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Natural Chemotherapy Support Part One

November 23, 2012 Written by JP    [Font too small?]

The topic of conventional chemotherapy is quite controversial in the natural health community. And, there’s certainly a time and place for people of goodwill to debate the pros and cons of this prevalent form of cancer treatment. However, once the decision has been made to utilize chemotherapy, the goal should then shift to finding safe ways of improving the efficacy and tolerability of this widely used procedure.

When seeking out complementary options for use during chemotherapy, mind-body approaches generally and justifiably top the list. The popularity of these techniques and their general acceptance among “integrative medicine” practitioners is due to a growing body of scientific evidence and the unlikelihood that such therapies will interfere with standard treatment.

In recent months, publications appearing in several peer-reviewed medical journals report that: a) acupuncture reduces chemotherapy-related anxiety, depression and fatigue; b) a supervised exercise routine likewise lessens chemotherapy and cancer-related fatigue; c) Mindfulness-based Art Therapy supports blood flow to the brains of women being treated for breast cancer, leading to a decline in anxiety and a boost in subjective energy levels; d) music therapy along with guided visual imagery is capable of lessening chemotherapeutic anxiety and nausea; e) reflexology, a form of foot massage that utilizes acupressure, improves health-related quality of life and repiratory function in advanced stage cancer patients undergoing chemotherapy; f) a 16 week course of Tai Chi helps to restore cellular and humoral immune function after cancer treatment; g) practicing yoga for 6 weeks supports greater emotional, functional and physical well being in patients newly diagnosed with breast cancer.

In part two of this column, I’ll write about the most current information on dietary supplements which may be useful adjuncts to conventional cancer treatment. In the meantime, please note that the above information is admittedly general in nature. Ideally, every treatment protocol ought to be uniquely tailored for each individual. Doing so can increase the probability of a more positive outcome irrespective of the modality that’s employed. Given this context, mind-body therapies are a very hopeful and promising avenue to consider and discuss with your health care team.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Acupuncture for Cancer-Related Fatigue in Patients w/ Breast Cancer (link)

Study 2 – The Effects of a Six-Week Supervised Multimodal Exercise Intervention (link)

Study 3 – Changes in Cerebral Blood Flow & Anxiety Associated w/ an 8-week(link)

Study 4 – Effects of Music Therapy and Guided Visual Imagery on Chemotherapy (link)

Study 5 – Health-Related Quality-of-Life Outcomes: A Reflexology Trial with (link)

Study 6 – Regular Tai Chi Exercise Decreases the Percentage of Type 2 Cytokine (link)

Study 7 – Pilot Study of Yoga for Breast Cancer Survivors with Poor Quality of Life (link)

Mindfulness Practice Improves Quality of Life During & After Cancer Treatment

Source: Brain Behav Immun. 2008 August; 22(6): 969–981. (link)

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Posted in Alternative Therapies, Exercise, Mental Health

13 Comments & Updates to “Natural Chemotherapy Support Part One”

  1. JP Says:

    Update: More support for the use of acupuncture as an adjunct to chemotherapy.


    Evid Based Complement Alternat Med. 2014;2014:217397. doi: 10.1155/2014/217397. Epub 2014 Jul 24.

    Effects of acupuncture on leucopenia, neutropenia, NK, and B cells in cancer patients: a randomized pilot study.

    Chemotherapy is one of most significant therapeutic approaches to cancer. Immune system functional state is considered a major prognostic and predictive impact on the success of chemotherapy and it has an important role on patients’ psychoemotional state and quality of life. In Chinese medicine, chemotherapy is understood as “toxic cold” that may induce a progressive hypofunctional state of immune system, thus compromising the fast recovery of immunity during chemotherapy. In this study, we performed a standardized acupuncture and moxibustion protocol to enhance immunity in cancer patients undergoing chemotherapy and to assess if the improvement of immunity status correlates with a better psychoemotional state and quality of life.

    Be well!


