In Norway, 7,400 individuals diagnosed with childhood cancer before the age of 18 are alive today, facing lasting burdens from the disease and its treatment. This study investigates the prevalence of complementary and alternative medicine (CAM) use among children with cancer in Norway, based on parental reports. It also examines the types of CAM modalities used, their perceived effects, safety, and associated demographic and cancer-related factors. An online cross-sectional survey was conducted in 2021 in collaboration with the Norwegian Children's Cancer Society. The study utilised a modified version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q), adapted for children with cancer. Data were collected from 95 mothers and 22 fathers, covering 117 children, using convenience sampling with a response rate of 17%. Nearly half (47%, n=55) of parents reported that their children used CAM during or after cancer treatment. Modalities included vitamin D supplementation (19%, n=22), music therapy (18%, n=21), art therapy (16%, n=19), psychotherapy (9%, n=10), and massage or aromatherapy (8%, n=9). Although 82% (n = 45) of parents of children using CAM reported benefits, 7% (n = 4) reported adverse effects associated with these modalities. CAM use was primarily motivated by the burden of adverse and late effects of cancer treatment, such as fatigue (p=0.004), worry or unrest (p=0.036), and memory or concentration difficulties (p<0.001). The findings suggest that non-verbal and creative forms of support, such as massage, music therapy, and art therapy, were highly valued in this national sample. Further research is needed to better understand the unmet needs and expectations of both parents and children and to improve the quality of life for children with cancer and their families.

BackgroundLoss of appetite (LOA) is a highly prevalent and distressing symptom in advanced lung cancer, leading to malnutrition, poorer treatment tolerance, and reduced quality of life. Although acupuncture may help manage cancer-related symptoms, its effect on LOA in patients receiving immunotherapy is unclear. This study aims to assess the efficacy and safety of acupuncture for alleviating LOA in this population.MethodsThis multicenter, randomized, double-blind, sham-controlled trial will enroll 80 eligible patients with advanced lung cancer undergoing immunotherapy who experience LOA, defined as a Visual Analogue Scale (VAS) score ≥30 mm. Participants will be randomly assigned to either true acupuncture or sham acupuncture in a 1:1 ratio, administered over 24 sessions within a 12-week period. The primary outcome is the LOA response rate at week 12. Secondary outcomes include changes in LOA severity, nutritional and hematologic markers, patient-reported measures (appetite/cachexia, disease symptoms, psychological distress, and sleep), and tumor response. Safety and blinding success will also be assessed. Data will be analyzed using SPSS 20.0 and R software.DiscussionTo our knowledge, this is the first rigorously designed trial evaluating acupuncture for LOA in advanced lung cancer patients undergoing immunotherapy. The findings may inform integrative supportive care strategies for this patient population.

Integrative oncology consultants bridge conventional and traditional therapies through evidence-informed care and shared decision-making. We report a 72-year-old man with metastatic cholangiocarcinoma who sought Ayurvedic therapies alongside chemotherapy. When traditional and conventional medicines are combined, concerns about herb-drug interactions create uncertainty for both patients and clinicians. Using an integrative, multidisciplinary framework, a virtual meeting was arranged between the patient, family, Ayurvedic practitioner, and integrative oncology physician. This synchronous collaboration allowed for a systematic approach to clarify concerns regarding safety, empower patient agency, and align care goals, resulting in a plan combining Ayurvedic dietary strategies with conventional oncology treatment. Open communication and patient involvement ensure safety and well-being. Further research is needed to evaluate integrative multidisciplinary team models that harmonize patient priorities with oncologist recommendations.

