NCI CAMNews

Spring 2008

Vol.3- Issue 1

In this issue:

1

Feature

3

A Conversation with

5

News from the Field

6

Funding Opportunities

8

Research Resources

8

Research Highlights

10

CAM Information

11

Meetings

12

Featured Scientific

Meetings

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al C

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c

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U.S. DEPARTMENT

OF HEALTH AND

HUMAN SERVICES

National Institutes

of Health

The Newsletter of the Office of Cancer Complementary and Alternative Medicine

Conference Convened on Collaboration

in Cancer CAM Research

Conference participants discuss their interests.

If the history of science has taught us

anything, it’s that teamwork is the

way to go.

“Nothing new that is really

interesting comes without

collaboration,” James Watson once

said after the double helix discovery

with Francis Crick back in the

1950s.

[e National Institute of Cancer’s

(NCI) Office of Cancer

Complementary and Alternative

Medicine (OCCAM) couldn’t agree

more.

In October 2007, OCCAM hosted

the Cancer Researchers and CAM

Practitioners: Fostering

Collaborations; Advancing the

Science conference to bring together

people who work with everything

from apoptotic cancer cells to

acupuncture. [e goal was to

facilitate one of the most important

factors in science: teamwork.

OCCAM has long recognized that

building and sustaining strong

interdisciplinary partnerships is a

critical factor in the success of some

cancer complementary and

alternative medicine (CAM) research

endeavors. To promote this,

OCCAM Director Dr. Jeffrey D.

White and his staff organized a twoday conference at the National

Institutes of Health’s (NIH) Natcher

Conference Center for over 100

participants from all over the world.

“Many seem to agree that the quality

and impact of research can be

improved through greater dialogue

and collaboration between

experienced CAM practitioners and

cancer researchers,” Dr. White said.

“However, there has been very little

examination or discussion of the

factors that lead to productive

dialogue and effective collaborations.

We envisioned this conference as one

step in a process toward a better

understanding of these issues and the

ways in which OCCAM can be

helpful.”

1

continued on next page
For the first day of the conference,

participants gathered to learn the

importance of collaborations and

how to build and sustain successful

ones from researchers and

practitioners in the CAM field.

[e purpose of the first session,

“Why collaborate?”, was to assemble

individuals who could represent the

diverse perspectives regarding cancer

CAM research: cancer researcher,

CAM practitioner, NIH program

officer, and patient advocate. Each

panelist provided a short statement

on why collaboration is important to

the further advancement of CAM

research. [e four panelists included

Dr. Keith Block of the Block Center

of Integrative [erapies, Dr. Wayne

Jonas of the Samueli Institute, Dr.

Barbara Sorkin of NIH’s National

Center for Complementary and

Alternative Medicine (NCCAM),

and Dr. Loice Swisher, a family

advocate who used alternative

therapies to help her cancer-stricken

daughter.

“Collaboration, simply put, advances

research in clinical care,” Dr. Block

said during his time on the panel.

Later in the day, the sessions shifted

to the topic of how to make a

successful collaboration happen.

During the “How to develop

relationships and prevent issues”

session, Ellen Goldstein, program

manager at the Clinical Translational

Science Institute of the University of

California, San Francisco, presented

“Are you a good date or bad date?”

Goldstein compared picking a

collaborator to picking a significant

other. “Such a relationship starts by

choosing partners carefully,”

Goldstein said, “taking time to get to

know each other, and clarifying the

prenuptial agreement.”

Although developing a good

collaboration is a big part of

advancing the science, the divide that

can exist between the traditional and

conventional world should be

addressed.

“Conventional health care is an

intimidating institution, and

professionals working within it are

largely unaware that there is a viable

health care culture outside their

domain,” said Pamela Miles, a Reiki

practitioner from New York. “More

mechanisms are needed to bridge the

gap between conventional health care

and traditional healers.”

To show that this can be

accomplished, the conference

presented some existing

collaborations.

Dr. Gwen Wyatt, a professor at

Michigan State University College of

Nursing, and Barbara Brower, a

certified foot reflexologist of the

Branch Reflexology Institute, spoke

about their experiences during the

“Examples of successful

collaborations” session.

“A project will not be successful

without the contribution from the

scientist and practitioner,” said Dr.

Wyatt, who has been working with

Brower for almost 10 years. “Barb

and I agree that mutual respect for

each other’s role is critical. We live it

everyday, and it is critical.”

Other sessions on the first day

included “How to sustain

relationships and conflict

resolutions” and “Aspects of

successful collaborations.” [e

audience heard from Dr. Jeanne

Drisko of the University of Kansas

School of Medicine and Dr.

Lawrence Kushi of Kaiser

Permanente, to name a few.

[e second day was divided into four

different breakout sessions.

[e “Developing CAM for Cancer:

U.S. Regulations” session was chaired

by Dr. Freddie Ann Hoffman of

HeteroGeneity, LLC, and included

presentations by Dr. Qin Ryan, Dr.

