Rhabdomyosarcoma

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Pokeweed Antiviral Protein (PAP) [1, 10, 11, 12, 13, 14]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Warning! All parts of the plant, Pokeweed (Phytolacca Americana), is poisonous and should not be ingested. Thoroughly cooking the plant reduces that toxicity. The effects of the improperly prepared plant include vomiting, diarrhoea, cramps, headache, confusion, convulstions, low blood pressure, heart block and death. Only plant extracts (PAP) or thoroughly prepared plants should be ingested, and even then, under professional medical guidance.

Recommendation: weakly in favor (Laboratory studies show that PAP may hold promise in the treatment of sarcomas, but more clinical trials are needed)

Grade of Evidence: very low of evidence

Pau D'Arco (Lapachol, Tabebuia Impetiginosa, Tabebuia Heptaphylla) [1, 9]:

Please note, this treatment has potentially serious side effects. Some of the chemicals in the plant are known to be toxic. High doses are known to cause liver and kidney. Even at low doses, chemicals in the plant may interfere with blood clotting, causing excess bleeding and anaemia. Pau D'Arco should be avoided, especially by pregnant or breastfeeding women.

Recommendation: Strongly against (Laboratory tests have shown that Pau D'arco can be effective in the treatment of sarcomas. However, further studies are needed on its effect in humans. This, combined with its potentially harmful side effects if taken without supervision from a doctor or pharmacist gives enough reason to avoid this treatment.)

Grade of Evidence: very low quality of evidence

Mistletoe (Iscador, Viscum Album) [1, 4, 5, 6, 7, 8]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. WARNING: The mistletoe plant should NOT be eaten because it is poisonous. May cause seizures, coma and death. It should only be taken as a purified mistletoe extract, and only in recommended doses.

Recommendation: No recommendation (Studies on the effect of Mistletoe on rhabdomyosarcomas have yielded mixed, conflicting results. More research is needed.)

Grade of Evidence: low quality of evidence

Cesium Chloride (High pH Therapy, CsCl) [1, 2, 3]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: Strongly against (Available evidence does not support claims that Cesium Chloride can help prevent or treat Rhabdomyosarcomas. In addition, Cesium Chloride can cause several potentially dangerous side effects such as heart arrythmia, seizures, loss of conciousness and electrolyte imbalance. NOT TO BE USED)

Grade of Evidence: low quality of evidence

* www.gradeworkinggroup.org

Rhabdomyosarcoma

A rhabdomyosarcoma is a type of cancer, specifically a sarcoma (cancer of connective tissues), in which the cancer cells are thought to arise from skeletal muscle progenitors. It can also be found attached to muscle tissue, wrapped around intestines, or anywhere, to include the neck area. It is most common in children ages one to five, and is also found in teens aged 15 to 19, although this is more rare. Rhabdomyosarcoma is a relatively rare form of cancer. Its two most common forms are embryonal rhabdomyosarcoma and alveolar rhabdomyosarcoma. In the former, which is more common in younger children, the cancer cells resemble those of a typical 6-to-8-week embryo. In the latter, which is more common in older children and teenagers, they resemble those of a typical 10-to-12-week embryo.

Diagnosis

When rhabdomyosarcoma is suspected, tests will be run for blood, muscle, and marrow. Diagnosis of rhabdomyosarcoma depends on recognition of differentiation toward skeletal muscle cells. The protein myo D1 is a protein normally found in developing skeletal muscle cells which disappears after the muscle matures and becomes innervated by a nerve. Thus, myo D1 is not found in normal skeletal muscle and serves as a useful immunohistochemical marker of rhabdomyosarcoma.

Treatment

Treatment for rhabdomyosarcoma consists of chemotherapy, radiation therapy and sometimes surgery. Surgery to remove the tumor is often difficult or impossible because the tumor is usually embedded deep within the tissue, leaving it difficult to reach. If a tumor presents itself in the extremities, amputation is often necessary to improve chances of survival. If there is no evidence of metastasis, surgery combined with chemotherapy and radiation offer the best prognosis. Patients whose tumors have metastasized usually have a poor chance for long-term survival. In patients who began treatment before metastasis, the prognosis is better, although the disease is generally incurable because the tumors that cannot be surgically removed tend to spread.

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.naturalstandard.com/index-abstract.asp?create-abstract=/monographs/herbssupplements/greatercelandine.asp

3. Sartori H. E. "Cesium therapy in cancer patients." Pharmacol Biochem Behav. 1984;21 Suppl 1:11-3.PMID: 6522427.

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mistletoe

5. http://nccam.nih.gov/health/mistletoe/ataglance.htm

6. http://www.nlm.nih.gov/medlineplus/ency/article/002883.htm

7. http://www.botanical.com/botanical/mgmh/m/mistle40.html

8. http://www.bmj.com/content/333/7582/1293.full?ijkey=56e55886cc53e0c478801e74001edc3bea1c322e&keytype2=tf_ipsecsha

9. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pau-d-arco   

10. http://www.cbif.gc.ca/pls/pp/ppack.info?p_psn=12&p_type=all&p_sci=sci&p_x=px

11. http://www.pfaf.org/user/Plant.aspx?LatinName=Phytolacca+americana

12. http://www.ncbi.nlm.nih.gov/pubmed/315368

13. http://www.nlm.nih.gov/medlineplus/ency/article/002874.htm

14. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pokeweed

 

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