Use of Complementary and Integrative Medicine Among Patients With Glioblastoma Multiforme Seen at a Tertiary Care Center
Glioblastoma multiforme (GBM) is among the most aggressive and lethal tumors, with a median survival of 12–15 months. Many patients use complementary and integrative medicine (CIM) therapies to supplement their cancer treatment.
To determine the prevalence of CIM use and identify the most frequently used types of CIM in a cohort of patients with GBM seen at a tertiary care medical center in the United States.
An anonymous survey was mailed through the US Postal Service from August 1, 2019, through February 21, 2020, to patients with GBM.
A total of 346 surveys were mailed, and 146 responses (42%) were received. The median age of respondents was 61 years (range, 52–68 years), and 85 (58%) were male. Most patients had undergone surgery (90%), chemotherapy (96%), and radiotherapy (95%). The median time from diagnosis of GBM to survey participation was 18 months (range, 12–31 months). Most respondents (81%) used some form of CIM, most frequently meditation (22%), relaxation and other stress management techniques (19%), chiropractic therapy (16%), and acupuncture (12%). Compared with men, women more commonly meditated (32% vs 16%; P = .046) and practiced yoga (20% vs 6%; P = .04). We observed age-based differences, with younger patients more commonly meditating, practicing relaxation and stress management techniques, and receiving chiropractic therapy (P < .05 for all).
Providers should encourage patients with GBM to discuss their interest in CIM therapies and guide them to evidence-based treatments that may help improve their quality of life.
Use of Antioxidants, Vitamins, and Herbal Supplements
The most commonly used antioxidants and vitamins were multivitamins (38%), vitamin D (34%), and vitamin C (27%) (Table 3). We did not observe any significant difference in antioxidant and vitamin use when stratifying respondents by gender, age, and time since GBM diagnosis.
Turmeric or curcumin (24%) was the most commonly used herbal supplement, followed by Boswellia (12%) and garlic (8%) (Table 4). We did not observe any significant difference in herbal supplement use when stratifying respondents by gender, age, and time since GBM diagnosis.
Use of Nonconventional Therapies
Three patients reported using fenbendazole, an anthelmintic drug with a broad antiparasitic effect in animals. Benzimidazole compounds, including fenbendazole, have been reported to have antitumor activities by destabilizing tubulin binding. 11
Unsurprisingly an overwhelming interest in CIM, but not one patient was using phenylbutyrate, tamoxifen, antineoplastons, magnolol, honokiol, niacinamide, etc!
This insurance company covers off label use of PB for the treatment of glioblastoma and acute promyelocytic leukemia:
"Since sodium phenylbutyrate has been approved by the FDA for treatment of other indications, physicians can prescribe it for patients without any danger of legal sanctions or need for compassionate use exemptions. However, there is no adequate evidence in the peer-reviewed published medical literature demonstrating that the use of sodium phenylbutyrate improves the clinical outcomes of patients with other indications such as cancers of the prostate, breast, or cancers other than acute promyelocytic leukemia and malignant glioma."
Does show how much publicity there has been for fenbendazole, in just a few years. As I have mentioned before it's a HIF activator.
I say unsurprisingly because glioblastoma has such a bad prognosis, so CIM makes so much sense. What does surprise me is that the options these patients mention are far from optimal CIM.