Advertisement

Supportive Care in Cancer

, Volume 22, Issue 11, pp 3007–3015 | Cite as

Effectiveness of combinations of Ayurvedic drugs in alleviating drug toxicity and improving quality of life of cancer patients treated with chemotherapy

  • Vineeta DeshmukhEmail author
  • Arvind Kulkarni
  • Sudhir Bhargava
  • Tushar Patil
  • Vijay Ramdasi
  • Sudha Gangal
  • Vasanti Godse
  • Shrinivas Datar
  • Shweta Gujar
  • Sadanand Sardeshmukh
Original Article

Abstract

Purpose

This study was conducted to assess the effectiveness of combinations of Ayurvedic drugs in alleviating the toxicity of chemotherapy and improving the quality of life of cancer patients. The following was the research question: Can Ayurvedic drugs be used to alleviate the side effects of chemotherapy and improve the quality of life of cancer patients?

Method

Random patients with malignancies of different tissues, grades, and stages were divided into two groups according to their treatment modality. Group 1 consisted of 15 patients treated with six cycles of chemotherapy alone and who did not receive any Ayurvedic drugs (control group). Group 2 consisted of patients (divided into three arms) who received Ayurvedic drugs during chemotherapy and after chemotherapy. Nineteen patients in arm 1 received the Ayurvedic drugs Mauktikyukta Kamdudha (MKD) and Mauktikyukta Praval Panchamruta (MPP) along with a full course of chemotherapy. Fifteen patients in arm 2 received the same Ayurvedic treatment, but the treatment was started after completing the sixth cycle of chemotherapy. Eighteen patients in arm 3 received the Suvarnabhasmadi formulation (SBD) in addition to MKD and MPP after completing the sixth cycle of chemotherapy. Treatment was given for 16 weeks in all three arms. Patients from both groups were observed for a period of 6 months. The assessment criteria depended on Common Toxicity Criteria (CTC designed by NIH and NCI): haemogram; weight; physical examination including Quality of Life Questionnaire (QLQ designed by the European Organization of Research and Treatment of Cancer (EORTC)) for functional, symptom and global scores; and Karnofsky score for assessment of general well-being and activities of daily life. ECOG (Eastern Cooperation Oncology Group) score was also additionally included for assessment of symptoms.

Results

From amongst the symptomatic criteria, there was significant improvement in all the three arms compared with the control group in nausea, loss of appetite, constipation, and fatigue. There was significant improvement in the Karnofsky score and global score of the QLQ, which in fact incorporate symptomatic criteria, general condition, functional ability and disease-related symptoms. These significant differences were observed in group 2 (arms 1, 2, 3) in comparison with group 1 (control), in spite of the fact that in arms 2 and 3, the Ayurvedic treatment was started after completion of chemotherapy. The haemogram did not show a significant difference between the control and the three arms of group 2.

Conclusion

Adjunct treatment with herbo-mineral and metallic Ayurvedic drugs appears to have a significant effect on reducing the toxic side effects of chemotherapy drugs in cancer patients. Our preliminary data suggests that Ayurvedic treatment should be given simultaneously from the beginning of chemotherapy to have the desired effect. However, there is a need to extend this work by conducting a well-planned two-armed study on cancer patients with defined cancer sites with selected Ayurvedic drug combinations, and observing the patients for a longer period of time to confirm the effectiveness of Ayurvedic drugs in reducing the side effects of chemotherapy.

Keywords

Toxicity of anti-cancer drugs Quality of life Ayurvedic drugs Mauktikyukta Kamadudha Mauktikyukta Praval Panchamrut Suvarnabhasmadi formulation 

Notes

Acknowledgments

We acknowledge the respected P.K. Sardeshmukh Maharaj, Founder Trustee of Bharatiya Sanskriti Darshan Trust and originator of the Cancer Research Project of the trust. We also wish to acknowledge Mr. D.V. Jogalekar, formerly statistician at BIAF, Development Research Foundation, Pune, India, for his excellent input in the statistical analysis of our data. Mr. Shyam Shitole is acknowledged for his help in the graphics and designing of the figures.

