Cancer Research
Alternative
& Complementary Therapies
Aromatherapy
& Cancer
The recent Nursing Times survey of nurses
relating to complementary medicine found overwhelmingly that aromatherapy
massage is the most popular form of complementary therapy employed by by
members of the nursing profession(1) . This is understandably so as more
and more research is revealing that aromatherapy essential oils together
with remedial massage offer demonstrable therapeutic benefits for many
patients requiring palliative care including alleviating anxiety in
hospital patients (2), chronic tension headaches (3) and cancer pain(4),
as well as reducing stress perceived by patients in intensive care
units(5).
However, the most recent investigation into
the benefits of aromatherapy massage in palliative care was undertaken by
the Centre for the Study of Complementary Medicine at Countess Mountbatten
House who conducted an audit into the effects of aromatherapy massage on
cancer patients in palliative and terminal care(7).
Consent to the proposed treatment was
obtained from the consultant medical staff and the patients themselves.
Individual patients were referred for the therapy either to aid relaxation
or because they were in pain, anxious or depressed.
Aromatherapy essential oils were
specifically selected by a trained therapist for each individual patient's
needs and diluted to half normal strength, because of fears that the
aromas may have been overpowering for terminally ill patients. The most
frequently used oils were lavender, marjoram and chamomile.
Throughout the period of the study which
commenced in January 1993 for a period of six months, the therapist was
available for treatment for four hours on a weekly basis and administered
the treatment in the ward, with patients either in their beds or sitting
at their bedside, whichever was deemed to be the most comfortable by the
patient.
Sixty nine patients ( 42 female and 27
male) participated in the study and received aromatherapy massage during
their stay at Countess Mountbatten House. None of the patients had
previously experienced hands-on massage, and so to help them adapt to the
treatment , music which had been especially composed for relaxation was
played throughout each session. After each session, the patients were
asked to complete a questionnaire to evaluate the perceived benefits of
the therapy.
The results revealed that eighty one per
cent stated that they either felt 'better' or 'very relaxed' after the
treatment. Sixty two per cent of the patients reported that the benefits
lasted for several hours and a further twenty five per cent stated that
the benefits lasted for more than a day. A majority of eighty one per cent
said that they would like to receive aromatherapy massage more than once a
week, and the same number of patients said that they found the relaxation
music which accompanied the treatment to be helpful.
The researchers themselves confessed that
it is "difficult to provide substantive data from this audit, because
of limited patient availability", and it is also uncertain whether
the benefits were the result of (i) the patient being given individual
attention and care for a period of time, (ii) talking with the therapist
(iii) the effects of touch and massage, (iv) the effects of the
aromatherapy essential oils or (v) the effects of the relaxation music. To
identify the exact catalyst(s) from which benefit was derived, further,
more controlled studies will need to be carried out. However,there is no
doubt that the findings of this initial study are very encouraging and
indicate that most of the patients who received the aromatherapy massage
in this setting benefited from the treatment they received. The report
went on to conclude that the patients "show immense courage in coming
to terms with their illness, and the stresses and strains of its many
side-effects, whilst still retaining their dignity and pride. For these
patients, in particular, aromatherapy massage is of great value."
The team leaders at Countess Mountbatten
House agreed with this sentiment and, after monitoring the results of the
study, stated that they would continue to offer aromatherapy massage to
patients.
(1) Trevelyan J. A True Complement? Nursing
Times 1996; 92: 5, 42-43.
(2) Groer M; Mozingo J; Droppleman P; Davis M; Jolly ML; Boynton M; Davis
K; Kay S. Measures of salivary secretory immunoglobulin A and state
anxiety after a nursing back rub. Appl Nurs Res (UNITED STATES) Feb 1994,
7;1: p2-6
(3) Puustjarvi K; Airaksinen O; Pontinen PJ. The effects of massage in
patients with chronic tension headache. Acupuncture &
Electro-therapeutics Research (UNITED STATES) 1990, 15;2 :159-62.
