Abstract
Integrative medicine includes a combination of current medical therapies in conjunction with evidence-based diet and nutrition support, mind-body practices, and additional practices, sometimes referred to as complementary or alternative. Patients with hepatobiliary or pancreatic cancer often seek integrative therapies to help manage the cancer itself, to support them through cancer treatment and its symptoms, or to provide a source of coping with the various stressors involved with having cancer. This chapter will focus on current integrative medicine practices such as diet and nutrition, nutritional supplements, acupuncture, and mind-body practices in relation to patients who have hepatobiliary or pancreatic cancer. The goal is to establish a set of integrative medicine practices that help optimize a patient’s diet and exercise regimen, provide appropriate stress management and coping techniques, and consider the pros and cons of various nutritional supplements commonly used to support patients through their cancer.
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Abd El-Atti S, Wasicek K, Mark S, et al. Use of probiotics in the management of chemotherapy-induced diarrhea: a case study. J Parenter Enter Nutr. 2009;33:569–70.
Abe K, Uwagawa T, Haruki K, et al. Effects of ω-3 fatty acid supplementation in patients with bile duct or pancreatic cancer undergoing chemotherapy. Anticancer Res. 2018;38(4):2369–75.
Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA. 2001;286:208–16.
Bargut TC, Frantz ED, Mandarim-de-Lacerda CA, Aguila MB. Effects of a diet rich in n-3 polyunsaturated fatty acids on hepatic lipogenesis and beta-oxidation in mice. Lipids. 2014;49(5):431–44.
Bartteo FG, Neale RE. Vitamin D and pancreatic cancer. Cancer Lett. 2015;368:1–6.
Bauer MR, Bright EE, MacDonald JJ, Cleary EH, Hines OJ, Stanton AL. Quality of life in patients with pancreatic cancer and their caregivers: a systematic review. Pancreas. 2018;47(4):368–75.
Berkson BM, Rubin DM, Berkson AJ. Revisiting the ALA/N (alpha-lipoic acid/low-dose naltrexone) protocol for people with metastatic and nonmetastatic pancreatic cancer: a report of 3 new cases. Integr Cancer Ther. 2009;8(4):416–22.
Bishop SR, Lau M, Shapiro S, et al. Mindfulness, a proposed operational definition. Clin Psychol Sci Pract. 2004;11:230–41.
Bitetto D, Fabris C, Falleti E, et al. Vitamin D and the risk of acute allograft rejection following human liver transplantation. Liver Int. 2010;30(3):417–44.
Boleij A, Tjalsma H. Gut bacteria in health and disease: a survey on the interface between intestinal microbiology and colorectal cancer. Biol Rev Cambridge Phil Soc. 2012;87:701–30.
Boyle RJ, Robins-Browne RM, Tang ML. Probiotic use in clinical practice: what are the risks? Am J Clin Nutr. 2006;83:1256–64.
Branch AD, Barin B, Rahman A, et al. Vitamin D status of human immunodeficiency virus-positive patients with advanced liver disease enrolled in the solid organ transplantation in HIV: multi-site study. Liver Transpl. 2014;20(2):156–64.
Carlson LE, Zelinski EL, Toivonen KI, et al. Prevalence of psychosocial distress in cancer patients across 55 North American cancer centers. J Psychosoc Oncol. 2019;37(1):5–21.
Corey KE, Kaplan LM. Obesity and liver disease: the epidemic of the twenty-first century. Clin Liver Dis. 2014;18(1):1–18.
Corey RL, Rakela J. Complementary and alternative medicine: risks and special considerations in pretransplant and posttransplant patients. Nutr Clin Pract. 2014;29(3):322–31.
Corpet DE. Red meat and colon cancer: should we become vegetarians, or can we make meat safer? Meat Sci. 2011;89:310–6.
de Moreno-de LeBlanc A, Matar C, Perdigón G. The application of probiotics in cancer. Br J Nutr. 2007;98:S105–10.
Diallo A, Latino-Martel P, Sm H, et al. Red and processed meat intake and cancer risk: results from the prospective NutriNet-Santé cohort study. Int J Cancer. 2018;142:230–7.
DuBroff R, Vasant L, Murray-Krezan C. A prospective trial of ayurveda for coronary heart disease: a pilot study. Altern Ther Health Med. 2015;21(5):52–62.
Elshazly SM, El-Moselhy MA, Barakat W. Insights in the mechanism underlying the protective effect of α-lipoic acid against acetaminophen-hepatotoxicity. Eur J Pharmacol. 2014;726:116–23.
