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      Herbal Medicine Practices of Patients With Liver Cancer in Peru: A Comprehensive Study Toward Integrative Cancer Management

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          Abstract

          Rationale: The highest burden of liver cancer occurs in developing countries, where the use of herbal medicine (HM) is still widespread. Despite this trend, few studies have been conducted to report HM practices of patients with a hepatic tumor in the developing world. Hence, this study aimed to document the use of HM among patients with liver cancer in Peru. Study Design and Methods: A comparative behavioral epidemiological survey was conducted among liver cancer patients attending the National Cancer Institute of Peru. Information was obtained by direct interviews based on a semistructured questionnaire. The use of HM in Peruvian liver cancer patients was reported, first, regarding general consumption prior to the onset of disease, and second, after the appearance of symptoms that patients would relate to their tumor. In parallel, general consumption of HM in noncancerous people was assessed as a comparative figure. A correspondence analysis was performed to reveal potential associations between the symptoms of cancer and the specific use of HM. Results: Eighty-eight patients and 117 noncancerous individuals participated in the survey. Overall, 68.3% of the people interviewed claimed to use HM on a regular basis for general health preservation. Furthermore, 56.8% of the patients turned to plants first to treat the disorders for which they later came to the cancer care center. When compared with the number of plant species used routinely (n = 78), a selection of plants was made by patients in response to the symptoms of cancer (n = 46). At least 2 plant species, Aloe vera and Morinda citrifolia, were significantly associated with the treatment of liver cancer–related symptoms in the patient group. Conclusions: The present study is the first survey on the HM practices of patients with liver cancer in Latin America and, more broadly, in the developing world. Our findings confirm that HM remains one of the principal primary health care resources in Peru, even for a severe disease like liver cancer. These traditional, complementary and alternative medicine practices should be taken into consideration in Peruvian health programs aiming to educate the population in cancer prevention and treatment, as well as integrative cancer management.

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          Most cited references45

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          Evaluation of biological properties and clinical effectiveness of Aloe vera: A systematic review

          Aloe vera (蘆薈 lú huì) is well known for its considerable medicinal properties. This plant is one of the richest natural sources of health for human beings coming. The chemistry of the plant has revealed the presence of more than 200 different biologically active substances. Many biological properties associated with Aloe species are contributed by inner gel of the leaves. Most research has been centralized on the biological activities of the various species of Aloe, which include antibacterial and antimicrobial activities of the nonvolatile constituents of the leaf gel. Aloe species are widely distributed in the African and the eastern European continents, and are spread almost throughout the world. The genus Aloe has more than 400 species but few, such as A. vera, Aloe ferox, and Aloe arborescens, are globally used for trade. A. vera has various medicinal properties such as antitumor, antiarthritic, antirheumatoid, anticancer, and antidiabetic properties. In addition, A. vera has also been promoted for constipation, gastrointestinal disorders, and for immune system deficiencies. However, not much convincing information is available on properties of the gel. The present review focuses on the detailed composition of Aloe gel, its various phytocomponents having various biological properties that help to improve health and prevent disease conditions.
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            Cancer patterns, trends and projections in Latin America and the Caribbean: a global context

            Abstract: Objective: To develop a situation analysis encompassing the patterns and trends in cancer incidence and mortality in South and Central America and the Caribbean, with comparisons globally and with selected external countries. Materials and methods: Data on cancer incidence and mortality rates for 31 countries were obtained from the 2012 GLOBOCAN database. Incidence and mortality trends for selected countries were analysed with data from the Cancer Incidence in Five Continents (CI5) series and the WHO Mortality Database, respectively. Results: In 2012, almost 1.1 million new cancer cases were estimated annually, with important variations in rates across countries. The most common cancer types were breast, prostate, colorectum and lung cancer; stomach and cervical cancer ranked high in less developed countries. Increasing trends were observed in prostate, breast and colorectal cancer; lung cancer mortality trends diverged among males and females, while cervix cancer incidence and stomach cancer mortality uniformly decreased. A 66% increase in cancer cases in the region by 2030 is projected based on population aging and growth. Conclusions: Cancer patterns and trends reflect the significant sociodemographic changes in the region: the growing burden imposes great challenges to national health care systems to implement cancer control actions, while improving cancer surveillance to effectively measure the response.
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              Medicinal uses, phytochemistry and pharmacology of the genus Uncaria.

              The genus Uncaria belongs to the family Rubiaceae, which mainly distributed in tropical regions, such as Southeast Asia, Africa and Southeast America. Their leaves and hooks have long been thought to have healing powers and are already being tested as a treatment for asthma, cancer, cirrhosis, diabetes, hypertension, stroke and rheumatism. The present review aims to provide systematically reorganized information on the ethnopharmacology, phytochemistry and pharmacology of the genus Uncaria to support for further therapeutic potential of this genus. To better understanding this genus, information on the stereo-chemistry and structure-activity relationships in indole alkaloids is also represented.
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                Author and article information

                Journal
                Integr Cancer Ther
                Integr Cancer Ther
                ICT
                spict
                Integrative Cancer Therapies
                SAGE Publications (Sage CA: Los Angeles, CA )
                1534-7354
                1552-695X
                08 December 2016
                March 2018
                : 17
                : 1
                : 52-64
                Affiliations
                [1 ]Aix-Marseille Université, IRD, INSERM, UMR 912, Marseille, France
                [2 ]Université de Toulouse, IRD, UPS, UMR 152, Toulouse, France
                [3 ]Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
                [4 ]Sorbonne Universités, UPMC Univ Paris 06, Institut Pasteur, Paris, France
                [5 ]Institut Pasteur, Paris, France
                [6 ]INSERM, U 993, Paris, France
                [7 ]Université de Montpellier, IRD, CNRS, UMR 5569, Montpellier, France
                Author notes
                [*]Teresa Rojas Rojas, Aix-Marseille Université, Centre d’Epidémiologie et de Santé Publique des Armées, Camp Militaire Sainte Marthe 408 rue Jean Queillau, Marseille 13014, France. Email: teresa.rojas@ 123456ird.fr
                Article
                10.1177_1534735416681642
                10.1177/1534735416681642
                5950939
                28088871
                0496ca11-3e70-4d2d-988a-953abb1541c9
                © The Author(s) 2016

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 23 August 2016
                : 13 September 2016
                : 22 October 2016
                Funding
                Funded by: French National Alliance for Life Sciences and Health (Aviesan), ;
                Award ID: ENV201408
                Funded by: Innóvate Perú, ;
                Award ID: 069-FINCyT-BDE- 2014
                Funded by: Institut de Recherche pour le Développement (IRD), ;
                Award ID: JEAI-INCAncer
                Funded by: Peruvian National Council of Science and Technology (CONCyTEC), ;
                Award ID: 212-2015-FONDECYT
                Categories
                Research Articles

                behavioral epidemiological survey,cancer,complementary and alternative medicine,developing world,ethnobotany,indigenous people,integrative medicine,latin america,liver disease,traditional medicine

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