Herbal For Cancer

2007-12-22T07:59:00.000-08:00

Herbal Medicine in Cancer Treatment

Herbal medicines have a vital role in the prevention and treatment of cancer. A great deal of pharmaceutical research done in technologically advanced countries like USA, Germany, France, Japan and China has considerably improved quality of the herbal medicines used in the treatment of cancer. With advanced knowledge of molecular science and refinement in isolation & structure elucidation techniques, we are in a much better position to identify various anticancer herbs and develop the remedy that might cure cancer. The therapeutic effect of anticancer herbs is executed by inhibiting cancer-activating enzymes, stimulating DNA repair mechanism, promoting production of protective enzymes, inducing antioxidant action and by enhancing activity of the immune cells. Some herbs protect the body from cancer by enhancing detoxification functions of the body. Certain biological response modifiers derived from herbs are known to inhibit growth of cancer by modulating the activity of specific hormones and enzymes. Some herbs reduce toxic side effects of chemotherapy and radiotherapy. Scientists all over the world are concentrating on the herbal medicines to boost immune cells of the body against cancer. By understanding the complex synergistic interaction of various constituents of anticancer herbs, the herbal formulations can be designed to attack the cancerous cells without harming normal cells of the body.

Catharanthus roseus or Vinca rosea (Periwinkle) contains vinca alkaloids, which were the first phytoconstituents ever used to treat cancer. Intense work on Catharanthus roseus, a folklore hypoglycaemic drug, led to isolation of more than 70 dimeric indole alkaloids, which include vinblastine, vincristine (leurocrystine), alstonine, ajmalicine and reserpine. Vinca alkaloids execute anticancer effect by binding to the tubulin (microtubule protein) thereby breaking down the microtubules, thus inhibiting formation of mitotic spindle in the metaphase that arrests division of the cancerous cells. Although structurally closely related, vinblastine and vincristine have significant difference in their clinical utility. Vinblastine is used in the treatment of Hodgkin’s disease, non-Hodgkin’s lymphoma and cancers of the kidney & the testis. Vincristine is usually given in combination with other anticancer agents to treat acute lymphocytic leukaemia, Wilm’s tumour, neuroblastoma, rhabdomyosarcoma, Ewing’s sarcoma, lymphoma and cancers of the breast, lung, bladder & the cervix.

Podophyllum peltatum (American May Apple) and Podophyllum hexandrum (Himalayan May Apple) contain podophyllin, which has similar therapeutic action on the dividing cancerous cells as that of the vinca alkaloids. Podophyllin arrests multiplication of cancerous cells by breaking down the microtubules into smaller subunits, thus inhibiting the cell division. Podophyllotoxin, an active principle of podophyllin, is used in the treatment of Hodgkin’s disease, non-Hodgkin’s lymphoma, leukaemia, bronchogenic carcinoma and cancers of the ovary & the testis.

Taxus brevifolia (Pacific Yew Tree), Taxus yunnanensis (Yunnan Yew Tree), Taxus baccata (European Yew Tree) and Taxus wallichiana (Himalayan Yew Tree) contain taxanes, which include paclitaxel (Taxol) and docetaxel (Taxotere). Taxanes have a different mode of action on the cancerous cells than that of the podophyllin and the vinca alkaloids. Taxanes arrest multiplication of cancerous cells by cross-linking the microtubules, whereas vinca alkaloids and podophyllin act by breaking down the cytoskeletal organelle (microtubule) into smaller subunits. Taxanes are used to treat leukaemia and cancers of the breast, ovary, colon & the lung. Taxol was first isolated from bark of Taxus baccata by Indian born scientist, Mansukh Wani, and his colleague Monroe Wall in 1992. Three mature Yew trees (60-100 years old) were consumed to extract one gram of Taxol. Later, in 1994, Taxol was synthesised successfully by two teams of American scientists, one headed by K. C. Nicalaou at the Scripps Research Institute, La Jolla, California and the other led by Robert Holton of Florida State University.

