Complementary and alternative medicine in the treatment of colorectal cancer: a systematic review on this promising therapy (Abstract P-273)

Wilfredo E. De Jesus-Monge, University of Massachusetts Medical School Worcester

Abstract

Background: Colorectal cancer is a common malignancy with an annual incidence of over 945,000 cases worldwide and an annual mortality of 492,000 individuals (Weitz et al, 2005). As a consequence, complementary and alternative medicine has been incorporated into its management programs in recent years. The National Center for Complementary and Alternative Medicine was founded in 1998 by the government of the United States of America to sponsor and to conduct scientific research on complementary and alternative medicine. The aim of this study is to systematically review some of the complementary and alternative medicine modalities, the study of their efficacy, and clinical trials registered in the United States of America in the treatment of colorectal cancer.

Method: A literature search was conducted in MEDLINE (1966 to date, via PubMed). The search terms used were: (complementary OR alternative) AND medicine AND colorectal AND cancer. Abstracts and articles were systematically reviewed by the author and considered in order to satisfy the aim of this study. The same terms were used to search for registered clinical trials of complementary and alternative medicine in colorectal cancer in ClinicalTrials.gov.

Results: Some of the most commonly used complementary and alternative medicine therapies in cancer patients are: ‘‘functional food’’, herbs, vitamins and minerals, and psychological and spiritual therapies. Ukrain is a compound derived from the common weed that has shown increased survival and no progression of tumor in colorectal cancer patients on randomized clinical trials but with many limitations, unreliable methodological quality, and confusing publication. Shark cartilage has shown anticancer activity through glycoproteins that has extended life in leukemic mice, inhibition of tumor angiogenesis, and protection against mutagenesis and DNA lesions. However, a two-armed, randomized, placebo-controlled, double-blinded clinical trial in patients with incurable colorectal cancer did not show any efficacy. Echinacea reduced cell viability in human colon cancer cell lines. An oral enzyme preparation given complementary to antineoplastic therapy for colorectal cancer improved the quality of life of the patients. A study in Canada (Tough et al, 2002) showed that 49% of colorectal cancer patients used complementary and alternative medicine. These patients most frequently used psychological and spiritual therapies, vitamins, minerals, and herbs. A study in Europe (Molassiotis et al, 2005) showed that 32% of colorectal cancer patients used complementary and alternative medicine and the most commonly used were herbs and homeopathy. The search for registered clinical trials revealed 3 colorectal cancer studies. The evaluated complementary and alternative medicine modalities are antineoplaston, shark cartilage, and acupuncture.

Conclusions: Physicians must prepare to discuss complementary and alternative medicine with cancer patients. Further high quality research with large sample size and controlled environments are necessary to confirm the potential benefits of complementary and alternative medicine use in patients with colorectal cancer, as suggested by preliminary basic and clinical science studies. This study was partially funded by the Department of Medicine of the University of Puerto Rico School of Medicine and United States of America National Institutes of Health grant 2R25RR017589-06.