Systematic Review of the Integrative Medicine Recommendations for Patients with Pancreatic Cancer
, Manana Gogol 2, Gaya Spolverato 3, Hebatallah Taher 4 and Elie K. Chouillard 1Round 1
Reviewer 1 Report
This is a interesting article on topic that is very important for patients with GI tract cancers/disease. Although may studies investigate the role of diet or dietary components on cancer outcomes, very few articles are written with the dietary and lifestyle changes/recommendations perspective as addressed in this review. There are no major concerns with the current form of this article.
Author Response
Thank you for your kind review.
Reviewer 2 Report
Authors reviewed integrative medicine for pancreatic cancer patients. This subject is very important because there are limitations in current cancer therapies. From integrative medicine, we can make up for the limitations. However there are parts should be revised.
- From thousands of articles, authors chose only 29 studies. Please indicate the criteria of exclusion process.
- Keywords for searching were biased.
- Please follow the MDPI style in manuscript. For example, in line 88 "Diet" should be "3.1. Diet".
- The definition difference of IM, CM, FM should be added in the introduction.
- Tables and figures are needed for systematical organizing of the studies in the same subject.
- Twenty-nine articles are very limited number for review.
Author Response
RESPONSE TO REVIEWER 2:
- From thousands of articles, authors chose only 29 studies. Please indicate the criteria of exclusion process.
Answer: A systematic review was done. PRISMA has now been utilized for the abstract, manuscript and Figures. The review has been submitted to PROSPERO on May 24, 2021 for registration. A figure was provided showing the articles included and excluded.
The protocol for inclusion and exclusion was clarified with Methods now reading:
Search terms and concepts were obtained during a 2-year IM Fellowship. A search was then done on Pubmed (https://pubmed.ncbi.nlm.nih.gov/) with the obtained words and combined with “pancreatic cancer/adenocarcinoma” for articles published over the last 10-years. All articles discussing complementary medicine (CM), functional medicine (FM) and holistic medicine were excluded. When available, this article reviewed the primary peer-reviewed published literature regarding recommendations for diet modification, lifestyle changes and oral supplementation for patients with pancreatic cancer according to the principles of IM. When unavailable, secondary literature consisting of meta-analyses was utilized. This systematic review was submitted to PROSPERO, however, it is currently awaiting approval. The PRISMA checklist for abstract (Figure 1) and manuscript design (Figure 2) was used for the drafting of this manuscript.
Articles on Traditional Chinese Medicine and Ayurvedic Medicine were excluded because although IM Fellows are exposed to the basics of these practices, these therapies should only be administered by doctors licensed in these respective fields and not IM doctors. The search was then repeated on google scholar.
2. Keywords for searching were biased.
Answer: The keywords were biased, but incorporated from topics learned during a 2 year Integrative Medicine Fellowship. Additional terms found during the review of the literature were included. As the literature on Integrative Medicine (IM) is limited, we hope that articles like this can begin to create a more robust literature for IM.
3. Please follow the MDPI style in manuscript. For example, in line 88 "Diet" should be "3.1. Diet".
Answer: The style was modified to better match the MDPI style, thank you.
4. The definition difference of IM, CM, FM should be added in the introduction.
Answer: The enhanced differences of CM and HM were added to the introduction, and the introduction now has this added to the end of the first paragraph:
“Additionally, unlike IM, CM and FM advocate for the use of pharmaceuticals such as Non-steroidal anti-inflammatories for off-label uses in the belief that these medications can potentially reduce the risk of carcinogenesis. Furthermore, FM advocates for the use of intravenous vitamin therapy. Quite literally, IM “integrates” all “medicine” that is evidence-based.”
5. Tables and figures are needed for systematical organizing of the studies in the same subject.
Answer: Please now see Table 1 and Figure 1
6. Twenty-nine articles are very limited number for review.
Answer: Now 133 articles were identified and reviewed. After exclusion, 50 articles were included in the final review. The Results and Discussion were drastically revised with more than 1,600 more words added to the manuscript.
Round 2
Reviewer 2 Report
Authors revised the manuscript carefully.
Although the study have some limitations, the topic is interesting and worth to be published after minor revision.
- There should be space between: "and10" in line 199, "3,200mg" in line 179
