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Patients Against Lymphoma

 

CAM & Life Style > M - R 

Last Update: 05/27/2012

TOPICS
Macrobiotic diet | Massage | Melatonin | Mind over Body?
 MistletoeMGN-3 | NAC | Naltrexone? |
Quercetin | Resveratrol | Rosemary 

Macrobiotic diet?

 

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TOPIC SEARCH: PubMed 

We have concerns that this diet can cause excessive weight loss in some individuals and contribute to cachexia - loss of muscle mass, or wasting.

"The macrobiotic diet is based loosely on Japanese eating patterns and principles of Traditional Asian Medicine. The traditional macrobiotic diet is vegan, consisting of whole grains, vegetables, seaweeds, fermented foods, nuts, seeds, and seasonal fruits. It excludes meat, eggs, and dairy products, and fluid intake is restricted, although some more liberal forms of the macrobiotic diet include fish and other animal products." [1]
 

  1. Macrobiotic diet and cachexia  medicine.wustl.edu
  2. Macrobiotic diet

 

Massage

Physical manipulation of the body to induce relaxation and promote healing
 
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Therapeutic massage appears to have positive physical and emotional benefits that may offset the effects of treatments for cancer 

CAUTION: "for lymphoma patients undergoing treatment, having a therapeutic massage can be especially helpful in relieving pain, fatigue and anxiety. However, experts caution that there are some inherent risks in getting a massage that patients should know about before having one done.

"For lymphoma patients, the massage has to be performed by someone who is familiar with working with cancer patients," says Kathleen Wesa, MD, assistant attending physician in the Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center. "You can't go to any massage therapist. There are some considerations, for example, if someone's blood counts are low, if the patient has had surgery or lymphedema. You don’t want to be doing deep tissue massage on someone who has low platelets or on someone who is frail."  2

Related Resources & Research News:
  1. Effects of therapeutic massage on the quality of life among patients with breast cancer during treatment. Sturgeon M, Wetta-Hall R, Hart T, Good M, Dakhil S.
  2. What Should I know About Getting a Massage? Lymphoma.org  
  3. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Kutner JS, Smith MC, Corbin L, Hemphill L, Benton K, Mellis BK, Beaty B, Felton S, Yamashita TE, Bryant LL, Fairclough DL. Ann Intern Med. 2008 Sep 16;149(6):369-79. PMID: 18794556

     

Mind over Body - over cancer?

Can positive thinking affect treatment and outcomes? 
Does stress cause cancer?
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From: Preventing Cancer Is There a Link Between Stress and Cancer?
By GINA KOLATA

... But the results were clear: there was no association between stressful events in the previous five years and a diagnosis of breast cancer. Other studies had the same result. Still, not everyone was convinced.

Comment on the caveats and limits of positive thinking: 

Our instinct is to swim hard
against the direction of a current, but experienced swimmers
know this is not the best way to escape a rip tide.

Certain kinds of stress or chronic reactions to stressful events are strongly linked to some illnesses. And it may be that stress is sometimes a contributing factor in the origin of some cancers as described in the study below. 

And there is no question that chronic fear and sadness degrades our quality of life, putting our health at risk. 

So it seems evident that mindfulness, meditation, prayer, and exercise can improve how well we live and experience life, and contributes in a positive way to to our general health.

The positive effects of such practices may also improve our ability to make better-informed medical decisions - to consider in a more deliberate and calm way the full range of reasonable treatment options and seek the best expert guidance.  

What is highly implausible and counterproductive, however, is the notion that we can alter the course of an existing cancer -- or influence if a treatment works with the power of our mind.

It's widely accepted for good empirical reasons that there is no placebo effect against cancer, a reason we don't have placebo controlled cancer studies -- it would be unethical. 

The unfounded belief that positive thinking can cause a cancer to regress or make therapies work better can increase our stress and diminish our quality of life as it causes us to worry about our anxiety -- increasing what we are attempting to limit by our act of will. 

... It also leads to self-blame - as in, " I failed my family: I did not believe hard enough to overcome the disease."

... Another danger is that we can stay with an an unproven alternative practice too long, convinced that it will work if we just try harder.  

Perhaps a way to avoid overreacting to stress is to recognize and accept that fear and sadness is a natural reaction to a very difficult circumstance.  A human reaction to an all-to-common affliction.

... "Touching bottom" is not the same as accepting that all is lost or that this fight with this cancer cannot be won ... but only to recognize that being human we are mortal and have limitations - but also many opportunities to win battles  - and opportunity to live well on this day in this moment.     

