Many cancers are removed surgically. Surgery may be followed, or preceded, by radiation therapy, chemotherapy or both. Some cancer cells are, however, resistant to the drugs used in chemotherapy. Furthermore, these drugs have unpleasant side effects causing nausea and vomiting, hair loss, fatigue and suppression of the immune system. Radiation therapy with x-rays also causes adverse effects including burning of the skin and it destroys healthy tissue as it passes through the body to the cancer cell mass.

We present some of the evidence from Cochrane systematic reviews about complementary and alternative treatments related to cancer treatment. This evidence comes from carefully researched reviews of information about clinical trials done to evaluate medical treatments. Studies are only included in these reviews if they meet pre-defined criteria.

AROMATHERAPY AND MASSAGE FOR SYMPTOM RELIEF 

Massage is the manipulation of the soft tissues of a person’s body, generally using the hands, to bring about therapeutic changes in the muscles, blood vessels and nerves. Adding essential oils to the massage oil or cream may enhance the benefits of massage. Essential oils are volatile fragrant extracts of plants that are used in a variety of ways in aromatherapy.

Massage and aromatherapy are methods of healing used to reduce anxiety and stress, relieve body pain and release muscular tension. People use these therapies to improve their sense of wellbeing after the diagnosis of cancer and to reduce treatment side effects. People often feel anxious and stressed when diagnosed with cancer, which makes it is easy for them to become angry or hostile, experience communication difficulties and to sink into depression. At the same time they are challenged with physical symptoms such as pain, nausea, vomiting, fatigue, constipation and digestive problems; many of them caused by their medical treatment.

What the synthesised research says

Massage and aromatherapy massage had a consistent and immediate benefit on people’s anxiety, with short-term benefits on their psychological wellbeing, when under active treatment for cancer, though the trials were small.

Four trials involving 207 people reported a 19 to 32% reduction in anxiety following massage. The additional benefit of aromatherapy oils was not clear.

Of the three trials that looked specifically at depression (in a total of 120 people), only one found any significant reduction with massage. Pain was reduced (three studies, 117 people) and two studies (71 people) reported reduced nausea (19 to 37%). Only single trials reported positive effects on anger, hostility, communication, digestive problems or overall distress because of symptoms.

How it was tested

The researchers made a thorough search of the medical literature and were able to identify and gather the findings from 8 authoritative controlled studies. The studies were small with the number of participants ranging from 6 to 87; the total number was 357 participants. Six studies (reporting information from 218 people) compared having a massage with sitting quietly and no massage. Massage was given two to three times a week for one to five weeks. In the other 2 trials 139 people received either a massage without or with aromatherapy; they had one massage a week for three or eight weeks.

Side effects and general cautions

Trials did not report information about adverse events.

Other complementary therapies such as therapeutic touch, acupressure and reflexology therapies were not looked at. Nor was localised massage for a specific purpose like relieving lymphoedema or preventing fluid retention.

People knew what treatment they were receiving in seven of the 8 trials. This meant that individual biases could affect the findings. Treatments varied considerably and their effects were assessed in small numbers of people within short periods of time.

Source

Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage for symptom relief in patients with cancer. The Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD002287.pub2. DOI: 10.1002/14651858.CD002287.pub2.

CHINESE HERBAL MEDICINES FOR REDUCING SIDE EFFECTS WITH CHEMOTHERAPY FOR COLORECTAL CANCER

Colorectal cancer is rarely diagnosed in people less than 40 years of age meaning that people affected are often elderly. People with colorectal cancer can be treated effectively if the cancer is diagnosed and treated in its early stages. This involves surgery and may be followed by chemotherapy to destroy remaining cancer cells. All patients who receive chemotherapy are exposed to its toxicity but only about 5 to 10% of treated patients actually obtain any benefit. The toxic side effects of chemotherapy include nausea and vomiting, sore and inflamed mouth, sores of blisters on the hands or feet (palmar-plantar syndrome), fatigue, diarrhoea, liver damage (hepatotoxicity), suppression of the bone marrow (myelosuppression), and immune system (imunosuppression).

Herbal medicines and nutritional supplements, vitamins antioxidants and alternative diets are commonly used to alleviate the side-effects of chemotherapy or radiotherapy. Cancer patients may use multiple therapies as well as conventional supportive treatments. Herbal medicines can improve appetite, boost the immune system and help with symptoms such as bleeding, diarrhoea, and pain. In traditional Chinese medicine, specific properties of the various medicinal herbs are used and herbal remedies such as Shen Mai or Chinese magnolia vine (Schisandra chinensis), and Huangqi are used for their effectiveness against chemotherapy-related toxicity.

Huangqi is prepared from the dried root of Astragalus membranaceus and Astragalus mongolicus, both types of milk vetch. The main chemical components of the extracts are triterpene saponins and astragaloglucans.

These remedies can cause allergic reactions and renal damage (nephropathy).

What the synthesised research says

Traditional Chinese herbal medicines reduced the proportion of patients with abnormally low white blood cell count (leucopenia) by stimulating the production of white blood cells. They also decreased the proportion of patients who experienced significant nausea and vomiting.

The traditional Chinese medicines used in all of the included trials were compounds containing extracts made by boiling Huangqi (decoctions of Huangqi). Shenbaibao was also used in one trial.

Three trials (294 participants) provided information on white blood cell (leucocyte) counts when treating people with Huangqi compounds in addition to chemotherapy. Three people (range 2 to 5) had to be given the herbs for one to benefit.

Two studies (154 participants) provided information on the proportion of people with nausea or vomiting with the Huangqi compounds decoction. Three people (range 2 to 5) had to be given the herbs for one to benefit.

Single studies reported reductions in the proportion of patients with reduced appetite, hair loss, or fatigue.

How it was tested

The researchers searched the medical literature thoroughly and found four controlled trials with a total of 342 participants (48 to 150 in each trial). The trials took place in China and had limitations in how they were conducted.

Only 2 studies (94 participants) contributed data on T-lymphocyte subset count changes with Hiangqi.

Side effects and general cautions

There were no reports of adverse effects related to the use of Huangqi compounds. The chemotherapy regimens used in the four studies are not typical of those currently used worldwide. The studies used interventions which, although primarily based on decoctions of Huangqi, differed from each other.

Source

Taixiang W, Munro AJ, Guanjian L. Chinese medical herbs for chemotherapy side effects in colorectal cancer patients. The Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD004540.pub2. DOI: 10.1002/14651858.CD004540.pub2.