Sarcoma is a type of cancer
that develops in connective tissues like bone, cartilage, fat, blood vessels,
muscle or fibrous tissues (related to tendons or ligaments).
The disease usually causes
tumors to form in the tissues below the skin or face or in the mucous membranes
of the nose, mouth or anus. Patients typically suffer from lesions on the skin,
which appear as raised blotches or lumps that may be purple, brown or red.
While the skin lesions may
be disfiguring, they are not usually life threatening. In some cases, the
lesions may be painful or cause swelling. If KS develops in the lungs, liver or
gastrointestinal tract, however, the disease may be life threatening, causing
internal bleeding or difficulty breathing.
Kaposi's sarcoma (KS) was
named after Dr. Moritz Kaposi who first described the disease in 1872. For
decades KS was considered a rare disease that primarily affected elderly men of
Mediterranean or Jewish descent, organ transplant recipients or young adult
African men. This type is called classic KS.
However, in the last 20
years, most KS cases have developed in association with the human
immunodeficiency virus (HIV) and the acquired immune deficiency syndrome
(AIDS). This type is called HIV-related KS, AIDS-related KS or epidemic KS.
Researchers believe a
herpes virus called human herpes virus 8 (HHV-8) causes HIV-related Kaposi's
sarcoma. In a recent study, men who had HHV-8 were nearly 12 times more likely
to develop KS than men who did not have HHV-8. The herpes virus is usually
dormant in healthy individuals. However, immunocompromised patients, including
HIV/AIDS patients, may develop KS as a result of the infection.
According to the U.S.
Centers for Disease Control and Prevention (CDC), KS is considered an
AIDS-defining disease. This means that when HIV-infected patients develop KS,
their condition has progressed to AIDS. In the United States, KS serves as an
AIDS-defining illness in about 10-15% of HIV-infected homosexual men.
With new treatments for
AIDS, including antiretroviral therapy (ART), as well as greater awareness of
HIV, the number of KS cases due to HIV infection has decreased about 85% to
90%, according to researchers. Before ART was available, an estimated 90% of
patients who had AIDS-related KS died from the disease. Today, researchers
estimate that in areas where antiretroviral therapy (HIV/AIDS treatment) is
available, 47% of patients who have AIDS-related KS die.
Local therapies, including
radiation therapy, intralesional vinblastine, cryotherapy (use of cold
temperatures to treat disease) and retinoids have been used to treat patients
who experience localized lesions. However, local therapy does not stop the
development of new lesions. Systemic therapies, including interferon-alpha and
chemotherapy, are indicated for extensive or symptomatic visceral disease (when
organs are involved).
A herpes virus called Human Herpes Virus 8 (HHV-8) has shown
to cause AIDS-related KS. However, not everyone who has HIV and HHV-8 develops
KS. One study found that the presence of HHV-8 in both blood cells and saliva
was associated with KS, while patients who only had HHV-8 in their saliva were
much less likely to develop KS.
In a recent study, men who had HHV-8 were nearly 12 times
more likely to develop KS than men who did not have HHV-8. For unknown reasons,
men who have sex with men are the most likely to develop the herpes infection.
Therefore, men are more likely than women to develop KS.
Early in the AIDS epidemic, doctors saw a sudden appearance
of KS. This is because HIV and AIDS patients have a weakened immune system, and
their ability to fight against disease and infection is impaired. HHV-8 is
usually dormant in healthy individuals. However, immunocompromised patients,
including HIV/AIDS patients, may develop KS as a result of the infection.
It has also been suggested that KS may sometimes be caused
by an overactive immune system. HIV infections activate T-cells, which secrete
a growth factor called oncostatin M. Increased levels of oncostatin M. may
stimulate the growth of early KS cells, which may eventually become cancerous.
However, further research is needed to confirm this theory.
Once the KS cells have developed in one part of the body
they can enter the bloodstream and lodge in other tissues, which causes
According to the CDC, KS is considered an AIDS-defining
disease. This means that when HIV-infected patients develop KS, their condition
has progressed to AIDS.
Symptoms of AIDS-related KS vary from minimal skin
involvement to widespread organ involvement.
Common symptoms include skin lesions that may erupt at many
places on the body, including on the skin (raised lumps that may be purple,
brown or red), in the mouth, on the lymph nodes and other organs (especially
organs in the gastrointestinal tract, lungs, liver and spleen). Most patients
experience enlarged lymph nodes and unexplained fever or weight loss. Sometimes
patients experience painful swelling, especially in the legs, groin area or
skin around the eyes.
