Download PDF
Deutsche Zeitschrift für Onkologie 2015; 47(4): 148-154
DOI: 10.1055/s-0035-1547583
Forschung
© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Komplementärmedizin in der Onkologie – Evidenz und praxisorientierte Vorgehensweise

Axel Eustachi
,
Wolfgang Doerfler
,
Dieter Melchart
Further Information

Publication History

Publication Date:
21 December 2015 (online)

    Permissions and Reprints

Zusammenfassung

Tumorpatienten sind im Verlauf ihrer Erkrankung häufig mit therapieresistenten Beschwerden und schlechter Lebensqualität konfrontiert. Mehr als die Hälfte der Betroffenen nimmt daher Methoden oder Produkte in Anspruch, die nicht Teil der konventionellen medizinischen Versorgung sind, deren wissenschaftlicher Evidenzgrad oft unklar ist und die teilweise mit Risiken verbunden sind. Lebensstilmaßnahmen (Ernährung, Bewegung, Entspannung) und viele Selbsthilfetechniken können die Lebensqualität stabilisieren, sind risikolos und stellen daher die Basis einer begleitenden Behandlung dar. Für die ärztliche Behandlung von Symptomen liegen insbesondere für die Akupunktur sowie für einige Naturstoffe (Medizinalkräuter, Pflanzenextrakte, Vitamine, Spurenelemente) ausreichende Hinweise aus der Forschung vor, die diese Methoden im Sinne einer vertretbaren Komplementärmedizin akzeptabel und möglicherweise sinnvoll erscheinen lassen.

Summary

Many cancer patients experience a worsened quality of life. This is due to the chronic nature of the disease or related to side effects of the conventional therapy. During the course of their disease, more than half of these patients use methods or products, which are not part of the conventional medical care. Numerous of these approach show an unclear or non-assessable level of scientific evidence and are partially subject to risks and high costs. Lifestyle modification (diet, exercise, relaxation) can stabilize quality of life and should be – if possible – addressed already within the initial physician consultation. The scientific evidence for particularly acupuncture and some natural products (medicinal herbs, plant extracts, vitamins and trace elements) meet the requirements for acceptable methods of complementary medicine and thus justify the use of these complementary medical approaches.

Schlüsselwörter

Kompetenztraining - Komplementärmedizin - Evidenz - Fatigue - Neuropathie - Mukositis - Schmerz - Nausea

Keywords

competence training - complementary and alternative medicine - evidence - fatigue - neuropathy - mucositis - pain - nausea
 