(4) Ferrell-Tory A.T., Glick O.J. The use of therapeutic massage as a
nursing intervention to modify anxiety and the perception of cancer pain.
Cancer Nursing 1993; 16:2: 93-101
(5) Dunn C, Sleep J, Collett D. Sensing an improvement: an experimental
study to evaluate the use of aromatherapy, massage and rest in an
intensive care unit. Journal of Advanced Nursing. 1995; 21(1):34-40.
(6) B. Evans. An audit into the effects of aromatherapy massage and the
cancer patient in palliative and terminal care. Complementary Therapies in
Medicine (1995) 3, 239-241
A recent investigation into the benefits of aromatherapy massage in
palliative care was undertaken by the Centre for the Study of
Complementary Medicine at Countess Mountbatten House who conducted an
audit into the effects of aromatherapy massage on cancer patients in
palliative and terminal care.
Consent to the proposed treatment was obtained from the consultant
medical staff and the patients themselves. Individual patients were
referred for the therapy either to aid relaxation or because they were in
pain, anxious or depressed.
Aromatherapy essential oils were specifically selected by a trained
therapist for each individual patient's needs and diluted to half normal
strength, because of fears that the aromas may have been overpowering for
terminally ill patients. The most frequently used oils were lavender,
marjoram and chamomile.
Sixty nine patients ( 42 female and 27 male) participated in the study
and the results revealed that eighty one per cent stated that they either
felt 'better' or 'very relaxed' after the treatment. Sixty two per cent of
the patients reported that the benefits lasted for several hours and a
further twenty five per cent stated that the benefits lasted for more than
a day. A majority of eighty one per cent said that they would like to
receive aromatherapy massage more than once a week, and the same number of
patients said that they found the relaxation music which accompanied the
treatment to be helpful.
The team leaders at Countess Mountbatten House were so impressed with
these results that they stated they would continue to offer aromatherapy
massage to patients.
B. Evans. An audit into the effects of aromatherapy massage and the
cancer patient in palliative and terminal care. Complementary Therapies in
Medicine (1995) 3, 239-241
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Massage
& Cancer
On of the top priorities in clinical research
is the evaluation of nursing intervention techniques helping to alleviate
pain. Unfortunately, most of the research on cancer pain relief has been
limited to treatment studies involving the administration of analgesic
drugs. Research is therefore needed to determine which alternative methods
of pain control are effective and under what conditions.
One experimental study examined the
effectiveness of massage as an alternative intervention for cancer pain.
Twenty-eight patients were randomly assigned to a massage or control
group. The patients in the massage group were given a 10 minute back
massage ; whereas the patients in the control group were visited for 10
minutes but received no treatment. Interestingly, male patients responded
more favourably than female patients, showing a significant decrease in
pain level immediately after the massage. However, there were no
significant differences between pain 1 hour and 2 hours after the massage
in comparison with the initial pain. the researchers concluded that, for
the male patients who participated in the study, massage was shown to be
an effective short-term nursing intervention for their pain.
Weinrich SP; Weinrich MC Appl Nurs Res
(UNITED STATES) Nov 1990, 3 (4) p140-5
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Ayurvedic
& Cancer
A study was performed at the Department of
Radiology School of Medicine, University of Colorado Health Sciences
Center, Denver to evaluate the relative efficacy of Maharishi Amrit Kalash
ambrosia (MAK-%) and Maharishi Amrit Kalash nectar (MAK-4) on human
(SK-Mel) melanoma cells in culture. Ethanol extract (EE) of MAK-5
(EE-MAK-5) inhibited the growth in human melanoma cells; however the
aqueous ex-tract (AE) of MAK-5 (AE-MAK-5) was ineffective. Boiling
EE-MAK-5 for 10 minutes or exposing it to light at room temperature for 72
hours did not alter growth-inhibiting potency. Ethanol extract of another
herbal agent, NAK-4 (FE-MAK-4), inhibited growth in human melanoma cells
but again the aqueous ex-tract was ineffective for both cells. These
results suggest that human melanoma growth-inhibiting agents are present
in both EE-MAK-5 and EE-MAK-4.
