Barrie R. Cassileth, MS, PhD

Native to India, boswellia is used extensively in Ayurveda, the traditional medical system of India, to treat arthritis. Extracts from the gum resin of boswellia have been tested in clinical trials and found effective for asthma and ulcerative colitis. More research is needed to determine if boswellia can benefit those with osteoarthritis. Boswellic acid has been found to display antitumor activity in bladder, cervical, and other cancer cell lines as well as anti-inflammatory activity.

Despite the widespread perception that dietary supplements are safe, few products have been subjected to rigorous research. The potential risks of dietary supplement use are not known. A powdered blend of fruits, vegetables, and grains, Juice Plus is aggressively promoted to cancer patients based on claims of antioxidant effects. Current research evidence indicates that the potential risks of antioxidants outweigh the benefits in the context of cancer treatment. Patients should discuss antioxidant supplementation with their physicians.

Native to Asia, ginger has many traditional uses. Current scientific evidence supports use of ginger for nausea and vomiting-clinical trials substantiate ginger’s effectiveness against nausea and vomiting associated with pregnancy, motion sickness, and postsurgery. A few studies of ginger for chemotherapy-induced nausea and vomiting yielded conflicting data, but a recent controlled trial demonstrates that ginger significantly reduces nausea and vomiting during the first day of chemotherapy.

Promoters of metabolic therapies claim that special diets, detoxification, and immune stimulation can treat and prevent a variety of diseases including arthritis, multiple sclerosis, and cancer.

Reishi mushroom is widely used in Asia and around the world as an immunostimulant. With extracts derived from both the cap and the stem of the mushroom, its biologic activity is thought be due to beta-glucan polysaccharides and compounds called triterpenes.

Music is a powerful tool that can evoke latent emotions, induce a range of emotional states, and enhance communication. It also offers a creative, lyrical, and symbolic means of addressing spiritual needs, and is increasingly used in end-of-life care.

Despite the widespread perception that herbal products are safe because they are “natural,” few of these products have been subjected to rigorous research. The potential risks associated with many herbal dietary supplements remain unknown.

A substantial number of cancer patients turn to unconventional agents used as anticancer therapies. However, “alternative cures” are unproved and may be harmful. They are not supported by clinical research and they can jeopardize patients’ lives, especially when patients delay needed care. Amygdalin, promoted as a popular alternative cancer cure for over 40 years, is used by many cancer patients. No solid data supports its effectiveness.

Despite the widespread perception that herbal products are safe because they are “natural,” few products have been subjected to rigorous research.

The recommendation to minimize sun exposure to prevent skin cancer has produced a pandemic of vitamin D deficiency. Vitamin D has generated considerable interest in the past decade, as accumulating evidence from both retrospective and prospective epidemiologic studies suggests an association between vitamin D deficiency and increased risk of autoimmune, infectious, and cardiovascular diseases, as well as cancer.

Acai demonstrated antioxidant and apoptotic effects in in vitro and in vivo studies, but no human studies have been conducted. Despite the lack of supportive data, acai, like many herbal products, is promoted to cancer patients on the ­Internet, often with false claims of cure.

Massage is an ancient technique that involves manual manipulation of muscles and soft tissues of the body. It increases circulation and promotes relaxation. Massage offers important emotional and psychological benefits as well.

Acupuncture is an important component of traditional Chinese medicine. The practice originated more than 2,000 years ago. It involves stimulation of one or more predetermined points on the body with sterile, filiform, disposable needles, sometimes with added heat (moxibustion), pressure (acupressure) or electricity to enhance therapeutic effect. The needles are much thinner than the hypodermic needles used for injections.

Maitake beta- glucan extract obtained from the fruiting bodies of maitake mushroom, or Grifola frondosa, is widely used in Asia as a cancer treatment, typically adjunctively. Research to determine the mechanisms that underlie maitake’s anticancer effects is ongoing, as detailed at http://www.mskcc.org/AboutHerbs.

SCIENTIFIC NAMES: Coriolus versicolor, Trametes versicolor, Polyporus versicolor, Polystictus versicolor

SCIENTIFIC NAMES: Silybum marianum, Carduus marianum

In this first installment of ONCOLOGY’s new department, we review “graviola.” Graviola was chosen for review because it is one of the most commonly searched terms sought by visitors to MSKCC’s “About Herbs” website. Because graviola is commonly promoted as a cancer treatment, your patients may be inclined to take it.

Integrative oncology, the synthesis of gold-standard care and evidence-based complementary modalities, deals not only with the patient’s tumor, but also with her physical and emotional needs and with the relevant cultural, scientific, and policy issues. This synthesis was one of Marty Abeloff’s main professional goals.

The field of integrative oncology represents the synthesis of mainstream cancer treatment and rational, databased complementary therapies. These therapies are used not to treat cancer, but to reduce physical and emotional symptoms using noninvasive, nonpharmacologic modalities such as massage and music therapies, acupuncture, meditation, and other mind-body therapies, fitness programs, and the like.

Commonly used by cancer patients, unproven therapies are treatments that the practitioner claims can alter the disease process although there is no proof to support the claim. The reasons for the popularity of uproven

Many oncologists are barraged with questions and declarations from patients regarding therapies and products that

NEW YORK-Barrie R. Cassileth, PhD, is chief of Memorial Sloan-Kettering Cancer Center’s new Integrative Medicine Service, which was officially opened April 1 of this year. As a researcher, educator, and planner, she has worked in psychosocial aspects of medicine and alternative and complementary therapies for more than 20 years.

Times change; the pendulum swings. Once, not so many years ago, mainstream health providers and insurers viewed all alternative and complementary practitioners as quacks.