Allium sativum (Garlic) has been used for thousand of years to treat various diseases. The earliest use of Allium sativum as a medicine has been recorded in ancient Egypt, Greece, India, China, Rome, Russia and Europe. Hippocrates was the first to recommend its use for cancer. Allium sativum contains more than 100 biologically useful secondary metabolites, which include alliin, alliinase, allicin, S-allyl-cysteine (SAC), diallyldisulphide (DADS), diallyltrisulphide (DATS) and methylallyltrisuphide. Garlic oil contains an amino acid known as alliin, which is converted to allicin when its bulbs are crushed. Allicin is a precursor to several sulphur-containing compounds that are responsible for the flavour, odour and pharmacological properties of Allium sativum. Recent studies revealed presence of bioflavonoids quercetin and cyanidin, which are responsible for antioxidant properties of garlic. Ajoene, a sulphur-containing compound, found in garlic oil, inhibits mutagenesis. Garlic oil prevents prostaglandin-dependent cancers by inhibiting lipoxygenase and cyclo-oxygenase enzymes. Garlic contains a rich content of selenium, which is a cellular antioxidant. Diallyltrisulphide, diallyldisulphide and S-allyl-cysteine, found in Allium sativum, have anticarcinogenic properties. Diallyltrisulphide prevents metastases in the lung cancer. Garlic has shown significant therapeutic effect in cancers of the stomach and the intestines. The Chinese Academy of Medical Sciences has reported inverse relationship between garlic consumption and incidence of the stomach cancer. Allium sativum inhibits genesis as well as growth of cancer by enhancing activity of the natural killer cells (NK cells) and the macrophages. Studies have revealed that Allium sativum increases count of the suppressor T cells and makes the lymphocytes more cytotoxic to cancerous cells. Allium sativum also inhibits metastases by preventing adhesion of the circulating cancerous cells to the blood vessels. A Japanese garlic expert, Wakunaga, worked with a German researcher in the Virgin Woodlands of Hokkaido, Japan and prepared a product called “Kyolic Aged Garlic Extract” in 1954 by using 20-month Cold Ageing Process. This ageing process removes toxic compounds and offensive odour of garlic as well as strengthens its therapeutic properties. The Aged Garlic Extract protects DNA from the damaging effect of carcinogens, increases activity of detoxifying enzymes, speeds up excretion of chemical carcinogens and enhances immunity of the body. The Aged Garlic Extract is found to inhibit growth of many cancers including those of the breast, bladder, skin, colon, oesophagus, stomach and the lung. The research done at National Medical Centre and Hospital in Japan has revealed that the Aged Garlic Extract reduces side effects of radiotherapy and chemotherapy. Japanese Wakunaga Pharmaceutical Company is still contributing US$ 10 million annually for further research on garlic.

Essiac is a herbal formula that was originally known to an American tribe as Lasagen. It was renamed Essiac in 1920 by a Canadian nurse, Rene Caisse. Essiac enhances activity of the immune cells and reduces toxic side effects of chemotherapy and radiotherapy. Recent studies have revealed that all the major components of Essiac including Arctium lappa, Rheum officinale, Rumex acetosella and Ulmus rubra have significant anticancer activity. Rheum officinale contains emodin that inhibits growth of cancer. Arctium lappa contains potent anticancer factors that prevent mutations in the oncogenes. Essiac has been used in the treatment of malignant melanoma, lymphoma and cancers of the pancreas, breast, ovary, oesophagus, bladder, bile duct & the bone. A study conducted on 30 terminal cases of cancer by Dr. John Wolfer, Director of Cancer Clinic at North-western University Medical School has revealed that Essiac reduces the size of tumour, relieves the pain and prolongs the survival period. Another study conducted at Brusch Medical Centre in Massachusetts has confirmed the anticancer effect of Essiac.

Hoxsey herbal formula was discovered incidentally in 1840s by Elder Hoxsey, when one of his horses suffering from cancer on the leg, got cured after grazing certain herbs. He made a note of these herbs. Later, his grandson Harry Hoxsey tried these herbs on the human cancer. Hoxsey herbal formula contains Arctium lappa, Berberis vulgaris, Glycyrrhiza glabra, Larrea tridentata, Picramnia antidesma, Rhamnus purshianus, Stillingia sylvatica, Trifolium pratense and Xanthoxylum americanum. Recent studies have revealed that all the ingredients of Hoxsey formula possess definite biological activity against cancer. Hoxsey herbal formula has been used to treat malignant melanoma, lymphoma and cancer of the skin. A five-year study conducted on 16 terminal cases of cancer has shown disease free survival in 6 patients after administration of Hoxsey formula. Another study conducted at the Bio-Medical Centre in Tijuana, Mexico on the advanced cases of malignant melanoma, metastatic prostate cancer and metastatic ovarian cancer has shown prolonged survival period and better quality of life after administration of Hoxsey herbal formula.

Iscaddor is a fermented extract of Viscum album (Mistletoe) that was discovered by the Austrian scientist, Rudolf Steiner and has been used in the treatment of cancer by European physicians since 1920s. Clinical studies done on more than 5000 cancer patients have revealed that Iscaddor arrests the growth of cancer. A study conducted on advanced cases of the breast cancer has revealed that the use of Iscaddor has considerably increased the life span and improved the quality of life. Iscaddor is also found to prevent malignant transformation of the bladder papilloma. In a study conducted on the patients of cervical cancer, who were given Iscaddor along with radiotherapy have shown 83 per cent survival rate after 5 years as compared to 69 per cent survival rate in those patients, who were given radiotherapy alone. Another study conducted on the bronchogenic carcinoma patients has recorded four year survival period in 75 per cent cases after administration of Iscaddor. Similarly, the patients of skin cancer, who were given Iscaddor, have shown three year survival period in 80 per cent cases. Iscaddor has been found to increase life span in the patients suffering from cancers of the stomach and the colon. A recent study conducted by Dr. Richard Wagner of Germany on 26 patients of the ovarian cancer (stage III), has shown full remission in 3 patients and partial remission in 8 patients while growth of the cancer was arrested in remaining 15 patients after administration of Iscaddor.

