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Complementary and Integrative Medicine in Pancreatic Cancer

  • INTEGRATIVE CARE (M FRENKEL, SECTION EDITOR)
  • Published:
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Abstract 

Purpose of Review

Pancreatic cancer has high mortality and morbidity rates, associated with the issues of typically late diagnosis and the limited effectiveness of current treatments. Patients tend to experience multiple symptoms that can include anxiety, fear, depression, fatigue, weakness, peripheral neuropathy, and abdominal pain, which reduce quality of life (QoL) and may compromise the treatment continuum. Many of those symptoms are amenable to complementary and integrative medicine (CIM) therapies as a part of supportive and palliative care. This article reviews research findings on the beneficial effect of use of CIM modalities in regard to pancreatic cancer, with emphasis on pancreatic ductal adenocarcinoma (PDAC).

Recent Findings

Given the often-poor prognosis of the disease, patients with PDAC often seek integrative therapies to help manage the disease itself, to provide support through cancer treatment and its symptoms, and to provide emotional stress relief. Data is accumulating in the past few years on the potential benefits of CIM to the management of pancreatic cancer symptoms and treatment side effects, in order to augment supportive care. This data reveal that nutrition counselling; digestive enzyme therapy; microbiome support; dietary supplements; lifestyle interventions (physical activity and circadian health/sleep hygiene) appear to improve QoL of these patients through reduced symptom burden and meeting psychological needs, such as distress and fatigue. Acupuncture, mindfulness, yoga, reflexology, massage, and homeopathy may also contribute to symptom reduction, both physical and psychological, in all stages of the disease.

Summary

There is supporting evidence that some CIM modalities may alleviate side effects and symptoms related to pancreatic cancer and its treatment, suggesting that practitioners might consider integrating these modalities in certain situations encountered in the treatment of pancreatic cancer. Further investigation is needed to define the optimal integration of CIM into the treatment and supportive care of patients affected by pancreatic cancer.

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Data Availability Statement

The authors confirm that the data supporting the findings of this article are available within the article.

References 

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.

    Article  PubMed  Google Scholar 

  2. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33.

    Article  PubMed  Google Scholar 

  3. Mizrahi JD, Surana R, Valle JW, Shroff RT. Pancreatic cancer. The Lancet. 2020;395(10242):2008–20.

    Article  CAS  Google Scholar 

  4. Barnes AF, Yeo TP, Leiby B, Kay A, Winter JM. Pancreatic cancer-associated depression: a case report and review of the literature. Pancreas. 2018;47(9):1065–77.

    Article  PubMed  Google Scholar 

  5. Bonucci M, Pastore C, Ferrera V, Fiorentini C, Fabbri A. Integrated cancer treatment in the course of metastatic pancreatic cancer: complete resolution in 2 cases. Integr Cancer Ther. 2018;17:994–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma, version 1.2022. 2022. https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf. Accessed Sept 23,

  7. Ducreux M, Cuhna AS, Caramella C, et al. ESMO Guidelines Committee. Cancer of the pancreas ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015;26(Suppl 5):56–68.

    Article  Google Scholar 

  8. National Comprehensive Cancer Network. NCCN guidelines: supportive care. 2022. https://www.nccn.org/guidelines/category_3 Accessed Sep 14, 2022.

  9. Frenkel M, Sapire KJ, Lacey J, Zollman C, Sierpina VS. What should I eat? —Addressing questions and challenges related to nutrition in the integrative oncology setting. Curr Oncol Rep. 2022;24:1557–1567. https://doi.org/10.1007/s11912-022-01308-x. This study cover the issue of nutrition in cancer care and unmet needs that patients express related to this issue. Authors bring a framework in which integrative medicine can become one of the solutions that can address these patients’ needs, while reserving the more complicated situations to the oncology dietician.

  10. World Cancer Research Fund/ American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity, and Pancreatic cancer. Available from: https://www.wcrf.org/wp-content/uploads/2021/02/pancreatic-cancer-report.pdf. Accessed 14 Sep 2022. This is an important document that bring the most comprehensive scientific data that relates to nutrition and physical activity related to pancreatic cancer prevention.