  2. JP Says:

    Update: A cold cap may protect against chemotherapy-induced hair loss …

    More Info: http://well.blogs.nytimes.com/2015/03/09/keeping-your-hair-in-chemo/?_r=0

    “Hair loss is one of the most obvious side effects of cancer treatment. Now, a growing number of breast cancer patients are freezing their scalps as a way to preserve their hair during chemotherapy.

    The hair-saving treatment, widely used in Europe, requires a specialized frozen cap worn tightly on the head before, during and for a couple hours after a chemotherapy session. The method can be time consuming, expensive and uncomfortable, but numerous women swear by the results.”

    Be well!


  3. JP Says:

    Updated 1/10/16:


    J Pain Symptom Manage. 2015 Dec 22.

    Tai Chi Exercise for Cancer-Related Fatigue in Patients with Lung Cancer Undergoing Chemotherapy: A Randomized Controlled Trial.

    OBJECTIVES: We aimed to assess the effectiveness of Tai Chi exercise for cancer-related fatigue (CRF) in patients with lung cancer undergoing chemotherapy.

    METHODS: We conducted a randomized trial of Tai Chi exercise as compared with low-impact exercise as a control intervention. Exercises were practiced every other day, a one-hour session for 12 weeks for each of the study groups. The primary endpoint was a change in total score of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary endpoints were changes in five subscale scores of the MFSI-SF. All assessments were repeated at three time points, T0: before first course of chemotherapy; T1: before third course of chemotherapy; and T2: at the end of the fourth course of chemotherapy.

    RESULTS: Between January 2012 and December 2014, 96 patients were enrolled in this trial. At six weeks and 12 weeks, the Tai Chi group had a lower MFSI-SF total score compared with the control group (59.5±11.3 vs. 66.8±11.9, P<0.05; 53.3±11.8 vs. 59.3±12.2, P<0.05). At six weeks, the Tai Chi group had lower MFSI-SF general subscale scores (18.1±4.6 vs. 20.4±4.5, P<0.05) and physical subscale scores (17.5±4.4 vs. 19.1±4.5, P<0.05), and higher MFSI-SF vigor subscale scores (14.5±3.3 vs. 11.6±3.4, P<0.05), compared with the control group. But no significant differences were found in emotional subscale (20.2±3.6 vs. 20.0±3.5, P>0.05) and mental subscale (18.2±4.0 vs. 18.9±3.9, P>0.05) scores between the Tai Chi group and the control group. At 12 weeks, the MFSI-SF subscale scores showed the same trends as at six weeks.

    CONCLUSION: Tai Chi is an effective intervention for managing cancer-related fatigue in patients with lung cancer undergoing chemotherapy, especially for decreasing general fatigue and physical fatigue, and increasing vigor.

    Be well!


  4. JP Says:

    Updated 06/26/16:


    PLoS One. 2016 Jun 24;11(6):e0156911.

    Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial.

    OBJECTIVE: Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy.

    METHODS: This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients’ self-reported health related quality of life-HRQoL. Chi-square tests (X2), independent T-tests and Linear Mixed Models were calculated.

    RESULTS: Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.0001) [PRE-POST: Intervention: Pain 4.2(2.5) - 2.5(1.6), Fatigue 27.6(4.1) - 19.3(4.1), HRQoL 54.9(22.7) - 64.5(23), Control: Pain 3.5(1.7) - 4.8(1.5), Fatigue 28.7(4.1) - 32.5(3.8), HRQoL 51.9(22.3)- 41.2(24.1)]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)- 20.6(5.6) compared to the control group (17.8(6.5)- 22.7(5.3) (F = 58.50 p<0.0001). More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02).

    CONCLUSION: This study provided evidence that the combination of GI and PMR can be effective in the management of a cluster of symptoms in cancer patients receiving chemotherapy. These techniques can complement existing management measures to achieve a comprehensive management of this symptom cluster and increase patients HRQoL.