Larix is a highly concentrated polysaccharide derived from Larix occidentalis. It was first identified and developed by Dr. Peter D’Adamo in 1992. Larix enhances cytotoxicity of the natural killer cells (NK cells). It stimulates immune cells of the body leading to production of various immune enhancing factors, known as cytokines, which include interferon, interleukin, tumour necrosis factors and colony stimulating factors. Larix prolongs survival period in cancer patients and prevents metastases in the liver. Larix is usually recommended along with modified citrus pectin, because both of these polysaccharides prevent adhesion of cancerous cells to the liver tissue.

Gyrophora esculenta (Maitake) is a mushroom that inhibits growth of cancer by enhancing activity of the natural killer cells (NK cells). A study done by Dr. Hiroaki Nanba, Department of Immunology at Kobe Women’s College of Pharmacy, Japan has shown that Maitake inhibits carcinogenesis and metastases. Another study conducted at the National Cancer Research Centre in Japan revealed that the extracts of Gyrophora esculenta (Maitake), Lentinus edodes (Shiitake) and Ganoderma lucidum (Reishi) have completely eliminated tumours in 80 per cent cases.

Bioflavonoids (flavonoids) are the water-soluble pigments, found in vegetables and fruits. These were known as “Vitamin P” till 1950. The list of bioflavonoids includes citrin, hesperidin, rutin, quercitin, epicatechin, flavones, flavonols, proanthocyanins and anthocyanins. Most of the bioflavonoids possess antioxidant properties. Bioflavonoids enhance therapeutic effect of vitamin C by increasing its absorption in the liver, kidneys and the adrenal glands. Anthocyanins found in citrus fruit and grape seed are known to inhibit growth of cancer by scavenging free radicals. Quercetin is known to inhibit growth of the stomach cancer.

Pau D’ Arco has been extracted from the bark of South American tree, Tabebuia impetiginosa. The major active ingredient of Pau D’ Arco is lapachol that possesses strong biological activity against cancer. In a clinical study, pure lapachol was given in 250 mg daily doses to the patients suffering from cancers of the liver, kidney, breast, prostate and the cervix. The regression in size of tumours was observed in all the cases, whereas complete remission was noticed in 30 per cent cases. Another study has shown 80 per cent increase in survival period of the leukaemic patients after administration of lapachol.

Bromelain is a mixture of proteases and some other enzymes. It is isolated from the stem and fruit of Ananas comosus (Pineapple). Bromelain stimulates defence mechanism of the body against cancer by enhancing cytotoxic activity of the monocytes and the macrophages, thus inhibiting growth of cancer. It is used in the treatment of leukaemia. Rectal administration of Bromelain is preferred, however it can be given orally.

Curcuma longa (Turmeric) contains curcumin, which inhibits the growth of cancer by preventing production of harmful eicosanoid such as PGE-2. The anticancer effect of curcumin has been demonstrated in all the steps of cancer development, i.e. initiation, promotion and progression of cancer. Data obtained from several studies suggest that curcumin inhibits the genesis of cancer as well as promotes the regression of cancer. Curcumin suppresses mutagenic effect of various mutagens including cigarette smoke condensates, 7, 12-dimethylbenz (a)anthracene (DMBA) and benzopyrene. Curcumin is found to decrease levels of urinary mutagens. It also possesses anti-inflammatory and antioxidant properties. The protective effects of Curcuma longa and its derivatives are partially due to direct antioxidant effect. Studies have revealed that Curcuma longa inhibits production of nitrosamine that enhances natural antioxidant functions of the body. Curcuma longa increases levels of glutathione and other non-protein sulfhydryls. It acts directly on several enzymes. Curcumin is used to treat squamous cell carcinoma of the skin and the ulcerating oral cancer. Curcuma longa also prevents malignant transformation of leukoplakia.

Camellia sinensis (Green tea) contains epigallocatechin gallate, which protects against cancer by preventing covalent bonding of carcinogens to the DNA. It also inhibits growth of cancer by eliminating free radicals from the body. Gallates found in green tea protect the body from damaging effects of radiation. A regular use of green tea protects the body against many cancers including those of the liver, oesophagus, stomach, intestine and the lung. Studies have shown that there is lower incidence of stomach cancer in habitual tea drinkers as compared to those, who do not drink tea. It has been observed that daily consumption of 5 grams of green tea inhibits synthesis of nitrosamine (a major carcinogen) in the body.