  11. Lu PY, Shu L, Shen SS, Chen XJ, Zhang XY. Dietary patterns and pancreatic cancer risk: a meta-analysis. Nutrients. 2017;9(1):38.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Zhang Z, Li Q, Hao F, Wu Y, Liu S, Zhong G. Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and pancreatic cancer incidence and mortality: a prospective cohort study. Cancer Med. 2020;9(18):6843–53.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Molina-Montes E, Salamanca-Fernández E, Garcia-Villanova B, Sánchez MJ. The impact of plant-based dietary patterns on cancer-related outcomes: a rapid review and meta-analysis. Nutrients. 2020;12(7):2010.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Bouvard V, Loomis D, Guyton KZ, Grosse Y, el Ghissassi F, Benbrahim-Tallaa L, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599–600.

    Article  PubMed  Google Scholar 

  15. Huang X, Gao Y, Zhi X, Ta N, Jiang H, Zheng J. Association between vitamin A, retinol and carotenoid intake and pancreatic cancer risk: evidence from epidemiologic studies. Sci Rep. 2016;6(1):38936.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Li L-y, Luo Y, Lu M-d, et al. Cruciferous vegetable consumption and the risk of pancreatic cancer: a meta-analysis. World J Surg Oncol. 2015;13(1):44.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ba DM, Ssentongo P, Beelman RB, Muscat J, Gao X, Richie JP. Higher mushroom consumption is associated with lower risk of cancer: a systematic review and meta-analysis of observational studies. Adv Nutr. 2021;12(5):1691–704.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Matsushita Y, Furutani Y, Matsuoka R, Furukawa T. Hot water extract of Agaricus blazei murrill specifically inhibits growth and induces apoptosis in human pancreatic cancer cells. BMC Complement Altern Med. 2018;18(1):319. https://doi.org/10.1186/s12906-018-2385-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Zhang M, Zhang Y, Zhang L, Tian Q. Mushroom polysaccharide lentinan for treating different types of cancers: a review of 12 years clinical studies in China. Prog Mol Biol Transl Sci. 2019;163:297–328.

    Article  CAS  PubMed  Google Scholar 

  20. Zhou DC, Gong H, Tan CQ, Luo JQ. Prognostic significance of anti-diabetic medications in pancreatic cancer: a meta-analysis. Oncotarget. 2017;8(37):62349–57.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wang Z, S-tao Lai, Xie L, et al. Metformin is associated with reduced risk of pancreatic cancer in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Res Clin Prac. 2014;106(1):19–26.

    Article  CAS  Google Scholar 

  22. Antunes F, Erustes AG, Costa AJ, Nascimento AC, Bincoletto C, Ureshino RP, et al. Autophagy and intermittent fasting: the connection for cancer therapy? Clinics. 2018;73:e814s.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lewis AR, Pihlak R, McNamara MG. The importance of quality-of-life management in patients with advanced pancreatic ductal adenocarcinoma. Curr Probl Cancer. 2018;42(1):26–39.

    Article  PubMed  Google Scholar 

  24. Pezzilli R, Caccialanza R, Capurso G, Brunetti O, Milella M, Falconi M. Pancreatic enzyme replacement therapy in pancreatic cancer. Cancers (Basel). 2020;12(2):275.

    Article  CAS  PubMed  Google Scholar 

  25. Mitchell T, Clarke L, Goldberg A, Bishop KS. Pancreatic cancer cachexia: the role of nutritional interventions. Healthcare. 2019;7(3):89.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Cereda E, Turri A, Klersy C, Cappello S, Ferrari A, Filippi AR, et al. Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy. Cancer Med. 2019;8(16):6923–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Védie AL, Neuzillet C. Pancreatic cancer: best supportive care. La Presse Médicale. 2019;48(3):e175–85.

    Article  PubMed  Google Scholar 

  28. Vujasinovic M, Valente R, del Chiaro M, Permert J, Löhr JM. Pancreatic exocrine insufficiency in pancreatic cancer. Nutrients. 2017;9(3):183.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Brennan GT, Saif MW. Pancreatic enzyme replacement therapy: a concise review. JOP. 2019;20(5):121–5.

    PubMed  Google Scholar 

  30. Landers A, Brown H, Strother M. The effectiveness of pancreatic enzyme replacement therapy for malabsorption in advanced pancreatic cancer, a pilot study. Palliative Care: Research and Treatment. 2019;17(12):117822421882527.