Conflict of interest

None

Participating investigators

The group of our research fellows, namely Dr. S. Gore, Dr. R. Nimbalkar, Dr. D. Deshpande, Dr, S. Chavan, Dr. S. Agashe, Dr. K. Karle, Dr. S. Mujawar, Dr. A. Mujawar, Dr. N. Patil, Dr. V. Awalkanthe, Dr. A. Patre, Dr. A. Salunkhe, Dr. A.A. Salunkhe, Dr. J. Kambale, Dr. A. Shingate and Dr. M. Madne, are acknowledged for meticulously conducting patients’ data collection, tests for criteria at four time points of patients included (and excluded), counselling and filling of the questionnaire.

Open access

The rights will remain with the publisher.

References

  1. 1.
    Vincent T, Lawrence T, Rosenberg S (2008) Cancer: Principles & Practice of Oncology, 8th edn. In: Devita, Hellman, Rosenberg (eds) Rehabilitation of the cancer patient. Publ. Lippincott Williams & Wilkins, pp 2858–2859Google Scholar
  2. 2.
    Guillot B, Bessis D, Dereure O (2004) Mucocutaneous side effects of antineoplastic chemotherapy. Expert Opin Drug Saf 3:579–587PubMedCrossRefGoogle Scholar
  3. 3.
    Burish TG, Tope DM (1992) Psychological techniques for controlling the adverse side effects of cancer chemotherapy: findings from a decade of research. J Pain Symptom Manag 7:287–301CrossRefGoogle Scholar
  4. 4.
    Artherholt S, Fann J (2012) Psychosocial care in cancer. Curr Psychiatr Rep 14:23–29. doi: 10.1007/s11920-011-0246-7 CrossRefGoogle Scholar
  5. 5.
    Moreno S, Lutgendorf S, Sood A (2010) Impact of stress on cancer metastasis. Futur Oncol 6:1863–1881. doi: 10.2217/fon.10.142 CrossRefGoogle Scholar
  6. 6.
    Tripathi B (2003) Charak Samhita, vol. 2, Chaukhamba Surabharati Prakashan, Varanasi, Rasayana 1/1/4, p. 3Google Scholar
  7. 7.
    Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, May 2009 (updated June 2010) U.S. Department Of Health and Human Services NIH, NCI http://www.eortc.be/services/doc/ctc/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf
  8. 8.
    Vincent T, Lawrence T, Rosenberg S (2008) Cancer: Principles & Practice of Oncology, 8th edn. In: Devita, Hellman, Rosenberg (eds) Rehabilitation of the cancer patient. Publ. Lippincott Williams & Wilkins, pp 2958–2959Google Scholar
  9. 9.
    Vyas P, Thakar AB, Baghel MS, Sisodia A, Deole Y (2010) Efficacy of Rasayana Avaleha as adjuvant to radiotherapy and chemotherapy in reducing adverse effects. Ayu 31:417–423. doi: 10.4103/0974-8520.82029 PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Vaidya B (1999) Nighantu Adarsha, part −2, 2nd edn. Chaukhamba Publications, pp 636–641Google Scholar
  11. 11.
    Vaidya B (1999) Nighantu Adarsha, part −2, 2nd edn. Chaukhamba Publications, pp 19–25Google Scholar
  12. 12.
    Vaidya B (1999) Nighantu Adarsha, Part −2, 2nd edn. Chaukhamba publications, pp 134–141Google Scholar
  13. 13.
    Vaidya B (1999) Nighantu Adarsha, part −2, 2nd edn. Chaukhamba Publications, pp 403–441Google Scholar
  14. 14.
    Sharma HP, Rasayogasagar. Part −2, Krishnadas Ayurved Series, p 93Google Scholar
  15. 15.
    Sharma HP, Rasayogasagar. Part −1, Krishnadas Ayurved Series, p 260Google Scholar
  16. 16.
    Paul W, Sharma CP (2011) Blood compatibility studies of Swarnabhasma (gold bhasma), an Ayurvedic drug. Int J Ayurveda Res 2:14–22. doi: 10.4103/0974-7788.83183 PubMedPubMedCentralGoogle Scholar
  17. 17.