Betula utilis (White-barked Birch Tree) contains betulin that can be easily converted into betulinic acid. Studies have revealed that betulinic acid inhibits growth of malignant melanoma and cancers of the liver and the lung.

Aloe vera contains aloe-emodin, which activates the macrophages to fight cancer. Aloe vera also contains acemannan, which enhances activity of the immune cells against cancer. Aloe vera is found to inhibit metastases.

Silybum marianum (Milk thistle) protects the body against liver cancer by accelerating regeneration of the liver cells. Bioflavonoids found in Silybum marianum such as silymarin and silybin are known to protect the liver tissue. Silybum marianum also contains antioxidant compounds

Echinacea angustifolia contains arabinogalactan, which protects the body from cancer by activating the macrophages. Echinacea angustifolia is used to treat metastatic carcinoma of the oesophagus and the colon.

Uncaria tomentosa (Cat’s claw) is a rain forest climber that has been traditionally used in Peru to treat tumours. Uncaria tomentosa contains many antioxidant compounds including polyphenols, triterpines, campesterol, stigmasterol and beta-sitosterol. Cat’s claw is used to treat the brain tumours.

Chlorella pyrenoidosa contains a very effective detoxifying agent, known as lysine. Chlorella pyrenoidosa also contains high content of albumin that neutralises free radicals. Chlorella pyrenoidosa protects the body from cancer.

Laminaria japonica (Kombu) possesses a strong anticancer activity and inhibits the growth of cancer. Studies have shown that a regular use of Laminaria japonica reduces risk of the breast cancer considerably.

Green drinks (Super vitamins) contain a combination of various herbs including Hordeum vulgare, Medicago sativa and Spirulina along with nutrients. Studies have shown that Green drinks enhance activity of the immune cells against cancer. Green drinks also possess direct anticancer activity.

Withania somnifera contains withanolides, which possess immuno- modulatory activity. Withaferin A & withanolide D found in Withania somnifera are known to inhibit growth of cancer. Studies have revealed that Withania somnifera enhances the therapeutic effect of radiotherapy.

Annona species contain acetogenins, which possess significant cytotoxic activity against leukaemia and sarcoma. Acetogenins are found to be effective in the treatment of nasopharyngeal carcinoma.

Hydrocotyl asiatica protects from cancer by enhancing immune functions of the body. Hydrocotyl asiatica extract has shown strong anticancer activity. In Brazil, Hydrocotyl asiatica is used to treat the uterine cancer.

Gossypium barbadense contains gossypol. Recent studies have revealed that gossypol possesses selective toxicity towards cancerous cells.

Mentha species contain phenolic antioxidants that prevent recurrence of cancer.

Lavandula angustifolia contains perillyl alcohol, which arrests growth of tumour by inhibiting p21 ras oncogene.

Combretum caffrum (African Willow Tree) contains combretastatin, which has been isolated recently. Combretastatin executes its therapeutic action against cancer by inhibiting blood supply to the tumour.

Camptothecin is a pyridoindole (quinoline) alkaloid, which is isolated from seeds of Camptotheca acuminata and Mappia foetida. Camptothecin is a well-known anticancer agent. Derivatives of camptothecin such as 18-OH-camptothecin, 11-OH-camptothecin and 10-OH-camptothecin have been found to possess a strong antileukaemic activity.

Ellipticine and 9-methoxy ellipticine are pyridocarbazole (monomeric indole) alkaloids that have been isolated from Ochrosia elliptica. These act as potent anticancer agents. Ellipticine and its derivatives are used to treat cancers of the breast and the kidney. Lipophilic derivatives of ellipticine act by binding to the DNA.

Homoharringtonine, a cephalotaxine alkaloid, derived from Cephalotaxus species and indicine N-oxide, a pyrrolizidine alkaloid, derived from Heliotropium indicum, are the two other herbal alkaloids, which are likely to be used in the treatment of cancer.

Other important anticancer herbs include Benincasa hispida, Brassica oleracea, Calendula officinalis, Dirca occidentalis, Feddiea fischeri, Larrea divaricata, Larrea tridentata, Morus alba, Ostodes paniculata, Passerina vulgaris, Piper futokadsura, Soulamea soulameoides, Thymus serpyllum, Trichosanthes kirilowii and Urtica dioica.

Magic Bullet

The battle against cancer can be won if we succeed in designing a drug that may act like a ballistic missile with target at the cancerous cells. Scientists are coming closer to develop such a drug that could differentiate the cancerous cells in the body. For example, the herb Ricinus communis (Castor) contains a cytotoxic alkaloid, the toxic molecule of which is made up of two parts. The first part gets attached to a cell and the second part kills the cell. Researchers are trying to prepare the magic bullet by attaching the second part of this toxic molecule to monoclonal antibodies, which could deliver the toxic molecule to the cancerous cells, thus killing them selectively without harming the normal cells.

