Homeopathic Treatment of Insomnia and Symptom Clusters Related to Cerebral Chemotoxicity in Oncology

Abstract

Background During chemotherapy, the correlation between insomnia and fatigue, anxiety, pain, depressed mood, and cognitive disorders makes these subjective complaints a ‘symptom cluster’ with common biological mechanisms. The theory of cerebral inflammation following the production of pro-inflammatory cytokines (high level of interleukin 1-β [IL1-β], IL6 and tumour necrosis factor-alpha) is currently the most generally accepted. Understanding these mechanisms should allow us to propose a chemoprotective homeopathic treatment of the nervous system.

Methods By retaining the inflammatory aetiology, we combined the rubrics ‘Inflammation of the brain’, ‘Inflammation of the meninges’, ‘Inflammation of the nerves’ with the symptom cluster: insomnia, fatigue, depressive state and memory disorders.

Results After repertorisation, we propose the following homeopathic protocol: Belladonna 15c, Phosphorus 15c, Cerebral cortex 4c and Nerves 4c, two pills of each medicine to be sucked together before breakfast, lunch and dinner, on each day of chemotherapy and for the following 2 days.

Conclusion This selected protocol, derived from a physiopathological knowledge of the symptoms, seems to be well suited to the prevention and treatment of post-chemotherapeutic cerebral inflammation. It is essential to start the homeopathic treatment before the chemotherapy session to anticipate the emergence of the ‘chemo-brain’ side effects. This proposed prevention protocol must be confirmed and quantified by randomised studies.

Keywords

Belladonna - cancer - cerebral chemotoxicity - fatigue - symptom cluster - homeopathy - insomnia - Phosphorus - supportive care

Highlights

• Cerebral inflammation caused by chemotherapy causes a symptom cluster.

• Insomnia, fatigue, anxiety, pain and cognitive disorders are typical of ‘chemo-brain’.

• This pathophysiology leads us to propose a chemoprotective homeopathic treatment approach.

• Phosphorus, Aconitum and Belladonna are homeopathic ‘chemo-brain’ medicine candidates.

