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Journal of Pain and Symptom Management- Abstract
Review Article
Context
Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists.
Objectives
To
review the literature and summarize the beneficial effects and safety
of NHNS in the prevention and reduction of treatment-related symptoms.
Methods
Databases
were searched for randomized, controlled clinical trials (Jadad
score ≥ 2) using AltHealthWatch, Cochrane Database of Systematic
Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine
Service Database, Natural Standard Database, and PubMed. The key words
searched were the following: alternative and/or complementary medicine,
nutritional and/or dietary supplements, quality of life, symptoms and/or
side effects, specific toxicities (e.g., neuropathy, mucositis), and
specific supplements (e.g., vitamin E, glutamine, etc.).
Results
A
number of NHNS products were found to be effective. The incidence and
severity of peripheral sensory neuropathy associated with taxane-agents
such as paclitaxel can be reduced with vitamin E, glutamine, and
acetyl-L-carnitine. Vitamin E and glutamine also have been shown to
reduce oral mucositis (mouth inflammation/sores) resulting from radiation and chemotherapy, and
glutamine and probiotics can reduce chemotherapy-induced diarrhea.
Conclusion
There
is a need to develop an open and nonjudgmental dialogue between
oncologists and cancer patients, addressing the needs of the patient
while dealing with issues related to the efficacy and safety of these
products. Referral of patients to an integrative medicine consultant may
help achieve these goals, providing both parties with the option of
reaching an informed and respectful decision about treatment.
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