Cancer and quality of life

Cancer and quality of life

Homeopathy (2016) 105, 287e288 Ó 2016 Published by Elsevier Ltd on behalf of The Faculty of Homeopathy. http://dx.doi.org/10.1016/j.homp.2016.11.001, ...

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Homeopathy (2016) 105, 287e288 Ó 2016 Published by Elsevier Ltd on behalf of The Faculty of Homeopathy. http://dx.doi.org/10.1016/j.homp.2016.11.001, available online at http://www.sciencedirect.com

EDITORIAL

Cancer and quality of life This issue of Homeopathy features two papers from France looking at the motives of patients with cancer for seeking homeopathic care, and the possible clinical benefits of the homeopathy in terms of treatment compliance in women with early breast cancer. Karine Danno and colleagues report an observational study including 644 patients with a range of primary tumours, studied over three years. Of these, 399 consulted 112 conventional general practitioners and 245 consulted 73 homeopathic general practitioners. The most frequent primary site was breast (30%); colorectal, prostate and genitourinary tumours were the next most frequent tumours in the study population. In line with other studies comparing patients who attend homeopathic family physicians with those who do not, those who attended homeopathic physicians were more likely to be female with higher educational attainment. They also tended to be younger and to have an executive or intellectual profession. At inclusion all patients completed the standard European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (QLQ-C30) and Hospital Anxiety and Depression Scale (HADS) questionnaires. The homeopathic patients were more likely to be constipated; beyond this were no important differences at baseline. Their motives for consulting a homeopathic GP were ‘overall care’ and adverse effects of cancer treatment. Those consulting conventional GPs did so in order to receive psychological care and for additional information on oncologists’ treatment decisions. Conventional GPs prescribed psychotropic drugs more than twice as frequently as homeopathic GPs (54% vs 22%). The most frequently prescribed homeopathic medicines were Ignatia amara, Nux vomica and Gelsemium sempervirens. While this study tells us nothing about the outcomes of homeopathic treatment in patients with cancer, it provides useful data on the motives and demographics of patients with a cancer diagnosis seeking homeopathic treatment and about the prescribing of homeopathic doctors in this situation.1

with early breast cancer, for three months. The study was conducted at two centres, one of which used the homeopathic treatment and the other did not, with 20 women recruited at each. The homeopathic group did better with a slight fall in composite pain score over three months compared to a rise in the control group; this was statistically highly significant. 45% of control group patients compared to 5% of homeopathic patients increased their analgesics and the homeopathic patients also reported better sleep. This study was small scale and non-randomised but is of interest since it suggests that a simple homeopathic regime has significant benefits in terms of the commonest adverse effect of a widely used treatment for a common malignancy. Clearly further investigation is warranted.3

In vitro effects of homeopathic dilutions on malignant cell lines Separately, Ruta graveolens has been reported to have selective effects on malignant cells, not affecting normal cells; similar claims have been made for several other ultra dilute homeopathic preparations.4,5 Terminalia chebula, a tree used for medicinal purposes in south Asia, now joins the list of homeopathic preparations for which this property is claimed. In this issue Ruchika Kaul-Ghanekar and colleagues report that the mother tincture of Terminalia chebula decreased the viability of both breast cancer and noncancerous cell lines while homeopathic dilutions of the same plant decreased the viability only of breast cancer cells without affecting that of non-cancerous cells.6 These are remarkable claims of great potential interest, but there are several such claims for different medicines in various malignant cell lines, none of which appears to have been independently reproduced. This area of research begs for more focused repetition, and must be distinguished from the clinical observations of Karp et al.

Ruta, aromataseinhibitors and cancer

Patient reported outcomesinlong term conditions

Joint pain is the commonest adverse effect of the aromatase inhibitors (such as anastrazole) widely used to treat breast cancer: up to half of women on aromatase inhibitors experience joint pain, and as many as 20% become noncompliant because of joint pain.2 In this issue JeanClaude Karp and colleagues report a prospective controlled but non-randomised clinical trial of homeopathic Rhus toxicodendron and Ruta graveolens in joint pain in women

Also in this issue Elizabeth Thompson and colleagues from the Portland Centre for Integrative Care (formerly the Bristol Homeopathic Hospital) report the use of the Measure Yourself Medical Outcome Profile (MYMOP) questionnaire in setting patient centred treatment goals in the routine care of a range of diagnoses. They collected data on nearly 200 patients treated by 20 homeopathic physicians. The most common diagnostic

Editorial P. Fisher

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categories were cancer, psychological problems and genitourinary complaints. Two thirds of the patients had had their problem for a least one year. There were highly significant improvements in their MYMOP scores after attending the Bristol Homoeopathic Hospital. Over half the patients did not attend the full course of treatment but the improvement was statistically highly significant both for completers and for non-completers (corrected for missing data), although those who completed the treatment course did better than those who did not. On average patients had at least moderate clinical improvement. The authors conclude that homeopathy is a low-cost, high impact intervention which extends patient choice and supports their self-care.7

References 1 Danno K, Colas A, Freyer G, et al. Motivations of patients seeking supportive care for cancer from physicians prescribing homeopathic or conventional medicines: results of an observational cross-sectional study. Homeopathy 2016; 105: 289e298. 2 Niravath P. Aromatase inhibitor-induced arthralgia: a review. Ann Oncol 2013; 24: 1e7.

Homeopathy

3 Karp J-C, Sanchez C, Guilbert PW, Mina W, Demonceaux A, Cure H. Treatment with Ruta graveolens 5CH and Rhus toxicodendron 9CH may reduce joint pain and stiffness linked to aromatase inhibitors in women with early breast cancer: results of a pilot observational study. Homeopathy 2016; 105: 299e308. 4 Pathak S, Multani AS, Banerji P, Banerji P. Ruta 6 selectively induces cell death in brain cancer cells but proliferation in normal peripheral blood lymphocytes: A novel treatment for human brain cancer. Int J Oncol 2003; 23: 975e982. 5 Frenkel M, Mishra BM, Sen S, et al. Cytotoxic effects of ultradiluted remedies on breast cancer cells. Int J Oncol 2010; 36: 395e403. 6 Wani K, Shah N, Prabhune A, Jadhav A, Ranjekar P, KaulGhanekar R. Evaluating the anticancer activity and nanoparticulate nature of homeopathic preparations of Terminalia chebula. Homeopathy 2016; 105: 318e326. 7 Thompson E, Viksveen P, Barron S. A patient reported outcome measure in homeopathic clinical practice for long term conditions. Homeopathy 2016; 105: 309e317.

Peter Fisher Editor-in-Chief, Homeopathy E-mail: [email protected]