Patients challenged with cancer diagnosis and treatments often seek solutions beyond conventional therapies to improve their quality of life and immunity and to manage symptoms, concerns, coping, and daily functioning. Ayurveda, a traditional medical system originating in India, has generated growing interest within integrative oncology; however, limited clarity and evidence exist regarding its appropriate application and integration across the oncology care continuum. This paper explores the evolving landscape of integrative oncology, focusing on the incorporation of Ayurveda into global cancer care. With emphasis on evidence-based practices, we discuss the similarities and distinctions between Ayurvedic and integrative oncology approaches including nutrition, exercise, mind body practices, sleep, and use of herbal supplements. We aim to stimulate further dialogue and multidisciplinary collaboration between oncology healthcare providers and Ayurveda clinicians. Developing a patient-centered, evidence-informed, integrative model of care that incorporates Ayurvedic approaches has the potential to enhance the quality of life for patients along the cancer trajectory. This discussion may stimulate further research and medical education with the goal of incorporating supported Ayurvedic approaches into mainstream cancer care.

PurposeAyurveda, a Traditional Indian Medicine practice, supports health and is used by trained professionals in the United States (US). However, little is known about their opinions and practices. This study explored the use of Ayurveda in managing individuals with cancer in the US.MethodsA questionnaire was developed to assess experiences and opinions of Ayurvedic medicine professionals caring for individuals with cancer in the US and was administered online using Microsoft Forms. The survey utilized a convenience sample of Ayurvedic medicine professionals.ResultsOf 321 participants, 199 had treated US individuals with cancer and continued the survey. Most (94%) held an Ayurvedic certification, 12% had an additional non-Ayurvedic medical degree, and 55% had a healthcare-related license. Over half (55%) managed/counseled individuals with cancer. Respondents indicated that individuals with cancer sought Ayurveda primarily to reduce allopathic treatment-related side effects (87%). Eighty-five percent of respondents recommended herbs for individuals with cancer in the US, though some herbs were also considered contraindicated. Most (65%) "never/rarely" or "occasionally" communicated with patients' allopathic doctors.ConclusionThis report is the first to document the opinions and practices of Ayurvedic professionals managing people with cancer in the US. Respondents noted limited communication and research collaboration with biomedical communities, despite interest in doing so. More research on Ayurveda's adjunctive role in cancer care is needed to define its place in Integrative Oncology. Improved education and communication between Ayurvedic and biomedical communities are essential for individuals with cancer safety and outcomes.

BackgroundAdherence is important for the internal validity of randomized controlled trials (RCTs), but adherence-related reporting in oral Chinese herbal medicine (CHM) RCTs for cancer has not been systematically examined. This study assessed reporting practices before the release of the CONSORT 2025 statement and explored factors associated with intervention completion.MethodsPubMed, Web of Science, EMBASE, and the Cochrane Library were searched for eligible studies published between January 2010 and April 2025. Study characteristics, adherence-related reporting, monitoring methods, and intervention completion were extracted. Binary logistic regression identified factors associated with reporting of adherence-related information. In parallel-group RCTs using CHM only in the intervention group, beta-binomial regression was used as the primary model to assess factors associated with intervention completion.ResultsA total of 113 studies were included, and 51 (45.1%) reported adherence-related information. English-language publication, higher modified Jadad score, and reporting of adherence monitoring methods were associated with reporting of adherence-related information. Only 24 studies (21.2%) described adherence monitoring methods, with diary cards being the most common. Mean intervention completion across the 51 studies was 93.4%. In 43 parallel-group RCTs, placebo use (OR = 0.38, 95% CI: 0.24-0.60; P < 0.001) and syndrome differentiation-guided treatment adjustment (OR = 0.58, 95% CI: 0.37-0.91; P = 0.019) were associated with lower intervention completion in the CHM intervention group, whereas solid dosage forms were associated with higher intervention completion (OR = 2.11, 95% CI: 1.26-3.55; P = 0.005). The directions of the associations were generally consistent across sensitivity analyses.ConclusionBefore the release of CONSORT 2025, adherence-related reporting in oral CHM RCTs for cancer was inadequate and non-standardized. Placebo use, syndrome differentiation-guided treatment adjustment, and oral dosage form were associated with intervention completion. These findings may inform adherence reporting and the design of future CHM trials.