~Karl Schwartz

 
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See evidence-based reasons for hope - Encouragement PAL
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THE TYRANNY OF POSITIVE THINKING  PDF

I got really depressed when people said I should think positive. I thought, "If that's what I have to do to survive, I'm never going to make it."
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Personality Does Not Influence Cancer; Hypothesis Should Be Retired http://bit.ly/9m78qV 
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Mind-Body Medicine for Cancer WebMD. com
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Cancer incidence in parents who lost a child: a nationwide study in Denmark. Cancer. 2002 Nov 15;95(10):2237-42. PMID: 12412179 | Related Articles 
 
The authors observed a slightly increased overall cancer risk in bereaved mothers at 7-18 years of follow-up. There was an increased risk for smoking-related malignancies among bereaved mothers during the 7-18 years of follow-up. The authors observed no significantly increased relative risk of breast carcinoma, alcohol-related malignancies, virus/immune-related malignancies, or hormone-related malignancies.
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Ann Behav Med. 2010: Positive Psychology in Cancer Care: Bad Science, Exaggerated Claims, and Unproven Medicine

Mistletoe

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Comprehensive history with references  Cancer.gov 

Melatonin

Questions and 
related abstracts
Natural sources:  a natural hormone; levels influenced by exposure to light
Review
-Dr Arlene Goldman
Review with Warning- InteliHealth
Health Guide Info
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Melatonin is a natural hormone, normally created by the pineal gland. It is stimulated by darkness and inhibited by light.  It regulates the human biological clock. Melatonin is a highly important antioxidant, it may also modulate immune function.

Questions:
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Should Melatonin be avoided by patients with immune system cancers? 

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Can Melatonin reduce side effects of chemotherapy without compromising efficacy?

Related Resources & Research News:
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A randomized trial of CHOP chemotherapy with or without melatonin in patients with favorable prognosis large B-cell lymphoma. - ASCO 2004 ~ Abstract No: 8066  

"The addition of melatonin to CHOP chemotherapy did *not* decrease the incidence of neutropenia after cycle 1 in this patient population. In addition, this study suggests that there is no improvement in neutrophil nadir, CR rate, infection rate, or change in hemoglobin or platelet counts with the addition of melatonin."
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A phase II study of neuroimmunotherapy with subcutaneous low-dose IL-2 plus the pineal hormone melatonin in untreatable advanced hematologic malignancies.
Anticancer Res. 2000 May-Jun;20(3B):2103-5. PMID: 10928160
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Effects of melatonin on doxorubicin cytotoxicity in sensitive and pleiotropically resistant tumor cells. J Pineal Res. 2001 Oct;31(3):206-13. PMID: 11589754 PubMed
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Lymphocyte Changes in Lymphoma Patients Receiving Melatonin Plus Chop Chemotherapy. Year: 2000 ASCO Abstract No: 72 
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Melatonin decreases bone marrow and lymphatic toxicity of adriamycin in mice bearing TLX5 lymphoma. Life Sci. 1998;63(19):1701-13. PMID: 9806226 PubMed
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Selective effect of melatonin on the proliferation of lymphoid cells. Int J Biochem. 1993 Mar;25(3):441-4. PMID: 8462731 PubMed
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Lymphocyte Changes in Lymphoma Patients Receiving Melatonin Plus Chop Chemotherapy.Click here, then Go to slide 72.
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The validity of melatonin as an oncostatic agent. J Pineal Res. 1997 May;22(4):184-202. Review.
PMID: 9247204 PubMed 
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Cyclophosphamide plus somatostatin, bromocriptin, retinoids, melatonin and ACTH in the treatment of low-grade non-Hodgkin's lymphomas at advanced stage: results of a phase II trial. Cancer Biother Radiopharm. 2001 Apr;16(2):171-7.  PMID: 11385964 PubMed
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Melatonin restores and enhances the human type B tonsillar lymphocyte subset in recurrent acute tonsillitis. Neurosci Lett. 1998 May 15;247(2-3):131-4. 
MGN3
Questions and 
related abstracts
Natural sources:  
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MGN3 is a polysaccharide composed of the hemicellose-ß extract of rice bran, modified by enzymes from Shiitake mushrooms. 

TOPIC SEARCH: PubMed 

Presently, there is only in vitro (test tube) evidence that MGN3 might increase NK cell levels or activity. No clinical data and few groups are investigating it.

