Kamikihito improves cancer related fatigue by restoring balance between the autonomic nervous system

Abstract

Purpose: Cancer-related fatigue is one of the most prevalent symptoms that patients with cancer experience. We aimed to quantify and mechanistically evaluate the improvement in fatigue related to administration of the Kampo medicine. Experimental Design: Initially, we compared fatigue levels of 37 patients with cancer to a control group of 23 volunteers who had recovered completely from cancer. Fatigue level was estimated by using an autonomic function analyzer. Next, Kamikihito was administered to another 35 patients treated with hormone or antitumor therapy for prostate cancer and with a molecular-targeted drug for metastatic renal cell cancer. Patient fatigue was assessed using a visual analogue fatigue scale, fatigue scale, depression scale and sleepiness scales. Serum levels of derivatives of reactive oxygen species (an index of oxidative stress) and biological antioxidant potential (an index of anti-oxidative activity) were also measured. Result(s): Patients in the cancer treatment group experienced more fatigue compared to the control patients when evaluated by using autonomic function analyzer. The group of 35 patients who were administered Kamikihito showed improved scores for fatigue, depression, and sleepiness; however, visual analogue scale score or Pittsburgh index did not change. Autonomic nervous systembalance evaluated by using the autonomic nerve analyzer was also improved with Kamikihito administration. The Kamikihito group also had significantly lower reactive metabolite levels and significantly higher antioxidant potential. Conclusion(s): Fatigue was more serious in patients with cancer than in control patients. Kamikihito rescued this fatigue and improved anxiety and sleepiness. It restored autonomic nervous system balance and antioxidant function.