Prostate cancer is the second most frequently diagnosed malignancy in men globally, with over 1.4 million new cases and approximately 397,430 deaths in 2022. Despite available treatments, incidence and mortality remain high, underscoring the need for novel, cost-effective therapeutic options. Myrianthus arboreus P. Beauv. (Cecropiaceae) is traditionally employed in Cameroonian herbal medicine for cancer-related conditions. This study assessed the anti-prostate cancer activity of aqueous and methanolic bark extracts of M. arboreus on LNCaP, DU145, and PC3 human prostate cancer cell lines and in a benzo(a)pyrene (B[a]P)-induced prostate cancer rat model. In vivo, 48 male Wistar rats were randomized into six groups (n = 8) receiving distilled water, casodex (13.5 mg/kg), or M. arboreus methanolic extracts (50, 100, or 200 mg/kg) orally for 196 days following B[a]P-induced carcinogenesis. In vitro, both extracts inhibited cancer cell growth in time- and concentration-dependent manner, with M. arboreus methanolic extracts showing greater potency. M. arboreus methanolic extracts promoted apoptosis in LNCaP and DU145 cells, suppressed clonogenicity, migration, and invasion in DU145 cells, and enhanced adhesion to collagen and fibronectin matrices. M. arboreus methanolic extracts significantly reduced tumor incidence, mass, volume, and PSA levels, and reversed B[a]P-induced oxidative stress, inflammation, dyslipidemia, and hepatorenal dysfunction. These findings indicate that M. arboreus methanolic extracts exerts potent chemopreventive and anti-proliferative effects in prostate cancer models, supporting its development as a plant-based therapeutic candidate against prostate cancer.

ObjectiveTryptophan metabolism plays a pivotal role in promoting tumor progression by modulating immune escape in breast cancer (BC). Shugan-Liangxue prescription (SLP), a traditional Chinese medicine, has shown beneficial effects in enhancing antitumor immunity for BC treatment. This study aims to investigate the effect of SLP on tryptophan metabolism in BC and to explore the underlying mechanisms.MethodsThe immunopharmacological BC model in rats was established by chemical carcinogen induction and complete freund's adjuvant perturbations and treated with SLP. Tamoxifen and other metabolism-associated drugs were used as controls. The therapeutic efficacy of SLP was evaluated by tumor volume, weight, and oncocyte proliferation. Serum cytokines and subsets of immune cells in the spleen were measured to evaluate the anti-tumor immunity. Metabolite levels and expressions of signal molecules of tryptophan metabolic pathway were measured to explore the mechanisms.ResultsOur findings demonstrated that SLP treatment significantly inhibited tumor growth and tumor cell proliferation, and enhanced antitumor immunity by promoting Th1 polarization, increasing cytotoxic immune cells (CD8+ T cells, NKG2D+ NK cells), and reducing inhibitory immune cells (Foxp3+ Tregs, NKG2A+ NK cells, M2 macrophages) in the spleen. Additionally, SLP regulated glucose and lipid metabolism, as evidenced by reduced serum glucose and non-esterified fatty acid levels. SLP suppressed tryptophan catabolism by down-regulating expression of IDO1 and AhR and reducing kynurenine levels.ConclusionsIn summary, correlative analyses suggest SLP may mitigate breast cancer immune escape partially via the Trp metabolic pathway to boost anti-tumor immune surveillance, and its immunomodulatory activity is potentially linked to glucose and lipid reprogramming. While our findings support the involvement of the Trp-Kyn-AhR axis, causal verification via pathway rescue and inhibition assays is still needed.

