Dissertation/Thesis Abstract

Cancer survival with Pan-Asian medicine & vitamins
by McCulloch, Michael Fintan, Ph.D., University of California, Berkeley, 2008, 250; 3353458
Abstract (Summary)

Background. Lung cancer is the leading cause of cancer death, and colon cancer the third leading cause. Complementary and alternative medicines (CAM) are used by up to 48% of people with lung cancer and up to 75% of those with colon cancer. This high prevalence of use makes recruitment of patients into randomized CAM trials difficult, suggesting a need for other study designs. Methods. Chapter 1 presents a brief discussion of the origins of East-West medical integration. Chapter 2 is a meta-analysis of randomized trials of Astragalus-based Chinese herbal medicines combined with platinum-based chemotherapy. Chapters 3 and 4 are cohort analyses of non-small cell lung cancer (n=239) and colon cancer patients (n=193) presenting for treatment at a center of Chinese medicine (Pine Street Clinic, San Anselmo CA). I analyze survival with Kaplan-Meier, Cox regression, the propensity score and marginal structural models. Results. In my meta-analysis, I showed that by adding herbal medicine to chemotherapy, the risk of death from lung cancer at 12-months was reduced by 33% (RR=0.67; 95% CI 0.52, 0.87), the risk of death at 24-months was reduced by 42% (RR=0.58; 95% CI 0.49, 0.69), and tumor response was improved by 34% (RR=1.34; 95% CI 1.24, 1.46). In my lung cancer survival analysis, PAM+V combined with conventional therapy reduced risk of death in stage IIIA by 60% (HR=0.40; 95% CI 0.30, 0.52), in stage IIIB by 86% (HR=0.14; 95% CI 0.07, 0.28), and in stage IV by 75% (HR=0.25; 95% CI 0.08, 0.41), compared to conventional therapy alone. In my colon cancer survival analysis PAM+V combined with conventional therapy reduced risk of death in stage II by 64% (HR=0.36; 95% CI 0.17, 0.76), in stage III by 29% (HR=0.71; 95% CI 0.50, 0.99), and in stage IV by 75% (HR=0.25; 95% CI 0.18, 0.35), compared to conventional therapy alone. Conclusions . Astragalus-based Chinese herbal medicine increases survival in non-small cell lung cancer. In lung cancer, long-term use of PAM+V showed survival than short-term use. PAM+V combined with conventional therapy increased survival benefit in patients with both lung and colon cancers, compared to conventional therapy alone.

Indexing (document details)
Advisor: Colford, John M.
School: University of California, Berkeley
School Location: United States -- California
Source: DAI-B 70/04, Dissertation Abstracts International
Subjects: Nutrition, Epidemiology, Medicine
Keywords: Cancer survival, Chinese herbal medicines, Colon cancer, Lung cancer, Vitamins
Publication Number: 3353458
ISBN: 978-1-109-09747-4
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