Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Multiple organizations around the world have issued evidence-based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health-related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home-based or community-based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.     

Use of complementary and alternative medicine by Chinese women with breast cancer

The use of complementary and alternative medicine (CAM) has been rapidly increasing among cancer patients. The aim of this study is to evaluate the prevalence and patterns of CAM use, particularly patients' intentions and their perceived effectiveness of using Chinese herbal medicine (CHM), as well as the relations between the herbal medicine use and demographic and clinical factors among Chinese women with breast cancer. We analyzed the data from a population-based sample of 1065 breast cancer women in urban Shanghai. Patients' average age at diagnosis was 48.1 years and the median time from the initial diagnosis to the follow-up survey was 4.3 years. Overall, 98% of patients had used at least one form of CAM therapy after diagnosis of breast cancer. The most popular CAM modality was traditional Chinese medicine (86.7%), followed by the use of supplements (84.8%), physical exercises (65.5%), and support group attendance (16.6%). CHM was used by 86.4% of patients, while acupuncture was used only by 4.9% of patients. Treating cancer (81.5%) was the most common intentions of using CHM. Other cited intentions included enhancing the immune system (12%), preventing metastasis of cancer or managing other discomforts (7.9%), and lessening menopausal symptoms (4.7%). The majority of patients reported that they had benefited from the use of CHM. Patients who were younger, married, had higher education or income, received chemotherapy or radiotherapy, or had recurrence/metastasis of cancer tended to use CHM more frequently than other patients. The relations between patient characteristics and use of CHMs varied with users' intentions. Given the high prevalence of CAM use among breast cancer patients, research is urgently needed to systematically evaluate the efficacy and safety of CAM use, particularly use of herbal medicines.     

Complementary therapy support in cancer survivorship: a survey of complementary and alternative medicine practitioners' provision and perception of skills

This study reviewed the confidence and perceived skills of complementary and alternative medicine (CAM) practitioners in providing care and symptom management for clients post cancer. An e‐survey was mailed to approximately 21 000 CAM practitioners, targeted at those working with clients who were experiencing consequences of cancer and its treatments. Questions were asked about the main symptoms and concerns of clients, the confidence and current skill levels of practitioners and additional training requirements. Six hundred and twelve practitioners responded to the survey, 507 of whom were working with individuals experiencing the consequences of cancer and its treatments. Forty‐five per cent (n = 134) had undertaken training in cancer prior to working with cancer patients, 61% (n = 182) had undertaken courses or study days relative to cancer care in the past two years. The most often treated symptoms or concerns of patients were those of a psychosocial nature, pain management and lymphoedema. CAM practitioners with limited knowledge and training are providing support to cancer survivors, particularly in services where the National Health Service has limited provision. CAM practitioners may fulfil a future role in providing long‐term support for cancer survivors; however, in order to properly safeguard patients they are in need of further training and development.     

中药治疗胃癌的机制研究进展

总结中药治疗胃癌的机制:逆转胃癌前病变、调控信号通路、诱导细胞凋亡、诱导肿瘤细胞分化、抑制肿瘤细胞端粒酶活性、抑制肿瘤血管生成、逆转肿瘤多药耐药性、抑制肿瘤细胞侵袭及转移、调节机体免疫功能等.本文就上述方面作一综述.     

骨转移癌中医及中西医结合治疗近况

骨是癌症远处转移的好发部位,骨转移也是晚期恶性肿瘤常见的并发症。恶性肿瘤细胞在骨组织形成骨转移时,发生骨的破坏,主要临床表现为顽固性疼痛、病理性骨折、截瘫、最后导致病人生活质量的严重下降。西医主要采用手术、放化疗、内照射治疗、骨吸收抑制剂、内分泌等治疗;中医则采用辨证论治为主的综合治疗方法,同时综合各学科的优势,对骨转移实施中西医结合治疗的原则也取得了较大的进展。     

The determinants of traditional Chinese medicine and acupuncture utilization for cancer patients with simultaneous conventional treatment

This paper investigates the determinants of traditional Chinese medicine (TCM) and acupuncture utilization for cancer patients who are simultaneously having conventional Western medical treatments. This study used five leading cancers in Taiwan, namely cervical, breast, lung, liver and colorectal cancers. A total of 2499 cancer patients were interviewed, of which 2034 had full information and were analysed. Logistic regressions were used for both TCM and acupuncture. The results showed that type of cancer and cancer duration determine the utilization for alternative treatments. While socio-economic factors also affect choice of alternative medicine, the magnitude differs by types of alternative treatment and cancer. Compared with men and older patients, women and younger patients tend to prefer alternative medicine, and patients from south have higher preference for alternative medicine, which could be a reflection of local culture. Our results are useful for the government to determine higher users of TCM and acupuncture among cancer patients, and make policies to suit these patients' needs.     