Wei Chen, and Dr. Jinhui Dou of

the Food and Drug Administration

(FDA), who elaborated on the FDA

regulations for natural products.

OCCAM’s Practice Assessment

Program (PAP) director, Dr. Farah

Zia, and PAP coordinator, CDR

Colleen Lee led the “Understanding

& Designing Clinical Case Reports”

session with the aid of Dr. Janet

Kahn of the Integrated Healthcare

Policy Consortium. [is breakout

focused on understanding and

designing clinical case reports.

“[e session was very educational for

attendees, specifically CAM

practitioners,” Dr. Zia said. “[ey

not only heard about the cases we

invite for presentation, but also the

important basic aspects about

effectively putting cases together for

submission to NCI’s Best Case Series

program.”

Dr. Phil Tonkins, a former OCCAM

scientific program analyst, chaired

the “Funding Sources: Federal and

Non-federal” session. Dr. Tonkins

was joined by Dr. Sorkin of

NCCAM, Angela Webster of the

Lotte and John Hecht Memorial

Foundation, Matthew Fritts of the

Samueli Institute, and Dr. Gail

Mallory of the Oncology Nursing

Society Foundation.

[e “Research Basics and Training

Opportunities for CAM

Practitioners” breakout session was

chaired by Dr. Drisko with help from

Dr. Block and Dr. Charlotte

Gyllenhaal of the Block Center of

Integrative [erapies, as well as

Pamela Miles.

In between these breakouts,

participants had the opportunity to

present their cancer CAM research

projects or details about their CAM

practices during the conference’s two

from previous page

2
A Conversation with:

Staff Scientist, Cancer and Inflammation Program

Laboratory of Molecular Immunoregulation

Center for Cancer Research

O.M. Zack Howard, Ph.D.

poster sessions. [is gave people the

opportunity to interact, learn about

other projects in the field, and

possibly begin planting seeds for

future collaborations.

“Collaboration alone invites

possibilities,” said Elizabeth Warson,

a professor in the Graduate Art

[erapy Program at Eastern Virginia

Medical School. “As I presented my

poster (art therapy workshops for

American Indian cancer survivors)

for an audience that appeared to be

uninformed about art therapy, I

began to realize that although the

language may be a bit different, we

shared similar ideas.”

Overall, the conference allowed

participants to learn that effective

communication is a skill needed to

develop successful projects. [e

conference also put some

misconceptions to rest about CAM

practitioners and cancer researchers

and gave everyone a chance to

network with their peers to hopefully

facilitate future collaborations.

“It was the most constructive cancer

CAM conference I've attended to

date,” said Heather Greenlee, a

naturopathic physician and assistant

professor at the Mailman School of

Public Health, Columbia University.

“I think this was because the focus was

on...doing good science, working in

collaborative relationships, and

keeping an open mind to what CAM

may or may not do.” ❧

3

Dr. O.M. Zack Howard

Q: What projects are you

currently working on?

I work on tumor immunology. [at

is a fancy way of saying I’d like to

find out how an individual’s immune

system gets hijacked by a tumor.

Currently, I’m pursuing projects

related to CAM. We are looking at

an inflammatory breast tumor model

called 4T1. It’s a mouse tumor that is

transplanted into another mouse and

induces a cell type called a myeloid

immunosuppressive cell – or MIC –

that suppresses the immune system.

[ese MICs have a particular

phenotype, and they cause T-cells –

which should kill the tumors by any

number of mechanisms – to stop

proliferating and to become nonfunctional. [e MICs do some other

interesting things. [ey produce

prostaglandins that cause a lot of

physiological effects downstream

ranging from pain to initiating a

general inflammatory response.

MICs are very potent inhibitors of

the immune system in tumor bearing

individuals.

[e CAM modality that we’re

studying at the moment involves

Sheng Qi Formula (SQF), a Chinese

herbal decoction that is commonly

used in China to decrease the side

effects of chemotherapy and as a

stand-alone therapy. It’s a hot water

extract of two plant roots. SQF has a

potent inhibitory effect on MIC

number and function.

Q: Is SQF a traditional

Chinese medicine (TCM)?

It is based upon TCM. [e original

formula was an extract of milkweed

vetch root and the other component

is Chinese ginseng root. [e SQF

concoction is delivered orally to the

animals and to Chinese patients. In

China, it is used to decrease the side

effects of chemotherapy such as

cisplatin and drugs of that nature continued on next page

To view sessions from OCCAM’s Cancer Researchers and CAM Practitioners: Fostering Collaborations Advancing the

Science conference, visit the OCCAM’s Web site at www.cancer.gov/cam/news/conference2007.html.

that are used to treat late-stage lung

and other cancers.

In China, the SQF concoction is also

believed to cause an enhancement of

the chemotherapeutic effects in

patients. We have not yet seen that

effect in the mice, but we probably

chose the wrong model for the initial

testing. We have tested SQF in

combination with taxol in this

inflammatory breast cancer model.