Prasad ML; Parry P; Chan C: Ayurvedic agents produce differential
effects on murine and human melanoma cells in vitro. Nutr Cancer (United
States) 1993, 20 (1) p79-86
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Oxygen Therapy
& Cancer
Whilst there has been no controlled study into the treatment of cancer
in humans using oxygen therapy, we have received a report from the Echo
(UK) centre of information for oxygen therapies relating to a Dr Kurt W
Donsbach at the Biogenesis Institute in Rosarita Beach, Baja, Mexico who
has reportedly achieved a remission rate exceeding 70% in over 300
patients diagnosed with terminal cancer.
Oxygen therapy is now given to all patients who arrive
at the clinic and, except
for patients who are close to death, they are reported to respond well.
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Acupressure
& Cancer
Despite the use of
antiemetic drugs, chemotherapy commonly causes severe nausea and vomiting in
cancer patients. But scientists have discovered that acupressure may hold
the solution to the problem. Researchers at the Northern Ireland Radio
therapy Centre, Belvoir Park Hospital, Belfast", found that of 105
patients who had failed to respond favourably to drug therapy. Acupressure
succeeded in preventing nausea and vomiting in 66% of the patients and, in
fact, only 6% of the patients failed to benefit from the acupressure
treatment.
The acupressure was given
alongside the antiemetic drugs and although there were no side effects, the
benefit only lasted 6-8 hours. This presented no problems for hospitalized
patients where the treatment could be repeated when needed, but it was a
problem for outpatients. The researchers therefore looked for ways of
extending the antiemetic action of the acupressure and eventually found the
answer. Simply by placing an elasticated wrist band with a stud placed over
the acupuncture point (P6), and pressed regularly every 2 hours alleviating
the feelings of nausea and vomiting for up to 24 hours. The treatment worked
for all (20/20) of the hospitalized patients and 75% (15/20) of outpatients.
(The researchers surmised that the treatment was more effective for
hospitalised patients because, unlike the outpatients, they were regularly
encouraged to press the stud on the acupuncture point.
The researchers concluded
that a commercially available elasticated band with a plastic stud (Sea
sickness Band) would be an effective method of applying pressure to P6 point
and alleviating vomiting and nausea induced by chemotherapy in cancer
patients.
In another study (2),
162 general surgical patients were randomly selected to receive one of three
treatments for post-operative nausea and vomiting:
(i) Acupressure using
elasticated bands containing a plastic button to apply sustained pressure at
the P6 (Neiguan) acupuncture point above the wrist,
(ii) Control dummy bands without the pressure button and,
(iii) Antiemetic injections of prochlorperazine.
All patients received
papaveretum injections as required for pain, and additional prochlorperazine
injections were prescribed if nausea was not controlled in groups 1 and 2.
The severity of nausea was assessed using a linear analogue scale and was
significantly reduced by acupressure in comparison to both the placebo and
drug groups. The incidence of postoperative vomiting, and the need for
unplanned antiemetic injections was also reduced by acupressure, and the
researchers were so impressed by the results that they recommended that
acupressure should be investigated in other clinical situations as well.
(1) Prolongation of the
antiemetic action of P6 acupuncture by acupressure in patients having cancer
chemotherapy. Dundee JW; Yang J Northern Ireland Radiotherapy Centre,
Belvoir Park Hospital, Belfast. J R Soc Med (ENGLAND) Jun 1990, 83 (6)
p360-2,
(2) Postoperative nausea is relieved by acupressure. Barsoum G; Perry EP;
Fraser IA Department of Surgery, Walsgrave General Hospital, Coventry. I R
Soc Med (ENGLAND) Feb 1990, 83 (2) p86-9
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Vegetarianism &
Cancer
Cancer is the second leading cause
of death in Britain, accounting for 25% of all deaths. It has been
estimated that diet may be linked to 30-70% of cancers (Doll, 1990).