  • Literatur

  • 1 Adams LS, Seeram NP, Aggarwal BB, Takada Y, Sand D, Heber D. Pomegranate juice, total pomegranate ellagitannins, and punicalagin suppress inflammatory cell signaling in colon cancer cells. J Agric Food Chem 2006; 54(3): 980-985
    CrossrefPubMedGoogle Scholar
  • 2 Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev 2010; 11: CD003048-
    PubMedGoogle Scholar
  • 3 Ashamalla H. Acupuncture for the alleviation of hot flashes in men treated with androgen ablation therapy. Int J Radiat Oncol Phys 2011; 79(5): 1358-1363
    CrossrefPubMedGoogle Scholar
  • 4 Bachmeier BE, Mohrenz IV, Mirisola V, Schleicher E, Romeo F, Höhneke C, Jochum M, Nerlich AG, Pfeffer U. Curcumin downregulates the inflammatory cytokines CXCL1 and -2 in breast cancer cells via NFkappaB. Carcinogenesis 2008; 29(4): 779-789
    CrossrefPubMedGoogle Scholar
  • 5 Bae K, Yoo HS, Lamoury G et al. Acupuncture for Aromatase Inhibitor-Induced Arthralgia: A Systematic Review. Integr Cancer Ther 2015; 14(6): 496-502
    CrossrefPubMedGoogle Scholar
  • 6 Balk J, Day R, Rosenzweig M et al. Pilot, randomized, modified, doubleblind, placebo-controlled trial of acupuncture for cancer related fatigue. J Soc Integr Oncol 2009; 1: 4-11
    PubMedGoogle Scholar
  • 7 Bannerman B, Xu L, Jones M et al. Preclinical evaluation of the antitumor activity of bortezomib in combination with vitamin C or with epigallocatechin gallate, a component of green tea. Cancer Chemother Pharmacol 2011; 68(5): 1145-1154
    CrossrefPubMedGoogle Scholar
  • 8 Bao Y, Kong X, Yang L et al. Complementary and alternative medicine for cancer pain: an overview of systematic reviews. Evid Based Complement Alternat Med 2014; 2014: 170396
    PubMedGoogle Scholar
  • 9 Barton DL, Soori GS, Bauer BA et al. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care Cancer 2010; 18(2): 179-187
    CrossrefPubMedGoogle Scholar
  • 10 Beijers AJ, Jongen JL, Vreugdenhil G. Chemotherapy-induced neurotoxicity: the value of neuroprotective strategies. Neth J Med 2012; 70(1): 18-25
    PubMedGoogle Scholar
  • 11 Ben-Arye E, Schiff E, Steiner M, Keshet Y, Lavie O. Attitudes of patients with gynecological and breast cancer toward integration of complementary medicine in cancer care. Int J Gynecol Cancer 2012; 22(1): 146-53
    CrossrefPubMedGoogle Scholar
  • 12 Boehm K, Borrelli F, Ernst E et al. Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database Syst Rev 2009; 3: CD005004-
    PubMedGoogle Scholar
  • 13 Brandenberger M, Simoes-Wüst AP, Rostock M, Saller R. An exploratory study on the quality of life and individual coping of cancer patients during mistletoe therapy. Integr Cancer Ther 2012; 11(2): 90-100
    CrossrefPubMedGoogle Scholar
  • 14 Bruns F et al. Selenium in the treatment of head and neck lymphedema. Med Princ Pract 2004; 13(4): 185-190
    CrossrefPubMedGoogle Scholar
  • 15 Butler LM, Wu AH. Green and black tea in relation to gynecologic cancers. Mol Nutr Food Res 2011; 55(6): 931-940
    CrossrefPubMedGoogle Scholar
  • 16 Carroll JK, Kohli S, Mustian KM, Roscoe JA, Morrow GR. Pharmacologic treatment of cancer-related fatigue. Oncologist 2007; 12 Suppl. 1: 43-51
    CrossrefPubMedGoogle Scholar
  • 17 Chan JM, Oh WK, Xie W et al. Plasma Selenium, Manganese Superoxide Dismutase, and Intermediate- or High-Risk Prostate Cancer. J Clin Oncol 2009; 27(22): 3577-3583
    CrossrefPubMedGoogle Scholar
