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19 May 2009

Ginger Really Does Ease Nausea



Grandma was right when she recommended ginger for an upset stomach — at least for cancer patients.

A randomized clinical trial has confirmed what many people suspect — that ginger can decrease nausea caused by chemotherapy. The effect goes beyond that provided by standard anti-vomiting drugs.

The results will be presented at the annual meeting of the American Society of Clinical Oncology, which begins May 29 in Orlando, Fla. Abstracts of most of the studies to be presented at the conference were made public Thursday.

The trial, financed by the National Cancer Institute, involved 644 patients, mostly women with breast cancer, who were undergoing chemotherapy at 23 oncology practices in the United States.

All patients took a standard anti-vomiting drug on each day of chemotherapy. They also took specially made capsules containing either extracts of ginger root or a placebo for six days, starting three days before each round of chemotherapy.

They then rated the severity of their nausea four times a day. Those taking the ginger had a reduction of about 45 percent in severity compared with a previous round of chemotherapy in which they did not take the ginger. Those on the placebo had almost no change, said Julie L. Ryan of the University of Rochester, the lead author of the study.

Previous studies have yielded inconsistent results. Dr. Ryan said the new study might have succeeded because the ginger was given before chemotherapy.

The best results corresponded to a quarter to a half teaspoon of ground ginger, she said. She added that either the ginger that comes in spice bottles or the ginger capsules sold in health food stores would probably work.

She was less sure about ginger cookies, ginger tea or ginger ale, though they might if they contained real ginger in the proper amount. “It’s a higher dose than you would get in one cookie,” she said.

Another study showed that a new type of treatment that helps the immune system “see” a tumor helped children with neuroblastoma, a rare but deadly cancer of the nervous system that strikes mainly toddlers.

After two years, about 66 percent of the children who received the new treatment were alive without a relapse of their cancer, compared with 46 percent of those who got only the standard treatment only, according to Dr. Alice Yu of the University of California, San Diego, the lead author. And 86 percent of the children who got the new treatment were alive after two years, compared with 75 percent of those getting the conventional treatment.

However, side effects like pain and fluid accumulation in the body were more severe with the new treatment.

The new therapy is an antibody that blocks the functioning of a molecule called GD2 on the surface of neuroblastoma cells. GD2 is thought to help conceal the tumor from the patient’s immune system, so blocking it with the antibody opens the cancer to attack. In the trial, which was sponsored by the National Cancer Institute and involved 226 children, the antibody was given along with two proteins that stimulated the immune system.

The antibody is being manufactured by the National Cancer Institute, which is looking for company to turn it into a commercial product, Dr. Yu said.

In another study, researchers developed a test that may allow some patients with early-stage colon cancer to forgo chemotherapy.

Nearly 80 percent of patients with Stage 2 colon cancer do not suffer a relapse after surgery, said Dr. David J. Kerr of the University of Oxford, the lead investigator. But doctors cannot identify those patients, so many needlessly undergo chemotherapy, with its costs and side effects, in hopes of keeping the cancer from coming back.

The test measures the activity levels of various genes in the tumor and computes a score showing the risk of recurrence. In the study, the test was performed on tumor samples from a trial that took place some years ago, so it was already known which patients suffered relapses.

About 10 percent of the patients with the lowest scores had a recurrence in three years, Dr. Kerr said, compared with 25 percent for those with the highest scores. He said those at the low risk might not want chemotherapy.

But a separate score aimed at predicting which patients would actually benefit from chemotherapy did not succeed. That could limit usefulness of the test, some analysts have said. So could the fact that the recurrence risk for a high score was not much greater than for a low score.

“Perhaps it is not as good as we might like in predicting who is at very high risk,” said Dr. Richard L. Schilsky, a professor at the University of Chicago who is president of the oncology society.

The test was developed by Genomic Health, a California biotechnology company that sells a similar test called Oncotype Dx for women with breast cancer. The company said it planned to start selling the colon cancer test next year. The price has not been set; the breast cancer test sells for nearly $4,000

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