Errington-Evans N. Acupuncture for anxiety. CNS Neurosci Ther. 2012;18(4):277–84.
Fanti L, Gemma M, Passaretti S, et al. Electroacupuncture analgesia for colonoscopy: a prospective, randomized, placebocontrolled study. Am J Gastroenterol. 2003;98:312–6.
Ferrucci LM, Bell BP, Dhotre KB, et al. Complementary and alternative medicine use in chronic liver disease patients. J Clin Gastroenterol. 2010;44:e40–5.
Foroncewicz B, Mucha K, Gryszkiewicz J, et al. Dietary supplements and herbal preparations in renal and liver transplant recipients. Transplant Proc. 2011;43:2935–7.
Gärtner S, Krüger J, Aghdassi AA, Steveling A, Simon P, Lerch MM, Mayerle J. Nutrition in pancreatic cancer: a review. Gastrointest Tumors. 2016;2(4):195–202. https://doi.org/10.1159/000442873. Epub 2016 Jan 8. PMID: 27403414; PMCID: PMC4924449.
Gianotti L, Besselink MG, Sandini M, et al. Nutritional support and therapy in pancreatic surgery: a position paper of the International Study Group on Pancreatic Surgery (ISGPS). Surgery. 2018;164(5):1035–48. https://doi.org/10.1016/j.surg.2018.05.040.
Gilliland TM, Villafane-Ferriol N, Shah KP, et al. Nutritional and metabolic derangements in pancreatic cancer and pancreatic resection. Nutrients. 2017;9(3):243.
Giugliano D, Ceriello A, Esposito K. The effects of diet on inflammation – emphasis on the metabolic syndrome. J Am Coll Cardiol. 2006;48:67–685.
Hargrove L, Francis T, Francis H. Vitamin D and GI cancers: shedding some light on dark diseases. Ann Transl Med. 2014;2(1):1–9.
Heller AR, Rössel T, Gottschlich B, et al. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients. Int J Cancer. 2004;111(4):611–6.
Henson JB, Brown CL, Chow SC, Muir AJ. Complementary and alternative medicine use in United States adults with liver disease. J Clin Gastroenterol. 2017;51(6):564–70.
Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression, a meta-analytic review. J Consul Clin Psychol. 2010;78:169–83.
Horneber M, Bueschel G, Dennert G, et al. How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther. 2012;11:187–203.
Jahns L, Conrad Z, Johnson LK, et al. A diet high in carotenoid-rich vegetables and fruits favorably impacts inflammation status by increasing plasma concentrations of IFN-α2 and decreasing MIP-1β and TNF-α in healthy individuals during a controlled feeding trial. Nutr Res. 2018;52:98–104.
Jirillo E, Jirillo F, Magrone T. Healthy effects exerted by prebiotics, probiotics, and symbiotics with special reference to their impact on the immune system. Int J Vitam Nutr Res. 2012;82:200–8.
Johnston BC, Ma SS, Goldenberg JZ, et al. Probiotics for the prevention of clostridium difficile associated diarrhea: a systematic review and meta-analysis. Ann Intern Med. 2012;157:878–88.
Kabat-Zinn J, Massion AO, Kristeller J, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatr. 1992;149:936–43.
Kawamura E, Habu D, Morikawa H, et al. A randomized pilot trial of oral branched-chain amino acids in early cirrhosis: validation using prognostic markers for pre-liver transplant status. Liver Transpl. 2009;15(7):790–7.
Kim SH, Lee SM, Jeung HC, et al. The effect of nutrition intervention with oral nutritional supplements on pancreatic and bile duct cancer patients undergoing chemotherapy. Nutrients. 2019;11(5):1145. https://doi.org/10.3390/nu11051145.
Kimant E, Wright H, Rubin D, et al. Intravenous vitamin C in the supportive care of cancer patients: a review and rational approach. Curr Oncol. 2018;25(2):139–48.
Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety, a systematic review of the research evidence. Br J Sports Med. 2005;39:884–91.
Kliemann N, Murphy N, Viallon V, et al. Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2020;147(3):648–61.
Kuyumcu A, Akyol A, Buyuktuncer Z, Ozmen MM, Besler HT. Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation. Nutr J. 2015;14:4. https://doi.org/10.1186/1475-2891-14-4.
Lahoud MJ, Kourie HR, Antoun J, El Osta L, Ghosn M. Road map for pain management in pancreatic cancer: a review. World J Gastrointest Oncol. 2016;8(8):599–606.