While the skin lesions may be disfiguring, they are not
usually life threatening. In some cases, the lesions may be painful or cause
swelling. If KS develops in the lungs, liver or gastrointestinal tract,
however, the disease may be life threatening, causing internal bleeding or
General: Several tests, including chest X-rays, thallium or
gallium scans, as well as a bronchoscopy, esophagogastroduodenoscopy (EGD) or
colonoscopy, may indicate KS. However, a tissue biopsy is the only definitive
diagnostic test for KS.
Biopsy: A biopsy is the only definitive diagnostic test for
KS. During the procedure a sample of tissue is analyzed under a microscope for
cancerous cells. The tissue sample may be taken from the skin (punch biopsy),
gastrointestinal tract (endoscopic biopsy), tissue that lines the lungs and the
inside of the chest wall, (pleural biopsy) or lung tissue (transbronchial
Chest X-ray: Chest X-rays provide variable and nonspecific
results. They may detect abnormal tissue growth, enlarged lymph nodes or an
isolated pulmonary nodule (oval-shaped sore (lesion) in the lungs.
Thallium or gallium scans: Thallium or gallium scans may
help a healthcare provider distinguish KS from an infection. Thallium or
gallium is injected into the patient before an X-ray is taken. KS lesions in
the lungs usually demonstrate intense thallium uptake and no gallium intake.
Infections, on the other hand, do not uptake either substance.
Bronchoscopy: A bronchoscopy may be used to determine if
there is pulmonary involvement. During the test, a bronchoscope (thin, flexible
tube with a camera) is inserted into the esophagus, through the mouth. The test
allows the healthcare provider to look inside the lungs. If KS is in the lungs,
a slightly raised, red lesion will be visible. However, a biopsy is generally
avoided because there is a risk of bleeding.
Esophagogastroduodenoscopy (EGD) or colonoscopy: A qualified
healthcare provider may observe the gastrointestinal tract during an
esophagogastroduodenoscopy or colonoscopy test. During the procedure, an
endoscope (thin, flexible tube with a camera) is either inserted through the
mouth (esophagogastroduodenoscopy) or the anus (colonoscopy) to view the
gastrointestinal tract. The physician looks for gastrointestinal lesions, which
are frequently observed in KS patients. In addition, the physician may insert a
biopsy needle into the endoscope to remove a small tissue sample. The sample is
then analyzed under a microscope for cancerous cells.
General: Highly active antiretroviral therapy (HAART) has
shown to reduce the risk of fatality in patients who have AIDS-related KS.
Local therapies, including radiation therapy, intralesional vinblastine,
cryotherapy (use of cold temperatures to treat disease) and retinoids have been
used to treat patients who experience localized lesions. However, local therapy
does not stop the development of new lesions. Systemic therapies, including
interferon-alpha and chemotherapy, are indicated for extensive or symptomatic
visceral disease (when organs are involved).
Highly active antiretroviral therapy (HAART): When HIV
reproduces, different strains of the virus emerge, and some are resistant to
antiretroviral drugs. Therefore, it is common for healthcare providers to
recommend a combination of antiretroviral drugs known as HAART. This strategy,
developed by NIAID-support researchers, usually combines drugs from at least
two different classes of antiretroviral drugs, and it has been shown to
suppress the virus. While these drugs cannot cure HIV infection or AIDS, they
can suppress the virus.
The U.S. Food and Drug Administration (FDA) has approved
several antiretroviral drugs to treat HIV. These drugs fall into three major
classes - reverse transcriptase (RT) inhibitors, fusion inhibitors and protease
inhibitors. In July 2006, the FDA approved a multi-class combination called
Fusion inhibitors prevent the virus from fusing with the
cellular membrane, thus blocking entry into the cell. The fusion inhibitor
Fuzeon© is FDA-approved.
Protease inhibitors (PIs) interfere with the protease enzyme
that HIV uses to produce infectious viral particles. They are a class of
medication used to treat or prevent viral infections, including HIV and
Hepatitis C. PIs prevent viral replication by inhibiting the activity of
protease, an enzyme used by the virus to cleave nascent proteins for final
assembly of new virons. FDA-approved protease inhibitors include Agenerase©,
Aptivus©, Crixivan©, Invirase©, Kaletra©, Lexiva©, Norvir©, Prezista©, Reyataz©
Reverse transcriptase (RT) inhibitors disrupt the reverse
transcription stage in the HIV lifecycle. During this stage, an HIV enzyme,
known as reverse transcriptase, converts HIV RNA to HIV DNA. There are two main
types of RT inhibitors - non-nucleoside RT inhibitors and nucleoside/nucleotide
RT inhibitors. Non-nucleoside RT inhibitors bind to reverse transcriptase,
preventing HIV from converting the HIV RNA into HIV DNA. Approved
non-nucleoside RT inhibitors include Rescriptor©, Sustiva© and Viramune©.
