Effect of Honey-Lime Spray as Add-On Therapy on Chemotherapy-Induced Xerostomia in Breast Cancer Patients: A Pilot Randomized Double-Blinded Controlled Trial.

INTRODUCTION: Xerostomia (dry mouth) is a common side effect among patients with cancer undergoing chemotherapy. There is no standard treatment for this symptom yet, although Persian medicine textbooks suggested some products to relieve xerostomia. We aimed to assess the efficacy of honey-lime spray in treating chemotherapy-induced xerostomia in breast cancer patients through a controlled study. METHODS: In this pilot, randomized, double-blinded clinical trial conducted in Shohadaye Tajrish Hospital, Iran, the intervention group received honey-lime spray and nystatin, while the control group used distilled water plus nystatin for 2 weeks. The six-item dry mouth form and visual analog score (VAS) were used to evaluate xerostomia extent and pain, respectively. RESULTS: The standardized value of the difference between the mean scores before and after the study was -10.21 (p < 0.001), and the effect size was estimated at 55%. Also, VAS showed a significant decrease in pain for the intervention group compared with the control group (p < 0.001). There were no serious side effects. CONCLUSION: Honey-lime spray may be a good treatment choice for xerostomia in chemotherapy-induced breast cancer patients, but robust trials with larger samples and prolonged follow-ups are highly recommended.Mundtrockenheit (Xerostomie) ist eine häufige Nebenwirkung bei Krebspatienten, die sich einer Chemotherapie unterziehen. Es gibt bisher keine Standardtherapie für dieses Symptom, doch Lehrbücher der persischen Medizin schlagen einige Mittel zur Linderung von Mundtrockenheit vor. Unser Ziel war es, die Wirksamkeit von Honig-Limetten-Spray zur Behandlung von chemotherapiebedingter Mundtrockenheit bei Patientinnen mit Brustkrebs im Rahmen einer kontrollierten Studie zu untersuchen.In dieser randomisierten, doppelt verblindeten klinischen Pilotstudie, die im Shohadaye Tajrish Hospital im Iran durchgeführt wurde, erhielt die Interventionsgruppe zwei Wochen lang Honig-Limetten-Spray und Nystatin und die Kontrollgruppe destilliertes Wasser plus Nystatin. Ein Mundtrockenheits-Fragebogen mit sechs Items wurde zur Beurteilung der Schwere der Mundtrockenheit verwendet und eine visuelle Analogskala zur Beurteilung der Schmerzen.Der standardisierte Wert der Differenz zwischen den mittleren Scores vor und nach der Studie betrug −10,21 (p < 0,01), und die geschätzte Effektstärke betrug 55%. Zudem zeigte die VAS eine signifikante Abnahme der Schmerzen in der Interventionsgruppe im Vergleich zur Kontrollgruppe (p < 0,01). Es traten keine schwerwiegenden Nebenwirkungen auf.Honig-Limetten-Spray könnte eine gute Wahl für die Behandlung von Mundtrockenheit bei Brustkrebspatientinnen unter Chemotherapie sein, doch hierzu werden belastbare Studien mit größerem Probenumfang und längerer Nachbeobachtung nachdrücklich empfohlen.

Efficacy of lettuce seed syrup on insomnia in patients with breast cancer: a pilot double blind randomized placebo controlled clinical trial.

OBJECTIVES: Insomnia and sleep disorders are common and can be severe amongst patients with cancer, especially during chemotherapy. The aim of this study was to evaluate the efficacy of lettuce seed syrup in breast cancer patients who suffer from insomnia or disordered sleep. METHODS: This pilot study was a double-blinded randomized controlled clinical trial conducted in Shoha-e-Tajrish Hospital (Tehran, Iran) from September 2018 to June 2019. 50 adult patients with breast cancer with insomnia or sleep disorders were enrolled. Participants were randomly allocated to lettuce seed syrup (5 mL twice daily), or placebo syrup at the same dose for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality before and after the intervention. RESULTS: Compared to placebo, the mean of the total PSQI score decreased significantly in participants who received lettuce seed syrup (p=0.014). In addition, there were statistically significant reductions in the mean scores of subject quality sleep (p=0.002), sleep duration (p=0.038), habitual sleep efficacy (p=0.029) and sleep disturbance (p=0.032) in patients who received lettuce seed syrup. CONCLUSIONS: Lettuce seed syrup may improve self-reported sleep quality in participants with breast cancer. Larger trials are indicated in diverse samples of participants with caner to learn if these finds are generalizable.

Herbal Medicines for Treatment of Radiodermatitis: A Systematic Review and Meta-Analysis.

Background: There is some evidence in favor of the efficacy of herbal medicine in the treatment of radiodermatitis as a frequent complication among cancer patients. Purpose: The present study aimed to evaluate the effect of herbal medicines on the treatment of radiodermatitis in cancer patients. Study design: Systematic review performed in accordance with the PRISMA guideline. Methods: We searched the electronic databases, Scopus, PubMed, Cochrane Library, Embase, Google Scholar, and ISI Web of Science, through July 2020 for randomized controlled trials (RCTs) that compared herbal compounds against a standard medication or placebo for treatment or prevention of radiodermatitis. Results: A total of 16 RCTs involving 1886 patients with breast, head and neck, or unspecified cancer were included. Risk of bias generally was high. Of those, three RCTs with 562 cancer patients (mainly breast cancer) who used Aloe vera to treat radiodermatitis were included in the meta-analysis. There was a significant level of heterogeneity between the studies (I2 = 95.8). One RCT found positive effects of Aloe vera in reducing the severity of radiodermatitis (standardized mean difference [SMD] = 3.37), whereas another revealed an inverse effect (SMD = -4). Conclusion: At present, there are no herbal compositions that are effective in treating radiodermatitis, with Aloe vera failing to show sufficient efficacy in the meta-analysis.