    Be well!


  5. JP Says:

    Updated 08/09/16:


    Holist Nurs Pract. 2016 Sep-Oct;30(5):257-262.

    Effect of Acupressure on Nausea-Vomiting in Patients With Acute Myeloblastic Leukemia.

    The aim of this study was to assess the effect of acupressure, applied at P6 (Neiguan) acupuncture point, on chemotherapy-induced nausea and vomiting in patients with acute myeloblastic leukemia. This was a randomized controlled trial conducted on patients with myeloblastic leukemia. A total of 90 patients, who received the same chemotherapy regimen and antiemetic therapy, were included in the study as 30 patients in the control group, 30 patients in the band group, and 30 patients in the pressure group. Although acupressure was applied by placing wristbands at P6 acupuncture point of both wrists in patients of the band group for totally 4 days, acupressure was applied with the use of finger pressure in patients of the pressure group for totally 4 days. No intervention was made in patients of the control group other than the routine antiemetic therapy. The data of the study were collected by using a questionnaire and nausea-vomiting chart. Severity of nausea-vomiting was assessed by using the visual analog scale on this chart. It was determined that the acupressure band applied to the patients included in the study reduced number and severity of nausea-vomiting (P < .05); however, the acupressure applied with pressure did not affect number and severity of nausea-vomiting (P > .05). It was found that the acupressure band was effective for reducing the chemotherapy-induced nausea and vomiting.

    Be well!


  6. JP Says:

    Updated 08/22/16:


    West J Nurs Res. 2016 Aug 11.

    Effects of Listening to Music on the Comfort of Chemotherapy Patients.

    The symptoms of an illness that requires chemotherapy and the corresponding effects of such treatment exacerbate the pain and discomfort that patients typically experience. Listening to music may help patients cope with chemotherapy symptoms, thereby contributing to their physical ease and well-being. Seventy patients who were receiving treatment at the outpatient chemotherapy unit were invited to participate in this work. During chemotherapy sessions and the week after the sessions, the patients listened to music with headphones. The occurrence of chemotherapy symptoms such as pain, tiredness, nausea, depression, anxiety, drowsiness, lack of appetite, not feeling well, and shortness of breath in the intervention group was statistically significant after listening to music (p < .05). Improvements in total general comfort, as well as physical, psychospiritual, and sociocultural comfort, were also statistically significant (p < .05). These findings indicate that listening to music effectively reduces the severity of chemotherapy symptoms and enhances the comfort of patients receiving the treatment. Be well! JP

  7. JP Says:

    Updated 12/12/16:


    Cancer Nurs. 2016 Dec 5.

    The Effects of Muscle Relaxation and Therapeutic Walking on Depression, Suicidal Ideation, and Quality of Life in Breast Cancer Patients Receiving Chemotherapy.

    BACKGROUND: The suicide rate of cancer patients is high in Taiwan. Breast cancer has a high incidence rate and is the leading cause of cancer in women. There is a lack of research examining breast cancer-related depression, suicidal ideation, and quality of life.

    OBJECTIVES: This study evaluated the effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in breast cancer patients receiving chemotherapy.

    METHODS: An experimental approach was adopted. A group of 87 breast cancer patients receiving chemotherapy were randomly assigned into an experimental group (n = 44) or a control group (n = 43). The subjects in the experimental group received 2 interventions for 3 months. This study used 3 instruments, including (1) the Center for Epidemiological Studies Depression Scale, (2) the Beck Scale for Suicidal Ideation, and (3) the World Health Organization Questionnaire on Quality of Life.