    Google Scholar 

  31. McQuade JL, Daniel CR, Helmink BA, Wargo JA. Modulating the microbiome to improve therapeutic response in cancer. Lancet Oncol. 2019;20(2):e77-91.

    Article  PubMed  Google Scholar 

  32. Pushalkar S, Hundeyin M, Daley D, Zambirinis CP, Kurz E, Mishra A, et al. The pancreatic cancer microbiome promotes oncogenesis by induction of innate and adaptive immune suppression. Cancer Discovery. 2018;8(4):403–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Riquelme E, Zhang Y, Zhang L, Montiel M, Zoltan M, Dong W, et al. Tumor microbiome diversity and composition influence pancreatic cancer outcomes. Cell. 2019;178(4):795-806.e12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Kaźmierczak-Siedlecka K, Stachowska E, Folwarski M, Przewłócka K, Makarewicz W, Bryl E. The potential of gut microbiome as a non-invasive predictive biomarker for early detection of pancreatic cancer and hepatocellular carcinoma. Eur Rev Med Pharmacol Sci. 2021;25(23):7275–84.

    PubMed  Google Scholar 

  35. Sobocki BK, Kaźmierczak-Siedlecka K, Folwarski M, Hawryłkowicz V, Makarewicz W, Stachowska E. Pancreatic cancer and gut microbiome-related aspects: a comprehensive review and dietary recommendations. Nutrients. 2021;13(12):4425.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Chen SM, Chieng WW, Huang SW, Hsu LJ, Jan MS. The synergistic tumor growth-inhibitory effect of probiotic Lactobacillus on transgenic mouse model of pancreatic cancer treated with gemcitabine. Sci Rep. 2020;10(1):20319.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Kita A, Fujiya M, Konishi H, Tanaka H, Kashima S, Iwama T, et al. Probiotic-derived ferrichrome inhibits the growth of refractory pancreatic cancer cells. Int J Oncol. 2020;57(3):721–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Ma YJ, Yu J, Xiao J, Cao BW. The consumption of omega-3 polyunsaturated fatty acids improves clinical outcomes and prognosis in pancreatic cancer patients: a systematic evaluation. Nutr Cancer. 2015;67(1):112–8.

    Article  CAS  PubMed  Google Scholar 

  39. Jentzsch V, Davis J, Djamgoz M. Pancreatic Cancer (PDAC): Introduction of evidence-based complementary measures into integrative clinical management. Cancers (Basel). 2020;12(11):3096.

    Article  CAS  PubMed  Google Scholar 

  40. Arshad A, Isherwood J, Mann C, Cooke J, Pollard C, Runau F, et al. Intravenous ω-3 fatty acids plus Gemcitabine. J Parenter Enter Nutr. 2017;41(3):398–403.

    Article  CAS  Google Scholar 

  41. Isherwood J, Arshad A, Chung WY, Runau F, Cooke J, Pollard C, et al. Myeloid derived suppressor cells are reduced and T regulatory cells stabilised in patients with advanced pancreatic cancer treated with gemcitabine and intravenous omega 3. Annals Transl Med. 2020;8(5):172–172.

    Article  CAS  Google Scholar 

  42. Gärtner S, Krüger J, Aghdassi AA, Steveling A, Simon P, Lerch MM, et al. Nutrition in pancreatic cancer: a review. Gastrointestinal Tumors. 2015;2(4):195–202.

    Article  Google Scholar 

  43. Venturella G, Ferraro V, Cirlincione F, Gargano ML. Medicinal mushrooms: bioactive compounds, use, and clinical trials. Int J Mol Sci. 2021;22(2):634.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. D’Orta A, del Buono A, de Monaco A, Zhiqiang P, Licito A, Di Martino S. Management and treatment of sarcopenia in fifty patients receiving chemotherapy with AHCC (active hexose correlated compound). WCRJ. 2018;5(2):e1089.

    Google Scholar 

  45. Yanagimoto H, Satoi S, Yamamoto T, Hirooka S, Yamaki S, Kotsuka M, et al. Alleviating effect of Active Hexose Correlated Compound (AHCC) on chemotherapy-related adverse events in patients with unresectable pancreatic ductal adenocarcinoma. Nutr Cancer. 2016;68(2):234–40.

