Abstract

Complementary and alternative medicines are used by up to 48% of lung cancer patients but have seen little formal assessment of survival efficacy. In this 10-year retrospective survival study, the authors investigated Pan-Asian medicine + vitamins (PAM+V) therapy in a consecutive case series of all non-small-cell lung cancer patients (n = 239) presenting at a San Francisco Bay Area Chinese medicine center (Pine Street Clinic). They compared short-term treatment lasting the duration of chemotherapy/radiotherapy with long-term therapy continuing beyond conventional therapy. They also compared PAM+V plus conventional therapy with conventional therapy alone, using concurrent controls from the Kaiser Permanente Northern California and California Cancer Registries. They adjusted for confounding with Kaplan-Meier, Coxregression, and newer methods –propensity score and marginal structural models (MSMs), which when analyzing data from observational studies or clinical practice records can provide results comparable with randomized trials. Long-term use of PAM+V beyond completion of chemotherapy reduced stage IIIB deaths by 83% and stage IV by 72% compared with short-term use only for the duration of chemotherapy. Long-term PAM+V combined with conventional therapy reduced stage IIIA deaths by 46%, stage IIIB by 62%, and stage IV by 69% compared with conventional therapy alone. Survival rates for stage IV patients treated with PAM+V were 82% at 1 year, 68% at 2 years, and 14% at 5 years. PAM+V combined with conventional therapy improved survival in stages IIIA, IIIB, and IV, compared with conventional therapy alone. Prospective trials using PAM+V with conventional therapy for lung cancer patients are justified

Location of trial:  USA

Medical Condition

Lung cancer is leading cause of cancer death in US today. IN 1988 The median survival rate for NSC lung cancer after chemo and added 8 months of B- and y- interferons was a mere 6 months. In 1988 all conventional treatments and adjunct therapy didn’t make a significant difference in reducing risk of death (for more details see paper).

Treatment

The treatment does not replace chemotherapy instead it is designed to complement a cycle of adjunctive chemotherapy. Treatment involved diet, exercise or appropriate activities (relaxation) , supplements and chinese herbs provided in the traditional dry form which were given to the patients to decoct. All patients were encouraged to continue being active when they returned home. Supplements and herbs were provided at specific stages of the chemotherapy cycle and the supplements varied at each stage (stage 2 and 3 were very similar).

Herbal formulas , as always, are modified for the patient. Often starting from a base formulae for presenting pattern the formula is then modified to address specific symptoms.

Participants

239 people followed from beginning of their treatment and until death of up to ten years after treatment begun. ,  but also retrospective survival analysis data of NSC lung cancer patients was taken from other clinics in US for statistical comparison against the specific population of patients who had  taken complementary program of Pacific Asian Medicine and Vitamins during conventional cancer treatments including chemo/surgery/radiotherapy.

Outcomes Measured

Median survival rates following conventional and conventional + PAM + V for stages II, IIIA/IIIB/IV of NSC lung cancer

Results

The overall study concluded that survival rates increased in patients who had participated in the complementary program taking PAM and vitamins and this was most significant at stages IIIA/B and IV.

For more details refer to a very detailed paper which also lists all supplements, herbal formulas and single herbs.

Comments

This is a great study that in my opinion has attempted to do everything possible to demonstrate a valid and reliable model to measure the benefits of  using a complementary program during conventional cancer treatments.

References

Lung Cancer Lung Cancer Survival With Herbal Medicine and Vitamins

in a Whole-Systems Approach: Ten-Year Follow-up Data Analyzed

With Marginal Structural Models and Propensity Score Methods

Michael McCulloch, LAc, MPH, PhD1,2, Michael Broffman, LAc1,

Mark van der Laan, PhD2, Alan Hubbard, PhD2, Lawrence Kushi, DSc3,

Alan Kramer, MD4, Jin Gao, MD, PhD5, and John M. Colford Jr, MD, PhD2