Because it is an inflammatory breast

cancer, taxol is not the most

efficacious therapy. We will repeat

this study probably at the end of

February 2008 with a different

chemotherapeutic agent gemcitabine

that will probably be more

efficacious.
We’ve accomplished two things in

the current study of SQF. First, we

have a verification of the efficacy of

this TCM agent in a mouse model.

Second, we have identified the

agent’s immune effect in this model,

and that effect is to reduce the level

of MICs. Following implantation of

the 4T1 tumor, the MIC levels in a

mouse can go up by 70%. [e SQF

formula can decrease MICs by at

least one-half the elevated levels after

implantation. SQF treatment

reduced the tumor volume by 30%

at 21 days following 4T1

implantation. So we have both an

immunological and a therapeutic

effect. We think we’re heading in the

right direction.

Q: How did you become

interested in CAM?

Over the years, I started looking at

ethno-botanicals that had antiinflammatory activity. We were

looking to inhibit chemokine

receptors. Back then, the

pharmaceutical companies just

ignored chemokine receptors. [e

companies were just interested in

inflammation. [ey had COX-2

inhibitors, so they didn’t care about

new ethno-botanicals. Actually, that’s

not a bad approach in some cases,

because it’s a regulatory circle. [e

COX-2 inhibitors suppress

chemokine receptors, and if you

suppress chemokine receptors, you

don’t get cells migrating into other

sites in the body as occurs with

inflammation.

I searched for a source for natural

products whose effects were specific

to the chemokine receptors. It’s

obvious that mankind over a period

of thousands of years has evolved

side-by-side with local environments.

[e ethno-botanicals found and used

during the long histories of

traditional medicines have given us

things as obvious as aspirin and less

obvious things such as Shikonin.

Shikonin is the Asian version of

aspirin. It has almost the same profile

of efficacy as aspirin.

We looked at these natural products

for a number of years. Eventually,

“Big Pharma” got involved in

research on finding chemokine

antagonists, and they took the

“rational drug development

approach”. [ey have identified some

things that are actually efficacious in

animal models. A few of these agents

have also made it to human testing.

Basically, the question of whether

chemokines are a good target has

been addressed, and the answer is

“yes”.

[e answer is less clear about

whether chemokine-antagonists can

be used to prevent or treat cancer.

However, the initial data suggest that

some of the chemokines are

intimately involved in the

progression and survival of individual

cancer cells. At that point, we

decided that as tumor immunologists

maybe we need to look and see if

there is a way to use the same ethnobotanicals in TCM for regulating

tumors.

Q: Do you see any specific

future research opportunities

in TCM or any other kinds of

CAM interventions?

I’m really excited about our SQF

research. I think this program still

has another 5-10 years to run,

because we don’t really understand

the role of the MICs.

Regarding the field of CAM, we

barely understand the mechanisms

for many interventions. [at’s not

unusual for Western medicine either.

For example, I recently attended a

seminar on vaccine research. Vaccines

in this country have been the focus

of empirical and hypothesis-driven

research since 1893. Despite that, the

scientist leading the recent seminar

admitted that we still don’t

understand the basic mechanisms of

how they work!

I think we’re going to learn a lot

about the way the human body

works by investigating the use of

these CAM approaches. In addition,

in recent years we went from being

very isolated from these traditional

Eastern medicines to now being

exposed to TCM and being able to

mix and match CAM with Western

medicine. If we don’t understand

what we’re doing – and we don’t – we

will have innumerable, unfavorable

effects.

For example, I was at a meeting

earlier this year where one of the

presentations was about a dietary

supplement that is available in a

popular nutrition store and is

reported to have a positive effect in

women. [e researchers gave it to

male rats with prostate cancer in a

controlled system and discovered the

agent made the prostate cancer

worse! [at’s just one example of the

necessity of fully understanding

when and to whom a CAM therapy

should be given; this knowledge will

give us a better understanding of

how CAM therapies interact with

each other and in combination with

Western medicines. I think it is

going to take us 25-50 years of

additional research to begin to figure

it out. All of that research and

experience is going to benefit

humanity, because it’s going to allow

us to better understand our bodies

and ourselves.

For more information on

Dr. Howard, please visit

http://ccr.cancer.gov/

staff/staff.asp?profileid=6249. ❧

4

from previous page
News from the Field

In the Winter 2007 issue of NCI

CAM News, OCCAM announced

that the first NCI T32 training grant

in integrative oncology research was

awarded to Memorial SloanKettering Cancer Center (MSKCC).

[e Integrative Medicine service at

MSKCC is now inviting applications

for its fellowship in integrative

oncology. [is 2 or 3-year NCI/NIH

fellowship program will teach clinical

and research skills. An applicant

must be a U.S citizen and have a

medical degree. Board Certified/

Board Eligible internists,

anesthesiologists, oncologists, pain

and palliative care physicians, or

specialists in other related areas are

invited to apply. [is program will

develop the future leaders in

complementary therapies and

botanicals research in oncology.

Applicants must intend to pursue

academic work following completion

of the fellowship.

