|
 
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| REVIEW ARTICLE |
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| Year : 2019 | Volume
: 14
| Issue : 6 | Page : 95-96 |
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Ethical issues in cancer care through ayurveda
Priyanka Shelotkar1, Swapnil Borage2
1 Department of Kaumarbhritya, MGACH and RC, Wardha, Maharashtra, India
2 Department of Shalakyatantra, MGACH and RC, Wardha, Maharashtra, India
| Date of Submission | 13-Mar-2019 |
| Date of Decision | 16-Mar-2019 |
| Date of Acceptance | 13-Apr-2019 |
| Date of Web Publication | 30-Sep-2020 |
Correspondence Address:
Dr. Priyanka Shelotkar
Department of Kaumarbhritya, MGACH and RC, Salod, Wardha, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdmimsu.jdmimsu_207_19
The second most common disease in India responsible for maximum mortality is cancer, with an incidence of about 0.3 million deaths per year. Although there are good diagnostic methods and treatment, cancer is still a big risk to our society. Ayurveda is the most commonly used complementary and alternative medicine in India, as it is add-on to conventional cancer care. Now, this is need of the hour to make collaboration between Ayurveda and modern physicians with mutual trust in the management of cancer. In various meetings, standard treatment protocols have been set, and integrative oncology programs have been initiated in a few institutes across India. But still, there are some ethical issues regarding this integrative oncology. Today is the era of evidence-based medicine, and we are lacking in generating evidence of the benefits of Ayurveda intervention. Also, there is a deficit of publications in systematic reviews of prior research studies, exploring the safety and efficacy of Ayurveda in the management of cancer, ensuring comprehensive clinical documentation based on categorization of patients. We have enough knowledge about the mode of action of herbal as well as modern drugs, but we are not aware of herb–modern drug interaction. Hence, herb–modern drug interaction studies and chemosensitivity studies, based on both laboratory research and clinical observations, should be conducted. Acknowledgment of the medicolegal and ethical issues involved in integrative oncology and developing strategies for clinical practice and research should be made. Making available insurance coverage for integrative oncology care, keeping in mind the aim of universal health coverage, will facilitate more number of patients toward integrative management for cancer. Through appropriate cooperation with modern medicine, Ayurveda can make substantial contributions for the advances of integrative oncology. This can discover the specific health challenges and open up new opportunities for the development of integrative Ayurveda oncology in the world.
Keywords: Ayurveda, cancer, integrative oncology
How to cite this article:
Shelotkar P, Borage S. Ethical issues in cancer care through ayurveda. J Datta Meghe Inst Med Sci Univ 2019;14, Suppl S2:95-6 |
| Introduction | |  |
Cancer load is increasing in India, and there is a significant difference between the ratios of cancer incidence to mortality. It is of extreme importance to find a solution for combating this terrible disease. There are many reasons why cancer patients across the world adopt complementary and alternative medicine (CAM) as an alternative or to complement conventional medical care, namely faith, belief in advantages of CAM, emotional support, expectation of better quality of life (QOL), to boost immune system, prevention of recurrence, dissatisfaction with conventional therapy, to obtain synergic effect with conventional therapy, or reduction of side effect of conventional therapy.[1],[2] Ayurveda is the most commonly used CAM in India, as it is add-on to conventional cancer care.[3] Now, this is the need of the hour to make collaboration between Ayurveda and modern physicians with mutual trust in the management of cancer. An ayurvedic approach to cancer supportive care focuses on restoring equilibrium, building strength, and rejuvenation. The present study is a complete review about various information regarding ethical issues while treating cancer through Ayurveda as integrative therapy under a single roof so as to help the future researchers to use the incorporated details about the same. It is aimed to highlight the ethical issues regarding integrative approach in cancer care through Ayurveda.
| Materials and Methods | | |
The study comprises ethical issues and their probable approaches in cancer care through Ayurveda. References established on data pertaining to available NCBI and PubMed peer-reviewed journals, Ayurveda texts, modern texts regarding cancer care, its integrative approach, ethical issues, and clinical trial.