Li QS, Cao SH, Xie GM, et al. Combined traditional Chinese medicine and Western medicine. Relieving effects of Chinese herbs, ear-acupuncture and epidural morphine on postoperative pain in liver cancer. Chin Med J. 1994;107(4):289–94.
Liu GY, Wang W, Jia WD, et al. Protective effect of S-adenosylmethionine on hepatic ischemia-reperfusion injury during hepatectomy in HCC patients with chronic HBV infection. World J Surg Oncol. 2014;12:27.
Mahendra A, Karishma, Choudry BK, et al. Vitamin D and gastrointestinal cancer. J Lab Phys. 2018;10(1):1–5.
Mai I, Stormer E, Bauer S, et al. Impact of St John’s wort treatment on the pharmacokinetics of tacrolimus and mycophenolic acid in renal transplant patients. Nephrol Dial Transplant. 2003;18:819–22.
Martucci G, Volpes R, Panarello G, et al. Vitamin D levels in liver transplantation recipients and early postoperative outcomes: prospective observational DLiverX study. Clin Nutr. 2020; https://doi.org/10.1016/j.clnu.2020.10.027.
Masuda T, Shirabe K, Yoshiya S, et al. Nutrition support and infections associated with hepatic resection and liver transplantation in patients with chronic liver disease. JPEN J Parenter Enteral Nutr. 2013;37(3):318–26.
Mayr HL, Thomas CJ, Tierny AC, et al. Randomization to 6-month Mediterranean diet compared with a low-fat diet leads to improvement in dietary inflammatory index scores in patients with coronary heart disease: the AUSMED heart trial. Nutr Res. 2018;55:94–107.
Michalsen A, Grossman P, Acil A, et al. Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga programme. Med Sci Monit. 2005;11:555–61.
Monti DA, Bazzan AJ. The great life makeover. New York: Collins Living; 2008.
Monti DA, Kash K, Kunkel EJ, et al. Psychosocial benefits of a novel mindfulness intervention versus standard support in distressed women with breast cancer. Psycho-Oncology. 2013;22(11):2565–75.
Montonen J, Boeing H, Fritsche HA, et al. Consumption of red meat and whole-grain bread in relation to biomarkers of obesity, inflammation, glucose metabolism and oxidative stress. Eur J Nutr. 2012;52:337–45.
Mullin GE. The use of complementary and alternative medicine for liver disease: part I. Nutr Clin Pract. 2013;28:138–9.
Mullin GE. The use of complementary and alternative medicine for liver disease: part II. Nutr Clin Pract. 2013;28:277–9.
Nagata S, Shirabe K, Sugimachi K, et al. Pilot study of preoperative immunonutrition with antioxidants in living donor liver transplantation donors. Fukuoka Igaku Zasshi. 2013;104:530–8.
Nomura T, Tsuchiya Y, Nashimoto A, et al. Probiotics reduce infectious complications after pancreaticoduodenectomy. Hepato-Gastroenterology. 2007;54(75):661–3.
Ospina MB, Bond TK, Karkhaneh M, et al. Meditation practices for health, State of the research. Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment No. 155. 2007.
Pantoflicek T, Koblihova E, Ryska M. S-adenosylmethionine does not reduce ischaemia-reperfusion injury to a marginal liver graft in an in vivo experiment. Hepato-Gastroenterology. 2012;59(113):216–8.
Petzel MQB, Hoffman L. Nutrition implications for long-term survivors of pancreatic cancer surgery. Nutr Clin Pract. 2017;32(5):588–98. https://doi.org/10.1177/0884533617722929.
Plank LD, Mathur S, Gane EJ, et al. Perioperative immunonutrition in patients undergoing liver transplantation: a randomized double-blind trial. Hepatology. 2012; https://doi.org/10.1002/hep.27433.
Rao MR, Raghuram N, Nagendra HR, et al. Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment. A randomized controlled trial. Complement Ther Med. 2009;17:1–8.
Rayes N, Seehofer D, Theruvath T, et al. Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant. 2005;5:125–30.
Robinson SM, Saif R, Sen G, et al. N-acetylcysteine administration does not improve patient outcome after liver resection. HPB (Oxford). 2013;15(6):457–62.
Sarno G, Mehta RJ, Guardado-Mendoza R, et al. New-onset diabetes mellitus: predictive factors and impact on the outcome of patients undergoing liver transplantation. Curr Diabetes Rev. 2013;9(1):78–85.
