Signos esperados de los coeficientes de regresión

Perhaps most, if not all, CAM therapies are palliative in nature. Their role is to provide a support for cancer treatment. Among the most common pal-liative CAM remedies utilized by cancer patients are herbal supplements, mind–body medicine (biofeedback), manipulative treatments, and “energy”

medicine.²Some of the CAM therapies that offer some relief, although not yet fully scientifically justified, are found in traditional medical systems such as TCM and homeopathy.⁸⁷Ayurveda, the traditional medicine in India, has ac-quired certain popularity in cancer management, since herbs and spices have been long used as components in the Indian cuisine.⁸⁸ For example women receiving tamoxifen for the treatment of breast cancer experience menopausal

Photo 11. Lavender (Lavendula officinalis). Pho-tographer Karen Bergeron, www.altnature.com.

symptoms of hot flashes and night sweats. In managing the menopausal symp-toms herbal remedies along with vitamin intake and cognitive behavioral therapy were the reported modalities women preferred in managing their symptoms.⁸⁹ Insomnia is often seen in cancer patients. The use of herbal remedies such as hops, lemon balm, Lavender (Photo 11), passionflower (Photo 12), and chamomile can help to induce mild sedation when insomnia ensues.⁹⁰

Cancer patients face many challenges in fighting their disease, including structural, emotional, and psychological issues. In addition, many of these patients undergo surgical procedures to eradicate the cancer, which by itself adds more stress. Those patients who receive chemotherapy may also suffer from side effects of treatment such as nausea and vomiting,⁹¹malaise, general fatigue and weakness, and hair loss. Radiation therapy is common in the management of many types of cancer and is often used in combination with chemotherapy. Radiation’s adverse effects can suppress bone marrow and have a deadly effect on other fast growing cells in body.

In addition to the conventional treatments mentioned above, many non-traditional approaches have been suggested. Many of these treatments were tested in a limited number of patients and under nonscientific conditions. Al-though many patients showed improvements using these methods, a definite

Botanicals with Anticancer Activity 33

Photo 12. Passionflower (Passiflora incarnate). Photo-grapher Karen Bergeron, www.altnature.com.

conclusion drawn from such studies cannot be reached. The benefits of com-plementary and alternative medicine (CAM) for cancer patients appears to be primarily due to psychological support and hope.⁹² The scientific com-munity has condemned the majority of these methods as dangerous.⁹³ This condemnation has its own negative influence on the relationship between clin-icians and their patients. Many cancer patients use CAM on a regular basis with or without the knowledge of their physicians.⁹⁴Some cancer centers are responding to these demands by introducing some of these methods in their palliative care,⁹⁵despite the fact that there is still lack of convincing supportive evidence for their usefulness.⁹⁶ One survey indicates that only 7% of cancer patients rely on CAM as therapy.⁹⁷ Another survey has placed the response rate for using CAM among cancer patients as high as 80%.⁹⁸ According to a survey obtained from colorectal cancer patients, 68% of them discussed the use of CAM with their doctors.⁹⁹ A recent study conducted at the Can-cer Research Center of Hawaii showed that when canCan-cer patients do discuss CAM issues with their physicians they often feel that physicians oppose these treatments due to lack of sufficient scientific support.¹⁰⁰ In a pilot study, re-searchers interviewed nineteen physicians on their opinion of CAM. All the physicians expressed the need for more information on CAM; however they did not feel that physicians should initiate discussions on this matter with their patients.¹⁰¹

The nontraditional treatments can be classified into two main cate-gories: complementary/integrative and alternative.¹⁰² The former compro-mises modalities that are used by patients along with traditional treatments.¹⁰³ Complementary/integrative methods are usually tolerated to some extent by health professionals and sometimes even recommended by them. Massage

therapy is one form of complimentary methods that is gradually gaining ac-ceptance among physicians and nurses. On the other hand, alternative methods are ones that claim “therapeutic” effectiveness on their own without the need of conventional treatments.¹⁰² Obviously, these methods are not accepted by clinicians, and many are considered dangerous. An example of alternative treatment is when a patient chooses to use herbal “anticancer” preparations instead of conventional therapies. Despite the potential risks associated with CAM,¹⁰³ patients who reportedly use alternative medicines to treat cancer perceive these treatments as less harmful than traditional treatments.¹⁰⁴ For-tunately only a minority of cancer patients (about 5%) choose an alternative mode of therapy.¹⁰⁵