To apply, please submit a letter of

interest and curriculum vitae to:

5

Applications Invited for MSKCC Integrative Oncology Fellowship

Dr. Barrie Cassileth

Memorial Sloan-Kettering Cancer

Center

Integrative Medicine Service

1429 First Avenue

New York, NY 10021

Please see related story in NCI CAM

News, Winter 2007, Vol. 2, Issue 1 at

http://www.cancer.gov/cam/newsletter/

2007-winter/home.html.

Laboratory experiments show that an

extract of the skin of muscadine

grapes can inhibit growth of prostate

cancer cells in the laboratory.

Investigators from NCI and their

research partners also show that

muscadine grape skin extract

(MSKE) does not contain significant

amounts of resveratrol, another grape

skin component that has been widely

studied and shown to be of potential

benefit in preventing prostate cancer

growth. [e results appear in the

September 1, 2007, issue of Cancer

Research.

Using a series of human prostate

cancer cells, representing different

stages of prostate cancer progression,

the researchers showed that MSKE

significantly inhibits the growth of

cancerous, but not normal, prostate

cells, primarily by inducing a process

called apoptosis, or programmed cell

death. Programmed cell death is one

of the mechanisms the body uses to

rid itself of cells with unrepaired

genetic damage before those cells can

duplicate themselves. In contrast,

resveratrol seems to act by blocking

the cell cycle, a sequence of steps that

a cell passes through when it grows

and divides into two identical cells.

Both mechanisms are used by the

body to prevent the development of

cancer.

According to Jeffrey E. Green, M.D.,

chief of the Transgenic Oncogenesis

and Genomics Section in NCI’s

Center for Cancer Research (CCR),

“[ese results show that MSKE may

have potent antitumor activities in

the lab that differ from the effects of

resveratrol. Further studies of MSKE

will be necessary to determine if this

extract has potential as a chemopreventive or therapeutic agent.”

[e fact that all of the cells studied,

which cover the different stages of

prostate cancer tumor progression,

responded to MSKE suggests that

the active compounds in this extract

potentially may inhibit tumor

development at very early stages.

[e muscadine grape (Vitis

rotundifolia) is distinct from the

more common red grapes used to

produce red wines, a major source of

resveratrol. [e chemical

constituents of muscadine grapes

NCI Intramural Program Finds Grape Skin May Prevent Prostate Cancer

NCI press release date August 31, 2007

http://www.cancer.gov/newscenter/pressreleases/ProstateGrapeMuscadine

differ from most other grape

varieties, as they are richer in

chemicals called anthocyanins.

Anthocyanins, which produce the

red and purple colors of the grapes,

have strong antioxidant activity and

have shown several antitumor effects,

continued on next page

Carl Hunter @ USDA-NRCS

PLANTS Database / USDA SCS.

1991. Southern wetland flora: Field

office guide to plant species. South

National Technical Center, Fort

Worth.
including inhibition of DNA

synthesis in breast cancer cells, of

blood vessel growth in some tumors,

and of enzymes involved in tumor

spread. Muscadine grapes can be

found growing wild from Delaware

to the Gulf of Mexico and westward

from Missouri to Texas.

While previous studies suggested that

anthocyanins might suppress the

cancer process, no rigorous study of

the mechanisms underlying these

effects has yet been done.

Resveratrol, by contrast, has been

widely examined. Although earlier

studies showed that it can induce

programmed cell death in prostate

cancer cells, resveratrol did not

significantly induce cell death in the

prostate cell model system used for

this muscadine study. [e results of

this study suggest that resveratrol

may activate different antitumor

mechanisms than MSKE.

Even though MSKE had significant

inhibitory effects on the prostate

cancer cells studied, it did not alter

the growth rate of the normal human

prostate cells in the lab, which served

as controls. Ongoing studies of

MSKE in animals will help to

determine the underlying

6

Inhibition of prostate cancer growth by muscadine grape skin extract and resveratrol through distinct mechanisms. Hudson TS,

Hartle DK, Hursting SD, Nunez NP, Wang TTY, Young, HA, Arany P, and Green JE. Cancer Res. 2007; 67(17).

Funding Opportunities

NCI Invites Investigators to Study Diet-induced Changes and Colon Cancer

[e National Cancer Institute

currently accepts grant applications

in response to two program

announcements (PA) both titled

“Diet-Induced Changes in

Inflammation as Determinants of

Colon Cancer.” [e first

announcement PA-06-283 uses the

R21 grant mechanism, and the

second PA-07-186 uses the R01

mechanism. [e goal of both PAs is

to foster innovative research that will

identify and characterize dietinduced changes in inflammation

and colon cancer risk.

[e increased risk of developing

colon cancer in patients with

ulcerative colitis and the observed

benefits of anti-inflammatory drugs

in retarding intestinal tumors provide

rather compelling evidence that

inflammation is involved with cancer

at this site. Several epidemiological

and preclinical studies reveal that

specific bioactive food components

can suppress colonic inflammation as

well as reduce colon cancer risk.