Chinese Medicine in Cancer Treatment

Panax ginseng (Ren Shen/Ginseng) is a forest herb that has been used by the Chinese medical practitioners for more than 2000 years. It inhibits growth of cancer by interfering with the DNA synthesis. Panax ginseng contains several active constituents, which include saponins, essential oils, phytosterols, amino acids, peptides, vitamins and minerals. Saponins enhance activity of the natural killer cells (NK cells), stimulate the macrophages and promote production of the antibodies. According to a report published in the Free Radical Biology and Medicine, the anticancer effect of Panax ginseng is mainly due to its ability to protect the body against free radicals. Studies have shown that Panax ginseng decreases incidence of the liver cancer by 75 per cent. Panax ginseng is used by the Chinese doctors to treat cancers of the ovary and the stomach. Two Korean researchers, T.K. Yun and S.Y. Choi, have reported that the incidence of cancer decreases significantly after administration of Panax ginseng. Studies have revealed that Panax ginseng regenerates the natural killer cells (NK cells), which are damaged by chemotherapy and radiotherapy

Astragalus membranaceus (Huang Qi) is used by the Chinese doctors to treat advanced cases of the liver cancer. Swainsonine, a derivative of Astragalus membranaceus, is known to prevent metastases. A study conducted at the Peking Cancer Institute has recorded much higher survival rate in the patients of advanced stage liver cancer after administration of Astragalus membranaceus along with conventional treatment as compared to those patients, who were given the conventional treatment alone. Astragalus membranaceus protects the liver from toxic effects of chemotherapy. Astragalus membranaceus is often used in combination with Panax ginseng. According to a research done in Japan, the Ginseng-Astragalus combination (GAC) has a regulatory effect on the natural killer cells (NK cells). Studies have also shown that GAC protects the body from toxic side effects of chemotherapy and enhances activity of the immune cells. GAC is found to regulate secretion of the stress hormone, cortisol. Astragalus membranaceus is used in China along with another herb called Ligustrum lucidum. A study conducted at Loma Linda University in California, has revealed that Astragalus membranaceus and Ligustrum lucidum, enhance the immune-stimulating effect of each other, when given together.

Amygdalin (Laetrile) has been used by the Chinese physicians for more than 3,500 years to treat various tumours. Ernest Krebs, a noted biochemist, has confirmed the anticancer activity of Amygdalin, which is derived from Fagopyrum esculentum, Panicum miliaceum and seeds of Prunasin family (including Prunus armenica, Prunus cerasus, Prunus persica and Prunus domestica). Amygdalin is one of the nitrilosides (natural cyanide-containing substances), which consists of two molecules, i.e. benzaldehyde and cyanide. In the body, these two molecules split off in the liver by an enzyme, called beta-glucosidase to form glucuronic acid. Another enzyme known as glucuronidase that is present in higher concentrations in the cancerous cells breaks glucuronic acid to produce cyanide that kills the cancerous cells. It is worth mentioning that cancerous cells do not contain rhodanase (sulphur transferase), an enzyme, which is found in normal cells of the body. Rhodanase protects normal cells of the body from the killing effects of cyanide by converting free cyanide into relatively harmless substance known as thiocyanate.

Haelan 851 is a concentrated extract of Glycine max (Soya bean). It was developed by scientists of Fujien Provincial Agricultural College in China (Healing is spelt in old English as “Haelan” and 851 denotes the year and month of its discovery, i.e. 1985 January). Haelan 851 is rich in zinc, selenium, vitamins (A, B1, B2, B12, C, D, E and K), amino acids, isoflavones, protease inhibitors, saponins and phytosterols. Studies have shown that isoflavones found in Haelan 851 convert the cancerous cells to normal cells by inducing cell-differentiation. Ross Pelton, a nutritional biochemist, has reported that many terminal cases of cancer get reversed after administration of Haelan 851. Genistein, one of the isoflavones found in higher concentrations in soya products, is known to induce apoptosis (programmed cell death) in the cancerous cells. Genistein also prevents platelet aggregation by inhibiting tyrosine kinase inhibitor enzyme. It is worth mentioning that platelet aggregation promotes the spread of cancer. It has been observed that genistein blocks the synthesis of DNA in the cancerous cells, thus inhibiting the growth of cancer. Genistein also inhibits growth of hormone dependent cancers of the breast and the prostate. Studies have revealed that genistein and other isoflavones found in Haelan 851 prevent growth of cancer by inhibiting angiogenesis (formation of new blood vessels). Haelan 851 has been found to enhance immunity of the body and prolong survival period in the liver and the stomach cancer patients. A clinical study done by Chinese doctors on 239 patients of various cancers including those of the lung, stomach, oesophagus, intestines and the lymphatic system, has revealed that Haelan 851 improves quality of life and physical functioning by improving appetite, strengthening immune system of the body and reducing toxic effects of chemotherapy and radiotherapy.