Nucleoside/nucleotide RT inhibitors serve as faulty DNA
building blocks, and once they are incorporated into the HIV DNA, the DNA chain
cannot be completed. Therefore, the drugs prevent HIV from replicating inside a
cell. Approved drugs include Combivir©, Emtriva©, Epivir©, Epzicom©, Hivid©,
Retrovir©, Trizivir©, Truvada©, Videx EC©, Videx©, Viread©, Zerit© and Ziagen©.
Radiation therapy: Radiation therapy (cancer treatment with
high-energy rays) is the most widely used and effective local therapy. About
80-90% of patients have positive responses to treatment, according to
researchers. A higher cumulative dose (40 grays) results in better local
control than lower doses (8 grays or 20 grays). Electron beam therapy is only
used to treat superficial lesions (on the skin surface). Radiation therapy
should be used cautiously because HIV patients are more prone to develop radiation-induced
mucositis (inflammation of the lining in the gastrointestinal tract) than
individuals who do not have HIV.
Intralesional vinblastine: Intralesional vinblastine, an
antineoplastic agent (anti-cancer drug) is commonly used, and it is generally
well tolerated. The lesion is injected with 0.1mL/cm2 (at a concentration of
0.2mg/mL). Side effects include skin discoloration and superficial erythema
(reddening of the skin).
Cryotherapy: During cryotherapy, liquid nitrogen is applied
topically (to the skin surface). This procedure may be an effective treatment
for small facial lesions. Cryotherapy may cause hypopigmentation (light spots
on the skin) or hyperpigmentation (dark spots on the skin), which generally
lasts a few months.
Topical retinoids: Topical retinoids (chemical compounds
similar to vitamin A) may reduce the chance of malignant degeneration. A 0.1%
alitretinoin gel (Panretin©) has been applied topically two to four times
daily, until the lesions are gone. This agent is generally well tolerated, but
it may cause local erythema (reddening of the skin) and irritation. Topical
retinoids should not be used during pregnancy because they may cause birth
Interferon-alfa: Interferon-alfa is most effective when the
CD4 count (helper T-cells that HIV primarily infects and destroys) is greater
than 150-200/mL or when administered along with antiretroviral therapy. The
agent is injected under the skin daily or three times weekly. Response may
occur with low (1 million U/m2), intermediate (30 million U/m2) or high doses
(50 million U/m2). It generally takes about four months for the patient to
respond to treatment. Toxicity is more common and severe with higher doses.
Symptoms of toxicity include fatigue, flu-like symptoms, myalgia (muscle pain),
arthralgia (joint pain), fever, myelosuppression (decreased bone marrow
activity) and hepatotoxicity (liver toxicity).
Chemotherapy: Chemotherapy is not a curative treatment.
However, it may help the patient achieve rapid tumor regression and may reduce
tumor-related symptoms. Chemotherapy is used for symptomatic visceral
(affecting internal organs) or rapidly progressive skin disease. Several
cytotoxic agents are FDA-approved for AIDS-related KS, including liposomal
doxorubicin (Doxil©), liposomal daunorubicin (DaunoXome©) and paclitaxel
Good scientific evidence :
Greater celandine : Ukrain™, a semisynthetic drug derived
from greater celandine (Chelidonium majus), has been studied in clinical trials
of various types of cancer with consistently positive outcomes. However, the
quality of the research performed to date is inadequate, and higher quality
studies are needed.
Use cautiously in patients taking amphetamines, morphine,
hexobarbital, MAOIs, or dopaminergic or serotonergic drugs, or in patients
undergoing radiation therapy. Avoid in patients with liver disease or in
pregnant and lactating women.
Guided imagery : Early research suggests that guided imagery
may help reduce cancer pain. Further research is needed to confirm these
Guided imagery is usually intended to supplement medical
care, not to replace it, and guided imagery should not be relied on as the sole
therapy for a medical problem. Contact a qualified health care provider if
mental or physical health is unstable or fragile. Never use guided imagery
techniques while driving or doing any other activity that requires strict
attention. Use cautiously with physical symptoms that can be brought about by
stress, anxiety or emotional upset because imagery may trigger these symptoms.
