Disease Free Survival in Breast Cancer Patients Who Receive Naturopathic Oncology Care

Standish, Leanna J.

doi:10.1177/15347354211058406

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…At higher doses of radiation, immune suppression occurs, while lower levels of radiation have subtle but persistent immune function alterations that can be immunosuppressive or immunostimulatory [ 135 – 137 ]. In a small series of irradiated Stage I–III patients with breast cancer, decreased TNF and lymphocyte counts persisted after ionising radiation [ 138 ]…”

Section: Recommendations and Supporting Evidencementioning

confidence: 99%

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Papp

Melosky

Sehdev

et al. 2023

Dermatol Ther (Heidelb)

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Background Patients with treated solid tumours (TSTs) are a highly heterogeneous population at an increased risk for malignancy compared with the general population. When treating psoriasis in patients with a history of TSTs, clinicians are concerned about the immunosuppressive nature of psoriasis therapies, the possibility of augmenting cancer recurrence/progression, and infectious complications. No direct, high-level evidence exists to address these concerns. Objectives We aim to provide a structured framework supporting healthcare professional and patient discussions on the risks and benefits of systemic psoriasis therapy in patients with previously TSTs. Our goal was to address the clinically important question, “In patients with TSTs, does therapy with systemic agents used for psoriasis increase the risk of malignancy or malignancy recurrence?” Methods We implemented an inference-based approach relying on indirect evidence when direct clinical trial and real-world data were absent. We reviewed indirect evidence supporting inferences on the status of immune function in patients with TSTs. Recommendations on systemic psoriasis therapies in patients with TSTs were derived using an inferential heuristic. Results We identified five indirect indicators of iatrogenic immunosuppression informed by largely independent bodies of evidence: (1) overall survival, (2) rate of malignancies with psoriasis and systemic psoriasis therapies, (3) rate of infections with psoriasis and systemic psoriasis therapies, (4) common disease biochemical pathways for solid tumours and systemic psoriasis therapies, and (5) solid organ transplant outcomes. On the basis of review of the totality of this data, we provided inference-based conclusions and ascribed level of support for each statement. Conclusions Prior to considering new therapies for psoriasis, an understanding of cancer prognosis should be addressed. Patients with TSTs and a good cancer prognosis will have similar outcomes to non-TST patients when treated with systemic psoriasis therapies. For patients with TSTs and a poor cancer prognosis, the quality-of-life benefits of treating psoriasis may outweigh the theoretical risks. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-023-00905-3.

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Section: Recommendations and Supporting Evidencementioning

confidence: 99%

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Papp

Melosky

Sehdev

et al. 2023

Dermatol Ther (Heidelb)

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“…Clinical research throughout Asia and in the U.S. has led to widespread use of the immunologically active mushroom species named Trametes versicolor by both integrative oncologists and patients. [13][14][15] Ipilimumab was the first checkpoint inhibitor approved by the FDA, in 2011. This monoclonal antibody binds to the T lymphocyte-associated protein 4 (CTLA-4), leading to an inhibition of cancer cell activity.…”

Section: High Dose Ascorbate Has Clinical Research-basedmentioning

confidence: 99%

Integrative Oncology’s 30-Year Anniversary: What Have We Achieved? A North American Naturopathic Oncology Perspective

