Der Onkologe

, Volume 14, Issue 11, pp 1165–1171

Komplementäre und supportive Therapieverfahren

  • K. Münstedt
  • B.O. Maier
  • A. Hackethal
  • J. Sehouli
Leitthema
  • 121 Downloads

Zusammenfassung

Komplementäre und supportive Therapieverfahren haben in der Onkologie durchaus überlappende Zielsetzungen, sind jedoch vom Ansatz her grundverschieden, da die Therapieempfehlungen der Komplementärmedizin im Gegensatz zur Supportiv- oder Palliativmedizin seltener die Anforderungen der evidenzbasierten Medizin erfüllen. Im Hinblick auf die Komplementärmedizin wurden in der Vergangenheit von Seiten der so genannten Schulmedizin die Verfahren methodenorientiert oft kritisch diskutiert. Im vorliegenden Beitrag werden Richtlinien vorgestellt, mit welchen die Sinnhaftigkeit des Einsatzes geprüft werden kann. Zum gegenwärtigen Zeitpunkt erscheinen ausgewogene Diäten mit einem höheren Anteil an Kohlgemüse, die Selensubstitution und der Konsum von grünem Tee als mögliche komplementäre Methoden der Ovarialkarzinombehandlung, wobei dies noch durch prospektive Studien belegt werden sollte. In der Palliativmedizin setzt sich zunehmend die symptomorientierte und bedarfsadaptierter Behandlungsstrategie durch. Hierbei hat die psychologische Unterstützung der Betroffenen und der Angehörigen eine herausragende Bedeutung.

Schlüsselwörter

Ovarialkarzinom Komplementärmedizin Palliativmedizin Selen Darmverschluss 

Complementary und supportive therapies

Abstract

Complementary and supportive methods indisputably share common goals; however, they are entirely different in terms of approach since therapy recommendations for complementary medicine, in contrast to supportive or palliative medicine, rarely fulfil the requirements of evidence-based medicine. In the past, so-called mainstream medicine was often critical of the methods used in complementary medicine. This report discusses some general guidelines which can be used to evaluate the meaningfulness of complementary methods. At present, diets with high cabbage content, selenium substitution and green tea can be considered potential complementary methods for patients with ovarian cancer. However, this remains to be established in prospective studies. Symptom-oriented and requirement-specific treatment strategies are gaining acceptance in palliative medicine, whereby psychological support for both patients and their relatives plays an important role.