Questions:
bullet Does MGN3 modulate immunity in ways that are beneficial to patients with NHL?
bullet What doses are needed to achieve clinically useful effects.
Related Resources & Research News:
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Production of tumor necrosis factor-alpha and interferon-gamma from human peripheral blood lymphocytes by MGN-3, a modified arabinoxylan from rice bran, and its synergy with interleukin-2 in vitro. Cancer Detect Prev. 2000;24(4):314-24. PMID: 11059563 - PubMed

 

NAC

Questions and 
related abstracts
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N-acetyl-L-cysteine (NAC) is an important natural supplement.  However, for individuals with NHL, it may prudent to avoid this supplement for the following rather technical reasons. 

TOPIC SEARCH: PubMed 

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NAC enhances IkappaB degradation and inhibits apoptosis. PMID: 10661865, UI: 20125507
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NAC stimulates IL-1 beta production PMID: 10609880, UI: 20075993 
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NAC protects cancer cells against cytotoxicity. PMID: 10925209  
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NAC inhibits apoptosis and supports NF-kappaB activation PMID: 10867640

 

See Alerts

Naltrexone
(low dose)?

 

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Low dose Naltrexone (LDN) for Cancers?  

Why we are skeptical

TOPIC SEARCH: PubMed 

NEW ITEM: Low Dose Naltrexone – Bogus or Cutting Edge Science? http://bit.ly/aIACkO Published by Steven Novella under Science and Medicine 
 

Low Dose Naltrexone (LDN)  is promoted as a anti-cancer therapy by Dr. Bihari on a website named LDN and Cancer.   A case report1 cites the reported outcomes for LDN on this website as a rationale for LDN and reports on the outcome.  Here we list the many reasons to be skeptical about the reports. 

Regarding the LDN and Cancer website:

First, we call attention to many red flags in the text, which begin with a qualifying statement about the need to do prospective studies (giving the appearance of objectivity), but consistently maintains that  cancer patients benefit from the use of LDN - the estimate being more than 60%.  

From => "Although prospective, controlled clinical trials on LDN in the treatment of cancer are yet to be accomplished, as of March 2004 clinical "off-label" use of this medication by Dr. Bihari in some 450 patients with cancer almost all of whom had failed to respond to standard treatments suggests that more than 60% of patients with cancer *may significantly* benefit from LDN."

To =>
"It will clearly require extensive study of LDN in prospective,
controlled clinical trials to determine which cancers respond best and which other therapies are complementary to or synergistic with LDN."2

The phrase "which cancers respond best" implies that it's known that some cancers respond to LDN,  which requires faith in Bihari's reporting of the responses, which are not defined, are kept internally, and have not been published in a respected journal.  The fact is that we don't know if ANY cancers respond to LDN.

RED FLAGS:  

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Misleading information: Regarding the text: "Although prospective, controlled clinical trials on LDN in the treatment of cancer are yet to be accomplished as of March 2004 ...
 
We are not aware of any clinical trial using low dose Naltrexone for any Cancer as of 2008! 
 

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Conspiracy of silence? It would be a major story if 60% of patients who did not respond to chemo really benefited from LDN.  That it has not been covered by the media or the research community would require a cover-up or conspiracy of silence - which would require the complicity of thousands of experts who also get cancers, whose loved one's get cancer.
  

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Too many conditions? The website text reports that patients with many types of cancers have benefited from LDN:  From Lung .... Ovarian cancers, along with a host of intractable medical conditions, including HIV.

Consider the number of cancers and conditions for which LDN is promoted:

“helping those with HIV/AIDS, cancer, autoimmune diseases, and central nervous system disorders”  (Nov 1 1997 http://www.lowdosenaltrexone.org)

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Conflict of interest: Dr. Bihari, who consults patients on the use of LDN, has an obvious financial conflict of interest.  We should consider the potential for bias is high when the claims come only from the provider - in this case the consultant.
 

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Practicing outside domain: Dr. Bihari is not an oncologist or even an internist; his degree is in Psychiatry and Neurology. 

Regarding the LDN case study 1 published on the Internet:

"Bihari reported that he has used LDN with promising results for people with various malignancies including but not limited to primary cancers of the bladder, breast, liver, lung, lymph nodes, colon, and rectum  Over the years, he has administered LDN to more than 450 people with cancer, most of whom initially failed standard conventional treatments. 

According to Bihari, 86 of the 354 patients followed regularly demonstrated at least a 75% reduction in overall tumor bulk, and an additional 125 patients demonstrated disease stability."[9]
1  

 
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The case report cites statistics provided by Dr. Bihari in LDN and Cancer2 website,  which is internally kept response data, with no way to substantiate it. The outcomes are not the result of randomized studies; nor are the claims made for specific indications.  The outcomes are not defined.  For example, we don't know what response means or how long the responses lasted.  There is no independent assessment or verification.
 