  • 18 Chan CL, Wang CW, Ho RT, Ng SM, Chan JS, Ziea ET, Wong VC. A systematic review of the effectiveness of qigong exercise in supportive cancer care. Support Care Cancer 2012; 20(6): 1121-1133
    CrossrefPubMedGoogle Scholar
  • 19 Chowdhury R, Kunutsor S, Vitezova A et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ 2014; 348: g1903-
    CrossrefPubMedGoogle Scholar
  • 20 Davalli P, Rizzi F, Caporali A, Pellacani D, Davoli S, Bettuzzi S, Brausi M, D’Arca D. Anticancer activity of green tea polyphenols in prostate gland. Oxid Med Cell Longev 2012; 2012: 984219
    PubMedGoogle Scholar
  • 21 Dhillon N, Aggarwal BB, Newman RA et al. Phase II trial of curcumin in patients with advanced pancreatic cancer. Clin Cancer Res 2008; 14(14): 4491-4499
    CrossrefPubMedGoogle Scholar
  • 22 Duffield-Lillico AJ et al. Selenium supplementation and secondary prevention of nonmelanoma skin cancer in a randomized trial. J Natl Cancer Inst 2003; 95(19): 1477-1481
    CrossrefPubMedGoogle Scholar
  • 23 Eardley S, Bishop FL, Prescott P et al. A systematic literature review of complementary and alternative medicine prevalence in EU. Forsch Komplementmed 2012; 19 Suppl. 2: 18-28
    CrossrefPubMedGoogle Scholar
  • 24 Ezzo et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Review (2011). The Cochrane Library 2011 Issue 1
    Google Scholar
  • 25 Finnegan-John J, Molassiotis A, Richardson A, Ream E. A systematic review of complementary and alternative medicine interventions for the management of cancerrelated fatigue. Integr Cancer Ther 2013; 12: 276-290
    CrossrefPubMedGoogle Scholar
  • 26 Franca CA, Nogueira CR, Ramalho A, Carvalho AC, Vieira SL, Penna AB. Serum levels of selenium in patients with breast cancer before and after treatment of external beam radiotherapy. Ann Oncol 2011; 22(5): 1109-1112
    CrossrefPubMedGoogle Scholar
  • 27 Frisk J, Källström AC, Wall N, Fredrikson M, Hammar M. Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes. Support Care Cancer 2012; 20(4): 715-724
    CrossrefPubMedGoogle Scholar
  • 28 Garcia MK, McQuade J, Haddad R et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J Clin Oncol 2013; 31(7): 952-960
    CrossrefPubMedGoogle Scholar
  • 29 Golden EB, Lam PY, Kardosh A et al. Green tea polyphenols block the anticancer effects of bortezomib and other boronic acid-based proteasome inhibitors. Blood 2009; 113(23): 5927-5937
    CrossrefPubMedGoogle Scholar
  • 30 Greenlee H, Crew KD, Shao T, Kranwinkel G et al. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 2013; 21(4): 1077-1087
    CrossrefPubMedGoogle Scholar
  • 31 Gupta SC, Patchva S, Aggarwal BB. Therapeutic roles of curcumin: lessons learned from clinical trials. AAPS J 2013; 15(1): 195-218
    CrossrefPubMedGoogle Scholar
  • 32 Harrigan JT. Patient disclosure of the use of complementary and alternative medicine to their obstetrician/gynaecologist. J Obstet Gynaecol 2011; 31(1): 59-61
    CrossrefPubMedGoogle Scholar
  • 33 He ZY, Shi CB, Wen H et al. Upregulation of p53 expression in patients with colorectal cancer by administration of curcumin. Cancer Invest Mar 2011; 29(3): 208-213
    PubMedGoogle Scholar
  • 34 Hoffmann MR, Senior PA, Mager DR. Vitamin D supplementation and health-related quality of life: a systematic review of the literature. J Acad Nutr Diet 2015; 115(3): 406-418
    CrossrefPubMedGoogle Scholar
  • 35 Horneber MA, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database Syst Rev 2008; 2: CD003297-
    PubMedGoogle Scholar
