Lung Cancer, Gastric Cancer, Esophageal Cancer
Conditions
Keywords
Natural Health Products, Thoracic Cancer, Surgery, Integrative Care, Nutrition, Physical Activity, Psychological Health
Brief summary
Despite enormous advances in thoracic surgery and oncology, two critical issues concern patients undergoing curative-intent surgery for lung, gastric and esophageal cancer: first, a majority (\ 60%) of patients experience minor and major adverse events occurring during and in the days following surgery; second, patients worry about the significant risk of cancer recurrence and mortality months to years after surgery. These issues, combined with side effects of chemotherapy and radiation, have detrimental effects on health-related quality of life (HRQoL). On a deeper level, there is the problem of an ongoing failure to integrate and evaluate the best of what complementary medicine has to offer surgical oncology care. Too many clinical trials focus on single agent therapies, rather than broad multi-faceted individualized and integrative care interventions that are used in real world settings. The Thoracic POISE project has the overarching goal of improving care for thoracic cancer patients by impacting HRQoL, reducing surgical adverse events, prolonging overall survival and pioneering integrative care delivery.
Interventions
DIETARY_SUPPLEMENTCoriolus Versicolor
1.5g twice daily for the duration of the study
DIETARY_SUPPLEMENTTrident SAP 66:33 Lemon
3g once daily for the duration of the study
DIETARY_SUPPLEMENTProbiotic Pro12
12 billion colony forming units daily during the peri-operative period (approximately 1 month pre and post-surgery)
DIETARY_SUPPLEMENTVitamin D3 Drops
1,000 - 10,000 units daily based on serum levels for the duration of the study
DIETARY_SUPPLEMENTProvitalix Pure Whey Protein
1 scoop (22g) once daily during the peri-operative period (approximately 1 month pre and post-surgery) and during any adjuvant chemotherapy and radiation treatments
DIETARY_SUPPLEMENTTheracurmin 2X
1.2g twice daily after the peri-operative period. including during adjuvant chemotherapy and radiation
DIETARY_SUPPLEMENTGreen Tea Extract
700 mg twice daily after the peri-operative period. Will not be given during adjuvant radiation or chemotherapy treatments.
OTHERNutrition Recommendations
Based on the Mediterranean diet and lower glycemic index foods
150 minutes moderate intensity aerobic exercise per week plus the addition of a resistance exercise program on 2 of those days
BEHAVIORALPsychological Recommendations
Activities with the intention of actively improving the participant's mental and emotional health
Sponsors
Ottawa Hospital Research Institute
The Canadian College of Naturopathic Medicine
Lotte & John Hecht Memorial Foundation
The Centre for Health Innovation
University of Ottawa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Adults eligible for complete resection of lung, gastric or esophageal cancer
Exclusion criteria
* Small cell, carcinoid, or gastrointestinal stromal (GIST) tumours * Any wedge resections of lung cancer * History of cancer with active treatment in the last 3 years (not including superficial bladder cancer or non-melanoma skin cancer) * Patients currently receiving care guided by an ND or who have previously seen an ND in the last 3 months * Pregnant or breastfeeding women\* * Any reason which, in the opinion of the Principal Investigator (or delegate), would prevent the subject from participating in the study * Use of an investigational drug or participation in an investigational study within 30 days prior to starting the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant Recruitment Rates | At the end of recruitment (estimated 1 year) | Measured by the number of people who are enrolled in the study compared to the total number screened. |
| Participant Retention Rates | 2 Years | Measured by the number of people who enrol in the study but subsequently withdraw. These numbers will be compared between arms. |
| Cross-over and contamination in the control arm - Supplement usage | 1 Year | Measured by the number of participants in the control arm who use the integrative interventions outlined in the protocol independent of a naturopathic doctor. Information on the number of supplements used and the length of use use will be collected at each standard of care visit. |
| Cross-over and contamination in the control arm - Mediterranean Diet Scores | 1 year | Measured by the number of participants in the control arm who use the integrative interventions outlined in the protocol independent of a naturopathic doctor. Mediterranean diet scores (scale of 0-9) will be calculated in the control group using the Harvard Food Frequency Questionnaire to assess for changes over the 1 year follow up period. |
| Cross-over and contamination in the control arm - Physical Activity levels | 1 Year | Changes in physical activity will be monitored using the International Physical Activity Questionnaire, which is used to calculate total metabolic equivalent task (MET) minutes. |
| Cross-over and contamination in the control arm - Psychological Health Activities | 1 Year | Measured by the number of participants in the control arm who perform activities in which the goal of the activity was to improve mental and emotional health. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Communication | 2 years | Assessing the type and frequency of communications between research staff at The Ottawa Hospital (TOH) and the Centre for Health Innovation (CHI), as well as within TOH and the CHI through number of emails, phone calls, meetings (in-person or virtual) or any other communication method. |
| Natural Killer Cell Function | Enrolment, 2-3 days pre-op, and 6 months and 12 months post surgery | Measured by serum Interferon Gamma Levels |
| Qualitative Experience | 2 years | Evaluate the qualitative experience of care of participants in both arms through semi-structured interviews |
| Inflammatory Response | Enrolment, 2-3 days pre-op, and 1 day, 3-4 weeks, 6 months, and 12 months post-surgery | Measured by serum C-Reactive Protein Levels |
| Neutrophil to Lymphocyte Ratio | Enrolment, 2-3 days pre-op, and 6 months and 12 months post surgery | Measured by collecting a complete blood count with differential and comparing neutrophil and lymphocyte levels |
Countries
Canada
Contacts
CONTACTAnna Fazekas, MA, CCRP
CONTACTMark Legacy, BSc
PRINCIPAL_INVESTIGATORAndrew Seely, MD, PhD, FRCSC
Ottawa Hospital Research Institute
PRINCIPAL_INVESTIGATORDugald Seely, ND, MSc
The Canadian College of Naturopathic Medicine
Outcome results
None listed