LWBK1006-48 LWW-Govindan-Review December 12, 2011 20:53
Chapter 48•Complementary, Alternative, and Integrative Therapies in Cancer Care 595Answer 48.6. The answer is B.
Chaparral is a Native American herb that has purported anti-
inflammatory and anticancer effects. There is no scientific evidence sup-
porting the anticancer effects of chaparral. Numerous reports indicate
hepatotoxicity after the use of chaparral and often severe fulminant hep-
atic failure requiring transplantation. Other common herbal supplements
with significant hepatic toxicity include birch oil, blessed thistle, Kava,
germander, dehydroepiandrosterone (DHEA), and turmeric.Answer 48.7. The answer is C.
PC-SPES is a herbal product that is a mixture of eight herbs: reishi mush-
room, Baikal skullcap, Rabdosia, Dyer’s woad, chrysanthemum, saw pal-
metto, Panax ginseng, and licorice. PC-SPES was a very popular herbal
supplement to treat prostate cancer. Use of PC-SPES has demonstrated
significant decreases in androgen and prostate-specific antigen (PSA) lev-
els in humans. In vitro experiments revealed inhibition of growth and
proliferation of human tumor cell lines, including androgen-sensitive and
-insensitive prostate cancer.Answer 48.8. The answer is D.
Coenzyme Q10 (also known as Vitamin Q10, ubiquinone, or ubide-
carenone) supplements are very popular among patients undergoing
chemotherapy. There has been some suggestion that Coenzyme Q10 might
reduce chemotherapy-induced fatigue and also has cardioprotective effect
when used with anthracycline-based regimens. However, in double-blind,
placebo-controlled trials in patients with breast cancer, use of Coenzyme
Q did not show any clinically significant benefit from chemotherapy-
related fatigue.
Although the use of Coenzyme Q for prevention of anthracycline-
induced cardiotoxicity appears promising based on preclinical models,
there is no strong evidence through randomized prospective trials. Two
small prospective trials have suggested benefit; however, these had serious
design flaws and no definitive conclusions could be drawn.Answer 48.9. The answer is D.
Kava extracts are commonly used by patients with cancer for anxiety
and insomnia. Several randomized, controlled clinical trials have reported
relief of anxiety and insomnia. However, numerous reports of severe hep-
atotoxicity have been reported. The use of Kava extracts has not been
approved by the Food and Drug Administration for the above indication.Answer 48.10. The answer is B.
Grapefruit extracts inhibit cytochrome P450 isoenzymes and, therefore,
affect serum concentrations of drugs metabolized by the cytochrome
P450 3A4 system. Several chemotherapy agents, including docetaxel,
paclitaxel, vincristine, vinblastine, vinorelbine, irinotecan, etoposide, and
tamoxifen, are metabolized by the cytochrome P450 3A4 system, and