The Effect of a Chickpea-Based Persian Diet on Cancer-Related Fatigue in Breast Cancer Patients: A Semi-Experimental Study.

BACKGROUND: Cancer-related fatigue (CRF) is one of the most common symptoms associated with cancer or its treatment. OBJECTIVES: The aim of the current study was to evaluate the effect of chickpea-based diet (Nokhodab) on CRF in female breast cancer patients undertaking routine treatment. METHOD: Forty female patients with diagnosis of breast cancer were enrolled. The patients were asked to use a chickpea-based Persian diet daily for the period of 3 weeks. Symptom assessment was made for all women by the Cancer Fatigue Scale (CFS) and the Fatigue Severity Scale (FSS) questionnaires and Visual Analogue Scale (VAS). RESULTS: CRF decreased significantly at the end of the study, compared to the beginning (p < 0.05). Mean of CFS was 40.72 before the intervention, while showing a significant decrease to 33.38 at the end of our study (p = 0.001). A comparison of FSS and VAS before and after intervention shows that FSS and fatigue VAS mean scores have a significant decline at the end (p < 0.001). CONCLUSIONS: Nokhodab, as an available diet, could be a good choice for relieving CRF in breast cancer women. Traditional/complementary medicine may present some effective therapeutic suggestions for cancer complications.

MicroRNA: A novel target of curcumin in cancer therapy.

Curcumin is known as a natural dietary polyphenol which is extracted from Curcuma longa L. It has been shown that curcumin has a variety of pharmacological effects such as antioxidant, anti-cancer, anti-inflammatory, and anti-microbial activities. Anti-cancer effects of curcumin are due to targeting of a wide range of cellular and molecular pathways involved in cancer pathogenesis including NF-kB, MAPK, PTEN, P53, and microRNAs (miRNA) network. Multiple lines of evidence have indicated that curcumin exerts its therapeutic effects via regulating miRNA expression (e.g., miR-1, miR-7, miR-9, miR-34a, miR-181, miR-21, and miR-19) which could lead to the regulation of underlying cellular and molecular pathways involved in cancer pathogenesis. Exosomes are one of the important classes of biological vehicles which could be released from various types of cells such as cancer cells and stem cells and could change the behavior of recipient cells. It has been shown that treatment of cancer cells with different dose of curcumin leads to the release of exosomes containing curcumin. These exosomes could induce anti-cancer properties in recipient cells and reduce tumor growth. Hence, exosomes containing curcumin could be applied as powerful tools for cancer treatment. Here, we highlighted various miRNAs which could be affected by curcumin in various types of cancer. Moreover, we highlight exosomes containing curcumin as suitable therapeutic tools in cancer therapy.

Curcumin: A new candidate for melanoma therapy?

Melanoma remains among the most lethal cancers and, in spite of great attempts that have been made to increase the life span of patients with metastatic disease, durable and complete remissions are rare. Plants and plant extracts have long been used to treat a variety of human conditions; however, in many cases, effective doses of herbal remedies are associated with serious adverse effects. Curcumin is a natural polyphenol that shows a variety of pharmacological activities including anti-cancer effects, and only minimal adverse effects have been reported for this phytochemical. The anti-cancer effects of curcumin are the result of its anti-angiogenic, pro-apoptotic and immunomodulatory properties. At the molecular and cellular level, curcumin can blunt epithelial-to-mesenchymal transition and affect many targets that are involved in melanoma initiation and progression (e.g., BCl2, MAPKS, p21 and some microRNAs). However, curcumin has a low oral bioavailability that may limit its maximal benefits. The emergence of tailored formulations of curcumin and new delivery systems such as nanoparticles, liposomes, micelles and phospholipid complexes has led to the enhancement of curcumin bioavailability. Although in vitro and in vivo studies have demonstrated that curcumin and its analogues can be used as novel therapeutic agents in melanoma, curcumin has not yet been tested against melanoma in clinical practice. In this review, we summarized reported anti-melanoma effects of curcumin as well as studies on new curcumin formulations and delivery systems that show increased bioavailability. Such tailored delivery systems could pave the way for enhancement of the anti-melanoma effects of curcumin.

Low Noncytotoxic Concentrations of 5-Fluorouracil Have No Adverse Effects on Maturation and Function of Bone Marrow-Derived Dendritic Cells in vitro: A Potentially Safe Adjuvant for Dendritic Cell-Based Cancer Therapy.

BACKGROUND: Low, noncytotoxic concentrations of various chemotherapeutic drugs like 5-fluorouracil (5-FU) induce antitumor immune responses by selectively depleting tumor-induced immunosuppressive cells, and could therefore be used in combination with dendritic cell (DC) vaccines in order to enhance their immunotherapeutic efficacy. However, the likely negative influences of low, noncytotoxic doses of 5-FU on bone marrow-derived (BM)-DCs in vitro have not yet been investigated. METHODS: The effects of low, noncytotoxic concentrations of 5-FU on mouse BM-DC differentiation and maturation markers (CD11c, MHC class II and CD80) as well as antigen-presenting capacity and cytokine production (IL-12p70 and IL-10) have been assessed. RESULTS: Different low doses of 5-FU had no significant effect on the expression of DC differentiation and maturation or on costimulatory markers (p = 0.5). Furthermore, suboptimal doses of 5-FU did not affect the immunostimulatory functions of DCs such as antigen presentation (p = 0.6) and cytokine production (p = 0.9). CONCLUSIONS: These data suggest that low doses of 5-FU have no adverse effects on DC maturation and function, and the efficacy of DC-based cancer immunotherapy may be greatly enhanced by combining it with suboptimal doses of 5-FU.