Cannabis for Cancer: What the Evidence Tells Us

Since 1995, the U.S. death rate from cancer has dropped 23%.  We have more treatment options than ever before to help cancer patients live longer.  But along with cancer cells, these treatments can also kill day-to-day well being. According to the NIH, about half of all cancer patients experience nausea and vomiting caused by cancer treatments. Over 90% report a big impact on their quality of life.  Although many anti-nausea drugs are now available, they often don’t work.  Only half of all patients on these drugs experience relief from their symptoms. Despite its illegality, many cancer patients turn to cannabis (marijuana) to ease their stomach. But does it actually help? A recent Cochrane review looked at the evidence on cannabis and chemotherapy-caused nausea and vomiting.

The reviewers identified 23 studies looking at the how effective cannabis was at reducing nausea and vomiting in chemotherapy patients. Most found cannabis to be more effective than a placebo (fake drug). Many also found it to be as effective as anti-nausea drugs. Overall, the review found promising evidence that cannabis can help. But cannabis side effects caused problems for many patients. Not surprisingly, patients using cannabis reported higher levels of dizziness, euphoria, and “feeling high”. A number of patients withdrew from the studies due to these side effects.

All of the reviewed studies were done between 1975 and 1991. In the early 1990’s, changes in drug laws led to a dramatic decrease in cannabis research. Since that time many new anti-nausea drugs have been developed. This means that the reviewed studies only compared cannabis to older, possibly less-effective drugs. Many of the studies also had design and reporting problems. The reviewers called for more high-quality studies comparing cannabis to newer drugs.

So if you are a cancer patient struggling with chemotherapy, is cannabis an option for you? If you live somewhere that medical or recreational marijuana is legal, the answer could be yes. However, this decision should only be made in partnership with your cancer care team. You also should consider how the side effects might impact your day-to-day functioning. The American Cancer Society offers an online guide to cannabis and cancer treatment. Like many medical organizations, the American Cancer Society has called for an easing of legal restrictions on medical cannabis research. With more research, we may identify new ways to use this ancient treatment to help improve well-being for millions of people now living with cancer.

Improving Cancer Comfort: Can Massage Help?

This year about 1.7 Americans will be diagnosed with cancer.  Many will turn to massage to help manage their symptoms.   For thousands of years, massage has been used to help humans feel better.  Scientists have found that friendly touch makes pleasure hormones rise and stress hormones fall.  But can massage be an effective treatment for cancer side effects?

A recent Cochrane review looked at whether massage could relieve pain and anxiety and improve quality of life in cancer patients. Eight studies (678 participants) in the review looked specifically at aromatherapy massage. Aromatherapy massage uses massage with essential oils such as lavender, rose or chamomile to promote healing and relaxation. The studies compared aromatherapy massage to no massage or to massage with carrier oils.

While some studies showed that aromatherapy massage was helpful for pain, anxiety, and quality of life, other studies did not show this. The available information on aromatherapy massage was low quality because the studies were small and different studies gave different results. The studies were also not well conducted. The researchers concluded that there is currently no reliable evidence that aromatherapy massage can relieve physical or mental symptoms or improve quality of life in people with cancer.

Does this mean that cancer patients should not use massage? Not at all. Cancer can rob you of even simple life pleasures. The comfort of a caring touch and the aroma of scented oils can provide welcome relief. Massage is widely available, relatively affordable, and appears safe. It is possible that additional, larger and better-conducted studies will reveal new evidence linking massage to cancer symptom relief. In the meantime, for a general sense of well-being, a massage can be just what the doctor ordered.

Easing the Ache: Acupuncture for Tension Headaches

Dull, aching pain. Tightness across your scalp. Sore neck and shoulders. These are the familiar symptoms of a tension headache. Up to 78% of the U.S. population reports having tension headaches, making it the most common form of headache. For most of us, tension headaches are an occasional problem. But frequent headaches can make every life activity more difficult. These frequent headaches can be especially hard to treat. Long-term use of either over-the-counter or prescription painkillers can have serious side effects. But a recent Cochrane review found that acupuncture may be able to help ease the burden of frequent headache sufferers.