In general, complementary/integrative methods are practiced by traditional health providers and others with varying backgrounds. Massage therapy, Reiki, relaxation techniques, and polarity therapy are just a few examples of CAM therapies. Massage therapy is now a recognizable tool in sports medicine as well as a stress reduction method. The nursing profession, in particular, has examined this method in palliative care in patients with various illnesses, including cancer.¹⁰⁶ The benefits of therapeutic massage in cancer patients include the feeling of well-being, relaxation, and comfort,¹⁰⁷ as well as help-ing with the nausea and pain associated with chemotherapy.¹⁰⁸ Reiki was initiated in Japan and then spread throughout the world as a method of heal-ing. Unlike massage therapists, Reiki practitioners do not undergo rigorous training, but rather they rely on what is known in Reiki’s circles as “initi-ation.” It is believed that through this initiation process the individual will possess a healing touch that can be transmitted to another person.¹⁰⁹ Very few reports in literature provide accounts of the benefits of Reiki. A report described a cancer patient with a “very aggressive” cancer under palliative treatment of chemotherapy and radiation, who received Reiki as a comple-mentary method. The report claimed that Reiki not only provided emotional support but also reduced his edema and pain.¹¹⁰Reiki was shown to induce a significant reduction in systolic blood pressure, an increase in skin tem-perature, and an increase in salivary IgA (immunoglobin A) concentration in relatively healthy volunteers.¹⁰⁹Other suggested effects of Reiki were seen on the hematocrit and hemoglobin readings following treatment.¹¹¹ Relaxation techniques, such as guided imagery, music, and progressive muscle relaxation, have been researched by many investigators. The main reason for the in-terest in relaxation techniques are the positive results that have been seen with cancer patients. Relaxation techniques have been shown to reduce fa-tigue, depression, tension, and anger.^112,113 They also reduce the intensity and duration of nausea and vomiting associated with chemotherapy.^113,114 Relaxation techniques work best when they are tailored to individual patient’s needs.¹¹⁵

Polarity therapy (PolT) is a form of touch therapy developed by Randolph Stone, N.D., D.C., that can be employed as a palliative method adjunct to the use of conventional therapies. It is one of the many methods known as

Botanicals with Anticancer Activity 35

energy therapies aimed at bringing back a balance in energy fields of the body disrupted by disease.¹¹⁶ PolT believes that the disturbance in energy fields leads to disease. PolT uses three approaches of therapy: diet, exercise, and hands-on techniques. PolT recognizes four different diet plans: the health building diet, the vegetarian diet, the gourmet diet, and everything else diet.

PolT yoga exercises are meant to improve stamina and muscular tone, as well as opening energy channels. Perhaps the most dramatic effect of PolT is its hands-on approach. Touch therapy is a well-known method for bring-ing comfort and calmbring-ing to a patient.^117−120 PolT utilizes a form of touch therapy that addresses specific tender points in the body by applying a di-rect pressure on the area, by holding, or by the hands hovering over the treated area. Three different qualities of touch are recognized. The first is sattvic touch, where the practitioner places his/her hands very gently on an area of the body without applying any movement. The second type of touch is known as rajasic. It involves applying pressure with vibration. The third form of touch is tamasic, where deep pressure is applied. Regardless of the type of touch used, PolT hands-on techniques were shown to affect the ex-tent of gamma ray count during the session; a reduction in this count was observed at the crown (head), heart, abdomen, and the pelvis areas.¹¹⁶ The authors suggested that this reduction in gamma counts may be associated with the absorption of energy by the body during PolT. The beneficial effects of absorbing this gamma radiation was compared to that of “hormesis” or the ex-posure of small amounts of ionizing radiation that may be beneficial to overall health.^116,121

C

Cancer as a disease is diverse in its manifestations and symptoms. Some types of cancer are easily dealt with and do not require major interference.

For example, squamous cell carcinoma of the skin is usually easy to treat by simply removing it surgically. Other forms of cancer are extremely aggressive, and a combination of chemotherapy, surgery, and radiation is needed in their treatment. In any case, botanicals play a role as adjuvant therapies in cancer management. They mainly enhance the defense mechanisms (immune system) of the patient, so he can better fight the disease. Other botanicals or dietary supplements may contribute to the cytotoxicity of chemotherapy and augment its effect. In all cases, in order to maximize therapeutic results, a close rela-tionship between the naturopathic physician, the allopathic doctor, and the patient must exist. Patients, in particular, should be aware of the danger asso-ciated with ignoring conventional treatments of cancer and any consequences that may ensue from such negligence. In addition to botanicals, patients may seek other forms of CAM to supplement their therapy. Most of these modal-ities work by alleviating the pain that is sometimes associated with certain forms of cancer. Usually, CAM practitioners are aware of the limitations and the contraindications of their modalities and request that their treatment be

coordinated with the patient’s physician. In general, the inclusion of botanicals in the diet on a regular basis may help to prevent cancer and may also be able to destroy single tumor cells at the early stages of development. In addition, it is expected that eating botanicals can improve the overall defense system in order for patients to be able to better fight cancer.

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Botanicals for Cardiovascular