Description of concept
Opportunities of Ayurveda in cancer care
Basic principles of Ayurveda for the promotion of healthy lifestyle can be incorporated in collaboration with the National Cancer Control Programme Establishment of Ayurveda Cancer Prevention Program: Patients having addiction history such as smoking, alcohol, or tobacco and strong family history of cancer may be subjected to this program. The diseases such as colon polyps, cervical dysplasia, and oral submucous fibrosis which can progress into cancer may be treated using the whole system approach. Ayurveda system of medicine can be used to boost immunity, building strength, and prevent recurrence in the patients who have completed conventional treatment. As a synergetic effect, Ayurveda treatment can be given with conventional treatment, namely with chemotherapy and radiation therapy. To reduce the adverse effects of conventional treatment, namely chemotherapy-induced fatigue, hair loss, nausea/vomiting, neutropenia, peripheral neuropathy and radiation-induced mucositis and xerostomia, and other complications such as sleep disturbances and loss of weight, it may be administered. In advanced stages of the disease, where palliative care is only the option, Ayurveda treatment can be used as only therapy for the management of pain, constipation, loss of appetite, wounds, etc. The patients not fit for conventional therapy can be treated with Ayurveda as a stand-alone therapy.[4] Ayurvedic medicines are often considered effective for treating chronic and lifestyle-related diseases.[5]
Ethical issues and their probable resolutions
- Evidence-based medicine – Generating evidence of the benefits of ayurvedic intervention in the management of cancer through scientific studies conducting with the help of practitioners, integrative oncology institutes, and research institutes
- Systematic reviews of previously published papers – Studying and publishing systematic reviews of prior research studies to establish the safety and efficacy of Ayurveda interventions in the management of cancer
- Conducting clinical trials – Conducting well-planned clinical trials to evaluate the efficacy of the complete ayurvedic intervention as whole system approach in Ayurveda rather than individual components[6]
- Comprehensive clinical documentation – Ensuring comprehensive clinical documentation of Ayurveda management as only therapy or add-on therapy based on categorization of patients[7]
- Clinical case registry – It is important to establish clinical case registry of the practitioners to report the clinical outcomes to learn from their experiences who practice across the country
- Establishing transdisciplinary team – Creating a team of experts from the different healthcare systems. It will focus on decisions to make better treatment outcomes and QOL for the patients
- Formation of a scientific body – To bring together a multidisciplinary team of professionals, establishment of a scientific body like “Society of Integrative Oncology” is important. Goal of the body is to develop standard protocols/guidelines for integrative Ayurveda oncology in India
- Interaction with global research – Interacting with global research and clinical community to integrate Ayurveda in the development of integrative oncology in the world
- Enlisting medicolegal and ethical issues – Identifying the medicolegal and ethical issues involved in integrative medicine and integrative Ayurveda oncology and developing standard guideline
- Conducting herbal and modern drug interaction study – The mode of action of herbal as well as modern drugs is well known, but herb–modern drug interactions are not yet known, so conducting herb–modern drug interaction and chemosensitivity studies based on both laboratory research and clinical observations
- Insurance coverage for integrative oncology – Focusing on universal health coverage, it is important to establish insurance coverage for integrative oncology care.
| Conclusion | | |
Ayurveda can make significant contributions for the advances of integrative oncology appropriate collaboration with modern medicine. This can open up new opportunities and establish the specific health challenges for the development of integrative Ayurveda oncology worldwide.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 3. | Kumar D, Goel NK, Pandey AK, Sarpal SS. Complementary and alternative medicine use among the cancer patients in Northern India. South Asian J Cancer 2016;5:8-11. [ PUBMED] [Full text] |
| 4. | Gundeti MS, Rammanohar P, Bhat SG, Narayanam S. Ayurveda in cancer care in India: Scope, challenges, and suggested approaches. J Altern Complement Med 2018;24:1023-4. |
| 5. | Rastogi S, Rastogi R. Ayurvedic intervention in metastatic liver disease. J Altern Complement Med 2012;18:719-22. |
| 6. | Furst DE, Venkatraman MM, McGann M, Manohar PR, Booth-LaForce C, Sarin R, et al. Double-blind, randomized, controlled, pilot study comparing classic ayurvedic medicine, methotrexate, and their combination in rheumatoid arthritis. J Clin Rheumatol 2011;17:185-92. |
| 7. | Gundeti MS, Sakethram T, Reddy RG, Marlewar SS, Bhurke L, Dedge A. Comprehensive integrated format for systematic documentation of cancer management through ayurveda interventions. J Res Ayurvedic Sci 2017;1:263-82. |
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