    Article  CAS  PubMed  Google Scholar 

  46. Hashimoto D, Satoi S, Yamamoto T, Yamaki S, Ishida M, Ryota H, et al. Nutritional impact of active hexose-correlated compound for patients with resectable or borderline-resectable pancreatic cancer treated with neoadjuvant therapy. Surg Today. 2021;51(11):1872–6.

    Article  CAS  PubMed  Google Scholar 

  47. Mach CM, Fugii H, Wakame K, Smith J. Evaluation of active hexose correlated compound hepatic metabolism and potential for drug interactions with chemotherapy agents. J Soc Integr Oncol. 2008;6(3):105–9.

    PubMed  Google Scholar 

  48. Bimonte S, Barbieri A, Leongito M, Piccirillo M, Giudice A, Pivonello C, et al. Curcumin anticancer studies in pancreatic cancer. Nutrients. 2016;8(7):433.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Mansouri K, Rasoulpoor S, Daneshkhah A, Abolfathi S, Salari N, Mohammadi M, et al. Clinical effects of curcumin in enhancing cancer therapy: a systematic review. BMC Cancer. 2020;20(1):791.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Giordano A, Tommonaro G. Curcumin and cancer. Nutrients. 2019;11(10):2376.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Zoi V, Galani V, Lianos GD, Voulgaris S, Kyritsis AP, Alexiou GA. The Role of Curcumin in Cancer Treatment. Biomedicines. 2021;9(9):1086.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Gumbs AA, Gogol M, Spolverato G, Taher H, Chouillard EK. Systematic review of the integrative medicine recommendations for patients with pancreatic cancer. Surgeries. 2021;2(2):216–30.

    Article  Google Scholar 

  53. Kanai M, Yoshimura K, Asada M, et al. A phase I/II study of gemcitabine-based chemotherapy plus curcumin for patients with gemcitabine-resistant pancreatic cancer. Cancer Chemother Pharmacol. 2011;68:157–64. https://doi.org/10.1007/s00280-010-1470-257.

    Article  CAS  PubMed  Google Scholar 

  54. Epelbaum R, Schaffer M, Vizel B, Badmaev V, Bar-Sela G. Curcumin and gemcitabine in patients with advanced pancreatic cancer. Nutr Cancer. 2010;62(8):1137–41.

    Article  CAS  PubMed  Google Scholar 

  55. Song S, Ji B, Ramachandran V, Wang H, Hafley M, Logsdon C, et al. Overexpressed Galectin-3 in pancreatic cancer induces cell proliferation and invasion by Binding Ras and Activating Ras signaling. PLoS ONE. 2012;7(8):e42699.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Nangia-Makker P, Hogan V, Raz A. Galectin-3 and cancer stemness. Glycobiology. 2018;28(4):172–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. de Pedrosa FL, Raz A, Fabi JP. The Complex Biological effects of pectin: Galectin-3 targeting as potential human health improvement? Biomolecules. 2022;12(2):289.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Kobayashi T, Shimura T, Yajima T, Kubo N, Araki K, Wada W, et al. Transient silencing of galectin-3 expression promotes both in vitro and in vivo drug-induced apoptosis of human pancreatic carcinoma cells. Clin Exp Metas. 2011;28(4):367–76.

    Article  CAS  Google Scholar 

  59. Eliaz I, Raz A. Pleiotropic effects of Modified Citrus Pectin. Nutrients. 2019;11(11):2619.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Wei D, Wang L, Zuo X, Bresalier RS. Vitamin D: Promises on the horizon and challenges ahead for fighting pancreatic cancer. Cancers (Basel). 2021;13(11):2716.

    Article  CAS  PubMed  Google Scholar 

  61. Sluyter JD, Manson JE, Scragg R. Vitamin D and clinical cancer outcomes: a review of meta‐analyses. JBMR Plus. 2021Nov 4;5(1):e10420. https://doi.org/10.1002/jbm4.10420

  62. Liu Y, Wang X, Sun X, Lu S, Liu S. Vitamin intake and pancreatic cancer risk reduction. Medicine. 2018;97(13):e0114.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Akce M, El-Rayes BF. Novel strategies on the horizon for metastatic pancreatic cancer management. Oncol Hematol Rev (US). 2019;15(1):27.