Nevertheless, it remains unclear

whether these diet-induced shifts in

the inflammatory process account for

their antitumorigenic properties. [e

lack of mechanistic information serves

as the basis for this funding

opportunity.

Specific goals of these initiatives are as

follows:

■ identify and characterize dietinduced changes in anti- and

proinflammatory mediators

that modulate colon cancer

risk,

■ define genetic polymorphisms

that modify the response to

specific bioactive food

components with regard to

colon cancer inhibition, and

■ unravel the physiological

effectiveness of dietary

components in terms of

concentration, activity,

duration of exposure, degree

of stability, chemical forms,

and binding affinity to

receptors in inflammatory

colonocytes.

Possible research topics include, but

are not limited to, the following

examples:

■ Examination of any

association(s) between the

inhibition of proinflammatory mediators (e.g.,

TNF-a, NF-kB) with the

efficacy of resveratrol and

curcumin and colon cancer

cell growth rates;

■ Evaluation of whether antiinflammatory mediators (e.g.,

TGF-b) might account for the

effect of dietary butyrate on

colon tumor growth

inhibition;

mechanisms of MSKE's inhibitory

effects in prostate cancer cells. [e

researchers hope that the lab effects

of MSKE will be reproducible in

testing on cancerous and normal

prostate cells in animals. Should

MSKE move on to trials in humans,

Green says that since “muscadine

grape products, including grape juice

and grape wine, have been used in

human studies without reported side

effects, they may be relatively safe for

use in clinical trials.”

For more information on Dr. Green’s

research at NCI, please go to

http://ccr.cancer.gov/staff/

staff.asp?profileid=13662. ❧

from previous page
7

■ Evaluation of whether

polymorphisms in anti- or

proinflammatory genes might

explain the differential

responsiveness among

individuals to dietary n-3 fatty

acids with regard to colon

cancer inhibition;

■ Examination of whether the

modulation of reactive oxygen

species (ROS) and/or reactive

nitrogen species (RNS) might

explain possible associations of

green tea polyphenols and

selenium with reductions in

colon cancer incidence; and

■ Examination of whether the

production of prostaglandin

E2 (PGE2) and/or nitric oxide

(NO) might be influenced by

dietary conjugated linoleic

acid and/or associated with

colon cancer risk.

[e expiration date for both PAs is

September 8, 2008. Applications

must be submitted electronically

through Grants.gov

(www.grants.gov) using the SF424

Research and Related (R&R) forms

and the SF424 (R&R) Application

Guide.

[e Bernard Osher Foundation/NCCAM CAM Practitioner Research

Career Development Award (K01) PA-07-003 01/03/2010

Basic and Preclinical Research on Complementary and Alternative

Medicine (R01) & (R21)

PA-07-007

PA-06-315 09/02/2008

Pathogenesis and Treatment of Lymphedema and Lymphatic Diseases (R01) PA-07-165 12/31/2009

Prioritizing Molecular Targets for Cancer Prevention with Nutritional

Combinations (R01) PA-07-100 11/02/2009

Mechanisms, Models, Measurement, & Management in Pain Research

(R01) (R03) & (R21)

PA-06-544

PA-06-543

PA-06-542

09/02/2009

NCCAM-Exploratory /Developmental Grant for Clinical Studies of

Complementary and Alternative Medicine (R21) PA-06-510 09/02/2008

Diet, Epigenetic Events, and Cancer Prevention (R01) (R03) & (R21)

PA-07-175

PA-06-414

PA-06-413

09/02/2009

Studies of Energy Balance and Cancer in Humans (R01) & (R21) PA-06-404

PA-06-405 05/09/2009

Exploratory Grants for Behavioral Research in Cancer Control (R21) PA-06-351 05/02/2009

Methodology and Measurement in the Behavioral and Social Sciences

(R01) (R03) & (R21)

PA-07-060

PA-06-344

PA-06-343

05/02/2008

Developmental Projects in Complementary Approaches to Cancer Care (R21) PA-06-400 02/02/2009

Clinical Cancer [erapy and Prevention Research (R01) PA-07-356 05/08/2010

PA Title PA Number Expires

Active Program Announcements

[e Office of Cancer Complementary and Alternative Medicine offers a list of active program announcements that are

relevant to cancer CAM on its Web site. For more information on the announcements below, please visit

www.cancer.gov/cam/research_funding_pa.html.

For more information on these PAs,

please visit www.cancer.gov/cam/

research_funding_pa.html.

Contact Information

Office of Cancer Complementary

and Alternative Medicine

6116 Executive Boulevard

Suite 609

Bethesda, Maryland 20892

ncioccam-r@mail.nih.gov

http://cancer.gov/cam
8

Coenzyme Q10 (also called CoQ10)

– a naturally occurring compound

that helps produce energy in the

body’s cells – is being tested for use

in relieving fatigue symptoms in

breast cancer patients who are

undergoing aggressive chemotherapy

after surgery.