    Dubey N, Mehta R, Saluja A, Jain D (2009) Antiulcer activity of a traditional pearl preparation: Mukta Bhasma Research. J Pharm Technol 2:287–290Google Scholar
  18. 18.
    Goel HC, Prasad J, Singh S, Sagar RK, Agrawala P, Bala M, Sinha AK, Dogra R (2004) Radioprotective potential of a herbal extract of Tinospora cordifolia. J Radiat 45:61–68CrossRefGoogle Scholar
  19. 19.
    Van den Bent MJ, Grisold W, Frappaz D, Stupp R, Desir JP, Lesimple T, Dittrich C, de Jonge MJ, Brandes A, Frenay M, Carpentier AF, Chollet P, Oliveira J, Baron B, Lacombe D, Schuessler M, Fumoleau P (2003) European Organization for Research and Treatment of Cancer (EORTC) open label phase II study on glufosfamide administered as a 60-minute infusion every 3 weeks in recurrent glioblastomamultiforme. Ann Oncol 14:1732–1734PubMedCrossRefGoogle Scholar
  20. 20.
    Cancer Care Ontario (CCO) Drug formulary, updated in 2013 www.cancercare.on.ca/toolbox/drugs/drugformulary
  21. 21.
    Leon AC, Marzuk PM, Portera L (1995) More reliable outcome measures can reduce sample size requirements. Arch Gen Psychiatry 52(10):867–871PubMedCrossRefGoogle Scholar
  22. 22.
    1995 EORTC Quality of Life Group. Version 3.0 http://groups.eortc.be/qol/eortc-qlq-c30
  23. 23.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRefGoogle Scholar
  24. 24.
    Crooks V, Waller S et al (1991) The use of the Karnofsky performance scale in determining outcomes and risk in geriatric outpatients. J Gerontol 46:139–144CrossRefGoogle Scholar
  25. 25.
    Oken M, Creech R, Tormey D, Horton J, Davis T, McFadden E, Carbone P (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655PubMedCrossRefGoogle Scholar
  26. 26.
    Dercksen MW, Hoekman, Ten Bokkel Huinink WW, Rankin EM, Dubbelman R, Tinteren H, Wagstaff J, Pinedo H (1993) Effects of interleukin-3 on myelosuppression induced by chemotherapy for ovarian cancer and small cell undifferentiated tumours. Br J Cancer 68:996–1003. doi: 10.1038/bjc. 1993.468 PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Deshmukh V, Sardeshmukh S (2006) To study the effect of Suvarnabhasmadi Yoga & Guduchi Siddha Kshirapak in the treatment of Aupasargik Rajayakshma—Shosha Vyadhi (HIV+ve patients). Dissertation, University of Pune, Maharashtra, IndiaGoogle Scholar
  28. 28.
    Mamgani A, Rooji PV, Tans L, Verduijn GM, Sewnaik A, Jong RB (2013) A prospective evaluation of patient-reported quality-of-life after (chemo) radiation for oropharyngeal cancer: which patients are at risk of significant quality-of-life deterioration? Radiother Oncol 106:359–363CrossRefGoogle Scholar
  29. 29.
    Kulkarni D (1981) Ayurvediya Rasaushadhi Nirman, 1st ed, Continental Publications, p 283Google Scholar
  30. 30.
    Yang AK, He SM, Liu L, Liu JP, Wei MQ, Zhou SF (2010) Herbal interactions with anticancer drugs: mechanistic and clinical considerations. Curr Med Chem 17(16):1635–1678PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Vineeta Deshmukh
    • 1
    Email author
  • Arvind Kulkarni
    • 1
  • Sudhir Bhargava
    • 1
  • Tushar Patil
    • 1
  • Vijay Ramdasi
    • 1
  • Sudha Gangal
    • 1
  • Vasanti Godse
    • 1
  • Shrinivas Datar
    • 1
  • Shweta Gujar
    • 1
  • Sadanand Sardeshmukh
    • 1
  1. 1.Integrated Cancer Treatment and Research CentrePuneIndia

Personalised recommendations