    Article  Google Scholar 

  64. Xie F, You Y, Huang J, Guan C, Chen Z, Fang M, et al. Association between physical activity and digestive-system cancer: an updated systematic review and meta-analysis. J Sport Health Sci. 2021;10(1):4–13.

    Article  PubMed  Google Scholar 

  65. Behrens G, Jochem C, Schmid D, Keimling M, Ricci C, Leitzmann MF. Physical activity and risk of pancreatic cancer: a systematic review and meta-analysis. Eur J Epidemiol. 2015;30(4):279–98.

    Article  PubMed  Google Scholar 

  66. Luo H, Galvão DA, Newton RU, Lopez P, Tang C, Fairman CM, et al. Exercise medicine in the management of pancreatic cancer. Pancreas. 2021;50(3):280–92.

    Article  PubMed  PubMed Central  Google Scholar 

  67. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cancer-related fatigue, version 1.2022. 2022. Available from: https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf. Accessed Sept 8, 2022

  68. di Marco M, Rubbi I, Baldi A, di Lorenzo R, Magnani D, Cremonini V, et al. Evaluation of fatigue in patients with pancreatic cancer receiving chemotherapy treatment a cross-sectional observational study. Acta Biomed. 2018;89(4-S):18–27.

    PubMed  PubMed Central  Google Scholar 

  69. Xiao Q, Jones RR, James P, Stolzenberg-Solomon RZ. Light at night and risk of pancreatic cancer in the NIH-AARP Diet and Health Study. Can Res. 2021;81(6):1616–22.

    Article  CAS  Google Scholar 

  70. Collins KP, Geller DA, Antoni M, Donnell DM, Tsung A, Marsh JW, et al. Sleep duration is associated with survival in advanced cancer patients. Sleep Med. 2017;32:208–12.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Chalhoub S, Yaghi M, Ard N, Kanso M, Allam J, Khalife M, et al. Prevalence of insomnia among pancreatic cancer patients following pancreaticoduodenectomy. Sleep Disorders. 2021;4(2021):1–6.

    Article  Google Scholar 

  72. David A, Hausner D, Frenkel M. Cancer-related fatigue—is there a role for complementary and integrative medicine? Curr Oncol Rep. 2021;23(12):145.

    Article  PubMed  Google Scholar 

  73. Block KI, Block PB, Gyllenhaal C. Integrative treatment for colorectal cancer: a comprehensive approach. J Alternative Complement Med. 2018;24(9–10):890–901.

    Article  Google Scholar 

  74. Lissoni P, Brivio F, Fumagalli L, Messina G, Vigoré L, Parolini D, et al. Neuroimmunomodulation in medical oncology: application of psychoneuroimmunology with subcutaneous low-dose IL-2 and the pineal hormone melatonin in patients with untreatable metastatic solid tumors. Anticancer Res. 2008;28(2B):1377–81.

    CAS  PubMed  Google Scholar 

  75. García-Costela M, Escudero-Feliú J, Puentes-Pardo JD, San Juán SM, Morales-Santana S, Ríos-Arrabal S, et al. Circadian Genes as therapeutic targets in pancreatic cancer. Front Endocrinol. 2020;11:11.

    Article  Google Scholar 

  76. González A, Alonso-González C, González-González A, Menéndez-Menéndez J, Cos S, Martínez-Campa C. Melatonin as an adjuvant to antiangiogenic cancer treatments. Cancers (Basel). 2021;13(13):3263.

    Article  PubMed  Google Scholar 

  77. Talib WH, Alsayed AR, Abuawad A, Daoud S, Mahmod AI. Melatonin in cancer treatment: current knowledge and future opportunities. Molecules. 2021;26(9):2506.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Adult Cancer Pain, version 2.2022. 2022. Available from: https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1413. Accessed 8 Sept 2022

  79. Coveler AL, Mizrahi J, Eastman B, et al. Pancreas cancer-associated pain management. Oncologist. 2021;26(6):e971–82.

    Article  PubMed  PubMed Central  Google Scholar 

  80. He Y, Guo X, May BH, Zhang AL, Liu Y, Lu C, et al. Clinical evidence for association of acupuncture and acupressure with improved cancer pain. JAMA Oncol. 2020;6(2):271.

    Article  PubMed  Google Scholar 

  81. Chen H, Liu TY, Kuai L, Zhu J, Wu CJ, Liu LM. Electroacupuncture treatment for pancreatic cancer pain: a randomized controlled trial. Pancreatology. 2013;13(6):594–7.