Fu Zhen therapy is used by the Chinese doctors to treat cancer. Fu Zhen formulation contains six herbs namely Atractylodes, Astragalus, Codonopsis, Ganoderma, Ginseng and Ligustrum. Fu Zhen therapy strengthens natural defences of the body against cancer by enhancing activity of the immune cells. According to a report published in the Journal of American Medical Association, survival period doubled in the patients suffering from advanced stages of cancer after administration of Fu Zhen. Moreover, these patients enjoyed a better quality of life. In another study conducted on 46 patients of the primary liver cancer who were treated with Fu Zhen therapy along with conventional treatment, 29 survived for one year and 10 survived for 3 years, whereas in the control group of 30 patients who were given conventional treatment alone, 6 survived for one year.

Ginkgo biloba (Yin Guo/ Bai Guo) contains Ginkgolide-B, which protects the body against cancer. It inhibits growth of cancer by regulating activity of the platelet-activating factor. A recent study done on the workers of nuclear power station at Chernobyl in Russia has shown that Ginkgo biloba protects the DNA from damaging effects of nuclear radiation.

Rabdosia rubescens (Dong Ling Cao) is used in China to treat cancer. A study conducted on 115 patients suffering from non-resectable oesophageal cancer has shown that the survival period of these patients prolonged by 300 per cent after administration of Rabdosia rubescens in combination with the conventional treatment.

Liu Wei Di Huang is a Chinese herbal formulation used in the treatment of cancer. It contains Rehmannia glutinosa, Corni officinalis, Dioscorea batatas, Poria cocos, Paeonia suffruticosa and Alismatis orientalis. The Beijing Institute for Cancer Research has reported significant regression of tumours in the patients of small-cell lung cancer after administration of Liu Wei Di Huang. Studies have shown that Liu Wei Di Huang enhances the therapeutic effects of chemotherapy and radiotherapy.

Angelica sinensis (Dang Gui) is used by the Chinese physicians to treat cancer of the cervix. The polysaccharide fraction of Angelica sinensis, known as “AR-4” possesses immunostimulating activities such as induction of interferon production, stimulation of the immune cell proliferation and enhancement of antitumour activity of the immune cell.

Berberine is used by the Chinese physicians to treat bone marrow depression caused by chemotherapy and radiotherapy. Berberine is isolated from Hydrastis canadensis (Goldenseal), Mahonia aquifolium (Oregon grape root) and Berberis vulgaris (Barberry).

Prunella vulgaris (Xia Ku Cao) also known as Wild Selfheal contains rosmarinic acid, which is considered as one of the best antioxidants. The Chinese physicians have been using this herb to treat cancer.

Actinidia chinensis (Yang-t’ao) root is used by the Chinese physicians in the treatment of cancer. Actinidia chinensis contains a polysaccharide known as “ACPS-R” that possesses immune-enhancing and anticancer activities.

Polyporus umbellatus (Zhu Ling) is found to increase the life span of cancer patients by enhancing activity of the immune cells against cancer.

In Longhua Hospital of Chinese Medicine, a study was conducted on 60 patients suffering from advanced stages of squamous cell carcinoma of the lung and the oral cavity. These patients were divided into two groups. One group was treated with the Chinese herbal medicines and the other with chemotherapy. The average survival period in the group treated by Chinese herbal medicines was 465 days, whereas in the chemotherapy group, the average survival period was 204 days. The survival rate after 1 year was 67 per cent in the herbal group and 33 per cent in the chemotherapy group. After 2 years, the survival rate was 13 per cent in the herbal group and 3 per cent in the chemotherapy group.

Dr. Chen-lian Pan has reported a very good survival rate in 300 patients suffering from the advanced stages of cancer after treatment with the Chinese herbal medicines. The total effective rate of the herbal medicines was 51 per cent with the longest survival period of 11 years.

Dr. Minyi Chang, who treated more than 5,000 cancer patients with the Chinese herbal medicines since 1982, has described the effectiveness of 256 Chinese anticancer herbs in his book, Anticancer Medicinal Herbs.

Kampo is the Japanese version of the Chinese herbal medicine. In kampo, the herbs are used in combinations. There are more than 140 kampo formulations, out of which the most effective anticancer combinations are Juzen-taiho-to and Sho-saiko-to.

Juzen-taiho-to (JT-48) is a combination of Astragalus, Angelica, Cinnamomum, Ginseng, Glycyrrhiza, Urtica, Paeonia and some other herbs. Juzen-taiho-to enhances anticancer activity of the natural killer cells (NK cells) and reduces toxic effects of chemotherapy and radiotherapy.