If feeling unusually anxious while practicing guided imagery, or with a history
of trauma or abuse, speak with a qualified health care provider before
practicing guided imagery.
Meditation : There is good evidence that various types of meditation
may help improve quality of life in cancer patients. Studies have shown
benefits for mood, sleep quality, and the stresses of treatment. The specific
effects of meditation are not fully understood. Additional research is needed
in this area.
Use cautiously with underlying mental illnesses. People with
psychiatric disorders should consult with their primary mental healthcare
professional(s) before starting a program of meditation, and should explore how
meditation may or may not fit in with their current treatment plan. Avoid with
risk of seizures. The practice of meditation should not delay the time to
diagnosis or treatment with more proven techniques or therapies, and should not
be used as the sole approach to illnesses.
Psychotherapy : Psychotherapy is an interactive process
between a person and a qualified mental health care professional (psychiatrist,
psychologist, clinical social worker, licensed counselor, or other trained
practitioner). There is good evidence that psychotherapy may enhance quality of
life in cancer patients by reducing emotional distress and aiding in coping
with the stresses and challenges of cancer. Therapy may be
supportive-expressive therapy, cognitive therapy or group therapy. While some
patients seek psychotherapy in hopes of extending survival, there conclusive
evidence of effects on medical prognosis is currently lacking. Psychotherapy
may help people come to terms with the fact that they may die of cancer, which
is the 4th stage of dealing with a terminal illness, including denial, anger,
bargaining, and acceptance.
Psychotherapy is not always sufficient to resolve mental or
emotional conditions. Psychiatric medication is sometimes needed. The
reluctance to seek and use appropriate medication may contribute to worsening
of symptoms or increased risk for poor outcomes. In order to be successful,
psychotherapy requires considerable personal motivation and investment in the
process. This includes consistent attendance and attention to treatment
recommendations provided by the practitioner. Not all therapists are
sufficiently qualified to work with all problems. The client or patient should
seek referrals from trusted sources and should also inquire of the
practitioner's training and background before committing to work with a
particular therapist. Some forms of psychotherapy evoke strong emotional
feelings and expression. This can be disturbing for people with serious mental
illness or some medical conditions. Psychotherapy may help with post-partum
depression, but is not a substitute for medication, which may be needed in
Yoga : Yoga is an ancient system of relaxation, exercise,
and healing with origins in Indian philosophy. Several studies report enhanced
quality of life in cancer, lower sleep disturbance, decreased stress symptoms
and changes in cancer-related immune cells after patients received relaxation,
meditation and gentle yoga therapy. Yoga is not recommended as a sole treatment
for cancer but may be helpful as an adjunct therapy.
Yoga is generally considered to be safe in healthy
individuals when practiced appropriately. Avoid some inverted poses with disc
disease of the spine, fragile or atherosclerotic neck arteries, risk for blood
clots, extremely high or low blood pressure, glaucoma, detachment of the
retina, ear problems, severe osteoporosis, or cervical spondylitis. Certain
yoga breathing techniques should be avoided in people with heart or lung
disease. Use cautiously with a history of psychotic disorders. Yoga techniques
are believed to be safe during pregnancy and breastfeeding when practiced under
the guidance of expert instruction (the popular Lamaze techniques are based on
yogic breathing). However, poses that put pressure on the uterus, such as
abdominal twists, should be avoided in pregnancy.
Unclear or conflicting scientific evidence :
Acupuncture : Acupuncture, or the use of needles to
manipulate the "chi" or body energy, originated in China over 5,000
years ago. There has been limited research on acupuncture for cancer pain, and
the research that was done was shown to have mixed results. More studies are
needed to determine potential benefits. Evidence from several small studies
supports use of acupuncture at a specific point on the wrist (P6) to help
chemotherapy patients reduce nausea and vomiting. Acupuncture may also reduce
the pain associated with cancer.
Needles must be sterile in order to avoid disease
transmission. Avoid with valvular heart disease, infections, bleeding disorders
or with drugs that increase the risk of bleeding (anticoagulants), medical
conditions of unknown origin, or neurological disorders. Avoid on areas that
have received radiation therapy and during pregnancy. Use cautiously with
pulmonary disease (like asthma or emphysema). Use cautiously in elderly or
medically compromised patients, diabetics or with history of seizures. Avoid
electroacupuncture with arrhythmia (irregular heartbeat) or in patients with
Alizarin : Limited available evidence suggests that alizarin
may be of benefit in the treatment of viral infections. Additional research is
needed in this area.