• References

• 1 Palesh OG, Roscoe JA, Mustian KM. , et al. Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. J Clin Oncol 2010; 28: 292-298
• 2 Cleeland CS, Zhao F, Chang VT. , et al. The symptom burden of cancer: evidence for a core set of cancer-related and treatment-related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study. Cancer 2013; 119: 4333-4340
• 3 Donovan KA, Jacobsen PB. Fatigue, depression, and insomnia: evidence for a symptom cluster in cancer. Semin Oncol Nurs 2007; 23: 127-135
• 4 Barsevick AM. The concept of symptom cluster. Semin Oncol Nurs 2007; 23: 89-98
• 5 Savard J, Ivers H, Savard MH, Morin CM. Cancer treatments and their side effects are associated with aggravation of insomnia: results of a longitudinal study. Cancer 2015; 121: 1703-1711
• 6 Benezech JP. . Troubles du sommeil et cancer Médecine Palliative : Soins de Support - Accompagnement - Éthique, Volume 9, Issue 4, Pages 184–190
• 7 Wood LJ, Weymann K. Inflammation and neural signaling: etiologic mechanisms of the cancer treatment-related symptom cluster. Curr Opin Support Palliat Care 2013; 7: 54-59
• 8 Lis CG, Gupta D, Grutsch JF. The relationship between insomnia and patient satisfaction with quality of life in cancer. Support Care Cancer 2008; 16: 261-266
• 9 Lis CG, Gupta D, Granick J, Grutsch JF. Can patient satisfaction with quality of life predict survival in advanced colorectal cancer?. Support Care Cancer 2006; 14: 1104-1110
• 10 Levi F. . Chronobiologie et Cancers - La rupture des rythmes biologiques du sommeil peut favoriser le cancer (Chronobiology and Cancers-Rupture of biological sleep rhythms can promote cancer) [on line]. Proceedings of the Congrès du sommeil. 2013 Nov. 21-23, Marseille, France. Available at: http://www.sfrms-sommeil.org/recherche/actualite-scientifique/archives-2013/les-interactions-entre-sommeil-et-cancer-congres-du-sommeil/ . Accessed February 6, 2017
• 11 Onen SH, Alloui A, Gross A, Eschallier A, Dubray C. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res 2001; 10: 35-42
• 12 Neckelmann D, Mykletun A, Dahl AA. Chronic insomnia as a risk factor for developing anxiety and depression. Sleep 2007; 30: 873-880
• 13 George M, Elias A, Shafiei M. Insomnia in cancer--Associations and Implications. Asian Pac J Cancer Prev 2015; 16: 6711-6714
• 14 Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci 2008; 10: 473-481
• 15 Roscoe JA, Kaufman ME, Matteson-Rusby SE. , et al. Cancer-related fatigue and sleep disorders. Oncologist 2007; 12: 35-42
• 16 Jung D, Lee KM, Kim WH. , et al. Longitudinal association of poor sleep quality with chemotherapy-induced nausea and vomiting in patients with breast cancer. Psychosom Med 2016; 78: 959-965
• 17 Fiorentino L, Ancoli-Israel S. Sleep dysfunction in patients with cancer. Curr Treat Options Neurol 2007; 9: 337-346
• 18 Van Onselen C, Paul SM, Lee K. , et al. Trajectories of sleep disturbance and daytime sleepiness in women before and after surgery for breast cancer. J Pain Symptom Manage 2013; 45: 244-260
• 19 Savard J, Villa J, Ivers H, Simard S, Morin CM. Prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period. J Clin Oncol 2009; 27: 5233-5239
• 20 Ancoli-Israel S, Savard J. Sleep and fatigue in cancer patients. In: Kryger MH, Roth T, Dement WC. , eds. Principles and Practice of Sleep Medicine. St Louis, MO: Elsevier Saunders; 2011: 1416-1421
• 21 Savard J, Savard MH. Insomnia and cancer: prevalence, nature, and nonpharmacologic treatment. Sleep Med Clin 2013; 8: 373-387
• 22 Jim HS, Small B, Faul LA, Franzen J, Apte S, Jacobsen PB. Fatigue, depression, sleep, and activity during chemotherapy: daily and intraday variation and relationships among symptom changes. Ann Behav Med 2011; 42: 321-333
• 23 Savard J, Liu L, Natarajan L. , et al. Breast cancer patients have progressively impaired sleep-wake activity rhythms during chemotherapy. Sleep 2009; 32: 1155-1160
• 24 Liu L, Fiorentino L, Natarajan L. , et al. Pre-treatment symptom cluster in breast cancer patients is associated with worse sleep, fatigue and depression during chemotherapy. Psychooncology 2009; 18: 187-194
• 25 Bagot JL, Bagot-Tourneur O. Pertinence de l'éducation thérapeutique dans le cancer du sein. Psycho-Oncol 2010; 4: S21-S25
• 26 Miaskowski C, Lee KA. Pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: a pilot study. J Pain Symptom Manage 1999; 17: 320-332
• 27 Trudel-Fitzgerald C, Savard J, Ivers H. Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Ann Behav Med 2013; 45: 329-337
• 28 Savard J, Hervouet S, Ivers H. Prostate cancer treatments and their side effects are associated with increased insomnia. Psychooncology 2013; 22: 1381-1388
• 29 Cleeland CS, Bennett GJ, Dantzer R. , et al. Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism? A cytokine-immunologic model of cancer symptoms. Cancer 2003; 97: 2919-2925
• 30 Wardill HR, Mander KA, Van Sebille YZ. , et al. Cytokine-mediated blood brain barrier disruption as a conduit for cancer/chemotherapy-associated neurotoxicity and cognitive dysfunction. Int J Cancer 2016; 139: 2635-2645
• 31 Cheung YT, Ng T, Shwe M. , et al. Association of proinflammatory cytokines and chemotherapy-associated cognitive impairment in breast cancer patients: a multi-centered, prospective, cohort study. Ann Oncol 2015; 26: 1446-1451
• 32 Galdiero M, Cipollaro de l'Ero G, Folgore A, Cappello M, Giobbe A, Sasso FS. Effects of irradiation doses on alterations in cytokine release by monocytes and lymphocytes. J Med 1994; 25: 23-40
• 33 Lyon DE, Cohen R, Chen H. , et al. Relationship of systemic cytokine concentrations to cognitive function over two years in women with early stage breast cancer. J Neuroimmunol 2016; 301: 74-82
• 34 Lee BN, Dantzer R, Langley KE. , et al. A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 2004; 11: 279-292
• 35 Hahnemann S. Organon de l'art de guérir. 6th ed. Trad. Schmidt P. Paris: Vigot Fr; 1952: 150
• 36 Kent JT. Phosphorus. In: Matière médicale homéopathique. 4th ed. Paris: Ann. Hom. Franç.; 1976: 736-746
• 37 Bagot JL, Frass M, Kruse S, Lechleitner P, Pichler E, Rossi E, Wurster J. Role of homeopathy for life quality in cancer patients oncology panel discussion [on line] November 18, 2016; Vienna ECH newsletter Jan. 2017 N°7, p 5-7, [consulted February 6, 2017]
• 38 Chirumbolo S, Signorini A, Bianchi I, Lippi G, Bellavite P. Effects of homeopathic preparations of organic acids and of minerals on the oxidative metabolism of human neutrophils. A controlled trial. Br Homoeopath J 1993; 82: 227-244
• 39 Hufeland M. On the prophylactic powers of belladonna against scarlet fever. Lancet 1829; 1: 135
• 40 Poitevin B, Aubin M, Royer JF. Effet de belladonna et ferrum phosphoricum sur la chemiluminescence des polynucleaires neutrophiles humains. Ann Homeopath Fr 1983; 3: 5-12
• 41 Cristea A, Nicula S, Dare V. Pharmacodynamic effects of very high dilutions of Belladonna on the isolated rat duodenum. In: Bastide M, ed. Signals Images. Dordrecht: Kluwer Academic Publishers; 1997: 161-170
• 42 Pedalino CM, Perazzo FF, Carvalho JC, Martinho KS, Massoco CO, Bonamin LV. Effect of Atropa belladonna and Echinacea angustifolia in homeopathic dilution on experimental peritonitis. Homeopathy 2004; 93: 193-198
• 43 Balzarini A, Felisi E, Martini A, De Conno F. Efficacy of homeopathic treatment of skin reactions during radiotherapy for breast cancer: a randomised, double-blind clinical trial. Br Homoeopath J 2000; 89: 8-12
• 44 Bastide M, Doucet-Jaboeuf M, Daurat V. Activity and chronopharmacology of very low doses of physiological immune inducers. Immunol Today 1985; 6: 234-235
• 45 Bagot JL. Homeopathy: a complementary and interstitial medicine in severe pathologies. Revhom 2016; 7: e7-e11