Patients with pancreatic cancer experience symptoms of disease and treatment-related symptoms that can reduce quality of life and negatively impact survival. This paper discusses practical tools for supporting patients in digestive tract symptom reduction with safe interventions such as nutritional counseling and evidence-based supplements. Patients and caregivers who are provided knowledge about digestive tract physiology, nutritional education, and detailed instructions for use of pancreatic enzymes may more effectively utilize treatment plans at home. Supporting overall nutritional status and maximizing digestive function with use of pancreatic enzymes and supplements such as probiotics and melatonin may help reduce suffering in pancreatic cancer patients and support quality of life.
The serendipitous discovery that grapefruit juice could dramatically increase the bioavailability of orally administered medications resulted from the findings of a 1989 clinical trial on the pharmacodynamics of felodipine. Grapefruit juice is now estimated to pose a nutrient-drug interaction with more than 85 different medications. The primary mechanism of this interaction is inhibition of cytochrome P450 3A4 (CYP3A4), but grapefruit juice also inhibits organic anion-transporter polypeptides (OATPs). These mechanisms can increase bioavailability, decrease bioavailability, or reduce the metabolic activation of certain medications. Many commonly prescribed drugs interact with grapefruit juice, and these interactions can produce clinically significant effects. Consumption of a single glass of juice is sufficient to alter drug metabolism, and the effect can last as long as 3 days. Practical implications of grapefruit juice-drug interactions are reviewed here.
In the 1980s national policies directed at lowering fat consumption emerged. One of the many reasons for recommending fat restriction was the apparent association between high dietary fat and breast cancer incidence—an association based on epidemiological and case control data. We now know that epidemiological studies and case controlled studies are poor predictors of how dietary patterns influence cancer risk. Furthermore, newer, prospective studies no longer support the association between dietary fat and breast cancer except in a small subset of cancers.
The current standard of care medical model is a disease-based approach. Diagnosis and determination of appropriate treatment options are complex processes that require a move toward a more patient-centric model of care that includes individualized diagnosis and treatment. The functional medicine model requires a diagnosis, but in addition, an understanding of the unique mechanisms including predisposing genetic factors, biochemical and psychosocial factors, and underlying dysfunctions in order to prescribe appropriate evidence-based therapies to improve overall health. The purpose of this case series is to describe the potential benefits of implementing a functional medicine approach for various chronic, complex pain syndromes.
Cancer cachexia is a multifactorial syndrome characterized by loss of lean body mass, which may adversely affect a patient’s overall survival, quality of life, level of physical activity, and ability to receive antineoplastic therapy. Where full eradication of tumor burden is not achieved, multimodal prevention or treatment of cachexia is indicated. This article serves to highlight strategies to consider based on available evidence and treatment goals in cancer cachexia.
The mitochondrial free radical theory of aging is currently one of the more widely accepted theories to explain the aging process. It posits that aging results from free radical damage to mitochondrial DNA that is caused by reactive oxygen species (ROS) generated within the mitochondria during complex I electron transport. Vulnerability to ROS peroxidation, and thus aging, varies with the quantity of polyunsaturated fatty acids incorporated into cellular membranes. The current data in support of this theory suggest that antioxidant intake has little impact on increasing maximal longevity and also that intake of polyunsaturated fatty acids may be associated with faster aging. These implications are relevant to clinical practice.
Restriction of methionine in the diet has been used in animal studies as a mimetic to caloric restriction with similar metabolic effects. Many of these effects, such as lower insulin-like growth factor, should induce favorable outcomes in patients with a history of cancer. This review explores the theory and evidence for a normal-calorie, methionine-restriction diet in the context of cancer care specifically.
The effects and perception of aging are directly reflected in the health and condition of the skin. Beauty and antiaging products largely focus on treatment of the skin with an outside-in strategy. There is demand for “beauty from within” products that support underlying internal processes necessary for healthy and vital skin. This study assesses the effectiveness of methylsulfonylmethane (MSM) as an oral supplement on skin health using expert grading, instrumental measurements, and participant self-evaluation.
In this article, the authors review the prevalence of magnesium (Mg) deficiency in patients undergoing platinum-based chemotherapy, summarize research on IV and oral Mg in supportive care, discuss the role of Mg in carcinogenesis, explore different forms of oral Mg, investigate current best evidence on the effect of Mg on survivorship, and review ways for clinicians to identify and remedy early signs of Mg depletion.
The World Health Organization has stated that air pollution accounts for 1.3 million deaths worldwide every year. This article reviews the association of air pollutants with all major causes of death. Those associations understood, it becomes clear that outdoor air pollution is likely to be an even greater cause of mortality across the globe than is currently recognized.