  • 36 Hotaling JM, Wright JL, Pocobelli G et al. Long-term use of supplemental vitamins and minerals does not reduce the risk of urothelial cell carcinoma of the bladder in the VITamins And Lifestyle study. J Urol 2011; 185(4): 1210-1215
    CrossrefPubMedGoogle Scholar
  • 37 Karp DD, Lee SJ, Shaw Right GL et al. A phase III, intergroup, randomized, double-blind, chemoprevention trial of selenium (Se) supplementation in resected stage I non-small cell lung cancer (NSCLC). J Clin Oncol 2010; (suppl; abstr CRA7004)
    PubMedGoogle Scholar
  • 38 Kern E, Schmidinger M, Locker GJ, Kopp B. Management of capecitabine-induced hand-foot syndrome by local phytotherapy. Wien Med Wochenschr 2007; 157(13–14): 337-342
    CrossrefPubMedGoogle Scholar
  • 39 Kienle GS, Grugel R, Kiene H. Safety of higher dosages of Viscum album L. in animals and humans – systematic review of immune changes and safety parameters. BMC Complement Altern Med 2011; 11: 72
    CrossrefPubMedGoogle Scholar
  • 40 Killian PH, Kronski E, Michalik KM, Barbieri O, Astigiano S, Sommerhoff CP, Pfeffer U, Nerlich AG, Bachmeier BE. Curcumin inhibits prostate cancer metastasis in vivo by targeting the inflammatory cytokines CXCL1 and 2. Carcinogenesis 2012; 33(12): 2507-2519
    CrossrefPubMedGoogle Scholar
  • 41 Kim ND, Mehta R, Yu W et al. Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat 2002; 71(3): 203-217
    CrossrefPubMedGoogle Scholar
  • 42 Koula-Jenik H, Holzhauer P. Anwendungsbeobachtung zum präventiven Potential von Hanföl beim Capecitabin-induzierten Hand-Fuss-Syndrom. Dtsch Z Onkol 2010; 42: 80-84
    PubMedGoogle Scholar
  • 43 Komatsu Y, Yuki S, Fuse N et al. Phase I/II clinical study of irinotecan and oralS-1(IRIS) in patients with advanced gastric cancer. Adv Ther 2010; 27: 483-492
    CrossrefPubMedGoogle Scholar
  • 44 Kraft M, Kraft K, Gärtner S et al. L-Carnitine-supplementation in advanced pancreatic cancer (CARPAN ) – a randomized multicentre trial. Nutr J 2012; 11: 52- Published online 2012 Jul 23. DOI: 10.1186/1475–2891–11–52.
    CrossrefPubMedGoogle Scholar
  • 45 Lansky EP, Jiang W, Mo H et al. Possible synergistic prostate cancer suppression by anatomically discrete pomegranate fractions. Invest New Drugs 2005; 23(1): 11-20
    CrossrefPubMedGoogle Scholar
  • 46 Leggett S, Koczwara B, Miller M. The impact of complementary and alternative medicines on cancer symptoms, treatment side effects, quality of life, and survival in women with breast cancer--a systematic review. Nutr Cancer 2015; 67(3): 373-391
    CrossrefPubMedGoogle Scholar
  • 47 Lim B, Manheimer E, Lao L, Ziea E, Wisniewski J, Liu J, Berman B. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev 2006; 4: CD005111-
    PubMedGoogle Scholar
  • 48 Lin LC, Wang MN, Tsai TH. Food-drug interaction of (-)-epigallocatechin-3-gallate on the pharmacokinetics of irinotecan and the metabolite SN-38. Chem Biol Interact 2008; 174(3): 177-182
    CrossrefPubMedGoogle Scholar
  • 49 Ling WM, Lui LY, So WK, Chan K. Effects of acupuncture and acupressure on cancer-related fatigue: a systematic review. Oncol Nurs Forum 2014; 41(6): 581-592
    CrossrefPubMedGoogle Scholar
  • 50 Maddocks-Jennings W, Wilkinson JM, Cavanagh HM, Shillington D. Evaluating the effects of the essential oils Leptospermum scoparium (manuka) and Kunzea ericoides (kanuka) on radiotherapy induced mucositis: a randomized, placebo controlled feasibility study. Eur J Oncol Nurs 2009; 13(2): 87-93