Avoid if allergic or hypersensitive to alizarin or any
plants in the Rubiaceae family. Alizarin may be toxic and should not be handled
for long periods of time, rubbed in the eyes, or eaten. Avoid if pregnant or
Aloe : Transparent gel from the pulp of the meaty leaves of
Aloe vera has been used on the skin for thousands of years to treat wounds,
skin infections, burns, and numerous other skin conditions. Dried latex from
the inner lining of the leaf has traditionally been used as an oral laxative.
Preliminary research suggests that aloe may help in the area of cancer
prevention or may aid in the regression of cancerous tumors. Additional
research is needed in this area.
Although aloe has been suggested as a possible treatment for
HIV infection, further research is needed before a firm conclusion can be made.
Caution is advised when taking aloe supplements as numerous
adverse effects including a laxative effect, cramping, dehydration and drug
interactions are possible. Aloe should not be used if pregnant or
breast-feeding, unless otherwise directed by a doctor.
American pawpaw : Evidence supporting the use of the
American pawpaw (Asimina triloba) tree for cancer treatment in humans is
largely anecdotal and subjective. However, use in humans has reported minimal
side effects, and evidence from animal and test tube studies suggest that
American pawpaw extract does have some anticancer activity. Pawpaw standardized
extract has been used for 18 months in patients with various forms of cancer.
Well-designed studies on the long-term effects of pawpaw
extracts are currently lacking. Pawpaw should not be used if pregnant or
breast-feeding, unless otherwise directed by a doctor.
Antineoplastons : Antineoplastons are a group of naturally
occurring peptide fractions, which were observed by Stanislaw Burzynski, MD,
PhD in the late 1970s to be absent in the urine of cancer patients. There is
inconclusive scientific evidence regarding the effectiveness of antineoplastons
in the treatment of cancer. Several preliminary human studies (case series,
phase I/II trials) have examined antineoplaston types A2, A5, A10, AS2-1, and
AS2-5 for a variety of cancer types. It remains unclear if antineoplastons are
effective, or what doses may be safe. Until better research is available, no
clear conclusion can be drawn.
Preliminary study reported increased energy and weight in
patients with HIV who were treated with antineoplaston AS2-1, as well as a
decreased number of opportunistic infections and increased CD4 cell counts.
However, this evidence cannot be considered conclusive. Currently, there are
drug therapy regimens available for HIV with clearly demonstrated effects
(highly active anti-retroviral therapy), and patients with HIV are recommended
to consult with their physicians about treatment options.
Avoid if allergic or hypersensitive to antineoplastons. Use
cautiously with high medical or psychiatric risk, an active infection due to a
possible decrease in white blood cells, high blood pressure, heart conditions,
chronic obstructive pulmonary disease, liver disease or damage, or kidney
disease or damage. Avoid if pregnant or breastfeeding.
Arabinoxylan : Arabinoxylan is made by altering the outer
shell of rice bran using enzymes from Hyphomycetes mycelia mushroom extract.
Arabinoxylan has been found to improve immune reactions in patients with
diabetes and cancer of various types.
Arabinoxylan products may contain high calcium and
phosphorus levels, which may be harmful for patients with compromised renal
(kidney) function. Caution is advised when taking arabinoxylan supplements, as
numerous adverse effects including drug interactions are possible. Arabinoxylan
should not be used if pregnant or breast-feeding, unless otherwise directed by
Aromatherapy : Healing with fragrant oils has been used for
thousands of years. Aromatherapy is often used in people with chronic illnesses
(frequently in combination with massage), with the intention to improve quality
of life or well-being. There is currently not enough scientific evidence to
form a firm conclusion about the effectiveness of aromatherapy for quality of
life in cancer.
Essential oils should only be used on the skin in areas
without irritation. Essential oils should be administered in a carrier oil to
avoid toxicity. Avoid with a history of allergic dermatitis. Use cautiously if
driving or operating heavy machinery. Avoid consuming essential oils. Avoid
direct contact of undiluted oils with mucous membranes. Use cautiously if
Art therapy : Art therapy involves the application of a
variety of art modalities including drawing, painting, clay and sculpture. Art
therapy enables the expression of inner thoughts or feelings when verbalization
is difficult or not possible. Limited evidence suggests that art therapy may be
of benefit in cancer caregiving for families of cancer patients. Possible
benefits include reduced stress, lowered anxiety, increased positive emotions
and increased positive communication with cancer patients and health care
professionals. Art therapy may also reduce pain and other symptoms in cancer
patients. More studies are needed to determine how best to use this form of
intervention with this population. Art therapy may also benefit children
hospitalized with leukemia during and after painful procedures. Limited
available study suggests that art therapy improves cooperation with treatment.