    Article  PubMed  Google Scholar 

  82. Mao JJ, Ismaila N, Bao T, Barton D, Ben-Arye E, Garland EL, Greenlee H, Leblanc T, Lee RT, Lopez AM, Loprinzi C, Lyman GH, MacLeod J, Master VA, Ramchandran K, Wagner LI, Walker EM, Bruner DW, Witt CM, Bruera E. Integrative medicine for pain management in oncology: society for integrative oncology-ASCO guideline. J Clin Oncol. 2022 Dec 1;40(34):3998–4024. https://doi.org/10.1200/JCO.22.01357. This article represents a new collaborative work of the Society of Integrative Oncology (SIO) and American Society of Clinical Oncology (ASCO) to produce practice guideline related to integrative medicine for pain management in oncology, and is based on 227 studies.

  83. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: distress management version 2.2022. Available from: https://www.nccn.org/professionals/physician_gls/pdf/distress.pdf. Accessed 8 Sept 2022

  84. Falkensteiner M, Mantovan F, Müller I, Them C. The use of massage therapy for reducing pain, anxiety, and depression in oncological palliative care patients: a narrative review of the literature. ISRN Nurs. 2011;2011:929868.

    PubMed  PubMed Central  Google Scholar 

  85. Moffat GT, Epstein AS, O’Reilly EM. Pancreatic cancer—a disease in need: optimizing and integrating supportive care. Cancer. 2019;125(22):3927–35.

    Article  PubMed  Google Scholar 

  86. Samuels N, Freed Y, Weitzen R, Ben-David M, Maimon Y, Eliyahu U, et al. Feasibility of homeopathic treatment for symptom reduction in an integrative oncology service. Integr Cancer Ther. 2018;17(2):486–92.

    Article  PubMed  Google Scholar 

  87. Gaertner K, Müllner M, Friehs H, Schuster E, Marosi C, Muchitsch I, et al. Additive homeopathy in cancer patients: retrospective survival data from a homeopathic outpatient unit at the Medical University of Vienna. Complement Ther Med. 2014;22(2):320–32.

    Article  PubMed  Google Scholar 

  88. Frenkel M. Is There a role for homeopathy in cancer care? Questions and challenges. Curr Oncol Rep. 2015;17(9):43. https://doi.org/10.1007/s11912-015-0467-8. (PMID: 26210222).

    Article  PubMed  Google Scholar 

  89. Focan C, Houbiers G, Gilles L, van Steeland T, Georges N, Maniglia A, et al. Dietetic and psychological mindfulness workshops for the management of cachectic cancer patients. A randomized study Anticancer Res. 2015;35(11):6311–5.

    CAS  PubMed  Google Scholar 

  90. Gidron Y, Deschepper R, de Couck M, Thayer J, Velkeniers B. The Vagus nerve can predict and possibly modulate non-communicable chronic diseases: introducing a neuroimmunological paradigm to public health. J Clin Med. 2018;7(10):371.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Tyagi A, Cohen M. Yoga and heart rate variability: a comprehensive review of the literature. International Journal of Yoga. 2016;9(2):97.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Djalilova DM, Schulz PS, Berger AM, Case AJ, Kupzyk KA, Ross AC. Impact of yoga on inflammatory biomarkers: a systematic review. Biol Res Nurs. 2019;21(2):198–209.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors acknowledge Ms. Sunita C Patterson from MD Anderson’s Research Medical Library for her editorial review of the article and helpful comments that increased the quality of this article.

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Authors and Affiliations

  1. Complementary and Integrative Medicine Service, Oncology Division, Rambam Health Care Campus, Haifa, Israel

    Moshe Frenkel

  2. Tal Center for Integrative Medicine, Institute of Oncology, Chaim Sheba Medical Center, Ramat-Gan, Israel

    Adi David & David Hausner

  3. Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kenneth Sapire

  4. Palliative Care Service, Chaim Sheba Medical Center, Ramat Gan, Israel

    David Hausner

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Frenkel, M., David, A., Sapire, K. et al. Complementary and Integrative Medicine in Pancreatic Cancer. Curr Oncol Rep 25, 231–242 (2023). https://doi.org/10.1007/s11912-023-01370-z

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