    CrossrefPubMedGoogle Scholar
  • 51 Melchart D, Bohnes E, Doerfler W et al. Kompetenztraining für Patienten. Dtsch Z Onkol 2014; 46: 158-162
    PubMedGoogle Scholar
  • 52 Micke O et al. Selenium in the treatment of radiation-associated secondary lymphedema. Int J Radiat Oncol Biol Phys 2003; 56(1): 40-49
    CrossrefPubMedGoogle Scholar
  • 53 Mishra SI, Scherer RW, Snyder C, Geigle PM, Berlanstein DR, Topaloglu O. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 2012; 8: CD008465-
    PubMedGoogle Scholar
  • 54 Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder DW, Filshie J, Ream E, Richardson A. Acupuncture for Cancer-Related Fatigue in Patients with Breast Cancer: A Pragmatic Randomized Controlled Trial. JCO 2012; online 29. Oktober
    PubMedGoogle Scholar
  • 55 Muecke R, Schomburg L, Glatzel M et al. Multicenter, Phase 3 Trial Comparing Selenium Supplementation with Observation in Gynecologic Radiation Oncology. Int J Radiat Oncol Biol Phys 2010; 78(3): 828-835
    CrossrefPubMedGoogle Scholar
  • 56 Mücke M, Mochamat, Cuhls H. et al. Pharmacological treatments for fatigue associated with palliative care. Cochrane Database Syst Rev 2015; 5: CD006788-
    PubMedGoogle Scholar
  • 57 Nissen N, Lunde A, Pedersen CG, Johannessen H. The use of complementary and alternative medicine after the completion of hospital treatment for colorectal cancer: findings from a questionnaire study in Denmark. BMC Complement Altern Med 2014; 14: 388
    CrossrefPubMedGoogle Scholar
  • 58 Ogunleye AA, Xue F, Michels KB. Green tea consumption and breast cancer risk or recurrence: a meta-analysis. Breast Cancer Res Treat 2010; 119(2): 477-484
    CrossrefPubMedGoogle Scholar
  • 59 Pace A, Giannarelli D, Galiè E, Savarese A, Carpano S, Della Giulia M, Pozzi A, Silvani A, Gaviani P, Scaioli V, Jandolo B, Bove L, Cognetti F. Vitamin E neuroprotection for cisplatin neuropathy: a randomized, placebo-controlled trial. Neurology 2010; 74(9): 762-766
    CrossrefPubMedGoogle Scholar
  • 60 Pachman DR, Price KA, Carey EC. Nonpharmacologic approach to fatigue in patients with cancer. Cancer J 2014; 20(5): 313-318
    CrossrefPubMedGoogle Scholar
  • 61 Paley CA, Johnson MI, Tashani OA, Bagnall AM. Acupuncture für cancer pain in adults. Cochrane Database Syst Rev 2011; 19(1): CD007753-
    PubMedGoogle Scholar
  • 62 Pantuck AJ, Leppert JT, Zomorodian N et al. Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer. Clin Cancer Res 2006; 12(13): 4018-4026
    CrossrefPubMedGoogle Scholar
  • 63 Pitkin J. Alternative and complementary therapies for the menopause. Menopause Int 2012; 18(1): 20-27
    CrossrefPubMedGoogle Scholar
  • 64 Saquib J, Madlensky L, Kealey S, Saquib N, Natarajan L, Newman VA, Patterson RE, Pierce JP. Classification of CAM use and its correlates in patients with early-stage breast cancer. Integr Cancer Ther 2011; 10(2): 138-147
    PubMedGoogle Scholar
  • 65 Schloss J, Colosimo M, Vitetta L. Herbal Medicines and Chemotherapy Induced Peripheral Neuropathy (CIPN): a Critical Literature Review. Crit Rev Food Sci Nutr 2015; Apr 7: 0
    PubMedGoogle Scholar
  • 66 Schmitz KH, Neuhouser ML, Agurs-Collins T et al. Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. J Natl Cancer Inst 2013; 105(18): 1344-1354
    CrossrefPubMedGoogle Scholar
  • 67 Servitja S, Martos T, Rodriguez Sanz M et al. Skeletal adverse effects with aromatase inhibitors in early breast cancer: evidence to date and clinical guidance. Ther Adv Med Oncol 2015; 7(5): 291-296
