Breast Cancer

Moegi Tanaka et al. (2021) · PloS one

This randomized controlled trial with 77 analyzed women explored whether Yokukansan, a traditional Japanese Kampo herbal formula, can reduce anxiety around breast cancer surgery. Kampo is the Japanese adaptation of traditional herbal medicine, and Yokukansan combines seven herbal extracts that are traditionally prescribed for irritability, restlessness, and insomnia. Perioperative anxiety (anxiety in the period around an operation) matters because the authors link it to faster heart rate, higher blood pressure, longer postoperative pain, and a higher risk of postoperative delirium. Common anxiety medicines such as benzodiazepines can cause sedation, which is why a short-course herbal option was tested. Women aged 20 to 60 undergoing partial or total mastectomy at two Niigata hospitals in Japan were randomly assigned to a Yokukansan group or a control group. The Yokukansan group took two 2.5 g doses of a standardized extract granule, one at bedtime the night before surgery and one 2 hours before anesthesia; the control group received water. Anxiety was measured objectively with salivary alpha-amylase (an enzyme that rises with stress) and subjectively with two questionnaires, the Hospital Anxiety and Depression Scale and the State-Trait Anxiety Inventory. Pain was rated on a 100-mm scale the day after surgery. Salivary alpha-amylase just before surgery was lower in the Yokukansan group than in controls (0.88 versus 1.14 on a log scale, p = 0.03), meaning a smaller physiological stress signal at that moment. HADS-Anxiety scores dropped by 2.77 points with Yokukansan and 1.43 points in controls (both significant, though the difference between groups did not reach significance, p = 0.083), and the authors suggest part of the drop may reflect reassurance once surgery was complete. Trait anxiety on the STAI fell by 4.23 points with Yokukansan and did not change in controls (p = 0.92), with a significant group-by-time interaction (p = 0.009). On both questionnaires higher scores mean more anxiety, so falling scores indicate improvement. Pain scores were nearly identical (1.4 versus 1.36, p = 0.70), and no adverse events were observed. The authors suggest two preoperative doses may reduce perioperative anxiety and that further research is justified. Several limitations apply. Patients knew which group they were in because no matching placebo exists for Kampo medicines, so reassurance may explain some of the effect. Salivary alpha-amylase measures stress generally, and the analyzed groups fell short of the planned size, leaving statistical power at 0.708. Pain was low in both groups, so any pain effect remains untested. Larger double-blind, placebo-controlled trials, including more invasive surgeries, are called for.

Georgios Mavropalias et al. (2022) · Breast cancer (Tokyo, Japan)

This randomized trial with 106 women getting radiation therapy for breast cancer tested whether a 12-week program of home-based exercise -- with no gym or supervision required -- could reduce cancer-related fatigue and improve quality of life during and after treatment. Cancer-related fatigue is an overwhelming tiredness affecting most breast cancer patients undergoing radiotherapy, and unlike ordinary tiredness, it does not resolve with rest alone. Conducted in Australia, the trial split participants into an exercise group, who received a one-on-one session with an exercise specialist plus biweekly phone check-ins, a resistance band, a pedometer, and an exercise guide, or a usual-care group with no exercise support. Eighty-nine women (43 exercise, 46 usual care) completed the full study. Fatigue was tracked weekly during the 6-week radiation course and at several points afterward using validated fatigue and quality-of-life questionnaires, along with measures of sleep and physical activity, over a full 12 months of follow-up. Women in the exercise group felt less fatigued than the usual-care group at several points during radiation treatment and recovered faster once treatment ended, while the usual-care group's fatigue did not meaningfully improve until 6 weeks after finishing radiation and took a full year to fully resolve. Quality of life followed a similar pattern, improving sooner and more in the exercise group. Sleep quality was poor in both groups throughout the study and did not improve with exercise. Notably, the women only managed modest amounts of exercise -- about 1 to 2 strength sessions and 30 to 40 minutes of cardio per week, less than typical guidelines recommend -- yet still saw real benefits, and no one was hurt by the program. These results suggest that even a small, home-based, unsupervised amount of exercise can meaningfully speed up recovery from cancer-related fatigue and improve quality of life during breast cancer radiotherapy, without needing a gym, a trainer, or a large time commitment. However, the study lacked a group that skipped radiotherapy entirely, so it cannot fully separate the effects of exercise from the natural course of treatment, and the fatigue and quality-of-life benefits appeared to fade once the structured 12-week program ended, suggesting ongoing activity is needed to keep the benefits going.

Urooj Ali et al. (2023) · Phytochemistry reviews : proceedings of the Phytochemical Society of Europe

This literature review explores Chimaphila umbellata, commonly called Pipsissewa or prince's pine, a small evergreen shrub in the Ericaceae (heath) family found across the cool temperate Northern Hemisphere. The review draws on nearly two centuries of phytochemistry research, starting with the 1892 discovery of chimaphilin — the compound that gave the plant's genus its name and remains its most characteristic chemical marker. Pipsissewa has a long history as both a traditional folk remedy and a homeopathic preparation, and this review asks what current phytochemical and biotechnological research says about the plant, what challenges stand in the way of studying and cultivating it further, and where research should go next. Rather than testing an intervention on participants, this is a narrative synthesis of previously published phytochemistry and biotechnology research on Pipsissewa. The authors trace historical findings (starting with the 1892 study isolating chimaphilin), catalog the plant's known chemical constituents, and summarize more recent studies — cited but not re-analyzed here — that tested the plant's extracts against tuberculosis bacteria, breast cancer cells in a lab dish, and cardiovascular-disease-related activity. The review identifies chimaphilin, arbutin, sitosterol, ursolic acid, and the essential oil methyl salicylate as Pipsissewa's key bioactive compounds, concentrated mainly in the leaves and roots (chimaphilin production drops to nothing in the fruit). Traditionally, the leaves have been brewed as teas or applied topically for urinary tract discomfort, bladder stones, fluid retention, epilepsy, anxiety, muscle spasms, chronic rheumatism, and skin sores, while the whole plant is used homeopathically as a fast-assimilating mother tincture. The review cites — without providing the original statistics — recent laboratory studies reporting antitubercular activity, an antiproliferative (cell-growth-slowing) effect on MCF-7 breast cancer cells, and cardiovascular-related activity. It also flags a real caution: long-term or excessive use has been linked to tinnitus (ringing in the ears), confusion, vomiting, and seizures. A major practical obstacle the review raises is that Pipsissewa is difficult to grow outside its natural habitat (it needs full shade early on, then partial shade) and its wild populations carry conservation concerns. Practically, the review recommends biotechnology and computational (bioinformatics) approaches — better lab-culture methods, nanoparticle delivery research, and pathway-mapping software — to responsibly scale up Pipsissewa's medicinal potential without over-harvesting wild plants. The clearest limitation is that this is a synthesis of other researchers' work, not new experimental data: none of the traditional uses or the cited tuberculosis, cancer-cell, or cardiovascular findings come with statistics reported in this paper itself, so they should be read as promising leads for future study rather than established clinical evidence.