Denis R. Miller, MD, global clinical manager at Aventis Pharmaceuticals, reports that preclinical studies suggest isolated Beta-glucan polysaccharides from these mushrooms may have the ability to stimulate the immune system and induce apoptosis, or programmed cell death. A few randomized clinical trials suggest mushroom extracts may improve overall survival and quality of life for cancer patients.

"Support for well-designed studies from government, industry and the private arena are needed. If these studies demonstrate significant clinical activity, maitake will appear on both gourmet restaurant menus and on pharmacy oncology drug lists," he wrote in a paper presented for Monday’s panel on alternative and complementary therapies.

Use of maitake mushrooms for medicinal purposes can be traced to the Han dynasty (206 BC to 220 AD), says Dr. Miller. An early Chinese medical text records the use of these mushrooms to treat ailments of the stomach and spleen and hemorrhoids as well as distraught nerves.

Uncontrolled trials – such as a study of 63 cancer patients in China – have been conducted, but their results are difficult to interpret, says Dr. Miller. "Uncontrolled clinical trials are difficult to understand because there is no measurement of response. It's hard to say from this data if there was evidence of clinical activity from these trials," he said.

There have been controlled trials in Japan, comparing chemotherapy alone to use of chemotherapy and an extract from the mushrooms. This research has shown "improvement in survival but not response rate," according to Dr. Miller.

In addition, an ongoing study in New Jersey is looking at the use of maitake mushrooms in treating breast and prostate cancer.

Barrie Cassileth, PhD, chief of the integrative medicine service at Memorial Sloan-Kettering Cancer Center in New York, agreed that more research should be done to learn about the mushrooms. "At Memorial Sloan-Kettering, we're very interested in this approach and its potential and are planning to initiate a clinical trial to further explore its use," she said.

Also presented at Monday’s panel was research into the use of electroacupuncture to treat chemotherapy-induced nausea and vomiting (known as emesis) in cancer patients. Nausea and vomiting affect a patient’s quality of life and can keep a doctor’s from being able to give adequate doses of chemotherapy, according to the paper presented by Lixing Lao, PhD, of the complementary medicine program in the School of Medicine at the University of Maryland at Baltimore.

Electroacupuncture is acupuncture with the application of electrical currents. It has been shown to be effective as a supplementary way of controlling nausea and vomiting, but there has not been much research into its effectiveness in treating people who don’t respond well to antiemetics, according to Dr. Lao.

Dr. Lao conducted two studies – the first evaluating the use of an electroacupunture-drug combination in ferrets. He found the combination of electroacupuncture with lower doses of the antiemetic drugs ondansetron, metoclopramide and droperidol significantly lowered the total number of episodes of nausea and vomiting by 55 percent, 74 percent and 43 percent, respectively.

The results from this first study have been used to design a second controlled study using electroacupuncture in human patients. This ongoing research is focusing on a special group of 15 to 20 percent of patients whose chemotherapy-induced nausea and vomiting are difficult to manage using the antiemetic drugs.

"We expect the EA [electroacupuncture] will be effective in controlling nausea and vomiting in patients who failed to respond to antiemetics, and will be helpful in improving the quality of life of cancer patients," Dr. Lao writes.

Following are other reports represented at Monday’s panel on alternative and complementary therapies:

• Abraham Mittelman, MD, of Westchester Medical Center in Valhalla, New York, and colleagues studied the effects of a Chinese herbal preparation PC-SPES, a refined powder made from eight plants, on rats with prostate cancer. They found dietary supplementation with the herbal preparation could reduce tumor incidence and the rate of tumor growth. The researchers say their study showed some rats would respond to PC-SPES, while others would not. "This is reminiscent of the human experience with PC-SPES, where some patients showed dramatic response or were partial responders, while others were completely refractory [resistant to treatment]. Although the precise mechanism for such an action is elusive, one can speculate that since PC-SPES is a mixture of several different medicinal plants, each with its target of action, induction of a synergistic response may be host dependent," Dr. Mittelman wrote.
• David W. Golde, MD, physician-in-chief at Memorial Sloan-Kettering Cancer Center, reported on his research into how tumors obtain vitamin C. Previously, Dr. Golde discovered a fundamental mechanism by which vitamin C is taken up in human cells. In this paper, he writes that, "Overall, we need to think about the nutritional needs of tumor cells… it would not seem prudent for patients who are undergoing chemotherapy or radiation therapy for cancer to concomitantly take high doses of supplemental vitamin C. In this situation, vitamin C theoretically could protect the tumor cells."