“We have been interested in the

problem of cancer-related fatigue for

nearly a decade,” noted the study’s

Principal Investigator Glenn Lesser,

M.D., Wake Forest University

Comprehensive Cancer Center.

Wake Forest Cancer Center is

designated as a research base for

NCI’s Community Clinical

Oncology Program (CCOP),

focusing on research into symptom

management – fatigue, anorexia, and

cognitive dysfunction – and cancer

prevention and control.

CoQ10 has been previously tested in

congestive heart failure and shown to

improve cardiac function and

improve some of the symptoms

experienced with advanced stages of

heart failure, including “cardiac

fatigue,” Dr. Lesser explained. In

addition, small studies have

produced data showing that CoQ10

reduces heart damage caused by the

anticancer drug doxorubicin.

However, until now there have been

no well-designed clinical trials

involving large numbers of cancer

patients. “CoQ10 is also a wellknown agent in the CAM world,”

Dr. Lesser continued. “Cancer

patients can buy it in health food

stores and supermarkets and are

taking this agent for its purported

benefits for fatigue and for other

reasons.”

[e study, which began in 2004, has

enrolled 202 women who were

randomly assigned to receive either

CoQ10 (100 mg) or placebo pills 3

times daily for 24 weeks. Both

groups also received Vitamin E

which increases the absorption of

CoQ10. [e participants underwent

detailed quality-of-life assessments

throughout the study period to

determine levels of fatigue,

depression, and other symptoms.

Dr. Lesser is seeking permission from

NCI to reopen the study to enroll an

additional 36 patients in part to

make up for higher than expected

rates of women dropping out of the

study. Preliminary data indicate the

drop outs were not caused by toxicity

or adverse effects of CoQ10, he

noted. Instead, patients undergoing

aggressive breast cancer treatment

often become overwhelmed and

frustrated and may decide to forgo

the extra burden of an experimental

treatment that may not benefit them,

he said. In addition, nausea

associated with their chemotherapy

sometimes causes patients to cut

back on taking other oral

medications including drugs like

CoQ10.

Research Highlights

considered for funding. However, it

is often useful to touch base with the

responsible program director about

topics not specifically identified as

relevant.

Q: What is the payline?

A: [e payline represents the cutoff,

above which an application will be

funded, as determined by its

scientific review and priority scores.

For the NCI, the payline is

determined by the Institute’s

Executive Committee (EC). [e

payline is established based on the

number of expected applications and

the available funds designated for

competing grants. [is means that

the payline can change throughout

the year as NCI can more accurately

assess the number of incoming

applications and available resources.

[e current payline for RO1’s is 14

percentile.

For further information visit the

following page:

http://deainfo.nci.nih.gov/

grantspolicies/FinalFundLtr.htm. ❧

Coenzyme Q10 Studied for Relief of Fatigue in Breast Cancer

Research Resources

[e Office of Cancer

Complementary and Alternative

Medicine often receives questions

regarding the grant funding process.

To assist investigators, a few of the

more frequently asked questions are

answered below.

Q: Is my project appropriate

for this Funding Opportunity

Announcement (FOA)?

A: [e research objective and the

mechanism of support sections of the

FOA generally explicitly define the

type of research that will be

Cancer CAM Research Grant FAQs
9

C o n t a c t

Now cancer CAM researchers can easily

connect with others in the field. Sign-up

for OCCAM’s free online research

directory and:

• Search for experts in specific areas

of CAM research

• Receive access to research news

and updates

• Discover collaboration

opportunities

• Learn about meetings

and events

• Post job openings

• Connect with the

National Cancer Institute

To join or find out more, please visit:

http://occamdirectory.cancer.gov/

Index.aspx.

Cancer CAM Researcher

Directory

Most participants “were quite

attracted to a study like this using a

natural compound with some

potential or theoretical benefit in

conjunction with their more

standard chemotherapy,” Dr. Lesser

said. If proven effective, CoQ10

“may be an additional strategy to

combat the problem of fatigue in

breast cancer patients,” he added.

For more information on Coenzyme

Q10, please read the PDQ® summary

at www.cancer.gov/templates/

doc.aspx?viewid=0E5B4097-610C4A49-844F-D935F1D7BB07

&version=0.

Phytonutrients Shown to Inhibit Cancer Stem Cells from

Regrowing Tumors

Scientists in NCI’s Center for Cancer

Research (CCR) are finding early

evidence that some phytonutrients –

specifically EGCG, a green tea

extract, and resveratrol, a compound

isolated from grapes and red wine –

can inhibit or eliminate cancer stem

cells (CSCs) which are increasingly

viewed as the driving force behind

relapse and chemotherapy resistance

in many cancers.

A growing body of evidence has

identified CSCs as being the major

cause of tumor progression,

explained William Farrar, Ph.D.,

CCR principal investigator for the

phytonutrient/chemical study which

is supported by OCCAM. CSCs are

distinct from the cancer “progeny

cells” which are created by CSCs and

make up the bulk of most tumors.