    CrossrefPubMedGoogle Scholar
  • 68 Sieja K, and Talerczyk M. Selenium as an element in the treatment of ovarian cancer in women receiving chemotherapy. Gynecol Oncol 2004; 93: 320-327
    CrossrefPubMedGoogle Scholar
  • 69 Somasundaram S, Edmund NA, Moore DT et al. Dietary curcumin inhibits chemotherapy-induced apoptosis in models of human breast cancer. Cancer Res 2002; 62(13): 3868-3875
    PubMedGoogle Scholar
  • 70 Stringer J, Donald G. Aromasticks in cancer care: an innovation not to be sniffed at. Complement Ther Clin Pract 2011; 17(2): 116-121
    CrossrefPubMedGoogle Scholar
  • 71 Stubbe CE, Valero M. Complementary strategies for the management of radiation therapy side effects. J Adv Pract Oncol 2013; 4(4): 219-231
    PubMedGoogle Scholar
  • 72 Tautz E, Momm F, Hasenburg A, Guethlin C. Use of Complementary and Alternative Medicine in breast cancer patients and their experiences: A cross-sectional study. Eur J Cancer 2012; 48: 3133-3139
    CrossrefPubMedGoogle Scholar
  • 73 Thomas F, Holly JM, Persad R et al. Green tea extract (epigallocatechin-3-gallate) reduces efficacy of radiotherapy on prostate cancer cells. Urology 2011; 78(2): 475.e15–21-
    PubMedGoogle Scholar
  • 74 Towler P, Molassiotis A, Brearley SG. What is the evidence for the use of acupuncture as an intervention for symptom management in cancer supportive and palliative care: an integrative overview of reviews. Support Care Cancer 2013; 21(10): 2913-2923
    CrossrefPubMedGoogle Scholar
  • 75 Tröger W et al. Viscum album [L.] extract therapy in patients with locally advanced or metastatic pancreatic cancer: a randomised clinical trial on overall survival. Eur J Cancer 2013; 49(18): 3788-3797
    CrossrefPubMedGoogle Scholar
  • 76 Turrini E, Ferruzzi L, Fimognari C. Natural compounds to overcome cancer chemoresistance: toxicological and clinical issues. Expert Opin Drug Metab Toxicol 2014; 10(12): 1677-1690
    CrossrefPubMedGoogle Scholar
  • 77 Turrini E, Ferruzzi L, Fimognari C. Potential Effects of Pomegranate Polyphenols in Cancer Prevention and Therapy. Oxid Med Cell Longev 2015; 938475-
    PubMedGoogle Scholar
  • 78 Wolin KY, Schwartz AL, Matthews CE, Courneya KS, Schmitz KH. Implementing the exercise guidelines for cancer survivors. J Support Oncol 2012; 10(5): 171-177
    CrossrefPubMedGoogle Scholar
  • 79 World Cancer Research Fund – American Institute for Cancer Research (2011) Food, nutrition, physical activity and the prevention of cancer – a global perspective. http://www.dietandcancerreport.org
    PubMedGoogle Scholar
  • 80 Worthington HV, Clarkson JE, Bryan G, Furness S, Glenny AM, Littlewood A, McCabe MG, Meyer S, Khalid T. Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2011; 4: CD000978-
    PubMedGoogle Scholar
  • 81 Yamashita T, Araki K, Tomifuji M, Kamide D, Tanaka Y, Shiotani A. A traditional Japanese medicine - Hangeshashinto (TJ-14) - alleviates chemoradiation-induced mucositis and improves rates of treatment completion. Support Care Cancer 2015; 23(1): 29-35
    CrossrefPubMedGoogle Scholar
  • 82 Zgaga L et al. Plasma vitamin D concentration influences survival outcome after a diagnosis of colorectal cancer. J Clin Oncol 2014; 32(23): 2430-2439
    CrossrefPubMedGoogle Scholar
  • 83 Zick SM, Alrawi S, Merel G et al. Relaxation acupressure reduces persistent cancer-related fatigue. Evid Based Complement Alternat Med 2011; pii: 142913
    PubMedGoogle Scholar