Supportive cancer care: is integrative oncology the future?

PURPOSE OF REVIEW: Nearly half of cancer patients use complementary therapies alongside the conventional cancer treatment. This clinical reality is a challenge for the medical team mainly to guarantee patient's safety. The evolution from Supportive Care to Integrative oncology is taking shape. RECENT FINDINGS: Integrative oncology, a new field in cancer care, combines conventional supportive care and validated complementary approaches. The first part of this review is to highlight the process of validation of one of the most popular complementary medicines among European cancer patients: homeopathy. It seems to be a well tolerated and useful complementary approach in integrative cancer care. The second part shows through the example of stage IV lung cancer the transition from conventional supportive care to integrative oncology with a benefit for their quality of life and survival. SUMMARY: The future of supportive cancer care seems to lead towards a move from coexistence of conventional care and complementary approaches to a combination of both in integrative oncology. This would require new skills among caregivers, specific academic training and adapted studies. Further research is needed to highlight the benefits in the specific field of integrative cancer care.

Probabilistic Reasoning in Homeopathy Practice and its Implications for Clinical Research.

The principle of similitude put forward by Hahnemann has challenging practical consequences in the selection of the right homeopathic medicine for a patient. According to this principle, only the medicines that best fit the totality of the symptoms of a given patient are supposed to really cure: this greatly depends on the homeopath's clinical analysis. In addition, a patient's illness may be more or less curable, depending on the characteristics of the disease. In their daily practice, homeopaths typically apply Bayesian reasoning to deal with uncertainty associated with both medicine and disease. We suggest that clinical research on homeopathy would gain by integrating this kind of prior estimation of (1) the probability of a given medicine being effective for that particular patient and (2) the probability of the patient's disease (or symptoms) being curable. We therefore suggest that future trials of N-of-1 design may gain (1) by testing a small number of "best candidate" medicines (instead of one) for a given patient facing a given disease, and (2) by including careful prior estimations of the probabilities that (a) each selected medicine will be efficient for that patient and (b) the patient's disease will be reversible with the medicine.

A Case of Recurrent Urinary Tract Infection Successfully Treated during Homeopathic Supportive Care in Oncology.

INTRODUCTION: A 32-year-old patient with colon cancer consulted for homeopathic supportive care (HSC). She had also suffered from recurrent urinary tract infections (RUTIs) for 20 years. Could homeopathy treat these two very different issues with the same medicine? THE PATIENT'S MAIN CONCERNS: Though the main reason for the consultation was a fear of the side effects of chemotherapy, the presence of Escherichia coli-induced RUTIs affected the patient's quality of life. INTERVENTIONS AND OUTCOMES: The repertory listing highlighted Pulsatilla as the patient's homeopathic constitutional medicine. It was prescribed both for HSC and also for RUTI. In association with Arsenicum album and Nerves, Pulsatilla enabled a good tolerance to chemotherapy, with rapid recovery from peripheral neuropathies. In combination with Colibacillinum, Pulsatilla provided relapse-free curing of the RUTIs. The MOdified NARanjo Criteria for Homeopathy (MONARCH) Inventory score was +9. CONCLUSION: The one individual's two different clinical complaints were treated with a constitutional homeopathic medicine, Pulsatilla, which covered the whole case. However, in HSC, the use of the constitutional remedy alone is rarely sufficient: it was reinforced by individualised symptomatic medication, organotherapy and isotherapy. For RUTI, isopathic and tubercular miasmatic treatments were each helpful. For both complaints, individualised homeopathy gave rapid, long-lasting and effective results.

Integrative Oncology: An International Perspective from Six Countries.

In June 2019, a meeting was held in Paris in which experts from different countries (Israel, Spain, Belgium, Italy, USA, and France) met to discuss a selection of topics in integrative oncology (IO). The objectives were to draw on the delegates' experience and expertise to begin an international collaboration, sharing details of differing existing models and discussing future perspectives to help define and guide practice in IO and define unmet needs. This report presents a summary of the meeting's main presentations, and also reports on the experts' responses to a questionnaire examining different aspects of IO service delivery, infrastructure, and utilization.

Use of Homeopathy in Integrative Oncology in Strasbourg, France: Multi-center Cross-Sectional Descriptive Study of Patients Undergoing Cancer Treatment.

