Phytotherapy and complementary medicines as psychophysical support in the oncological journey and palliative care

The diagnosis of neoplastic disease and the associated treatment pathway are highly emotionally and physically impactful events for the patient. In this context, the concept of care is evolving towards an integrated approach: Integrated Medicine and Complementary Medicines (CM) do not replace conventional cancer therapies (chemotherapy, radiotherapy, surgery), but complement them with the primary goal of improving quality of life, reducing adverse effects, and supporting the person's psycho-physical balance.

Prevention and lifestyles: the first level of protection

According to estimates by the World Health Organization (WHO), between 20% and 30% of cancers can be prevented by adopting healthy lifestyles and undergoing regular screening. Among the modifiable risk factors, diet and physical activity play a primary role.

The main scientific societies recommend:

·         Regular physical activity: promotes gastrointestinal motility, helps maintain body weight, and supports immune system efficiency.

·         Predominantly plant-based diet: rich in whole grains, legumes, vegetables, and fruit, which are sources of fiber, antioxidants, and anti-inflammatory molecules.

·         Limiting ultra-processed foods: reducing the intake of red and processed meats, refined sugars, saturated fats, and alcohol.

·         Use of anti-inflammatory spices: moderate daily intake of turmeric, ginger, and cinnamon.

Nutritional support in oncology patients

During antineoplastic therapies, maintaining adequate nutritional status is essential to prevent malnutrition and sarcopenia, optimize drug tolerance, and support immune defenses.

Meals can become a source of stress due to dysgeusia (taste alteration), nausea, and loss of appetite. Supportive nutritional approaches include:

·         Breaking meals into frequent small snacks.

·         Using low-glycemic carbohydrates for a steady release of energy.

·         Adding aromatic herbs and carminative spices (mint, thyme, fennel, rosemary, turmeric) to stimulate appetite and reduce flatulence.

·         Adequate hydration with warm infusions or herbal teas, preferably away from main meals.

The Role of the Professional and the Effectiveness of Phytotherapy

The use of plant-based preparations in oncology requires rigorous professional guidance to prevent drug-herb interactions, pharmacokinetic alterations, and adverse toxicity. The herbalist and phytotherapist work in synergy with the medical team to identify the most suitable plant molecules that do not interfere with established chemotherapy regimens.

1. Anxiety, Depression, and Mood Disorders

Emotional disorders are common complications related to the burden of diagnostic and therapeutic stress. Among the medicinal plants with anxiolytic and neuroprotective properties:

·         Red valerian (Centranthus ruber (L.) DC.) and Valerian (Valeriana officinalis L.): extracts rich in valepotriates and valerenic acid with modulating activity on the GABAergic system [1].

·         Hawthorn (Crataegus monogyna Jacq.): with sedative and muscle-relaxant properties, useful for somatic manifestations of anxiety (e.g., palpitations).

·         Saffron (Crocus sativus L.): its constituents (crocin and safranal) show a modulating effect on monoaminergic neurotransmitters, making them useful for mild or moderate depressive states [2].

·         Lavender (Lavandula angustifolia Miller) and Lemon Balm (Melissa officinalis L.): used to manage neurotonic and visceral manifestations of anxiety.

·         Passionflower (Passiflora edulis Sims / incarnata L.): promotes relaxation without causing dependence.

·         Rhodiola (Sedum roseum (L.) Scop.): an adaptogen that supports mood.

2. Cancer-Related Fatigue (CRF)

Cancer fatigue is a persistently asthenic state, disproportionate to physical activity and not resolvable with rest. Adaptogenic plant extracts act by regulating the hypothalamus-pituitary-adrenal (HPA) axis and inflammatory mediators:

·         Astragalus (Astragalus propinquus Schischkin): with immunomodulating and tonic properties, reduces feelings of exhaustion and supports recovery [3].

·         Eleuthero (Eleutherococcus senticosus Maxim.) and Schisandra (Schisandra chinensis Baill.): improve the body's non-specific resistance to stress and mental concentration.

·         Ginseng (Panax ginseng C.A.Meyer): widely studied for cancer-related fatigue; caution is required due to possible metabolic interactions with specific chemotherapeutic agents (e.g., cytochrome P450 isoenzymes) [4].

·         Rhodiola (Sedum roseum (L.) Scop.): demonstrates neuroprotective properties and reduces mental and physical fatigue.

3. Sleep Disorders

Sleep onset disorders and sleep fragmentation negatively affect the patient's ability to recover.

·         Passionflower (Eschscholzia californica Cham.): containing isoquinoline alkaloids, induces physiological sleep and reduces nighttime awakenings.

·         Sweet cicely (Melilotus officinalis (L.) Pall.): with antispasmodic and mild sedative properties.

·         Passionflower and Valerian: used together to reduce sleep latency.

Complementary Medicines in Palliative Care

In the advanced stages of disease or in the context of palliative care, clinical management focuses on the patient's "global suffering," which combines physical pain, psychological distress, and relational dimensions.

While conventional medicine offers indispensable pharmacological protocols for controlling acute symptoms (e.g., opioids for severe pain, neuroleptics for agitation), the early integration of complementary medicines allows for the management of secondary symptoms, sometimes reducing the dose of symptomatic medications and their associated adverse effects (such as opioid-induced constipation).

Homeopathy and Symptomatic Treatments

In the context of palliative integration, traditional homeopathic formulations are sometimes used to support:

·         Constitutional asthenia (Aceticum acidum).

·         Nausea and emetic reflex (Nux vomica, Ipeca).

·         Intestinal atony and flatulence (Carbo vegetabilis, Natrum muriaticum).

·         Predominantly musculoskeletal or contusion-type pain (Arnica).

Traditional Chinese Medicine and Acupuncture

Acupuncture and related techniques (electroacupuncture, auriculotherapy, moxibustion, and digitopressure) have a solid body of scientific literature supporting their use in managing cancer-related symptoms and the effects of oncological treatments:

·         Nausea and vomiting: stimulation of the Pericardium 6 (PC6) point is widely validated for controlling chemotherapy-induced and postoperative vomiting [5].

·         Neuropathic pain and xerostomia: acupuncture promotes the release of endorphins and endogenous neuromodulators, proving useful in managing chronic pain and dry mouth.

·         Dyspnea and asthenia: electroacupuncture and moxibustion at specific points (e.g., Stomach 36 - ST36, Governing Vessel 4 - GV4) are used as non-invasive support in advanced stages to improve fatigue tolerance parameters [6].

Bibliographic References

1.     Bent S, et al. (2006). Valerian for sleep: a systematic review and meta-analysis. The American Journal of Medicine, 119(12), 1005-1012.

2.     Lopresti AL, Drummond PD. (2014). Saffron (Crocus sativus) for depression: a systematic review of clinical trials and examination of underlying antidepressant mechanisms. Human Psychopharmacology: Clinical and Experimental, 29(6), 517-527.

3.     Liu P, et al. (2017). Anti-aging implications of Astragalus membranaceus (Huangqi): a known Chinese tonic. Aging and Disease, 8(6), 868-886.

4.     Barton DL, et al. (2013). Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. Journal of the National Cancer Institute, 105(16), 1230-1238.

5.     Garcia MK, et al. (2013). Systematic review of acupuncture in cancer care: a summary of the evidence. Journal of Clinical Oncology, 31(7), 952-960.

6.     Choi TY, et al. (2012). Moxibustion for managing cancer-related fatigue: a systematic review and meta-analysis. Integrative Cancer Therapies, 11(2), 91-104.