Children requested art therapy again when procedures were repeated, and parents
reported that children were more manageable after art therapy.
Art therapy may evoke distressing thoughts or feelings. Use
under the guidance of a qualified art therapist or other mental health
professional. Some forms of art therapy use potentially harmful materials. Only
materials known to be safe should be used. Related clean-up materials (like
turpentine or mineral spirits) that release potentially toxic fumes should only
be used with good ventilation.
Astragalus : Astragalus (Astragalus membranaceus) has been
used in Chinese medicine for centuries for its immune enhancing properties.
Although early laboratory and animal studies report immune stimulation and
reduced cancer cell growth associated with the use of astragalus, reliable
human evidence in these areas is currently lacking. In Chinese medicine,
astragalus-containing herbal mixtures are also sometimes used with the
intention to reduce side effects of chemotherapy and other cancer treatments.
Some studies suggest that astragalus may inhibit herpes
viruses. Antiviral effects have been also been reported in early studies for
HIV. Additional research is needed in this area.
Caution is advised when taking astragalus supplements, as
numerous adverse effects including drug interactions are possible. Astragalus
should not be used if pregnant or breast-feeding, unless otherwise directed by
Baikal skullcap : Although the outcomes of early studies
using baikal skullcap for cancer are promising, high-quality clinical studies
are needed in this area before a conclusion can be made.
Avoid if allergic or hypersensitive to Baikal skullcap
(Scutellaria barbata), its constituents, or members of the Lamiaceae family.
Use cautiously if taking sedatives and/or operating heavy machinery. Use
cautiously if taking antineoplastic (anticancer) agents or agents metabolized
by cytochrome P450 enzymes. Avoid if pregnant or breastfeeding. Baikal skullcap
is an ingredient in PC-SPES, a product that has been recalled from the U.S.
market and should not be used.
Bee pollen : Bee pollen is considered a highly nutritious
food because it contains a balance of vitamins, minerals, proteins,
carbohydrates, fats, enzymes, and essential amino acids. Research has found
that bee pollen may reduce some adverse effects of cancer treatment side
effects. Additional study is needed before a firm recommendation can be made.
Caution is advised when taking bee pollen supplements as
allergic reactions may occur in sensitive individuals. Bee pollen should not be
used if pregnant or breast-feeding, unless otherwise directed by a doctor.
Beta-glucan : Treatment with a beta-glucan, called lentinan,
plus chemotherapy (S-1) may help prolong the lives of patients with cancer that
has returned or cannot be operated on. More research is needed in this area.
Avoid if allergic or hypersensitive to beta-glucan. When
taken by mouth, beta-glucan is generally considered safe. Use cautiously with
AIDS or AIDS-related complex (ARC). Avoid using particulate beta-glucan. Avoid
if pregnant or breastfeeding.
Beta sitosterol : Beta-sitosterol is found in plant-based
foods, such as fruits, vegetables, soybeans, breads, peanuts, and peanut
products. It is also found in bourbon and oils (such as olive oil, flaxseed,
and tuna). Due to data that suggest immune modulating effects of
beta-sitosterol and beta-sitosterol glucoside, these sterols have been studied
in combination in the treatment of HIV. Larger populations of patients with HIV
should be evaluated in randomized controlled trials to draw any conclusions.
Avoid if allergic or hypersensitive to beta-sitosterol,
beta-sitosterol glucoside, or pine. Use cautiously with asthma or breathing
disorders, diabetes, primary biliary cirrhosis (destruction of the small bile
duct in the liver), ileostomy, neurodegenerative disorders (like Parkinson's
disease or Alzheimer's disease), diverticular disease (bulging of the colon),
short bowel syndrome, celiac disease, and sitosterolemia. Use cautiously with a
history of gallstones. Avoid if pregnant or breastfeeding.
Bitter melon : Bitter melon (Momordica charantia) is used in
Avurvedic medicine from India to lower blood sugar levels. Research has also
found that bitter melon extracts may be beneficial in cancer therapies. MAP30,
a protein isolated from bitter melon extract, is reported to possess
anti-cancer effects in laboratory studies. Potential anti-cancer effects have
not been studied appropriately in humans.
Laboratory studies have also shown that MAP30 may have
antiviral activity against HIV. However, this has not been studied in humans.
Further research is needed before a firm conclusion can be made.
Caution is advised when taking bitter melon supplements, as
numerous adverse effects including blood sugar lowering and drug interactions
are possible. Bitter melon should not be used if pregnant or breast-feeding,
unless otherwise directed by a doctor.