Keywords

Ovarian cancer Complementary medicine Palliative care Selenium Bowel obstruction 

Literatur

  1. 1.
    Brard L, Weitzen S, Strubel-Lagan SL et al. (2006) The effect of total parenteral nutrition on the survival of terminally ovarian cancer patients. Gynaecol Oncol 103: 176–180CrossRefGoogle Scholar
  2. 2.
    Chan MM, Soprano KJ, Weinstein K et al. (2006) Epigallocatechin-3-gallate delivers hydrogen peroxide to induce death of ovarian cancer cells and enhances their cisplatin susceptibility. J Cell Physiol 207: 389–396PubMedCrossRefGoogle Scholar
  3. 3.
    Cohen ST, Block S (2004) Issues in psychotherapy with terminally ill patients. Palliat Support Care 2: 181–189PubMedCrossRefGoogle Scholar
  4. 4.
    Dennert G, Horneber M (2006) Selenium for alleviating the side effects of chemotherapy, radiotherapy and surgery in cancer patients. Cochrane Database Syst Rev 3: CD005037PubMedGoogle Scholar
  5. 5.
    Feuer DJ, Broadley KE (1999) Systematic review and meta-analysis of corticosteroids for the resolution of malignant bowel obstruction in advanced gynaecological and gastrointestinal cancers. Systematic Review Steering Committee. Ann Oncol 10: 1035–1041PubMedCrossRefGoogle Scholar
  6. 6.
    Feuer DJ, Broadley KE, Shepherd JH et al. (1999) Systematic review of surgery in malignant bowel obstruction in advanced gynecological and gastrointestinal cancer. The Systematic Review Steering Committee. Gynecol Oncol 75: 313–322PubMedCrossRefGoogle Scholar
  7. 7.
    Gioiella ME, Berkamn B, Robinson M (1998) Spirituality and quality of life in gynaecologic oncology patients. Cancer Pract 6: 333–338PubMedCrossRefGoogle Scholar
  8. 8.
    Grossarth-Maticek R, Ziegler R (2007) Prospective controlled cohort studies on long-term therapy of ovarian cancer patients with mistletoe (Viscum album L.) extracts iscador. Arzneimittelforschung 57: 665–678PubMedGoogle Scholar
  9. 9.
    Herrinton LJ, Neslund-Dudas C, Rolnick SJ et al. (2007) Complications at the end of life in ovarian cancer. J Pain Symptom Manage 24: 237–243CrossRefGoogle Scholar
  10. 10.
    Horneber MA, Bueschel G, Huber R et al. (2008) Mistletoe therapy in oncology. Cochrane Database Syst Rev 2: CD003297PubMedGoogle Scholar
  11. 11.
    Huh SW, Bae SM, Kim YW et al. (2004) Anticancer effects of (-)-epigallocatechin-3-gallate on ovarian carcinoma cell lines. Gynecol Oncol 94: 760–768PubMedCrossRefGoogle Scholar
  12. 12.
    Jatoi A, Podratz KC, Gill P et al. (2004) Pathophysiology and palliation of inoperable bowel obstruction in patients with ovarian cancer. J Support Oncol 2: 323–334PubMedGoogle Scholar
  13. 13.
    Kleeberg UR, Suciu S, Brocker EB et al. (2004) Final results of the EORTC 18871/DKG 80-1 randomised phase III trial. rIFN-alpha2b versus rIFN-gamma versus ISCADOR M versus observation after surgery in melanoma patients with either high-risk primary (thickness >3 mm) or regional lymph node metastasis. Eur J Cancer 40: 390–402PubMedCrossRefGoogle Scholar
  14. 14.
    Larsson SC, Wolk A (2005) Tea consumption and ovarian cancer risk in a population-based cohort. Arch Intern Med 165: 2683–2686PubMedCrossRefGoogle Scholar
  15. 15.
    Laval G, Arvieux C, Stefani L et al. (2006) Protocol for the treatment of malignant inoperable bowel obstruction: a prospective study of 80 cases at Grenoble University. J Pain Symptom Manage 31: 502–512PubMedCrossRefGoogle Scholar
  16. 16.
    Lee AH, Fraser ML, Binns CW (2005) Possible role for green tea in ovarian cancer prevention. Future Oncol 1: 771–777PubMedCrossRefGoogle Scholar
  17. 17.
    Matulonis UA, Seiden MV, Roche M et al. (2005) Long acting octreotide for the treatment and symptomatic relief of bowel obstruction in advanced ovarian cancer. J Pain Symptom Manage 30: 563–569PubMedCrossRefGoogle Scholar
  18. 18.
    Nagle CM, Purdie DM, Webb PM et al. (2003) Dietary influences on survival after ovarian cancer. Int J Cancer 106: 264–269PubMedCrossRefGoogle Scholar
  19. 19.
    Petersen RW, Graham G, Quinlivan JA (2005) Psychologic changes after a gynecologic cancer. J Obstet Gynaecol Res 31: 152–157PubMedCrossRefGoogle Scholar
  20. 20.
    Piao BK, Wang YX, Xie GR et al. (2004) Impact of complementary mistletoe extract treatment on quality of life in breast, ovarian and non-small cell lung cancer patients. A prospective randomized controlled clinical trial. Anticancer Res 24: 303–309PubMedGoogle Scholar
  21. 21.
    Rolnick SJ, Jackson J, Nelson WW et al. (2007) Pain management in the last six months of life among women who died of ovarian cancer. J Pain Symptom Manage 33: 24–31PubMedCrossRefGoogle Scholar
  22. 22.
    Ryerson AB, Eheman C, Burton J et al. (2007) Symptoms, diagnoses and time to key diagnostic procedures among older U.S. women with ovarian cancer. Obstet Gynecol 109: 1053–1061PubMedGoogle Scholar
  23. 23.
    Sehouli J, Lichtenegger W (2005) Palliativmedizinische Aspekte aus gyn-onkologischer Sicht. In: David M, Siedentopf F, Siedentopf J-P et al. (Hrsg) Willkommen und Abschied – Psychosomatik zwischen Präimplatationsdiagnostik und palliativer Karzinomtherapie. Psychosozial, Gießen, S 91–97Google Scholar
  24. 24.
    Shima Y, Ohtsu A, Shirao K et al. (2008) Clinical efficacy and safety of octreotide (SMS 201-995) in terminally ill Japanese cancer patients with malignant bowel obstruction. Jpn J Clin Oncol 38: 254–359CrossRefGoogle Scholar
  25. 25.
    Spinella F, Rosanò L, Di Castro V et al. (2006) Green tea polyphenol epigallocatechin-3-gallate inhibits the endothelin axis and downstream signaling pathways in ovarian carcinoma. Mol Cancer Ther 5: 1483–1492PubMedCrossRefGoogle Scholar
  26. 26.
    Spinella F, Rosanò L, Decandia S et al. (2006) Antitumor effect of green tea polyphenol epigallocatechin-3-gallate in ovarian carcinoma cells: evidence for the endothelin-1 as a potential target. Exp Biol Med 231: 1123–1127Google Scholar
  27. 27.
    Song YJ, Kristal AR, Wicklund KG et al. (2008) Coffee, tea, colas and risk of epithelial ovarian cancer. Cancer Epidemiol Biomarkers Prev 17: 712–716PubMedCrossRefGoogle Scholar
  28. 28.
    Steuer-Vogt MK, Bonkowsky V, Ambrosch P et al. (2001) The effect of an adjuvant mistletoe treatment programme in resected head and neck cancer patients: a randomised controlled clinical trial. Eur J Cancer 37: 23–31PubMedCrossRefGoogle Scholar
  29. 29.
    Sundström H, Yrjänheikki E, Kauppila A (1984) Serum selenium in patients with ovarian cancer during and after therapy. Carcinogenesis 5: 731–734PubMedCrossRefGoogle Scholar
  30. 30.
    Vadgama JV, Wu Y, Shen D et al. (2000) Effect of selenium in combination with adriamycin or taxol on several different cancer cells. Anticancer Res 20: 1391–1414PubMedGoogle Scholar
  31. 31.
    von Grueningen VE, Daly BJ (2005) Futulity: clinical decisions at the end-of-life in women with ovarian cancer. Gynaecol Oncol 97: 638–644CrossRefGoogle Scholar
  32. 32.
    Zhang M, Lee AH, Binns CW et al. (2004) Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer 112: 465–469PubMedCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  • K. Münstedt
    • 1
  • B.O. Maier
    • 2
  • A. Hackethal
    • 1
  • J. Sehouli
    • 3
  1. 1.UniversitätsfrauenklinikJustus-Liebig-Universität, GießenGießenDeutschland
  2. 2.PalliativmedizinDr. Horst Schmidt Kliniken GmbHWiesbadenDeutschland
  3. 3.Klinik für Frauenheilkunde und GeburtshilfeCharité – Universitätsmedizin Berlin, Campus Virchow-KlinikumBerlinDeutschland

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