    RESULTS: The results showed no significant difference in any outcome variable in the pretest. The results of the posttest indicated that the 2 groups scored significantly differently only on the Center for Epidemiological Studies Depression Scale (U = 638.00, P < .05). The breast cancer patients who participated in the 3 month muscle relaxation and therapeutic walking interventions had a lower level of depression (RE¯ = 37.00) than those who did not (RC¯ = 51.16). CONCLUSION: The muscle relaxation and therapeutic walking program was effective in the reduction of breast cancer patients' depression. IMPLICATIONS FOR PRACTICE: Nursing staff could teach muscle relaxation and therapeutic walking to breast cancer patients to reduce their depression. Be well! JP

  8. JP Says:

    Updated 12/28/16:


    J Clin Oncol. 2011 May 20;29(15_suppl):9035.

    Effect of Medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in patients with cancer: A randomized controlled trial.

    Background: Cancer patients often experience diminished cognitive function and quality of life (QOL) due to side effects of treatment and the disease symptoms. This study evaluates the effects of Medical Qigong (combination of gentle exercise and meditation) on cognitive function, quality of life and inflammation in cancer patients.

    METHODS: Eighty one cancer patients were randomly assigned to two groups: a control group (n=44) who received usual healthcare, and an intervention group (n=37) who participated in a 10-week Medical Qigong (MQ) program. Self-reported cognitive function was measured by the European Organization for Research and Treatment of Cancer (EORTC-CF) and the Functional Assessment of Cancer Therapy-Cognitive (FACT-Cog). The Functional Assessment of Cancer Therapy- General (FACT-G) was used to measure QOL. C-reactive protein (CRP) was assessed as a biomarker of inflammation.

    RESULTS: The MQ group self-reported significantly improved cognitive function (t51= -2.532, p=0.014, mean difference =7.78) in the EORTC-CF and all the FACT-Cog subscales: perceived cognitive impairment (t43= -2.254, p=0.029, mean difference =4.70), impact of perceived cognitive impairment on QOL (t45= -2.377, p=0.024, mean difference=1.64), and perceived cognitive abilities (t45= -2.229, p=0.031, mean difference =3.61) compared to controls. The MQ group reported significantly improved QOL (t45= -5.715, p<0.001, mean difference=12.66) and had reduced CRP levels (t45= 2.092, p=0.042, mean difference= -0.72) compared to controls.

    CONCLUSIONS: Results suggest that the MQ intervention may have positive effects on self-reported cognitive function, QOL and inflammation. Further research with an objective measure of cognitive function is needed.

    Be well!


  9. JP Says:

    Updated 04/24/17:


    Cancer Nurs. 2017 Apr 20.

    The Preliminary Effects of Massage and Inhalation Aromatherapy on Chemotherapy-Induced Acute Nausea and Vomiting: A Quasi-Randomized Controlled Pilot Trial.

    BACKGROUND: Despite pharmacological treatment, chemotherapy-induced nausea and vomiting (CINV) are observed in patients.

    OBJECTIVE: This quasi-randomized controlled pilot study evaluated the feasibility and preliminary effects of massage and inhalation aromatherapies on chemotherapy-induced acute nausea/vomiting.

    METHODS: Seventy-five patients with breast cancer were randomly grouped into 1 of 3 groups: massage (n = 25), inhalation (n = 25), and control (n = 25). The patients in the massage group received 20-minute aromatherapy foot massage, whereas those in the inhalation group received 3-minute inhalation aromatherapy before their second, third, and fourth chemotherapy cycles. The control group underwent only the routine treatment. A nausea, vomiting, and retching patient follow-up form was used to evaluate nausea severity by visual analog scale and frequency of vomiting and retching.

    RESULTS: The incidence of nausea and retching was significantly higher in the control group than in the other groups in the third and fourth chemotherapy cycles (P < .001). Furthermore, in these 2 cycles, the incidence of nausea and retching was significantly lower in the massage group than in the inhalation group (P < .001). Nausea severity was significantly lower among patients in the massage and inhalation groups than in the control group in all 3 cycles (P < .001). CONCLUSION: Nausea severity was significantly lower in the massage and inhalation aromatherapy groups than in the control group. Nausea and retching incidence was reduced in the aromatherapy groups compared with that in the control group. IMPLICATIONS FOR PRACTICE: Nonpharmacological approaches are recommended for managing CINV. Massage and inhalation aromatherapy seems promising regarding the management of CINV. Be well! JP

  10. JP Says:

    Updated 06/27/17:


    Oncol Nurs Forum. 2017 Jun 16;44(4):E185-E193.