Studies have shown vegetarians to suffer less from various other
cancers. Mills (1989) studied the incidence of prostate cancer amongst 14
000 Seventh Day Adventists and found a relationship between increased risk
and increasing animal product consumption. Certain cancers, such as colon,
breast and prostate are clearly diet related.
Mills (1988) also found pancreatic cancer to be associated with
consumption of animal products. Increasing consumption of fruit,
vegetables and pulses was shown to have a protective effect. Rao (1989)
found a vegetarian diet to be protective against oesophageal cancer.
Studies have also shown vegetarians to have lower incidence of lung
cancer. This can be largely attributed to vegetarians tending to be
non-smokers. High consumption of fruit has also shown to be protective
against lung cancer (Fraser, 1991).
Sir Kenneth Calman, Chief Medical Officer, has stated (1997) that
"there is a relationship between eating red meat and cancer".
The Oxford Vegetarian Study found cancer mortality to be 39% lower
among vegetarians compared with meat-eaters (Thorogood, 1994).
A study of 23 000 largely vegetarian Seventh Day Adventists found
cancer mortality rates to be 50-70% of those of the general population for
several cancer sites unrelated to smoking or alcohol (Phillips, 1975).
Professor Nick Day of the University of Cambridge and the European
Prospective Study into Cancer has stated that vegetarians may suffer 40%
fewer cancers than the general population.
The World Cancer Research Fund’s dietary advice to minimise cancer
risk involve reducing the intake of dietary fat and increasing the
consumption of fruits, vegetables and wholegrains.
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Non-Pharmacologic
strategies & Cancer pain.
Health care professionals at 2 Ontario cancer centres were surveyed to
determine their familiarity with, perceptions of and interest in learning
more about non-pharmacologic strategies for the management of cancer pain.
Evidence-based education sessions were then developed for the strategies in
which participants were most interested - acupuncture, massage therapy,
hypnosis . The search yielded 1 randomised controlled trail of acupuncture,
1 of massage therapy and 6 of hypnosis.
The studies of hypnosis suggested that there is much support for its use
in the management of cancer pain. The evidence was either lacking or
less clear for the other therapies examined.
The report concluded that
because patients use a wide variety of non-pharmacologic strategies
regardless of their effectiveness, clinicians need to be familiar with
available research and able to discuss those strategies for which the
evidence is strong, weak or non-existent. More research on the effectiveness
of non-pharmacologic strategies for pain management is needed.
Cancer Prev Control 1998
Feb;2(1):7-14 Sellick SM, Zaza C
Northwestern Ontario Regional Cancer Centre, Thunder Bay. scott_sellick@cancercare.on.ca
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Relaxation/Music
therapy & Cancer pain
OBJECTIVE: Registration of the
influence of musical rhythm on synchronisation and coordination of
heart rate.
DESIGN: Randomized pilot study. PROBANDS: 28 patients with
chronic cancer pain in a stable phase of the disease.
Intervention:14-day training of a relaxation therapy designed for
improving the falling asleep, including a 30-minute lullaby-like,
rhythmically dominated music with gradually decreasing tempi. No
training in the control group.
OUTCOME MEASURES: Continuous registration of heart rate and
comparison with musical beat on day 1 and 15. Analysis of the degree
of synchronisation, i.e. the coordination of systole and musical
central time point (1st beat of the 6/8 time alla breve). Recording
of the time of falling asleep and registration of the patient's
subjective evaluation of the relaxation therapy and the pain
intensity using verbal rating scales. Documentation of the use of
analgetics.