The reviewers found twelve studies that compared acupuncture to one or more non-acupuncture treatments for tension headache. Together they involved 2349 participants. Two studies compared acupuncture to usual treatment, four studies compared acupuncture to a physiotherapy, massage or relaxation treatment, and seven compared true acupuncture to “fake” acupuncture. In “fake” acupuncture the needles did not go into the skin or were not put in the right places.

Researchers consider comparing true acupuncture to ‘fake’ acupuncture to be the best way to discover whether the effects of acupuncture treatment are due to needles in the skin at acupuncture points, or due to something else (such as belief in the treatment). In the studies comparing true and “fake” acupuncture both treatments cut headache frequency. But true acupuncture was more effective than “fake” acupuncture. With true acupuncture the proportion of people having their number of headaches cut in half was 52 out of 100. With “fake” acupuncture the proportion of people having their number of headaches cut in half was 43 out of 100.

People getting true acupuncture also had about 2 more headache-free days each month, compared to people getting “fake” acupuncture.

The two studies comparing usual treatment to acupuncture were very different from each other. Because of this, although people getting acupuncture were more likely to cut their headache rate by half or more in both studies, the researchers couldn’t make definite conclusions about how helpful acupuncture might be. Studies comparing acupuncture to physiotherapy, massage or relaxation didn’t have any useful information. However, based on the comparison between true and “fake” acupuncture, the researchers concluded that acupuncture may be a useful option for treating frequent tension headache.

Many national acupuncture professional associations now offer directories to help you find a trained and licensed practitioner. If cost is an issue, low-cost or sliding scale programs may be available. Before trying acupuncture, check with your medical team to make sure it will be safe for you. But if tension headaches are robbing you of life’s enjoyments, acupuncture may offer a way to improve your health and ability to enjoy life.

Lungs, mind, and breath: The positive effects of yoga on asthma

If you don’t have asthma yourself, you almost certainly know someone who does. Over 300 million people worldwide suffer from asthma’s shortness of breath and fatigue. Even with medical treatment, asthma can take a big toll. Over half of all children and a third of all adults with asthma miss school or work each year due to their disease. A recent Cochrane review suggests that yoga may be a promising way to improve health and well-being asthma patients.

The reviewers identified 15 studies involving 1048 patients. Five looked only at yoga breathing exercises. The other studies included breathing, posture, and meditation. All of the studies compared yoga to either regular care, no care, or “sham yoga”. The studies measured health impact in a variety of ways. Some looked at lung function or amount of medications used. Some tracked rates of bad events like hospital visits. Others looked at overall measures of health like reported symptoms and quality of life.

The reviewers found significant evidence that yoga improves quality of life and reduces asthma symptoms. There was a small amount of evidence that yoga might also reduce the need for asthma medication. Overall, the reviewers concluded that yoga probably improved health and well-being for asthma patients.

There are still many unanswered questions about yoga and asthma. More studies are needed on how yoga affects lung function and medication usage. But unlike other asthma treatments, doing yoga can be free, rarely causes side effects, and may have other mental and physical benefits. Yoga can be tailored to your health status and fitness level. Before trying yoga, you should check with your doctor about any special precautions. But whether you roll out your mat at your health club or your living room floor, yoga may offer a new way to help you breathe easier.

Omega-3 for Dementia: What Cochrane Evidence Shows

As we get older, many of us worry about the confusion, memory loss, and other challenges that come with dementia.  About 5 million Americans over age 65 are now living with Alzheimer’s disease.  Right now, there are very few available treatments for slowing down or halting the progress of the disease. One supplement sometimes recommended for brain health is omega-3 fatty acids. These fats come from foods like fish, vegetable oils, nuts, flax seeds, and leafy vegetables. They play a key role in normal brain growth and health.  A Cochrane team recently looked at the evidence to see whether omega-3 fatty acids could help improve brain function in people with dementia.

