pattern is expected for patients with cancer in other Asian countries.