Black tea : Black tea (Camellia sinensis) is from the same
plant as green tea, but the leaves are processed differently. Black tea usually
contains more caffeine than green tea. Several studies have explored a possible
association between regular consumption of black tea and rates of cancer in
several populations. This research has yielded conflicting results, with some
studies suggesting benefits, and others reporting no effects. Laboratory and
animal studies report that components of tea, such as polyphenols, have
antioxidant properties and effects against tumors. However, effects in humans
remain unclear, and these components may be more common in green tea rather
than in black tea. Some animal and laboratory research suggests that components
of black tea may actually be carcinogenic, or cancer causing, although effects
in humans are not clear. Overall, the relationship of black tea consumption and
human cancer prevention remains undetermined.
Avoid if allergic or hypersensitive to caffeine or tannins.
Skin rash and hives have been reported with caffeine ingestion. Use caution
with diabetes. Use cautiously if pregnant. Heavy caffeine intake during
pregnancy may increase the risk of SIDS (sudden infant death syndrome). Very
high doses of caffeine have been linked with birth defects. Caffeine is
transferred into breast milk. Caffeine ingestion by infants can lead to sleep
disturbances/insomnia. Infants nursing from mothers consuming greater than 500
milligrams of caffeine daily have been reported to experience tremors and heart
rhythm abnormalities. Tea consumption by infants has been linked to anemia,
decreased iron metabolism, and irritability.
Blessed thistle : Laboratory studies report no activity of
blessed thistle against herpes viruses, influenza, or poliovirus. Effects of
blessed thistle (or chemicals in blessed thistle called lignans) against HIV
are not clear. Human research of blessed thistle as a treatment for viral
infections is lacking.
Blessed thistle is generally considered to be safe when
taken by mouth in recommended doses for short periods of time, with few
reported side effects such as birth defects, bleeding, breathing problems,
bruising, cancer of the nose or throat, increased production of stomach acid,
itching, kidney disease, liver toxicity, skin rash, stomach discomfort, stomach
ulcers, and vomiting. Allergic reactions to blessed thistle including rash may
occur, as well as cross-sensitivity to mugwort and Echinacea. Cross-reactivity
may also occur with bitter weed, blanket flower, Chrysanthemum, coltsfoot,
daisy, dandelion, dwarf sunflower, goldenrod, marigold, prairie sage, ragweed
or other plants in the Asteraceae/Compositae family. Avoid if pregnant or
Bovine cartilage : In early study, bovine tracheal cartilage
(preparations such as Catrix© and VitaCarte©) has been studied for the
treatment of cancer with encouraging results. High quality clinical research is
needed to better determine the effectiveness of bovine tracheal cartilage
preparations for cancer treatment.
Avoid if allergic or hypersensitive to bovine cartilage or
any of its constituents. Use cautiously with cancer, renal (kidney) failure, or
hepatic (liver) failure. Avoid if pregnant or breastfeeding.
Boxwood : Trials have been conducted for SPV30 (extract of boxwood,
Arkopharma, France) to evaluate its potential effectiveness for HIV/AIDS.
Rigorous clinical study is needed to confirm these early study results.
Avoid if allergic or hypersensitive to boxwood, its
constituents, or any plants in the Buxaceae family. Use cautiously with HIV or
AIDS. Avoid if pregnant or breastfeeding.
Bromelain : Bromelain is a sulfur-containing digestive
enzyme (proteins which help with digestion) that is extracted from the stem and
the fruit of the pineapple plant (Ananas comosus). There is not enough
information to recommend for or against the use of bromelain in the treatment
of cancer, either alone or in addition to other therapies. One small study
found that a bromelain supplement decreased tumor size in 12 breast cancer
patients. Patients took the supplements for different periods of time, lasting
from months to years.
Caution is advised when taking bromelain supplements, as
numerous adverse effects including blood thinning and drug interactions are
possible. Bromelain should not be used if pregnant or breast-feeding, unless
otherwise directed by a doctor.
Carrageenan : Carrageenan-based gels may reduce HIV
transmission during sexual intercourse and have been investigated for safety
and acceptability in published studies involving healthy females. Overall,
studies suggest that carrageenan is not associated with abnormal genital
clinical findings or severe side effects, and is considered acceptable for use
by females and their male partners. Additional research is needed to better determine
the role of carrageenan for HIV infection prevention.