    The Effect of Aromatherapy on Insomnia and Other Common Symptoms Among Patients With Acute Leukemia

    Purpose/Objectives: To determine if the use of aromatherapy improves insomnia and other common symptoms in hospitalized patients with newly diagnosed acute leukemia.

    Design: A randomized, crossover, washout trial.

    Setting: An inpatient acute leukemia unit at the Arthur G. James Cancer Hospital and Richard L. Solove Research Institute of the Wexner Medical Center at Ohio State University in Columbus.

    Sample: 50 patients who were newly diagnosed with acute leukemia and hospitalized to receive their initial four weeks of intensive induction chemotherapy.

    Methods: Patients were offered a choice of three scents to be used during the trial: lavender, peppermint, or chamomile. Each patient was randomized to receive either the chosen aromatherapy intervention or a placebo intervention during alternate weeks, with a washout period in between. Sleep quality and other common symptoms were measured.

    Main Research Variables: Aromatherapy, sleep, insomnia, pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, and well-being.

    Findings: Most patients reported poor quality sleep at baseline, but aromatherapy had a statistically significant positive impact. Improvements were noted in tiredness, drowsiness, lack of appetite, depression, anxiety, and well-being because of aromatherapy.

    Conclusions: Aromatherapy is a viable intervention for improving insomnia and other symptoms commonly experienced by patients with acute leukemia.

    Implications for Nursing: Oncology nurses can employ aromatherapy safely and inexpensively, and with minimal training, as an effective tool in decreasing many symptoms that plague patients with leukemia. Patients can exercise a greater sense of control over their treatment environments through the use of aromatherapy.

    Be well!


  11. JP Says:

    Updated 06/05/18:


    Pain Manag Nurs. 2018 May 15.

    Effects of Reflexology and Progressive Muscle Relaxation on Pain, Fatigue, and Quality of Life during Chemotherapy in Gynecologic Cancer Patients.

    Our aim was to investigate the effect of reflexology and progressive muscle relaxation (PMR) exercises on pain, fatigue, and quality of life (QoL) of gynecologic cancer patients during chemotherapy. Eighty participants were randomly assigned to one of four groups: reflexology, progressive muscle relaxation (PMR) exercises, both (reflexology + PMR), or a control group. Data were collected with a general data collection form, Brief Pain and Fatigue inventories, and Multidimensional Quality-of-Life Scale-Cancer. In reflexology and reflexology + PMR groups, a significant decrease in pain severity and fatigue and an increase in QoL were found (p < .05). In the PMR alone group, pain severity and fatigue decreased significantly (p .05). Reflexology and PMR exercises given to gynecologic cancer patients during chemotherapy were found to decrease pain and fatigue and increase QoL.

    Be well!


  12. JP Says:

    Updated 09/28/18:


    Int J Yoga. 2018 Sep-Dec;11(3):249-254.

    Home-Based Yoga Program for the Patients Suffering from Malignant Lymphoma during Chemotherapy: A Feasibility Study.

    Background: Yoga is proven beneficial in improving quality of life among breast cancer survivors receiving chemotherapy, but its effectiveness in lymphoma patients needs to be explored. As chemotherapy-induced neutropenia is very common among lymphoma patients, they are much prone to infections from the environment. Furthermore, trained yoga instructors are not available in every setting, so there is a need to develop home-based yoga program modules for lymphoma patients receiving chemotherapy.

    Aim: The aim of the study was to explore the feasibility and safety of yogic exercises among lymphoma patients during chemotherapy.