Current cancer treatments focus on

destroying the progeny cells “but in

many cases, even after the tumor is

reduced or seemingly eliminated, it

grows back and becomes resistant to

further treatment,” he added. Many

researchers now believe that the

CSCs often survive initial treatment

and act like “evil seeds” that regrow

new, more treatment-resistant

progeny cells.

Dr. Farrar is head of CCR’s Cancer

Stem Cell Section laboratory. One of

the initial challenges faced was due to

the miniscule numbers of CSCs

found in tumors. “[e very first time

we extracted CSCs we came up with

only 280 cells in the sample!” Dr.

Farrar recalled. In contrast, highthroughput screening methods

typically produce millions of progeny

cells for study and analysis. Dr.

Farrar and his colleagues focused first

on developing tools for extracting

and analyzing the small populations

of CSCs from tumors.

“Phytochemicals (plant-derived

compounds) have a long history

demonstrating their cancer

preventive properties,” he continued.

However, the natural compounds

had not been studied specifically for

their effects on CSCs until now.

Dr. Farrar’s lab winnowed down 22

potential phytochemical compounds

“into what I call our short list.” [ey

ultimately decided to first study

EGCG and resveratrol in lab cultures

of CSCs from breast and prostate

cancer tumors and in xenografts of

human CSCs.

“[e good news is our studies

confirm that CSCs are not

invulnerable to treatment as some

have been concerned,” he reported.

Both of the phytochemical

compounds were shown to prevent

proliferation and block tumor

formation by CSCs. [ey were also

effective against cancer progeny cells

and did not trigger drug-resistance

responses in the tumor cells.

In future studies, Dr. Farrar’s lab will

expand its library of phytonutrients

and isolate CSCs to determine the

effectiveness of phytonutrients for

other cancers (i.e., pancreatic, lung,

skin). ❧

C o n n e c t

C

olla

b

o

r

a

t

e
10

[e National Cancer Institute

recently released its second annual

report on CAM activities, NCI’s

Annual Report on Complementary

and Alternative Medicine: Fiscal Year

2006. [e report covers, in detail,

the CAM-related research

achievements and ongoing projects

that NCI supported in fiscal year

2006. In addition to write ups about

extramural and intramural research,

the report highlights the Institute’s

training, conferences,

communications activities, and

contributions to the field of cancer

CAM research made by OCCAM.

Examples of articles in the report

include:

CAM Information

■ Antioxidants and

Chemotherapy: Help or

Hindrance?

■ Studies Suggest Exercise

Improves Colorectal Cancer

Outcomes

■ Tai Chi Chih Effects on

Insomnia Studied in Breast

Cancer Patients

■ Exploring the Role of Cooked

Red Meat in Cancer Risk

Dr. Jeffrey D. White, OCCAM

director, says this about the report,

“Our first report was well-received by

the research community, cancer

advocates, and NCI staff members.

[is year’s report further demonstrates

NCI’s continued efforts in the

emerging field of CAM.”

NCI’s CAM Second Annual Report for Fiscal Year 2006 Now Available

Inaugural NIH Yoga Week Planned for May

[e Office of Cancer

Complementary and Alternative

Medicine will be participating in

NIH’s first annual Yoga Week this

May 19-23, 2008. Highlighting the

science and practice of yoga, this

five-day series of events will serve

NIH employees and the public,

allowing participants to learn about

the benefits of yoga and experience

them first-hand through stretching

and practice.

[e week will include presentations by

leading yoga instructors, lectures by

current NIH grantees conducting

research on yoga, including Dr.

Lorenzo Cohen, director of the

Integrative Medicine Program at [e

University of Texas M.D. Anderson

Cancer Center, and a discussion of

NCI‘s yoga research portfolio

by OCCAM Director Dr.

Jeffrey D. White. Yoga classes

will be taught by local

instructors throughout the

week.

Rachel Permuth-Levine,

Ph.D., MSPH, acting

director for the Office of

Strategic and Innovative

Programs at the National

Heart, Lung, and Blood Institute

(NHLBI), who originated the idea of

NIH Yoga Week explains, “Yoga is a

fun, energizing activity that offers

many health benefits. While people are

more aware of yoga and its benefits,

many people haven’t had the

opportunity to give it a try or explore

the many reasons to incorporate yoga

into their lifestyle.” To PermuthLevine, NIH seemed like a great place

to bring people together to share their

knowledge about yoga, especially since

NIH supports research in this topic

area. “Whether you’re a novice or

experienced student, we encourage

you to learn from and enjoy the

activities during Yoga Week,” says

Permuth-Levine.

Permuth-Levine and her team at

NHLBI have partnered with the

To view this report, please visit the

OCCAM Web site:

www.cancer.gov/cam/attachments/

CAMAnnualReportFY2006.pdf.
11

Meetings

Declaration of International Cooperation for Traditional Chinese Medicine Research

On November 28-29, 2007, the

Ministry of Science and Technology

(MOST) the People’s Republic of

China and other ministries of the

Chinese government in conjunction

with the World Health Organization

held the first “International

Traditional Chinese Medicine

Conference for Cooperation in

Science and Technology” in Beijing,

China. [is conference assembled

over 400 researchers, government

officials, and TCM practitioners

from various countries around the

world to discuss TCM research and

the role it can play in human health

and well-being.