RESULTS: Under the relaxation therapy trained patients showed
an increasing synchronisation and coordination of heart rate and
musical beat. At a musical tempo between 48 and 42 beats per min a
very stable 2 : 3 synchronisation occurred. Trained patients who
reported the best relaxing and analgetic effects showed the highest
degree of synchronisation. Relaxation therapy led to an improvement
of falling asleep and to a decrease in consumption of analgetics.
CONCLUSIONS: Lullaby-like music within a special range of
tempi can induce atrainable synchronisation of heart rate,
functionally associated with the formation and intensity of a
relaxation reaction. Further investigations are promising, however,
substantial improvements in the measurement and documentation
methods are needed.
Forsch
Komplementarmed 1999 Jun;6(3):135-41 Reinhardt U Ambulanz fur
Hamatologie und Onkologie, Klinikum Bayreuth, Germany.
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Complementary
and Alternative Therapies & Cancer
Recent
evidence suggests that at least one cancer patient in three uses some
form of complementary and alternative medicine (CAM). We conducted a
review of the published research on the efficacy of these treatments
for breast cancer, which resulted in some observations about the
current state of research and guidelines for future research. Although
many of the papers reported encouraging results, the preponderance of
phase I and II trials and other limitations precluded definitive
conclusions about the efficacy of the treatments reported in these
studies. A growing institutional base in this country has begun to
facilitate improved research on CAM for cancer, yet many gaps remain.
For example, there are no published reports of clinical trials or
observational studies with survival endpoints for treatment agents
used by many cancer patients. Clinical trials of a few CAM treatments
are now in progress, but the results will not be available for several
years. More complex and customized treatments may require innovative
study designs and practitioner-investigator collaborations. Given the
mounting evidence that CAM treatments are biologically active as well
as widely used, CAM research may affect cancer outcomes.
J Am Med Womens Assoc 1999 Fall;54(4):177-80,
Jacobson JS, Workman SB, Kronenberg F, Herbert Irving Comprehensive
Cancer Center, Columbia University, USA.
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Breakthrough
in skin cancer prevention
A recent
Italian study of sun exposure collating data from France, Germany and
Belgium concludes that melanoma risk was the least if childhood exposure
was low. If adult and childhood exposure remained equal the effect was
much the same as if childhood exposure was high and adult exposure was
low.
This is a definite
inducation as to the wisdom of protecting our children from sun exposure
with a view to reducing the risk of skin cancer in later life.
International Journal of
Cancer 998;77:533-537
Environment and Health News 1998;3:3,p5
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Music
therapy aids relaxation and pain control in cancer patients
Scientists in Germany have investigated the influence of music therapy
upon the heart in cancer patients suffering from chronic pain.
Monitoring the synchronisation and co-ordination of heart rate in cancer
patients, the scientists carried out a pilot study with 28 patients
suffering chronic cancer pain in a stable phase of cancer. The
intervention was a 14-day training of a relaxation therapy for improving
falling asleep, which included a 30-minute lullaby-like, rhythmically
dominated music with gradually decreasing tempi.
The researchers measured
the continuous registration of heart rate and its comparison with
musical beat on day 1 and 15; analysis of the degree of synchronisation
-–coordination of systole and musical central time point; time of
falling asleep and the patient’s subjective evaluation of the
relaxation therapy and pain intensity.
It was found that the
music had a profound effect; the patients in the relaxation group showed
an increasing synchronisation and co-ordination of heart rate and
musical beat. At a tempo of between 48 and 42 beats per minute there
occurred a very stable.2:3 synchronisation. Those patients reporting the
best relaxation and analgesic effects showed the most synchronisation.
Music therapy also led to an improvement of falling asleep and a
decrease in consumption of analgesics.
The study showed that
Lullaby-like music within a specific range of tempi may induce a
trainable synchronisation of heart rate, and thereby induce a relaxation
and analgesic response.
Reinhardt U.
Investigation into synchronisation of heart rate and music rhythm in a
relaxation therapy in patients with cancer pain. Forschende
Komplementaermedizin 6(3): 135-41. Jun 1999
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