Standish,

Malani,

Lynch

et al. 2023

Integr Cancer Ther

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In 1991 the U.S. Congress mandated that the National Institutes of Health (NIH) form the Office of Alternative Medicine to study alternative medical therapies, especially in oncology care. Shortly after, the National Cancer Institute (NCI) created its own division of complementary and alternative medicine (Office of Complementary and Alternative Medicine). At the genesis of the field 30 years ago, what were we hoping to see accomplished by now? In this article we take a look back at milestones, shortfalls and future directions. Exciting opportunities exist to direct our established subspeciality’s future directions and we have made valuable advances the field of integrative oncology over the last 30 years: 1, IV high dose ascorbate has clinical research-based applications when used concurrently with some chemotherapeutic agents. 2. Whole body, extracorporeal and locoregional hyperthermia are being applied in treating solid tumors, including brain tumors. 3. PDL-1 tumor microenvironment testing and PDL-1 inhibitor immunotherapies have surprisingly excellent outcomes in a subgroup of cancer patients. 4. Tumor DNA sequencing (resected tumor and circulating tumor DNA in blood) has led to personalized precision targeted treatments. 5. Glucose metabolism’s role in cancer progression is better understood and better therapies are available (e.g., intermittent fasting, metformin). 6. Medical cannabis has a larger role in treating chemotherapy-related side effects and shows promise for anti-proliferative effects. 8. Greater understanding has been gained of the interdependence and mutual regulation of processes in psychoneuroendocrinoimmunology (PNEI). The burgeoning field of PNEI has exponentially expanded the discussion of tumorigenesis, apoptosis, and introduced to the field the investigation of more holistic approaches to immune regulation and cancer care. 8. Psychedelic-assisted psychotherapy is gaining traction especially for cancer patients facing demoralization, existential and spiritual distress, anxiety, depression and trauma related to the diagnosis and treatment of their cancer. 9. Spiritual health of cancer patients is more commonly addressed and measurable with an NIH validated scale. 10. Mind-Body therapies are efficacious for reducing cancer-related distress and are included in many cancer care programs.

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“…Lymphocytopenia has long been observed in patients with cancer treated with radiotherapy, including those with breast cancer. 1 Although standard adjuvant radiotherapy for breast cancer does not target hematopoietic tissues, such as the bone marrow or spleen, irra-This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2024 The Authors.…”

Section: Introductionmentioning

confidence: 99%

“…Lymphocytes are one of the most radiosensitive cell types in the human body. Lymphocytopenia has long been observed in patients with cancer treated with radiotherapy, including those with breast cancer 1 . Although standard adjuvant radiotherapy for breast cancer does not target hematopoietic tissues, such as the bone marrow or spleen, irradiation of circulating lymphocytes passing through the radiation field is believed to cause lymphocytopenia.…”

Section: Introductionmentioning

confidence: 99%

Lymphocytopenia following adjuvant radiotherapy for breast cancer

Takeda,

Umezawa,

Yamamoto

et al. 2024

Precision Radiation Oncology

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ObjectiveWe retrospectively analyzed breast cancer patients who received adjuvant radiotherapy to determine the incidence of lymphocytopenia and its risk factors.MethodsWe reviewed 812 patients with breast cancer who received postoperative radiotherapy. Patients were divided into two groups based on the use of chemotherapy, and a generalized linear regression model was used to explore predictive factors for grade 2 or higher lymphocytopenia. We also examined the effect of lymphocytopenia on overall survival.ResultsGrade 2 or higher lymphocytopenia was observed in 19.4% of patients who did not receive chemotherapy and 45.1% of patients who received chemotherapy. In multivariate analysis, bilateral disease, regional lymph node irradiation, and baseline lymphocytopenia were associated with lymphocytopenia in patients who did not receive cytotoxic chemotherapy. Regional lymph node irradiation, baseline lymphocytopenia, use of antimetabolites, and use of molecular‐targeted agents were associated with lymphocytopenia in patients treated with chemotherapy. In the survival analysis, lymphocytopenia was associated with worse overall survival only in patients treated with cytotoxic chemotherapy (p = 0.039), and not in patients who did not receive chemotherapy (p = 0.77).ConclusionThe analysis revealed the incidence and risk factors of lymphocytopenia after postoperative radiotherapy in patients with breast cancer.

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Disease Free Survival in Breast Cancer Patients Who Receive Naturopathic Oncology Care

Cited by 6 publications

References 5 publications

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Use of Systemic Therapies for Treatment of Psoriasis in Patients with a History of Treated Solid Tumours: Inference-Based Guidance from a Multidisciplinary Expert Panel

Integrative Oncology’s 30-Year Anniversary: What Have We Achieved? A North American Naturopathic Oncology Perspective

Lymphocytopenia following adjuvant radiotherapy for breast cancer

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