Sho-saiko-to contains Bupleurum, Pinellia, Scutellaria, Ziziphus jujuba, Panax ginseng, Glycyrrhiza and Zingiber. Sho-saiko-to enhances activity of the macrophages and enables the patient to fight cancer effectively.

Herbal For Cancer

2007-12-22T07:10:00.000-08:00

Introduction

The use of herbs and herbal products has become broadly accepted in our contemporary culture. Consumer surveys consistently find that nearly half of all Americans now use herbs (1, 2) a statistic that is particularly remarkable when we realize that today's herbal products "industry" is just over a quarter century old. In spite of this widespread acceptance of herbal products in individual self-care choices, misconceptions exist as to the regulation, safety and effectiveness of herbal products.

Why should I use herbal products?

The decision to use herbs for their health promoting value is, as with all health decisions, a personal one. There are, however, many good reasons to consider herbal products as complements to your own health care. The best reason, however, may be the fact that herbs and herbal products, with their incredibly wide use throughout time and place, continue to provide real health benefits while maintaining a remarkable safety profile. Readily available natural substances were the first medicines used by humans. Primitive and ancient civilizations as well as contemporary cultures throughout the world have always relied on herbs to provide the benefits that have been observed with their use. In fact, the World Health Organization has estimated that 80% of the world's population continues to use traditional therapies, a major part of which are derived from plants, as their primary health care tools. (3) In our own time and culture, most herbs are available in the form of "herbal supplements." (4) These products are found in the form of teas, tablets, capsules, liquid extracts, and others. We now have ready access to products that bring the herbal traditions from all over the world in a variety of convenient forms. In addition, scientific inquiries continue to develop our knowledge of the benefits of plants, and often validate the observations made over the past centuries.

Are herbs safe?

Plants that enjoy broad culinary and therapeutic usage are generally safe. We can flavor our food with any number of herbs to make a meal more flavorful. We can appreciate a delicious cup of peppermint leaf or ginger root tea, or benefit from the soothing properties of marshmallow root or the bark of slippery elm. We can take an herbal supplement containing dandelion root or saw palmetto berries, or any number of the other herbs. Although allergies and reactions have been recorded for a few herbs that are widely used in foods and supplements, such individual concerns are also seen with many foods, and do not diminish the safety profile of the many herbs that are generally recognized as safe. On the other hand, and as everyone knows, there are any number of plants that are highly toxic, even deadly. Every ten-year-old hiker knows to stay away from poison ivy (Toxicodendron spp.) when walking in the woods. The death sentence imposed on Socrates by an Athenian jury 2400 years ago was carried out with a fatal dose of hemlock (Conium maculatum). The poison curare, a blend of several equatorial rain forest plants (e.g., species of Chondrodendron, Curarea and Strychnos (5) is used by some South American hunter cultures to make their arrows more deadly. Just this year, in the "concrete jungle" of Los Angeles, two young boys died from ingesting a few leaves of the ubiquitous oleander (6) (Nerium oleander). Federal law (7) and good common sense, however, prevent the use of any such highly toxic plant in products that are readily available to consumers. The better question then, for today's American consumer, is "Are herbal supplement products safe?"

Are herbal supplement products safe?

Federal law requires that every food product, including herbal supplements, is free of "adulteration" and is not "misbranded." This legal language translates into a requirement that all foods and supplements have a reasonable expectation of safety when offered for sale and when used as directed. So manufacturers of soups, cereals, and supplements all have an obligation to sell only safely made and properly labeled goods, and can find their products subject to seizure should they fail to do so. In addition, manufacturers of herbal products are specifically required to limit their ingredients to either those that were already in the market prior to passage of landmark legislation in 1994 or those that a company can convincingly show, by providing information to the Food and Drug Administration, to be safe. What that means is that any manufacturer who wants to introduce a new herbal ingredient must first provide FDA with information that shows that the herb will be "reasonably expected to be safe" (8) Additionally, the safety of herbal products as a general class has been well established by both their long history of traditional use worldwide and by their broad contemporary use by a significant proportion of the population, estimated to be nearly half of the U.S. population

(9) There are so few credible reports of unexpected side effects due to herbal products that most experts consider problems with herbal products to be of only minor or occasional concern. Norman Farnsworth, Director of the WHO Collaborating Centre for Traditional Medicine and Research Professor of Pharmacognosy at the University of Chicago at Illinois, is generally considered to be one of the most respected experts on the scientific research of botanical medicines. In a 1993 article written on the subject of herbal safety (10), Dr. Farnsworth concluded, "...side effects or toxic reactions associated with herbal medicines in any form are rare. In fact, of all classes of substances reported to cause toxicities of sufficient magnitude to be reported in the United States, plants are the least problematic." This is not to say that every herbal ingredient that is sold as an ingredient in a supplement is appropriate for every consumer or in any quantity. Responsible and informed use by consumers is essential to insure that herbal products maintain their established safety profile. Accurate product labeling must provide consumers with all information that is material to the use of the product, and such disclosure is required by Federal law

