Article type
Year
Abstract
Introduction: Approximately 50% of cancer patients seek alternative therapies. In 1995, the University of Texas - Houston Center for Alternative Medicine Research, was funded by NIH to 1) review the state of the science of these treatments, 2) establish a research agenda, and 3) facilitate research. With increasing prevalence of use and promotion of these therapies, critical evaluation is needed.
Objective: To present current evidence and assess the state of the science.
Methods: Four modalities were assessed: herbal therapies, biologic/organic therapies, chemical/pharmacologic therapies, and special regimens. Agents were selected by recommendations from experts in the field, classified by research methodology, and prioritized according to screening criteria (i.e., prevalence of use, theory, toxicity.) Search strategy: Medline, Cancerlit, Embase, and Current Contents searches were expanded by scanning the Internet, alternative medicine (AM) journals and books, lay press and government publications. Furthermore, references for specific agents were supplemented by informal reports, site visits and unpublished documents. Selection criteria: Articles were considered applicable if they reported original data, investigated immunological effects or toxicity of the agent, reported clinical efficacy or reviewed background information. The studies were classified according to the strength of the evidence from experimental to clinical data and from anecdotal to randomized clinical trials. Data collection and analysis: Each agent was classified by study type 1) Clinical (human), 2) Experimental (in vivo and in vitro) and 3) Other. Human studies were classified by study design: randomized clinical trial (RCT), cohorts (ie, retrospective, prospective uncontrolled or with historical or internal controls), case control, clinic series, case report, or best case.
Results: Of the 6,085 articles identified for 24 therapies, 3613 were applicable to cancer, and 2495 were retrieved. Of these, 2105 articles were derived from peer review or scientific publications including foreign journals, 56 from government and symposium reports, 133 from AM Journals, 33 from books, 99 from lay press and 69 from other sources including unpublished reports. The number of articles related to cancer ranged from 8 to 474 per therapy. Overall, 494 clinical and 1126 experimental studies were retrieved. The greatest volume of experimental data was in traditional Chinese medicine (TCM) (n=211), green tea (n=165), garlic (n=109), and mistletoe (n=102); the greatest volume of clinical data were in melatonin (n=95), TCM (n=74), and mistletoe (n=44).
Discussion: Despite the broad use of alternative cancer treatments, a paucity of data exists on safety and efficacy (i.e., clinical outcomes, quality of life, and symptoms). Additional efforts must be directed towards prioritization of the most promising agents and research with valid endpoints.
Objective: To present current evidence and assess the state of the science.
Methods: Four modalities were assessed: herbal therapies, biologic/organic therapies, chemical/pharmacologic therapies, and special regimens. Agents were selected by recommendations from experts in the field, classified by research methodology, and prioritized according to screening criteria (i.e., prevalence of use, theory, toxicity.) Search strategy: Medline, Cancerlit, Embase, and Current Contents searches were expanded by scanning the Internet, alternative medicine (AM) journals and books, lay press and government publications. Furthermore, references for specific agents were supplemented by informal reports, site visits and unpublished documents. Selection criteria: Articles were considered applicable if they reported original data, investigated immunological effects or toxicity of the agent, reported clinical efficacy or reviewed background information. The studies were classified according to the strength of the evidence from experimental to clinical data and from anecdotal to randomized clinical trials. Data collection and analysis: Each agent was classified by study type 1) Clinical (human), 2) Experimental (in vivo and in vitro) and 3) Other. Human studies were classified by study design: randomized clinical trial (RCT), cohorts (ie, retrospective, prospective uncontrolled or with historical or internal controls), case control, clinic series, case report, or best case.
Results: Of the 6,085 articles identified for 24 therapies, 3613 were applicable to cancer, and 2495 were retrieved. Of these, 2105 articles were derived from peer review or scientific publications including foreign journals, 56 from government and symposium reports, 133 from AM Journals, 33 from books, 99 from lay press and 69 from other sources including unpublished reports. The number of articles related to cancer ranged from 8 to 474 per therapy. Overall, 494 clinical and 1126 experimental studies were retrieved. The greatest volume of experimental data was in traditional Chinese medicine (TCM) (n=211), green tea (n=165), garlic (n=109), and mistletoe (n=102); the greatest volume of clinical data were in melatonin (n=95), TCM (n=74), and mistletoe (n=44).
Discussion: Despite the broad use of alternative cancer treatments, a paucity of data exists on safety and efficacy (i.e., clinical outcomes, quality of life, and symptoms). Additional efforts must be directed towards prioritization of the most promising agents and research with valid endpoints.