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in the case report 1:
no definitions of "reduction in bulk"; 
no definition of time to response or response durations; 
no description of methods and how outcomes were measured  … 

no scientific method.  Nothing "regularly demonstrated."

Dr. Bihari hasn't published his findings for peer review ... the reference [9] in the case report is to a website that promotes LDN, not a medical journal. 

Be aware, that the professional-looking case report does not provide verifiable or reliable measures of outcome in the follow up:

At the 6-month follow-up on May 2, 2006, T.M. stated that his nodes had almost completely resolved, and on examination, neither the large cervical nodes nor the large inguinal nodes were palpable. 

... At the time of this report, and per telephone communication from the patient’s wife, T.M. remains asymptomatic from his disease, now 1 year after his last CT/PET imaging.

... Follow-up by telephone, reported by the patient's wife, is the very opposite of objective independently assessed evidence. 

Furthermore, as noted in the report, the condition could  easily "represent a period of spontaneous remission", which is very common for follicular lymphoma.

The case study (any case report) cannot tell us how many people have tried LDN and had no regressions, or if the intervention caused the observed response, or were coincidental. 

The report ends with a conclusion that ethical scientists would never make on the basis of a case report:

We believe that by the mechanisms presented herein, LDN demonstrates significant potential to increase disease-free as well as overall survival in people with FL.

Clearly, nothing has been demonstrated regarding the proposed mechanisms.    

That the authors suggest that LDN can improve overall survival is especially baffling, when even large randomized studies with very long follow up often fail to demonstrate this for treatments of indolent lymphomas. 

Recommendation: Dr. Bihari should publish his findings in a respected journal, or make a public statement contradicting the promotions of others who quote him to promote the off-label use of LDN. If the data is judged compelling by his peers, he will be able to attract capital to do a controlled study to prove his claims. It really is that simple.  The information on the LDN website for cancers 2 should be removed until clinical studies are done that demonstrate benefit for specific cancers.   

We remind the reader that it's very easy to make claims (we could all dash them off in seconds), but it's vital that we prove them before promoting interventions for disease. In fact, it’s the law.

... It’s vital because without an evidence-based system we would have no idea which therapy has true value and would be subjected to endless sales promotions from all points on the compass. 

  1. Reversal of Signs and Symptoms of a B-Cell Lymphoma in a Patient Using Only Low-Dose Naltrexone  http://www.ldn4cancer.com/files/berkson-b-cell-lymphoma-paper.pdf 
     
  2.  LDN and Cancer,  website Feb 2008: 
     http://www.lowdosenaltrexone.org/ldn_and_cancer.htm   

Quercetin

Questions and related abstracts
Natural sources:  onions,  apple skin, black tea
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Flavonoids, such as quercetin, are plant pigments which color flowers, fruits and vegetables. Thousands of flavonoids have been identified; notable ones include proanthocyanidins, quercetin, citrus bioflavonoids, black and green tea polyphenols.

TOPIC SEARCH: PubMed 

CAUTION: High dietary intake of Bioflavonoids may contribute to infant leukemia - Reuters

There is some evidence that the flavonoid Quercetin might have anticancer properties specific to lymphoma under certain conditions. 

Questions:
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Can flavonoids like quercetin reduce inflammation and slow progression of lymphomas in clinically significant ways?

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What are the risks associated with high dietary intake of bioflavonoids?

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What doses, if any, of flavonoids are required to achieve clinically useful effects?

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Can herbs with anticancer properties be used in combination to achieve synergies and clinically significant effects?

Related Resources & Research News:
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Antiproliferative activity of flavonoids on several cancer cell lines. Biosci Biotechnol Biochem. 1999 May;63(5):896-9. PMID: 10380632; UI: 99309751.
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Effect of black tea on (iso-)prostaglandins and platelet aggregation in healthy volunteers. Prostaglandins Leukot Essent Fatty Acids. 2002 May;66(5-6):529-33. PMID: 12144875 - PubMed
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The effects of flavonoids on human lymphocyte proliferative responses. Prog Clin Biol Res. 1986;213:511-20. PMID: 3714747; UI: 86233563. - PubMed

Resveratrol

Questions and related abstracts

Natural sources:  
dark red grapes

It is produced by Vitis vinifera and labrusca grapes and is found in grape products including red and white wines. The consumption of muscadines and muscadine products, especially those made from pomace purees, could help incorporate a significant quantity of resveratrol into the average diet.

