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J Korean Med Assoc > Volume 51(5); 2008 > Article
Choi: Complementary Therapy for Improvement of Quality of Life in Cancer Patients

Abstract

Complementary Therapy for Improvement of Quality of Life in Cancer Patients. As a results of reviews of database for effects of complementary therapies for improvement of Quality of Life on cancer patients, there were 8 mind?body therapies, 2 manual based therapies, 17 biologic based therapies(3 vitamin or minerals, 6 health nutrient products, 8 herbs). There were relative much more proportional studies of mind?body therapies and manual based therapies for quality of life of cancer. It were reported much more positive results in cognitive behavioral therapy, meditation, art therapy, music therapy, yoga included to mind-body therapies also it were reported much more positive result in massage & acupressure included to manual based therapies. And then these findings can be considered to us clinical application of these therapies by additional studies. On the other hand, the amount of study for quality of life of cancer in biologic based therapies was relatively more smaller than mind?body therapies and the results were contrary to each other. The mistletoe, one of the biological therapeutic products, can be considered to relatively useful material as a results of this review and its seems like to have positive value for further study, materials such as honey, ginseng or heat?treated ginseng, AHCCR, selenium. The others of biologic based therapies were inconclusive due to relatively small amounts of studies or revealed negative conclusion or negative tendency by their studies. The high usual rate of complementary therapy in cancer patients in Korea is applying the screw to us study for complementary medicine and is producing needs of complementary closed co?works or cooperation between the citizens, the government, medical doctors for high quality study.

Table 1.
Summary of studies of mind body therapy and manual therapy for cancer QoL
Therapy Study design* Quality Cancer type Target variable Effect direction Comment
Acupressure 2RCT* 1+ breast ca CTx induced N/V positive p6 acupressure
Art therapy 2RCT 1++ various cancer QoL
Psychosocial distress, depression, anxiety
positive 1RCT: combined with meditation
Biofeedback 1RCT 1++ prostatic cancer postop urinary incontinence negative similar effect size compaired with conventional Tx
Cognitive behavioral therapy 5SR 24RCT 1+ ∼ 1++ + various cancer 1.QoL
2. pain
3. Sx severity
4. immune function
5. depression, anxiety
1∼4: positive
5: negative
 
Massage 1SR
6RCT
1+ ∼ 1++ + various cancer 1. CTx induce N/V
2. lymph edema
3. pain
4. anxiety
5. QoL
6. depression
1∼4: positive
5∼6: negative
anxiety: at least short term effect
Mindfulness meditation 1SR 2RCT 1COH 3CBA 2- ∼ 1+ various cancer QoL stress mood state positive generally low quality studies
Music therapy 2SR 1+ ∼ 1++ + various adult & pediatric cancer 1. pain
2. Post OP opoid dose
3. psycho, physiologic Sx
1,3: positiv
2. positive, low effect size
no sig. difference between simple music & music therapy
Qigong 1SR
1CBA
2++ 2- various cancer QoL
CTx side effects
positive not high quality studies included in SR
Tai Chi 1SR 1++ breast cancer QoL
physical perfomance
negative similar effect size compaired with walking exercise
Yoga 3RCT 1+ ∼ 1++ + breast cancer lymphoma 1. QoL
2. sleep
3. N/V
4. anxity, depression, fatigue
1∼3: positi
4: negative
 

* RCT: randomized control trial, SR: systematic review, COH; cohort study, CBA: controlled before and after study, BA: noncontrolled before and after study

† evidence: levels of evidence by SIGN (Scottish Intercollegiate Guidelines Network)

1++ High?quality meta?analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias

1+ Well?conducted meta?analyses, systematic reviews of RCTs, or RCTs with a low risk of bias

1- Meta?analyses, systematic reviews of RCTs, or RCTs with a high risk of biasa

2++ High?quality systematic reviews of case?control or cohort studies. High?quality case?control or cohort studies with a very low risk of confounding, bias or chance and a high probability that the relationship is causal

2+ Well?conducted case?control or cohort studies with a low risk of confounding, bias or chance and a moderate probability that the relationship is causal

2- Case?control or cohort studies with a high risk of confounding, bias, or chance and a significant risk that the relationship is not causal

Table 2.
Summary of studies of natural health products & vitamin & minerals for cancer QoL
Therapy Study design* Evidence Cancer type Target variable Effect direction comment
Agaricus 1RCT 1- gynecologic cancer NK cell, CTx side effects all positive  
AHCC 2RCT 1+ hepatoma, prostatic cancer QoL, pain positive  
Aloae 2 SR 1+ pediatic cancer breast cancer head & neck cancer RTx induced dermatitis or mucositis prevention negative  
Aromatherap py 1RCT 1++ various cancer Depression Anxiety all negative  
Astragalus 2 SR 1+ ∼ 1++ colon cancer lung cancer Physical activity or Cx improve positive combined several herbal effect with astragalus
Cranberry 1RCT 1+ prostatic cancer RTx induced urologic Sx (IPSS) negative  
Enzyme therapy RCT 1++ breast cancer lymphatic edema all negative lowered tension & CRP
Ginseng 1RCT, 1CO OH 1+ ∼ 2++ various cancer breast cancer QoL positive  
Honey 2RCT 1+ 1- head & neck cancer breast cancer RTx induced mucositis RTx induced dermatitis positive  
Lycopen BA 2+ prostate cancer QoL positive improvement of performance, urinary tract Sx, bone pain
Mistletoe 1SR 1++ various cancer QoL CTx side effects all positive  
Multivitamin RCT 1+ breast cancer fatigue d/t RTx negative  
Omega 3 2SR 2RCT 1- ∼ 1++ 1+ ∼ 1++ various cancer Cachexia negative partially weight gain effect
Selenium SR** 1+ various cancer breast cancer infection diarrhea d/t RTx positive  
Shark RCT 1+ colon & breast cancer r QoL negative  
Soy 2RCT 1RCT 1- ∼ 1++ 1++ breast cancer 2 Facial flushing menopausal Sx all negative  
Zinc 2RCT* 1- head & neck cancer appititis after RT negative low quality studies

* RCT: randomized control trial, SR: systematic review, COH; cohort study, CBA: controlled before and after study, BA: noncontrolled before and after study

† evidence: levels of evidence by SIGN (Scottish Intercollegiate Guidelines Network)

1++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias

1+ Well-conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias

1- Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of biasa

2++ High-quality systematic reviews of case-control or cohort studies. High-quality case-control or cohort studies with a very low risk of confounding, bias or chance and a high probability that the relationship is causal

2+ Well-conducted case-control or cohort studies with a low risk of confounding, bias or chance and a moderate probability that the relationship is causal

2- Case-control or cohort studies with a high risk of confounding, bias, or chance and a significant risk that the relationship is not causal

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