量子医学与中医药现代化研究

量子医学是一门融合了物理学、力学、数学、统计学和现代生物医学等的新兴学科,在疾病预防、早期诊断、 治疗和药物开发等领域已经获得一些突破性成果,并显现出了独特优势。量子非定域性与贝尔定理是量子医学的理论基础 和本质特征,量子纠缠、量子导引和贝尔非定域性是生物体本身及外界因素相互作用的三种主要形式,生物量子信息的 分析、计算和检测是研究量子医学的基本方法。量子是物理学最小基本单位,反映生命体量子变化的量子医学对人体疾病 的发生、发展具有高度的敏感性,有利于实现对人体疾病的早期诊断和早期治疗（如量子检测实体瘤准确率93.37%,血液 肿瘤准确率88.75%）,并且适合于亚健康状态早期预警、物质和能量代谢机制研究和药物开发等。量子医学的非定域性赋 予了这门新兴医学“整体观”和“辨证论治”特性,与中医中药具有可通约性,对阐明传统中医中药的一些基本理论、明确中药复方的效应成分和作用机制有重要价值,可促进中医药的现代化进程。量子医学目前尚处于起步阶段,尤其量子信 息的检测方法的复杂性制约了量子医学的应用和发展,随着量子物理理论、量子力学和现代医学的不断发展,需要有更多高质量的基于量子医学的研究、生物量子信息检测和应用的研究。     

肺癌中医药治疗的研究进展及展望

肺癌严重威胁人类的生命健康,中医药治疗肺癌有自己独特的理论体系和确切疗效,中西医学互为补充、相互交融的模式成为肺癌治疗发展的方向与趋势。目前对肺癌中医治疗的临床与基础研究已取得一定成绩,但仍缺乏真正符合肺癌中医药证治规律的研究方法及相关技术。随着研究的不断深入和系统化,中医药治疗肺癌将得到进一步发展。     

中药溻渍疗法配合中药食疗治疗肿瘤患者化疗所致便秘的疗效观察

目的:探讨中药溻渍疗法配合中药食疗对肿瘤患者化疗所致便秘的疗效观察。方法:选择我院在2016年3月至2017年7月收治的肿瘤化疗患者80例,随机分为治疗组和对照组各40例,对照组给予常规治疗和饮食护理,治疗组在对照组治疗和护理的基础上采用中药溻渍疗法和中药食疗。结果:治疗组患者化疗所致便秘发生率低于对照组,出现纳差、腹胀、疼痛、大便干结的不良反应发生率较对照组也减少,两组差异均有统计意义(P＜0.05)。结论:中药溻渍疗法配合中药食疗可减轻化疗的不良反应,有效改善化疗所致便秘。     

胃肠道菌群与胃癌的关系及中医药的作用研究

随着现代分子生物学技术的发展、宏基因组学研究的深入和代谢组学的进步,肠道菌群及其代谢研究越来越受 到人们的重视。胃癌作为世界上第五大最常见的肿瘤,也是世界上肿瘤相关死亡中排名第三的肿瘤,其与胃肠道菌群的关 系也越来越引起大家的重视。胃肠道微生态系统内的微生物数量和种类最多,其平衡对人体健康起重要作用。早期,人类 认为胃内是无菌的,随着研究的深入,幽门螺杆菌感染与人类胃癌的发生关系也被逐渐揭示,人类胃肠道菌群与胃癌的 关系的报道也越来越多,研究证实胃肠道菌群可以参与机体的营养、代谢、免疫等作用,胃肠道菌群的改变也会导致炎 症的发生、发展。中医认为脾胃不合,必然会出现胃肠道菌群失调,而菌群失调又会引起机体不同程度的代谢异常。因此, 利用中医药辅助治疗胃癌不仅能改善胃癌患者脾胃不合症状,也能够调节胃癌患者的胃肠道菌群及机体的代谢,纠正胃肠 道菌群失调引起的不良症状。本文就胃肠道菌群代谢与胃癌的关系及中医药的作用进行概述。     

癌痛内服中药的药性分析

目的:评价中医内服方剂治疗癌痛的常用中药的药性,探讨用药趋势.方法:计算机检索配合手工检索1990年1月-2015年12月国内医学期刊公开发表的中医内服方剂治疗癌性疼痛的临床研究文献,统计分析常用中药和药性的频次和频率.结果:治疗癌痛的内服中药主要为活血化瘀药和补虚止痛药,药性多温平,味多苦、辛、甘,主要归肝、肺、脾经,大多无毒.结论:中医内服中药治疗癌痛应首先考虑行气活血化瘀和补虚止痛药,选用平性、温性,辛、苦味,归厥阴肝经、太阴肺脾经的药物,同时注意毒性中药的使用,以确保临床用药安全.     