Details from usda.gov
 - a government source

Muscadine Grape Nutrition - ncwine.org 

ON STABILITY and CONCENTRATIONS: Resveratrol was stable for up to 5 days at 4 degrees C in the dark but was not stable at room temperature without protection from light. Resveratrol was detected in grape, cranberry, and wine samples. Concentrations ranged from 1.56 to 1042 nmol/g in Concord grape products, and from 8.63 to 24.84 micromol/L in Italian red wine. The concentrations of resveratrol were similar in cranberry and grape juice at 1.07 and 1.56 nmol/g, respectively. [7]

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Resveratrol, (RES-VEAR-A-TROL) a phytoalexin found in red grapes, appears to have anti-inflammatory (inhibited cox-2-cyclooxygenase),  anti-promotion, and anti-progression activity.  

Bioavailability?  Although trans-resveratrol appears to be well-absorbed by humans when taken orally, its bioavailability is relatively low due to its rapid metabolism and elimination ...  Information about the bioavailability of resveratrol in humans is important because much of the basic research on resveratrol has been conducted in cultured cells exposed to unmetabolized resveratrol at concentrations that are often 10-100 times greater than peak concentrations observed in human plasma after oral consumption. Although cells that line the digestive tract are exposed to unmetabolized resveratrol, research in humans suggests that other tissues are exposed primarily to resveratrol metabolites.  Little is known about the biological activity of resveratrol metabolites, and it is not known whether some tissues are capable of converting resveratrol metabolites back to resveratrol (7).

Source: http://lpi.oregonstate.edu 

TOPIC SEARCH : PubMed | Sources and stability  

Questions:
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Can Resveratrol reduce inflammation and slow progression of lymphomas in clinically significant ways?

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What doses, if any, of Resveratrol are required to achieve clinically useful effects?

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Can natural compounds with anticancer properties be used in combination to achieve synergies and clinically significant effects?

Related Resources & Research News:

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Resveratrol: Don't Buy the Hype http://bit.ly/h1zhLG 
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Resveratrol (SRT501): Development Halted by GSK
http://bit.ly/fvASql 

"According to a GlaxoSmithKline spokesperson, an internal analysis of the kidney failure cases has concluded that they “most likely were due to the underlying disease … However, the formulation of SRT501 was not well tolerated, and side effects of nausea / vomiting / diarrhea may have indirectly led to dehydration, which exacerbated the development of the acute [kidney] failure.”
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About - diet-and-health.net 
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Resveratrol modifies the expression of apoptotic regulatory proteins and sensitizes non-Hodgkin's lymphoma and multiple myeloma cell lines to paclitaxel-induced apoptosis.

Mol Cancer Ther. 2004 Jan;3(1):71-84. PMID: 14749477 | Related articles
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Scientists to Study Red Wine for Anti-Cancer Drug - Reuters 11_05_02 "... possible new cancer prevention drug based on resveratrol, a natural compound found in red wine. "
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Involvement of c-jun NH(2)-terminal kinases in resveratrol-induced activation of p53 and apoptosis. Mol Carcinog. 2002 Apr;33(4):244-50. PMID: 11933078 - PubMed
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Chemopreventive agent resveratrol, a natural product derived from grapes, triggers CD95 signaling-dependent apoptosis in human tumor cells. Blood. 1998 Aug 1;92(3):996-1002. PMID: 9680369 - PubMed
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HOW A PLANT'S ANTI-FUNGAL DEFENSE MAY PROTECT AGAINST CANCER - CancerResearchUK.org
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ON STABILITY AND CONCENTRATIONS: An LC-MS method for analyzing total resveratrol in grape juice, cranberry juice, and in wine. J Agric Food Chem. 2002 Jan 30;50(3):431-5. PMID: 11804508 
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Piceatannol, a hydroxylated analog of the chemopreventive agent resveratrol, is a potent inducer of apoptosis in the lymphoma cell line BJAB and in primary, leukemic lymphoblasts. Leukemia. 2001 Nov;15(11):1735-42. - PubMed

Rosemary

Questions and related abstracts
Natural sources: 
 rosemary plant
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Rosemary, a common herb, has anti-inflammatory properties, inhibits prostaglandin 2/cox-2. 

TOPIC SEARCH: PubMed 

Questions:
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Can rosemary reduce inflammation and slow progression of lymphomas in clinically significant ways? If so, at what doses?
 

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Can herbs with anticancer properties be used in combination to achieve clinically significant effects?

Related Resources & Research News:
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Antioxidant and cyclooxygenase inhibitory phenolic compounds from Ocimum sanctum Linn. Phytomedicine. 2000 Mar;7(1):7-13. PMID: 10782484 - PubMed
 
Disclaimer:  The information on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
Patients Against Lymphoma, Copyright © 2004,  All Rights Reserved.