Wednesday, May 4, 2016

Combining alternative and conventional treatments for melanoma....a risky business!

Mother Nature is a tricky B!!!!  She can give us rains that provide our water supply and make crops grow one minute followed by torrential floods that kill and wipe out cities the next. All that is found in nature is not benign.  In the plant world, poison ivy and hemlock come to mind.  Yet we are lucky to have Vincristine, derived from the periwinkle and categorized as an essential medication by the WHO, for the wonderful cures it can provide folks suffering from leukemia, Hodgkin's disease and other cancers.  Morphine, aspirin, digitoxin, quinine, and Paclitaxel are just a few of the drugs derived from plants that have benefited humans across the globe.  Then again, we have the beauty of tics and mosquitoes along with the germs they carry from the natural world. Speaking of the littlest beings - viruses and bacteria - while they can damage the unborn, bring illness, suffering and even death - alternatively, they also allow us the enjoyment of cheese, beer and wine and the incredible life saving properties of penicillin.  All this is merely a reflection of the pros and cons of the "natural/alternative" world.  Because there is also this: 

Risk of interactions between complementary and alternative medicine and medication for comorbidities in patients with melanoma.  Loquai, Dechent, Garzarolli et al.  Med Oncol. 2016 May.  

Complementary and alternative medicine (CAM) is used widely among cancer patients. Beside the risk of interaction with cancer therapies, interactions with treatment for comorbidities are an underestimated problem. The aim of this study was to assess prevalence of interactions between CAM and drugs for comorbidities from a large CAM usage survey on melanoma patients and to classify herb-drug interactions with regard to their potential to harm. Consecutive melanoma outpatients of seven skin cancer centers were asked to complete a standardized CAM questionnaire including questions to their CAM use and their taken medication for comorbidities and cancer. Each combination of conventional drugs and complementary substances was evaluated for their potential of interaction. 1089 questionnaires were eligible for evaluation. From these, 61.6 % of patients reported taking drugs regularly from which 34.4 % used biological-based CAM methods. Risk evaluation for interaction was possible for 180 CAM users who listed the names or substances they took for comorbidities. From those patients, we found 37.2 % at risk of interaction of their co-consumption of conventional and complementary drugs. Almost all patients using Chinese herbs were at risk (88.6 %). With a high rate of CAM usage at risk of interactions between CAM drugs and drugs taken for comorbidities, implementation of a regular assessment of CAM usage and drugs for comorbidities is mandatory in cancer care. 

Given the horrible tenacity and morbidity associated with melanoma, and the fact that some of the best treatments provide only a 40% response rate, it is sorely tempting to add a dab of this and a bit of that to our chosen medical treatment plan.  Adding things like NSAIDs (mentioned recently in the post:  Celecoxib (stuff that's in NSAIDs like aspirin and advil) works synergisticaly with anti-PD1) sounds like a no brainer, right?  And while an aspirin a day USUALLY causes no harm, there are those for whom it is NOT a good idea!  In fact, most medical researchers agree...if aspirin were put before the FDA would likely be a prescription medication!!!  So...just remember:  all things over the counter and 'natural' are not always good for us.  Talk to your oncologist before adding ANYTHING to your cancer treatment plan.

Wishing you well! - c

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