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14th October, 2009
European Survey on Standards of Care in paediatric oncology centres. J. R. Kowalczyk, M. Samardakiewicz, K. Pritchard-Jones, R. Ladenstein, S. Essiaf, E. Fitzgerald, G. Petrarulo, G. Vassal - EJC , Volume 61, pp 11-19
8th December, 2014
The purpose of this website is to provide good and clear information about the long-term effects of childhood cancer and to refer to the various late-effects outpatient clinics (LATER outpatient clinics) that exist in the Netherlands.
8th September, 2015
Cancer in young people is rare, but it is still a major health issue in Europe. Each year, more than 6,000 young people in Europe die of cancer. There are more than 300,000 European childhood cancer survivors (in 2020, they will be nearly half a million): two-thirds of them have some late side effects of treatment, that are severe and impact on the daily life of half of those affected.
A placebo is a harmless, inactive substance or treatment given to a patient, often used in clinical trials as a control group. It’s designed to resemble actual medication in appearance and administration, without therapeutic effects. Its aim is to measure the impact of belief on health outcomes and to isolate the efficacy of the actual treatment under consideration.
Within the extensive world of healthcare and clinical studies, the term ‘placebo’ is frequently used, yet often misunderstood. Placebo treatments, their appurtenant effects and their utilisations within the spectrum of medicine present many intriguing aspects of human physiology and psychology. This article attempts to untangle the intricacies of placebos, their types, how they work, their role in clinical trials, and their implications on healthcare, supplemented by a brief FAQ section including common queries on the subject.
A placebo, derived from the Latin word meaning ‘I shall please’, is a pharmaceutically inert treatment that may induce mental or physical benefits to the patient. In most cases, placebos don’t have any therapeutic value. Nevertheless, patients might perceive an improvement in their health condition owing to their beliefs or expectations on the treatment effects.
Placebo usage can be traced back to ancient times when physicians used to speak to their patients in soothing tones or prescribed simple and essentially ineffectual treatments to ease their anxiety and discomfort. Over time, placebos were gradually recognized and accepted as an integral part of various clinical trials and research studies.
The placebo effect is a profound psychological reaction occurring in which a placebo treatment leads to actual, beneficial effects on a patient’s health condition. It is a manifestation of the mind’s ability to influence the body’s functioning, often as a result of the patient’s faith in the treatment or the healthcare provider.
Research on the placebo effect delineates a strong correlation between the individual’s psychological state and the body’s response to treatments. Studies show the brain releasing endorphins, the body’s natural painkillers, when a patient takes a placebo, thus explaining the often, surprising effectiveness of placebo treatments.
Inert placebos are substances without active pharmacological properties, typically used as controls in clinical trials. They are commonly made from sugar, saline solution, or starch.
On the contrary, active placebos do have pharmacologically active properties but are ineffective for the condition under study. Used to mimic the side effects of the actual drug being studied, they aim to ensure that the patient’s knowledge of potential side effects doesn’t influence the perceived effectiveness of the treatment.
Verum placebos are genuine treatments used in unblinding studies to compare the effects side by side with the treatment under examination.
Functional Magnetic Resonance Imaging (fMRI) offers an avenue for investigating neural correlates of the placebo effect. It records changes in brain activity in response to placebos, illuminating the neural pathways involved in the placebo effect.
Placebos play a crucial role in clinical trials, acting as a control group to assess the effectiveness and side effects of a new treatment or drug.
In placebo-controlled studies, participants are randomly assigned to receive either the treatment being studied or a placebo. An improvement in the placebo group, contrasted with the treatment group, provides an evaluation of the effectiveness of the therapy studied.
Despite its significance, placebo usage in studies also invites ethical debates, particularly when an effective treatment already exists for the condition being studied. Ensuring voluntary and informed consent from the participant is paramount before using placebos.
The placebo effect can significantly affect patient care. A positive interaction with the healthcare provider can imitate the placebo effect, amplifying the perceived effectiveness of a treatment.
Case studies further testify to the potency of placebos. Quite often, patients experience significant improvements even when unknowingly subjected to placebo treatments, thus highlighting the strength of mind over matter.
Similar to the placebo effect, the nocebo effect happens when a patient’s negative expectations lead to deteriorating symptoms. Awareness and careful management of both placebo and nocebo effects are important for healthcare providers.
In the evolvement of patient-centric healthcare, the understanding and strategic use of the placebo effect will play a vital role. While respecting ethical boundaries, healthcare providers can harness this to improve patient satisfaction and overall health outcomes.
Deeper comprehension of placebos’ scope and limitations will help ensure their appropriate usage. They are powerful tools in the hands of science but are not replacements for robust evidence-based treatments.
The world of placebos and the placebo effect, undoubtedly fascinating, continues to be an area of extensive exploration and research, bearing the potential to revolutionize our understanding of medicine’s interplay with the human mind.
Placebos can be beneficial as they rely on the power of suggestion and mind-body interaction. They help manage symptoms, especially those linked to stress and anxiety. However, a key drawback is that it can undermine patients’ trust if they discover they’ve been given a placebo without their knowledge.
The placebo effect can complicate the interpretation of trial results, as improvements may be attributable to the placebo effect rather than the intervention itself.
It depends on the specific context. If a placebo is administered without deceiving the patient and does not deprive them of necessary treatment, it can be ethical.
Inert, active, and verum placebos are commonly used in research. The type of placebo used depends on the nature of the trial and the condition being studied.
The patient’s belief in the treatment’s efficacy can significantly enhance the placebo effect. The psychological state directly influences physical health.
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