[e main purpose of the conference

was to present and adopt the Beijing

Declaration on the International

Science and Technology Cooperation in

Traditional Chinese Medicine (Beijing

Declaration), a document which

serves as a formal indication of

China’s interest in soliciting support

for international collaboration of

TCM research, product

development, and practice. [e

Beijing Declaration was created as an

activity of the International

Traditional Chinese Medicine

Program for Cooperation in Science

and Technology, a program instituted

by the Chinese government in

August of 2006.

[e opening session of the

conference was given by Vice Premier

of China, Ms. Wu Yi, who

emphasized the need for greater

international collaboration in regards

to TCM theory and development.

Examples of plenary session topics

include the challenges of TCM

research, regulatory and globalization

issues of the TCM industry,

intellectual property rights, and the

progress of acupuncture research.

Also during the conference, the

Preparatory Committee of the

International Expert Board was

formed to establish a group of

experts to help advance the TCM

field through worldwide

collaboration.

OCCAM has identified the

exploration of the pharmacopeia of

traditional medical systems, such as

TCM, for novel anti-cancer

therapeutics as a research priority.

“OCCAM’s presence at this meeting

provided an opportunity to interact

with world leaders in this area and

express NCI’s commitment to

international collaboration,” said

Dr. White.

Evidence-based Complementary and Alternative Medicine Conference for Cancer Advocates

On January 10-11, 2008, the Annie

Appleseed Project brought together

cancer advocates, patients, and CAM

health care professionals for the

conference “Evidence-based

Complementary and Alternative

Medicine”. [e conference, held in

West Palm Beach, Florida, had 178

registered attendees who represented

organizations from across the United

States, Canada, and Australia. [e

meeting featured 21 speakers who

collectively shared their knowledge

and experience on a variety of topics

including cancer CAM research

studies; the history and use of some

CAM therapies; and ended with a

discussion of treatment, integrative

oncology, and advocacy. In addition,

there were 20 exhibitors representing

treatment centers, organizations

offering educational resources, and

manufacturers of natural products.

OCCAM sent two of its staff

members CDR (USPHS) Colleen

Lee, M.S., CRNP, AOCN®, Practice

Assessment Program Coordinator,

and Shea Buckman, M.A.,

Communications and Outreach

Coordinator, to the event. CDR Lee

said of the conference, “I wanted a

more global idea of what patients are

seeking in terms of cancer CAM

information. I also wanted to know

how patients are incorporating these

therapies into the areas of

prevention, treatment, and

supportive care. [e CAM practice

community is highly diverse and

scattered throughout the country at

this time, and the opportunity to

interact with this group provided me

with insight into their approach to

treatment and interest in research.”

[e Annie Appleseed Project hopes

to sponsor another conference in

2009 that will focus on nurses,

dieticians, nutritionists, patients, and

advocates. ❧

Office of Research Services, the

National Center for Complementary

and Alternative Medicine, NCI,

NIH Recreation & Welfare

Association, Weight Watchers

International, International

Association of Yoga [erapists, Inner

Reaches Yoga, and [rive Yoga.

[e kick-off event is on Monday,

May 19 from 11am-1pm at the

Natcher Auditorium (45 Center

Drive; Bethesda, MD). All events are

free and open to the public. For

more information, please visit

http://does.ors.od.nih.gov/fitness/

yogaWeek.htm. ❧
To obtain a copy of this newsletter or for inquiries on

cancer and CAM, please contact

1-800-4-CANCER (1-800-422-6237).

NIH Publication No. 08-6407

May 2008

12

Date Meeting Location OCCAM Staff

Attending

*Indicates that an OCCAM staff member will be at the NCI or OCCAM exhibit booth.

Featured Scientific Meetings

April 25-26, 2008

May 14-18, 2008

May 19-23, 2008

June 6-8, 2008

August 13-16, 2008

September 17-19,

2008

November 20-21,

2008

Shanghai, China

Philadelphia, PA

Bethesda, MD

Sendai, Japan

Phoenix, AZ

Lexington, KY

Atlanta, GA

Dr. Jeffrey D. White

Dr. Dan Xi

CDR (USPHS)

Colleen Lee

Shea Buckman

Shea Buckman

Jennifer Frazier

Dr. Jeffrey D. White

Dr. Jeffrey D. White

Shea Buckman

CDR (USPHS)

Colleen Lee

Shea Buckman

Shea Buckman

Shanghai International

Symposium: Integrative

Oncology Theory, Research,

and Practice

Oncology Nursing Society*

NIH Yoga Week

Annual Congress of Japan

Society for Oriental Medicine

American Association of

Naturopathic Physicians

23rd Annual Convention and

Exposition*

4th International Conference on

Holistic Health and Medicine*

5th International Conference of

the Society for Integrative

Oncology*