CONTEXT: The use of homeopathy in oncological supportive care seems to be progressing. The first French prevalence study, performed in 2005 in Strasbourg, showed that only 17% of the subjects were using it. What is the situation 12 years later? MATERIALS AND METHODS: This is a descriptive study, using a questionnaire identical to that used in 2005, on 633 patients undergoing treatment in three anti-cancer centers in Strasbourg. The results of the "homeopathy" sub-group were extracted and studied. RESULTS: Of the 535 patients included, 164 used homeopathy: that is 30.7%. The main purpose of its use was to reduce the side effects of cancer treatments (75%). Among the users, 82.6% were "somewhat" or "very" satisfied, against "quite" satisfied for 15.5%, and "not at all" satisfied for 1.9%. The homeopathic treatment was prescribed by a doctor in 75.6% of the cases; the general practitioner was kept informed in 87% of the cases and the oncologist in 82%. Fatigue, pain, nausea, anxiety, sadness and diarrhea were improved in 80% of the cases. However, alopecia, weight disorders and loss of libido were the least improved symptoms. The use of homeopathy was significantly associated with the female sex. CONCLUSION: With a prevalence of 30.7%, homeopathy is the most used complementary medicine in integrative oncology in Strasbourg. Over 12 years, we have witnessed an increase of 83% in its use in the same city. Almost all respondents declare themselves satisfied and tell their doctors more readily than in 2005.

My best case: homeopathic management of adverse effects of tamoxifen.

BACKGROUND: Nearly half of patients discontinue tamoxifen hormone therapy early because of side effects, thus increasing the risk of breast cancer recurrence. Could a homeopathic treatment improve compliance? METHODS: A patient suffering from side effects of tamoxifen was seen in consultation every 2 months for 10 months by a senior homeopathic doctor and a registrar. RESULTS: Case analysis and repertorisation led to the identification of Pulsatilla as the simillimum drug and tamoxifen 7c as the etiological treatment. This treatment resulted in a rapid and lasting improvement of all the symptoms. CONCLUSIONS: The combination of a homeopathic medicine and a hetero-isotherapic illustrates both the principles of "similarity" and "the identical". It has proved to be an excellent response to the side effects of tamoxifen. By enhancing the patient's quality of life, this combined approach also improved adherence to treatment.

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

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-ß [IL1-ß], 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.

Using hetero-isotherapics in cancer supportive care: the fruit of fifteen years of experience.

BACKGROUND: Chemotherapy, hormone therapy, and new targeted therapies for cancer lead to adverse effects which are often difficult to relieve using classical homeopathy. Besides diminishing the quality of life of the patient, they can force the oncologist to reduce or even to cease treatment prematurely, which represents a loss of opportunity for the patient. Faced with these recurring problems, would the use of homeopathic dilution of chemotherapy, also called hetero-isotherapy, be a suitable response for improving the tolerance of and the adherence to cancer treatment? METHODS: Based on experiments conducted for over 50 years by many authors, we have offered our patients, since 1998, a protocol of hetero-isotherapy chemotherapy starting the day after each cytotoxic infusion. It involves taking a daily dose of a dilution of the chemotherapy used, using the increased dilution technique from 5c to 15c. RESULTS: We observed a significant decrease in side effects, allergic reactions and late sequelae in the more than 6000 hetero-isotherapic treatments given to some 4000 patients. The better tolerance to chemotherapy and the improvement in quality of life led to an increase in treatment adherence. No interference with chemotherapy was observed. When it was necessary to prescribe another homeopathic medicine, combination with hetero-isotherapy generally improved its effectiveness. CONCLUSION: In a large population, followed for over 15 years, we observed that hetero-isotherapics, well tolerated and easy to use, reduced the side effects of chemotherapy, targeted therapy or hormone therapy, and so improve the quality of life of patients.

A homeopatia como tratamento complementar à cancerologia / Formação Médica Continuada CEDH / Homeopathy as a complementary treatment to oncology

O autor por sua formação universitária em cancerologia, experiência enriquecedora e pela originalidade de seus procedimentos, inaugura esta coleção, tornando possível a ligação entre essas duas disciplinas aparentemente opostas e, entretanto, atualmente tão complementares.

A homeopatia como tratamento complementar à cancerologia / Formação Médica Continuada CEDH / Homeopathy as a complementary treatment to oncology

O autor por sua formação universitária em cancerologia, experiência enriquecedora e pela originalidade de seus procedimentos, inaugura esta coleção, tornando possível a ligação entre essas duas disciplinas aparentemente opostas e, entretanto, atualmente tão complementares.