中药对大肠癌治疗作用的研究进展

大肠癌是常见的恶性肿瘤之一,其早期以手术治疗为主,中、晚期以化疗、放疗为主,然而各种治疗手段配合中医中药治疗,对降低复发,减轻放化疗副反应,延长病人生存期,改善病人的生存的质量有着重要的意义。     

Research progress of integrated traditional Chinese and Western medicine in the treatment of advanced gastric cancer

Gastric cancer (GC) is a malignant tumor originating from the gastric epithelium, and its incidence and mortality rates rank third among all malignant tumors worldwide. It is also one of the most common cancers in China and is treated predominantly by Western medicine in clinical practice. However, with the advancements in medical technology and informatics, the values of traditional Chinese medicine (TCM) in preventing and treating GC and improving prognosis have increasingly been recognized. According to TCM, clinical manifestations of GC can be divided into Yege (dysphagia), regurgitation, stomach pain, and Zhengxia (abdominal mass). Due to the unbalanced distribution of health care resources in China, most GC patients already have progressive or advanced-stage disease at the first diagnosis. As a result, most GC patients have poor physical function, and surgery or chemotherapy alone will aggravate the impairment to the immune function and seriously affect the quality of life. In contrast, TCM therapies have shown promising efficacy in the management of these patients. Here we review the role of the integrated TCM and Western medicine in treating advanced GC.     

中药防治肠道菌群相关性结直肠癌的研究进展

结直肠癌发病率和死亡率居我国全部恶性肿瘤的第 3 和第 5 位,严重威胁居民健康。结直肠癌病因复杂,其中 肠道微生态是影响癌变过程的关键环节。肠道菌群是维持人体胃肠道及机体健康的重要因素,肠道微生物病原体在结直肠 癌发病机制包括微生物代谢、宿主免疫和炎症途径的调节、氧化应激与抗氧化防御调节、细菌基因毒素等环节。传统中药 给药方式主要为口服,中药进入胃肠道后不可避免与肠道微生物发生相互作用。中药主要通过调节肠道菌群结构,从而调 节宿主免疫功能,以及氧化应激与抗氧化防御调节等途径实现防治结直肠癌的作用。实验研究证实,中药对肠道微生态系 统的平衡具有很好的保护作用,对菌群失调具有改善作用;中药可以提高宿主抗癌免疫反应以及通过调节肿瘤微环境下的 骨髓来源的细胞功能发挥抗肿瘤疗效;促进有氧培养菌的耐酸能力并抑制了厌氧培养菌的耐酸能力,从而增强了整体肠道 菌群的抗氧化性。另外,中药亦能改善微生物的代谢、减轻代谢性炎症,以及抑制产生大肠杆菌的体外和体内基因毒性, 中草药的药效成分经肠道微生物转化后发挥抗炎、镇痛和抗肿瘤等药理作用。综上,肠道菌群在部分结直肠癌的发生发展 中具有重要作用,调节肠道菌群是中医药防治结直肠癌的重要靶标。     

中药注射液治疗肺癌研究进展

中药注射液在肺癌的治疗过程中应用广泛,疗效显著,意义重大,有关中药注射液治疗肺癌的研究越来越深入,现从基础研究和临床研究方面对近年来中药注射液治疗肺癌的研究情况进行综述。     

中药抗肺癌实验研究进展

中药抗肺癌已成为当今研究的热点,本文就近年来中药直接杀伤肺癌细胞,调节机体免疫功能,抑制肿瘤细胞增殖、诱导肿瘤细胞分化、凋亡,抑制肿瘤血管形成等实验研究作了综述。     

中医药治疗肺癌对患者血清CA-125的影响

背景与目的:CA-125已经是公认的卵巢癌标志物,在长期的临床观察中发现血清CA-125在肺癌诊治中具有一定的诊断及判定预后的价值.本研究探讨中医药治疗术后与不能切除肿瘤的肺癌患者时对血清CA-125的影响;同时探讨血清CA-125与肺癌临床分期及病理学类型相关性.方法:用微粒学酶免分析法检测30例健康人及60例肺癌患者中医综合治疗方案治疗前后血清CA-125水平,并作对比分析.结果:血清CA-125在肺癌患者的值(91±45)与健康人(18±5)相比,差异有非常显著性,(P＜0.001),血清CA-125在ⅢA/ⅢB及Ⅳ期肺癌患者中值分别为85±21及142±25,与Ⅰ/Ⅱ期患者的35±11相比,差异有非常显著性(P＜0.001)肺腺癌患者CA-125水平(127±31)与鳞癌(58±27)及小细胞癌(56±26)相比,差异有非常显著性(P＜0.001).ⅢA/ⅢB及Ⅳ期肺癌患者中医药综合治疗方案治疗后CA-125值分别为(36±11;87±15)于治疗前(85±21;142±25)相比,差异有非常显著性.(P＜0.001).但对于Ⅰ/Ⅱ期患者治疗后(33±10)与治疗前(35±11)相比,差异无显著性(P＞0.05).结论:中医药治疗肺癌,在Ⅲ/Ⅳ期的肺癌患者可显著的降低血清CA-125水平,在Ⅰ/Ⅱ期的肺癌患者也有明显的降低血清CA-125水平的趋势.血清CA-125水平与肺癌患者临床分期、病理类型有关.