Sheikh-Ali M, Keaveny AP, Chamseddin A, et al. 25-hydroxyvitamin d levels and acute cellular rejection in liver transplant patients. Endocr Pract. 2014;20(8):769–74.
Stanger MJ, Thompson LA, Young AJ, Lieberman HR. Anticoagulant activity of select dietary supplements. Nutr Rev. 2012;70:107–17.
Strader DB, Bacon BR, Lindsay KL, et al. Use of complementary and alternative medicine in patients with liver disease. Am J Gastroenterol. 2002;97(9):2391–7.
Sumantran VN, Tillu G. Cancer, inflammation, and insights from Ayurveda. Evid Based Complement Alternat Med. 2012;306346. https://doi.org/10.1155/2012/306346.
Sumimoto K, Inagaki K, Ito H, et al. Ischemic damage prevention by coenzyme Q10 treatment of the donor before orthotopic liver transplantation: biochemical and histologic findings. Surgery. 1987;102(5):821–7.
Tang FY, Pai MH, Chiang EP. Consumption of high-fat diet induces tumor progression and epithelial-mesenchymal transition of colorectal cancer in a mouse xenograft model. J Nutr Biochem. 2012;23:1302–13.
Tang Y, Zhang W, Zhang Y, et al. 5′-Methylthioadenosine attenuates ischemia reperfusion injury after liver transplantation in rats. Inflammation. 2014;37(5):1366–73. https://doi.org/10.1007/s10753-014-9861-x.
Togo S, Tanaka K, Morioka D, et al. Usefulness of granular BCAA after hepatectomy for liver cancer complicated with liver cirrhosis. Nutrition. 2005;21(4):480–6.
Toneatto T, Nguyen L. Does mindfulness meditation improve anxiety and mood symptoms? A review of the controlled research. Can J Psychiatr. 2007;52:260–6.
Uster A, Ruehlin M, Mey S, et al. Effects of nutrition and physical exercise intervention in palliative cancer patients: a randomized controlled trial. Clin Nutr. 2018;37(4):1202–9.
Vanden Heuvel JP. Nutrigenomics and nutrigenetics of ω3 polyunsaturated fatty acids. Prog Mol Biol Transl Sci. 2012;108:75–112.
Wanchai A, Armer JM, Stewart BR. Complementary and alternative medicine use among women with breast cancer: a systematic review. Clin J Oncol Nurs. 2010;14:E45–55.
Wang SM, Peloquin C, Kain ZN. The use of auricular acupuncture to reduce preoperative anxiety. Anesth Analg. 2001;93:1178–80.
Xia X, Su C, Fu J, et al. Role of α-lipoic acid in LPS/d-GalN induced fulminant hepatic failure in mice: studies on oxidative stress, inflammation and apoptosis. Int Immunopharmacol. 2014;22:293–302.
Xue R, Wang J, Yang L, et al. Coenzyme Q10 ameliorates pancreatic fibrosis via the ROS-triggered mTOR signaling pathway. Oxidative Med Cell Longev. 2019;2019:8039694. https://doi.org/10.1155/2019/8039694.
Yang Y, Li W, Liu Y, et al. Alpha-lipoic acid improves high-fat diet-induced hepatic steatosis by modulating the transcription factors SREBP-1, FoxO1 and Nrf2 via the SIRT1/LKB1/AMPK pathway. J Nutr Biochem. 2014;S0955-2863(14):00133–8. https://doi.org/10.1016/j.jnutbio.2014.06.001. [Epub ahead of print].
Zhou J, Liang Y, Lin XM, et al. Acupuncture in treating hepatic fibrosis: a review with recommendation for future studies. Afr J Tradit Complement Altern Med. 2012;9(4):452–8.
Zhu M, Sun W. The effects of acupuncture at Zusanli and Guanyuan on the model rats with hepatic fibrosis. J Mudanjiang Med Coll. 1998;19:1–3.
Zhu XH, Wu YF, Qiu YD, et al. Liver-protecting effects of omega-3 fish oil lipid emulsion in liver transplantation. World J Gastroenterol. 2012;18:6141–7.
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Hriso, C., Bazzan, A., Monti, D., Newberg, A. (2021). Integrative Medicine and Hepatobiliary and Pancreatic Cancer: What to Expect. In: Doria, C., Rogart, J.N. (eds) Hepato-Pancreato-Biliary Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-030-37482-2_49-1
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