Use oral carrageenan cautiously in infants. Use cautiously
in patients with, or at risk for, cancer. Use cautiously in patients treated
with azoxymethane or nitrosomethylurea. Use cautiously in patients with
gastrointestinal, immune, inflammatory, or bleeding disorders, or in patients
with low blood pressure or diabetes. Use cautiously intravaginally. Use
cautiously in patients using antilipemic agents. Use cautiously in combination
with any oral medication, as the fiber in carrageenan may impair the absorption
of oral medications.
Cat's claw : Originally found in Peru, the use of cat's claw
(Uncaria tomentosa) has been said to date back to the Inca civilization,
possibly as far back as 2,000 years. Cat's claw has anti-inflammatory
properties, and several low-quality studies suggest that cat's claw may slow
tumor growth. However, this research is early and has not identified specific
types of cancer that may benefit; thus, the results are not clear.
Caution is advised when taking cat's claw supplements, as
numerous adverse effects including blood thinning and drug interactions are
possible. Cat's claw should not be used if pregnant or breast-feeding, unless
otherwise directed by a doctor.
Chaparral : Chaparral was used by the Native Americans for
various health conditions. The chaparral component nordihydroguaiaretic acid
(NDGA) has been evaluated as a treatment for cancer but due to risk of toxicity
is considered unsafe and not recommended for use. Chaparral and NDGA have been
associated with cases of kidney and liver failure, liver cirrhosis, kidney
cysts, and kidney cancer in humans. In response to these reports, the U.S. Food
and Drug Administration (FDA) removed chaparral from its "generally recognized
as safe" (GRAS) list in 1970. Chaparral and NDGA are generally considered
unsafe and are not recommended for use.
Avoid if allergic to chaparral or any of its components,
including nordihydroguaiaretic acid. Use cautiously if taking blood thinners
(anticoagulants), blood sugar medication, or drugs that are broken down by the
liver (like amiodarone, phenobarbital, valproic acid). Stop use two weeks
before surgery/dental/diagnostic procedures with bleeding risk, and do not use
immediately after these procedures. Use cautiously if driving or operating
heavy machinery. Avoid if pregnant or breastfeeding.
Chiropractic : Chiropractic care focuses on how the
relationship between musculoskeletal structure (mainly the spine) and bodily
function (mainly nervous system) affects health. There is currently not enough
reliable scientific evidence to conclude the effects of chiropractic techniques
on CD4 cell count or quality of life in patients with HIV/AIDS.
Use extra caution during cervical adjustments. Use cautiously
with acute arthritis, conditions that cause decreased bone mineralization,
brittle bone disease, bone softening conditions, bleeding disorders or
migraines. Use cautiously with the risk of tumors or cancers. Avoid with
symptoms of vertebrobasilar vascular insufficiency, aneurysms, unstable
spondylolisthesis, or arthritis. Avoid with agents that increase the risk of
bleeding. Avoid in areas of para-spinal tissue after surgery. Avoid if pregnant
or breastfeeding due to a lack of scientific data.
Chlorophyll : Preliminary evidence in suggest that
chlorophyll may aid in the reduction of side effects associated with
photodynamic therapies, such as those used in management of malignant tumors.
Further research is required to support the use of chlorophyll as a laser
therapy adjunct for cancer treatment.
Avoid if allergic or hypersensitive to chlorophyll or any of
its metabolites. Use cautiously with photosensitivity, compromised liver
function, diabetes or gastrointestinal conditions or obstructions. Use cautiously
if taking immunosuppressant agents or antidiabetes agents. Avoid if pregnant or
Chrysanthemum : Early study indicates that hua-sheng-ping
(includes Chrysanthemum morifolium, Glycyrrhiza uralensis, and Panax
notoginseng) may be beneficial for patients with precancerous lesions. However,
more research is needed.
Avoid if allergic or hypersensitive to Chrysanthemum, its
constituents, or members of the Asteraceae/Compositae family, such as
dandelion, goldenrod, ragweed, sunflower, and daisies. Use cautiously if taking
medication for gout, cancer, or HIV. Use cautiously with compromised immune
systems or if taking immunomodulators. Avoid with photosensitivity or if taking
photosensitizers. Avoid large acute or chronic doses of ingested pyrethrin.
Avoid pyrethrin with compromised liver function, epilepsy, or asthma. Avoid
ocular exposure to pyrethrin. Avoid if pregnant or breastfeeding.
Patients who are taking antiretroviral therapy are less
likely to develop the disease. In fact, antiretroviral therapy has decreased
the rate of KS by more than 80%.
Copyright © 2011
Natural Standard (www.naturalstandard.com)