Article 1
Quimby, Erin L. "The use of herbal therapies in pediatric oncology patients: treating symptoms of cancer and side effects of standard therapies."Journal of
Pediatric Oncology Nursing Jan.-Feb. 2007: 35+. Academic OneFile. Web. 20 Nov. 2014.

Summary: Erin L. Quimby graduated from the University of Pennsylvania with her Masters of Science in Nursing. She currently works for Penn State as a Nurse Practitioner caring for pediatric oncology patients. Throughout the article she explains many aspects of using herbal therapies along with chemotherapy. Quimby gives us positive and negative notations on these affects. According to Quimby, the use of complementary and alternative medicine (CAM) has increased in the pediatric oncology community. CAM is the use of herbal therapies to minimize the side effects of chemotherapy. Complementary and alternative medicine is commonly used, but is not always discussed with the health care provider. Not consulting a health care provider before using prescription drugs, with non-prescription drugs can be very harmful towards a child. According to Quimby “a study conducted by Friedman et al. (1997) showed that 64% of children with cancer use some type of CAM, where only 22% of them told their health care provider. These results suggested that families with chronically ill children are more likely to disclose information about herbal therapy usage in their homes. “ When asked by a health care provider, parents often times only list prescribed medications rather than the herbal supplements they give their child without consultation. This could lead to problems concerning drug interactions between herbal supplements and chemotherapy pharmaceuticals. Parents are the initial prescribers of herbal supplements. Parents tend to collect their information from sources such as friends, family members, web searches, and television. Although the source may seem trustworthy and knowledgeable, a parent may not be able to determine what is researched based versus opinion based. These sources could lead to false information potentially causing harm to the child. Three of the most common herbs used to minimize side effects of chemotherapy are ginger, St. Johns wort, and Echinacea. However, Quimby implied that ginger is the most frequently used of all. Ginger is used to treat nausea and vomiting. Components of ginger stimulate serotonin receptors making it possible for ginger to act on the central nervous system. The direct result of this is action in the gastrointestinal track, preventing the acid movement that causes vomiting. Pediatric patients undergoing chemotherapy frequently suffer from depression and anxiety. St. Johns wort is used to help minimize depression and anxiety in pediatric patients. St. Johns wort has proved to be a very effective herbal supplement not only being useful with chemotherapy patients but also patients with severe depression. A random study also showed that St. Johns wort is more effective than fluoxetine, a common depression supplement, when treating patients with severe depression. Echinacea is most commonly used to stimulate the immune system. Very little research has been conducted to find the exact effect it has on oncology patients however, Echinacea has been proven to help symptoms of the common cold in pediatric oncology patients. Although all three herbal supplements have shown positive results in minimizing side effects of chemotherapy, combining these herbal supplements with certain pharmaceuticals could cause a negative effect. For instance interaction between ginger and anticoagulants could be dangerous due to excessive anti-clotting levels throughout the bloodstream. St. Johns wort has also been proven to interact with hormones, antibiotics, and chemotherapeutic agents placing oncology patients at risk. Long-term use of Echinacea may suppress the immune system longer once finished with chemotherapy pharmaceuticals. Quimby states that it is of the utmost importance to insure that families are aware of the good and bad effects of combining herbal therapies with chemotherapy pharmaceuticals. Health care providers should also be well educated about all of their pharmaceuticals and how they interact with certain herbs. Education of the health care provider and the family is critical when dealing with the child’s heath.

Article 2
Brouillard, Daniela, et al. "Perceptions and experiences of patients receiving oral chemotherapy." Clinical Journal of Oncology Nursing Aug. 2010: 447+. Academic OneFile. Web. 29 Nov. 2014.

Summary: Daniela Brouillard studied at Harvard University. She is currently working as an administrative specialist at the Dana Farber Cancer Institute in Boston Massachusetts. Throughout the article she discuss feelings and questions many families have about their child taking Oral Chemotherapy. She also explains the importance of education throughout the health system. Studies were conducted to gather information determining the quality of care given to pediatric oncology patients and their families. The researchers gathered several people who had been part of a targeted oral chemotherapy program. When studies began the participants were all supplied with parking, dinner, and $100 compensation. Researchers found that 87% of the participants had very strong trust and confidence in their doctor. Participants also reported being very satisfied with oral chemotherapy in general. Many parents said they liked oral chemotherapy because their child could take it at home, meaning less frequent trips to and from the hospital. However, taking the medication at home came with some problems as well. Some parents reported not being comfortable with the responsibility of medication, not only having to be a parent to their child but their caregiver as well. Many parents also said that directions given by the doctor differed from the pharmacist. Some parents complained that when picking up the medication from the pharmacist they did not have enough; therefore they would have to make another trip to get the proper dosage. Although many parents were satisfied with oral chemotherapy in general they said the main concern lied within the pharmacy. Many parents stated that the pharmacist often times didn’t know how the pharmaceuticals would interact with each other and could not warn the parent of possible side effects. This caused stress on the parent’s part concerning their child’s heath. Many parents were also stressed when health care providers and doctors did not check in. Parents wanted to be sure they were doing everything right and in a timely manner. Parents often times got frustrated when doctors were too busy to respond to their questions, especially questions regarding proper handling precautions of the pharmaceuticals. Parents eventually discovered that handling their child’s pharmaceuticals without using proper precautions could be dangerous for themselves. In conclusion, oral chemotherapy provided some cancer patients with the convenience of using pharmaceuticals in the comfort of ones home. However, users encountered problems with safe and reliable prescribing and monitoring of the pharmaceuticals.

Compare/Contrast: The two articles shared many similarities. First off, both of them discussed confusion between the health care provider and the family. Both had many questions as to what pharmaceuticals could interact with others safely. Many parents were also worried about safety precautions when it came to handling the pharmaceuticals. However, there were many differences between the two articles as well. Article one discussed using herbal supplements to try to minimize side effects of chemotherapy. Article two discussed questions and concerns about taking oral chemotherapy. In article one families often times tried to give minimal information to the health care provider however, in article two, many families were upset because doctors were not curious enough for information.

Analysis: Quimby and Brouillard made many great points. Throughout the articles both authors did a great job of giving evidence and detail to back up their statements. I enjoyed reading both of these essays because I hope to one day find myself in the field of Pediatric Oncology. I learned a lot about how patients feel and questions they may have. I thought that one thing the medical field could improve on is education for their health care providers and the families of the patients. I also believe that more studies should be conducted on the effects of using herbal therapies with chemotherapy pharmaceuticals.