The reviewers found three studies enrolling 632 people with mild to moderate Alzheimer’s disease. In each study, the participants were randomly assigned to take either an omega-3 fatty acid supplement or a placebo (a pill with no medicine). After six months, both groups took a variety of tests to measure brain function. The tests measured learning and memory, quality of life, and mental health. They also tested how well people could perform simple everyday tasks. None of the studies showed that taking omega-3 supplements had any impact on these areas. The reviewers concluded that there is currently no evidence that omega-3 fatty acids can improve brain health in patients with mild to moderate Alzheimer’s disease. For those of us not yet diagnosed with Alzheimer’s disease, more research is needed to show whether omega-3 fatty acids might play a role in its prevention.

So what can you do to keep your brain as healthy as possible? The National Institute on Aging offers a number of tips for protecting your brain as you age. These include exercising daily and eating a healthy diet. Connecting with other people and doing activities you enjoy may also help keep your brain young. Many scientists are working on identifying new treatments to prevent or cure dementia. But for now, these simple steps may help you stay healthy, active, and connected.

Good Germs, Bad Germs: Probiotics for preventing antibiotic-associated diarrhea in children

The world is full of germs, and children can be especially vulnerable. They spend all day in crowded classrooms and are rarely perfect at hand washing. Bacterial illnesses ranging from skin infections to strep throat can get passed along with every hug and thumb war. Before the invention of antibiotics, these illnesses often led to fatal complications. Nowadays, antibiotics can quickly kill these bacteria and return children to health. But antibiotics also kill the “good” bacteria that help us digest. Many children suffer from antibiotic associated diarrhea (AAD). A recent Cochrane Review found that probiotics offering a promising way to avoid the loose stools and stomach pain that often come with childhood antibiotic use.

The Cochrane team looked at 23 studies involving just under 4,000 children. The children in the studies were given probiotic supplements, placebo, another treatment, or nothing in addition to their antibiotics. The type and dosage of probiotics varied. Overall, they found that using supplements cut the rate of AAD from 19% with placebo or no treatment to 8% with probiotics. The rate of adverse events was very low. The reviewers found enough evidence on two forms of probiotics: lactobacillus rhamnosus and saccharomyces boulardii. They concluded that these forms of probiotics, at a dosage of between 5 and 40 billion colony forming units per day, may be effective in preventing AAD in children.

If you want to try this for your children, talk to your doctor first. Probiotics can pose special health risks for those with certain health conditions. If your child hates pills, or cost is an issue, you might also consider probiotic foods like yogurt. Because they do not come in standard dosages, probiotic foods are difficult to study.  But they have been shown to positively affect gut flora. Although more evidence on different types and doses of probiotics is needed, probiotics may offer you and your child a way to make using antibiotics a healthier, happier experience.

Green Tea for Weight Loss? Yes and No

Can green tea help you lose weight? A 2012 Cochrane Review found good news: there is some evidence that people who drink green tea may lose a bit more than those who do not. The bad news? The amount lost is likely too small to make a difference.

The review team found 14 studies that compared how much weight people lost with or without drinking green tea. The results varied. Many studies showed no impact from tea drinking, one study showed that tea drinkers gained more than the control, and several studies reported weight losses ranging from 0.2 kg to 3.5 kg. The reviewers were able to combine information from six studies. The combined studies showed that those drinking green tea lost only about 0.4 kg (or a tenth of a pound) more than those who did not. The reviewers concluded that this difference is too small to have any impact on health.

But if you are someone who likes soda, mocha lattes, or other sweet drinks, switching to unsweetened green tea could be a great way to improve your diet. A typical 20 oz soda contains from 15 to 18 teaspoons of sugar.  Sugary beverages have been linked not only to weight gain, but to diabetes, heart disease, osteoporosis and cancer.  Public health experts agree that Americans consume way too much sugar, and beverages are the single largest source. Why? The feeling of fullness that comes with eating is missing when you drink. This makes it very easy to over consume all that extra sweetness. Even if you sweeten your tea, you are unlikely to put in the eight teaspoons of sugar per serving found in commercial products.

Sitting down to a hot cup of tea this winter might also help more than your waistline. A 2013 Cochrane review found some preliminary evidence that drinking tea may lower blood pressure and lipid levels. One experiment even found that drinking warm beverages together increased people’s interpersonal warmth. And we all know how good wrapping your hands around a hot cup can feel on an icy day. So put on the kettle, relax, and enjoy your tea.