    Subjects and Methods: An interventional, single-arm prepost design study was conducted at a tertiary health-care center. Patients suffering from malignant lymphoma (18-65 years) with Eastern Cooperative Oncology Group performance status from 0 to 2, planned to receive chemotherapy were administered a home-based yoga program over a period of 2 months from the start of chemotherapy. The primary outcome variables were retention rate, acceptance rate, safety, and adherence. Health-related quality of life (HRQOL), fatigue level, overall sleep quality, depression, anxiety level, and pain were also assessed.

    Statistical Analysis: Descriptive statistics was used to see the feasibility and adherence. The paired t-test was used to compare various pre and postintervention outcome measures.

    Results: Fourteen patients (median age: 36 years, range13-65 years) of malignant lymphoma were enrolled in the study. Male-to-female ratio was 9:5. Non-Hodgkin’s lymphoma patients constituted 64%. The recruitment rate was 93%. Favorable retention (100%), acceptability (97%), adherence (78.6%), and no serious adverse events following yoga practice were reported. Improvement was also found in HRQOL, fatigue, sleep, depression, and anxiety. However, it needs further validation in a randomized study.

    Conclusion: Home-based yoga program is safe and feasible among the patients suffering from malignant lymphoma receiving chemotherapy.

    Be well!


  13. JP Says:

    Updated 11/25/18:


    J Nurs Res. 2018 Dec;26(6):411-419.

    Significant Effect of Acupressure in Elevating Blood Stem Cell Factor During Chemotherapy in Patients With Gynecologic Cancer.

    BACKGROUND: Chemotherapy is used mainly to treat and control the progression of gynecological cancer. Bone marrow suppression, one of the adverse side effects of chemotherapy, may decrease immune function, increasing the risk of serious, fatal infections.

    PURPOSE: The aims of this study were to evaluate the effectiveness of noninvasive acupressure in preventing and diminishing chemotherapy-induced myelosuppression in patients with gynecologic cancer and to determine whether this effect is associated with the regulation of the expressions of granulocyte-macrophage colony-stimulating factor and stem cell factor (SCF).

    METHODS: In total, 28 women with gynecological cancer were randomly assigned either to the experimental group (n = 10) or to the control group (n = 18). The experimental group received acupressure of 5-minute duration to the Hegu (LI4), Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), Taixi (K3), Zusanli (ST36), Taichong (LR3), and Baihui (GV20) points, respectively, three times per day for 6 weeks. The control group did not receive the acupressure intervention. The blood count, including white blood cells, platelets, and hemoglobin, and serum levels for SCF and granulocyte-macrophage colony-stimulating factor were assessed before (pretest) and 6 weeks after (posttest) the participants’ first course of chemotherapy.

    RESULTS: At posttest, blood hemoglobin had significantly decreased from (mean ± SD) 11.6 ± 2.2 to 10.8 ±1.6 mg/dl (p = .03) in the control group. However, no significant pretest-posttest difference in hemoglobin concentration (11.4 ± 1.0 vs. 10.9 ± 1.1 mg/dl) was detected in the experimental group. Levels of SCF increased significantly between pretest and posttest in both the control group (from 1196.10 ± 293.17 to 1325.05 ± 253.77 ng/ml; p = .01) and the acupressure group (from 1046.78 ± 469.52 to 1387.06 ± 310.00 ng/ml; p = .007). In addition, a borderline difference (p = .05) in mean pretest-posttest SCF increase was found between the acupressure group (340.28 ± 255.46 ng/ml) and the control group (128.94 ± 250.64 ng/ml). Finally, a significant time-dependent interactive effect was found between acupressure and the increased blood level of SCF at posttest (β = 211.34, p = .02).

    CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings support that acupressure on specific acupoints increases blood SCF levels significantly, which may help protect chemotherapy patients from experiencing reduced hemoglobin levels and may relieve chemotherapy-induced myelosuppression in patients with gynecologic cancer. This noninvasive approach is suggested for practical implementation in patients undergoing a course of chemotherapy.

    Be well!


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