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Hubner J.,Dr Senckenbergisches Chronomedizinisches Institute | Mucke R.,Klinikum Lippe GmbH | Munstedt K.,Universitatsfrauenklinik Giessen | Micke O.,Klinik fur Strahlentherapie
Onkologe | Year: 2012

The German Society for Biological Cancer Defence has a strong position in counseling cancer patients concerning methods of complementary and alternative medicine. In spite of the purpose to strengthen patient autonomy for which goal objective information on the disease and treatment options is mandatory, methods of conventional medicine are described as being of low efficacy but with a high potential for side effects. In contrast methods of unconventional therapy are depicted as being positive. In several cases recommendations against guidelines and recommendations of the scientific societies are given. Thus communication between oncologists and patients can become difficult and patients can be led to omit or delay helpful conventional therapy. A clear distinction between evidence-based complementary methods and alternative medicine is missing. © Springer-Verlag 2012.

Huebner J.,Dr Senckenbergisches Chronomedizinisches Institute | Muenstedt K.,Universittsfrauenkllinik Giessen
Trace Elements and Electrolytes | Year: 2013

Introduction: Different methods from complementary and alternative medicine (CAM) are used by many cancer patients. The goal is mainly to support body and soul in the fight against cancer. Physicians have some difficulties finding evidence on the different CAM methods. The goal of our work was to assess the information on CAM in reviews in the most often assessed database MedLine. Methods: We did a systematic search in MedLine for all reviews on supportive therapy in cancer and analyzed them according to information on CAM, types of cancer represented and questions from supportive therapy dealt with. Results: 66 reviews included at least some statement on CAM, 30 are systematic ones. The number of reviews considering CAM is rising since the year 2000. Reviews focusing on a defined CAM method mainly analyze natural products and less often mind and body medicine or whole medical systems. The most important supportive treatment aims are also represented in reviews with CAM. On the other side there are only a few reviews for patients with tumors that often use CAM like breast cancer patients. We found a high number of reviews on traditional Chinese medicine (TCM) as proof of the high interest on TCM which is in contrast with the low to missing evidence for these methods. Discussion: Most CAM methods are used complementary to conventional therapy and have a supportive aim. This aim can be chosen as defined endpoint and the method can be tested in clinical trials to gather evidence. In the article we discuss arguments against evidence based medicine in CAM and whether there are alternative ways to evidence in CAM which should be included in reviews or replace them? In our opinion the reviews analyzed in this article show that the technique of systematic search and evaluation is applicable to CAM. They provide results which can be used to build up guidelines and individual treatment recommendations. © 2013 Dustri-Verlag Dr. K. Feistle.

Hubner J.,Dr Senckenbergisches Chronomedizinisches Institute | Senf B.,Goethe University Frankfurt | Munstedt K.,Universitatsklinikum Giessen | Mucke R.,Ruhr University Bochum | Micke O.,Abteilung fur Strahlentherapie
Onkologe | Year: 2014

Context. The Krebskompass is the most important independent internet platform for patients with cancer in Germany. An analysis of the subject area of complementary and alternative oncology shows that the topics vary but the main topics have been stable over the last 10 years. Material and Methods. We categorized and analyzed all threads from the topic "other therapies" published before 30.03.2011. Results. Important topics are phytotherapy, mistletoe and holistic medicine. The most thoroughly discussed topics in alternative medicine are vitamin B17 (amygdalin and laetrile), energy healing and Germanische Neue Medizin®. The spectrum of topics delineates the range for which counseling is necessary. For institutions specialized in counseling on complementary oncology, a high standard of information is necessary. For counseling during everyday communication between patient and physician, knowledge of the most relevant topics is sufficient. Conclusion. The high number of discussions on alternative and esoteric practices and the high frequency of recommendations for non-scientific institutions, books and clinics should lead to a growing engagement in providing sound information. © Springer-Verlag 2014.

Schick S.,Institute of Molecular Biology | Becker K.,Institute of Molecular Biology | Thakurela S.,Institute of Molecular Biology | Fournier D.,Institute of Molecular Biology | And 3 more authors.
Molecular and Cellular Biology | Year: 2016

Organisms adapt their physiology and behavior to the 24-h day-night cycle to which they are exposed. On a cellular level, this is regulated by intrinsic transcriptional-translational feedback loops that are important for maintaining the circadian rhythm. These loops are organized by members of the core clock network, which further regulate transcription of downstream genes, resulting in their circadian expression. Despite progress in understanding circadian gene expression, only a few players involved in circadian transcriptional regulation, including transcription factors, epigenetic regulators, and long noncoding RNAs, are known. Aiming to discover such genes, we performed a high-coverage transcriptome analysis of a circadian time course in murine fibroblast cells. In combination with a newly developed algorithm, we identified many transcription factors, epigenetic regulators, and long intergenic noncoding RNAs that are cyclically expressed. In addition, a number of these genes also showed circadian expression in mouse tissues. Furthermore, the knockdown of one such factor, Zfp28, influenced the core clock network. Mathematical modeling was able to predict putative regulator-effector interactions between the identified circadian genes and may help for investigations into the gene regulatory networks underlying circadian rhythms. © 2016, American Society for Microbiology. All Rights Reserved.

Huebner J.,Dr Senckenbergisches Chronomedizinisches Institute | Muenstedt K.,Universitatsfrauenkllinik Giessen
Trace Elements and Electrolytes | Year: 2013

Introduction: Complementary and alternative medicine (CAM) is frequently used by cancer patients. Physicians are often unfamiliar with this topic and patients have difficulties in getting sound information. Therefore we decided to assess the information provided on CAM in cancer by Cochrane reviews. Methods: We systematically searched the Cochrane library for reviews including CAM. The reviews were analyzed concerning contents and evidence concerning CAM. Results: 15 reviews were identified. There is a mismatch between most frequently used CAM methods and the actual number of Cochrane reviews to these topics. Vitamins and trace elements, which are most often used, are only assessed in one review. In contrast acupuncture and Traditional Chinese Medicine (TCM) have been dealt with in several reviews. Positive evidence for CAM is low or missing in the Cochrane reviews. The methodological quality of the studies is mostly low. Discussion: Evidence based medicine provides adequate tools to assess CAM. The randomized controlled trial is suitable for biological based therapies which are the most commonly used CAM methods in Europe. Reviews focusing on supportive therapy should use a search strategy which includes CAM. This will make them highly relevant because the evidence on CAM will be given in context with all treatment options. Cochrane reviews can point to areas of missing evidence where research is needed. Reviewers should evaluate the relevance of endpoints chosen in studies on CAM. These endpoints should be clinically relevant and assessed by valid and generally recognized instruments. © 2013 Dustri-Verlag Dr. K. Feistle.

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