Mistletoe treatment in cancer-related fatigue: a case report

Cancer-related fatigue (CRF) is a major and very common disabling condition in cancer patients. Treatment options do exist but have limited therapeutic effects. Mistletoe extracts are widely-used complementary cancer treatments whose possible impact on CRF has not been investigated in detail. A 36-year-old Swedish woman with a 10-year history of recurrent breast cancer, suffering from severe CRF, started complementary cancer treatment with mistletoe extracts. Over two and a half years a correspondence was observed between the intensity of mistletoe therapy and the fatigue. Mistletoe extracts seemed to have a beneficial, dose-dependent effect on CRF. Although such effect has also been noted in clinical studies, it has never been the subject of detailed investigation. More research should clarify these observations

Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research

<p>Abstract</p> <p>Background</p> <p><it>Viscum album </it>L. extracts (VAE, European mistletoe) are a widely used medicinal plant extract in gynaecological and breast-cancer treatment.</p> <p>Methods</p> <p>Systematic review to evaluate clinical studies and preclinical research on the therapeutic effectiveness and biological effects of VAE on gynaecological and breast cancer. Search of databases, reference lists and expert consultations. Criteria-based assessment of methodological study quality.</p> <p>Results</p> <p>19 randomized (RCT), 16 non-randomized (non-RCT) controlled studies, and 11 single-arm cohort studies were identified that investigated VAE treatment of breast or gynaecological cancer. They included 2420, 6399 and 1130 patients respectively. 8 RCTs and 8 non-RCTs were embedded in the same large epidemiological cohort study. 9 RCTs and 13 non-RCTs assessed survival; 12 reported a statistically significant benefit, the others either a trend or no difference. 3 RCTs and 6 non-RCTs assessed tumour behaviour (remission or time to relapse); 3 reported statistically significant benefit, the others either a trend, no difference or mixed results. Quality of life (QoL) and tolerability of chemotherapy, radiotherapy or surgery was assessed in 15 RCTs and 9 non-RCTs. 21 reported a statistically significant positive result, the others either a trend, no difference, or mixed results. Methodological quality of the studies differed substantially; some had major limitations, especially RCTs on survival and tumour behaviour had very small sample sizes. Some recent studies, however, especially on QoL were reasonably well conducted. Single-arm cohort studies investigated tumour behaviour, QoL, pharmacokinetics and safety of VAE. Tumour remission was observed after high dosage and local application. VAE application was well tolerated. 34 animal experiments investigated VAE and isolated or recombinant compounds in various breast and gynaecological cancer models in mice and rats. VAE showed increase of survival and tumour remission especially in mice, while application in rats as well as application of VAE compounds had mixed results. <it>In vitro </it>VAE and its compounds have strong cytotoxic effects on cancer cells.</p> <p>Conclusion</p> <p>VAE shows some positive effects in breast and gynaecological cancer. More research into clinical efficacy is warranted.</p

Les soins de support en oncologie : dispositif d’appui ou grain de sable des machines à guérir hospitalières ?

International audienc

The ethical aim in health care. Teaching ethico-practical conflicts.: The ethical aim in health care. Teaching ethico-practical conflicts.

International audienceMost ethical think tanks will at some point face ethico-practical conflicts that will make them feel that they go around in circles, making them hesitate and preventing them from moving forward. This is notably the case when judicial and organizational notions and the respect of good practice no longer suffice. The experience of the Group of Ethical Reflection in Voironnais, described in this article, lead the members of the group to question the meaning of these conflicts. Such clinical situations for which no practical reply or concrete solution can be given have been considered a medical scandal. There is however one issue that has been completely omitted from the discussion of these clinical situations, namely the figure of evil—evil that must be eradicated but that has instead been transformed into a functional defect to be remedied simply by means of improving management.However an ethical question only arises because evil exists. And it is this evil that must be questioned, the human enigma by which there are only two bad solutions to a problem, two solutions that neutralize each other, forcing us to make difficult choices between bad and worse, between grey and grey. From this insight arose the two principal aims of the ethical think tank: (i) Putting into words the actual experience of professional health care workers, allowing to take distance and displace the center of gravity. (ii) Preventing evil, fighting evil but without completely eradicating it from the institution. For evil is the price to pay for human liberty. This ethical think tank gave rise to a kind of communal phronesis—a collective form of prudence which becomes a factor in a triangulation that allows appealing to law, to moral norms when necessary, but also to the non-sense of life

Du compas à la boussole : de l’Evidence Based Medicine au sens de la relation de soin. Réflexions à partir de la recommandation de la Haute Autorité de santé concernant l’autisme

International audienc