Integrating Traditional Chinese Medicine (TCM) with Western medical treatments enhances cancer patients' survival rates and quality of life. However, there is a lack of large-scale studies on the integration of TCM with immune checkpoint inhibitors (ICIs) or chemotherapy in cancer treatment. This retrospective cohort study analyzed data from the Taiwan National Health Insurance Research database and Taiwan Cancer Registry, including 2,512 patients treated with ICIs and 130,010 with chemotherapy between January 1, 2019, and June 30, 2021. Patients receiving TCM were classified as TCM users, while those who did not were nonusers. The primary outcome was all-cause mortality, assessed using Cox proportional hazards regression to estimate hazard ratios (HR) with 95% confidence intervals (CI), adjusting for demographics and comorbidities. Among ICI-treated patients, TCM users (n=720) had lower mortality rates than nonusers (n=1,792), with an incidence of 45.84 vs. 83.72 per 100 person-years (adjusted HR: 0.58; 95% CI: 0.51-0.66). Similarly, in chemotherapy-treated patients, TCM users (n=51,292) had reduced mortality (11.54 vs. 24.86 per 100 person-years; adjusted HR: 0.59; 95% CI: 0.57-0.60). These associations remained consistent across subgroup and sensitivity analyses. Commonly used TCM herbs included Hedyotis diffusa Willd (Bai Hua She She Cao), Scutellaria barbata (Ban Zhi Lian), and Astragali Radix (Huang Qi). These findings suggest that TCM use alongside ICIs or chemotherapy is associated with lower mortality, even after adjusting for confounders. Further prospective studies are needed to confirm these results and explore underlying mechanisms, advancing integrative cancer care.

BackgroundBreast cancer is the most frequent malignancy among women worldwide. Despite advances in medical treatment, many survivors experience distressing symptoms and therapy-related side effects that impair quality of life. Acupuncture-related therapies are increasingly employed as supportive care strategies, yet their evidence base remains fragmented.ObjectiveTo construct an evidence map of systematic reviews (SRs) and meta-analyses evaluating acupuncture and related therapies for breast cancer-related symptoms.MethodsSearches were performed in PubMed, Embase, and Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI), Wanfang, Research Information Service System (RISS), Oriental Medicine Advanced Search Integrated System (OASIS), and Korean Studies Information Services System (KISS) from inception to April 24, 2025. Eligible SRs included breast cancer populations, any acupuncture-related intervention, and reported outcomes relevant to symptom management or treatment side effects. Data extraction included bibliographic details, intervention type, outcomes, number of studies, sample size, effect direction, and methodological quality (AMSTAR-2). Evidence was synthesized descriptively and presented using heatmaps.ResultsA total of 47 SRs with meta-analysis were included, covering 11 distinct symptom domains and 6 categories of interventions. The most frequently studied outcomes were hot flashes (n=9), general supportive care during chemotherapy (n=9), lymphedema (n=7), general side effect management (n=6), and aromatase inhibitor-associated arthralgia (n=4). The most common interventions were acupuncture (n=17), acupuncture combination therapies (n=16), and acupoint injection (n=9). Across the included SRs, 20 reported positive effects, 23 were mixed, and 4 reported no clear evidence of benefit. Only 8 of 47 SRs achieved moderate confidence, and none were rated high, indicating widespread methodological limitations across the evidence base (29 low, 10 critically low).ConclusionAcupuncture and related therapies are widely studied as supportive care strategies for breast cancer-related symptoms with promising evidence. However, the majority of SRs are of low methodological quality. High-quality trials and rigorously conducted systematic reviews are needed to strengthen the evidence base, reduce redundancy, and guide integrative oncology practice.

IntroductionHepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, particularly in patients with cirrhosis. Genistein (GEN), a tyrosine kinase inhibitor with a favorable safety profile, has potential as a chemoprotective agent in high-risk populations. This study evaluated the effects of GEN in a rat model of diethylnitrosamine (DEN)-induced cirrhosis and HCC.MethodsThirty-three male Sprague Dawley rats were randomized into three groups (n=11/group): Control, HCC, and HCC+GEN. HCC was induced by weekly intraperitoneal DEN injections (70 mg/kg) for 16 weeks. From weeks 8-16, the GEN group received oral genistein (50 mg/kg/day), while other groups received vehicle. Liver tissues were examined histopathologically and immunohistochemically for HCC, caspase-9, ERK-1, α-SMA, and MMP-2. Tumor burden was calculated to reflect tumor size and number. Serum AFP, p53, and biochemical parameters were analyzed.ResultsTumor burden was significantly increased in the HCC group compared with controls and was significantly reduced by GEN treatment (p=0.002). Elevated serum AFP and p53 levels in the HCC group were significantly decreased with GEN. Although cirrhosis developed in both HCC groups, collagen deposition was significantly lower in the GEN-treated rats. GEN treatment was associated with reduced expression of ERK-1, α-SMA, and MMP-2, and increased caspase-9 expression, indicating anti-proliferative, anti-fibrotic, and pro-apoptotic effects.ConclusionsGenistein reduced tumor burden, serum tumor markers, and liver fibrosis in a rat model of HCC, supporting its potential as a chemoprotective agent in cirrhotic livers. Further dose-optimization and clinical studies are warranted.

Traditional Chinese medicine (TCM) has demonstrated potential benefits in cancer treatment, yet its relatively low utilization may limit the realization of these benefits. This study aimed to explore cancer patients' preferences for TCM services and assess how various service characteristics influence their utilization. A discrete choice experiment was conducted among 500 cancer patients aged 18-75 years. Each patient completed nine choice tasks, each involving two hypothetical TCM service alternatives characterized by five attributes: service institution, care provider, type of treatment, risk of side effects, and monthly cost. A mixed logit model was used to estimate patients' preferences, willingness to pay and predicted utilization. In total, 469 patients (93.8%) completed the questionnaire. All five attributes significantly influenced patients' preferences. Service institution had the greatest impact on TCM utilization (importance score, 47.59%), followed by care provider and type of treatment. Changing the service setting from a TCM clinic to a cancer hospital or a general hospital would increase the predicted utilization of TCM services by 87.60% and 69.20%, respectively. Gender, age, annual family income, cancer stage, and family history of cancer were also associated with TCM utilization. Cancer patients generally had positive attitudes toward TCM services. Service institution was the primary driver of TCM utilization, whereas monthly cost was the least important factor. These findings provide policymakers and healthcare professionals with valuable insights into the effective integration of TCM as an adjunct to cancer treatment, with the potential to improve patient care.

BackgroundThis study aimed to evaluate differences in adherence to integrative therapy recommendations provided by the Consultation Service for Integrative Medicine (SIM) at the Women's Clinic of the University Hospital Erlangen, Germany, across patient subgroups. The study sought to identify opportunities for further optimization and refinement of the integrative care program.MethodsIn this cross-sectional study, data of 120 women who visited the SIM consultancy were collected at the first presentation (Baseline) and after 3 to 6 months of therapy (Follow-Up) using standardized questionnaires. The adherence variable was defined as the proportion of integrative therapy methods implemented for at least four weeks of the total number of therapy recommendations received per patient. Differences in patient-reported adherence to integrative therapies among cohorts defined by demographic characteristics, lifestyle factors, and tumor-related characteristics were evaluated using independent-samples t-tests and analyses of variance (ANOVA).ResultsThere was no significant difference in adherence with Integrative therapy recommendations in cohorts based on age, education, Body-mass-index (BMI), tumor localization and treatment modality. Factors significantly associated with lower adherence, were low physical activity, defined as self-reported absence of regular exercise, compared with patients reporting approximately 1 hour or 2-4 hours of exercise per week, and presence of distant metastases.ConclusionAdherence with SIM recommendations was significantly lower among patients with low physical activity levels, as well as among patients with distant metastatic disease. This shows that the treatment concepts of the SIM need to be adapted more individually and, in particular, body-based treatments need to be reviewed in order to make them accessible for patients with poorer physical condition.