(11) To assist in assuring that herbal manufacturers provide material information about their products, the American Herbal Products Association has developed specific labeling guidelines for a number of botanical ingredients. Labeling recommendations exist for products containing chaparral (Larrea tridentata); comfrey (Symphytum spp.); ephedra (Ephedra spp.); kava (Piper methysticum); saw palmetto (Serenoa repens); and St. John's wort (Hypericum perforatum), among others. Botanical Safety Handbook is a wealth of information related to established herbal safety concerns, entitled . (12) This reference classifies over 500 herbs with safety categories that can assist both manufacturers in their labeling and consumers in making informed choices in their use of herbs. A general rule for assuring responsible use of an herbal product is to follow all of the labeled directions. If the product bears a caution that suggests that the product is inappropriate for your use, you should take that message seriously. More information can often be provided by a qualified expert, and often from well-informed retail personnel.

Are herbal supplements effective?

Botanicals have remained a primary source of traditional medicine for millennia. They have made contributions over the last centuries to the development of some of the most widely used and effective modern drugs. In the last several decades, there has been a resurgence of research in the clinical efficacy of herbs. The results of such studies often verify that the empirical observations of the past centuries were accurate. For example, recent studies on the effect of valerian have produced results that led researchers to conclude that valerian root can produce "significant improvement in sleep quality" (13) and that valerian root extract can be "recommended for the treatment of patients with mild psychophysiological insomnia" (14).

But can a consumer have confidence in the claims made for the products that are available in the market? To begin with, Federal labeling law and regulations for supplements limit allowable claims to those for which a manufacturer "has substantiation that such statement is truthful and not misleading" (15). The manufacturer therefore has a legal burden to assure that the claim that is made for their products has scientific evidence to back it up. Because there is a greater acceptance of herbal therapies by conventional physicians in Europe, a significant body of clinical data supporting the use of herbs has been developed there. More recently, a number of U.S. companies have designed clinical studies for their branded products. It is estimated that there are over 1,000 clinical trials now being undertaken in the U.S. to increase our knowledge about herbs. The National Institutes of Health has even set up a center with a special focus on "alternative" medicine, and is now concentrating much of its resources on the study of herbal products.

How soon can I expect to notice the benefits of an herbal product?

Herbs are rich mixtures of diverse natural compounds. Although the effects of certain herbs will be observed within a short time after consumption, others are more subtle and provide their health promoting benefits gradually. If you have ever used ginger root (Zingiber officinale) or peppermint leaf (Mentha × piperita) tea to promote healthy digestion, you know that you can feel the comforting effects of these herbs almost as you drink the soothing brew. The effect of ephedra (Ephedra spp.) in promoting bronchodilation or better breathing is usually felt within ten or twenty minutes of use. The sense of well-being that results from the use of kava root (Piper methysticum) should manifest in only a short time when using a well manufactured product. Similarly, all of the herbs that contain anthrones, such as rhubarb root (Rheum spp.) or cascara sagrada bark (Frangula purshiana), will produce a laxative effect within a half a day or so.

Other herbs are known to produce noticeable benefits only after several days or weeks. For example, improvement in sleep when using an extract of valerian root (Valeriana officinalis) has been shown to be somewhat dependent on continued use (16). With saw palmetto (Serenoa repens), the berries of which are used to promote the health of the prostate, the full benefits have been shown in one study to be achieved after 12 to 18 months (17). Other herbs, such as those that are rich in antioxidants, work to improve your health without a noticeable effect. For more information about what to expect from an herbal product (and when to expect it), consult with the product's manufacturer or an herbal health practitioner. You can find a regional list of herbalists the American Herbalists Guild's professional member referral list at http://www.healthy.net/herbalists, or your local acupuncturist at the American Association of Oriental Medicine http://www.aaom.org.

How do I know how much to use?

Two different parts of the Federal laws that govern dietary supplements present manufacturers with guidelines for providing quantitative recommendations on the package of their products. First, all supplement manufacturers are responsible for assuring that their products do not present significant or unreasonable risks under conditions of use recommended in labeling or under ordinary conditions of use (18). In addition, all dietary supplements, including herbal supplements, are required by Federal regulation to identify the "serving size" (19). A general recommendation then, with regard to how much of an herbal product to use: the amount recommended on the label. The idea that "more is better" is no more relevant for an herbal supplement than for any other food that, while it might be delicious, refreshing or nutritive in moderation, becomes unhealthful when consumed in excess. It may also be useful to speak with a qualified herbal expert. A regional list of herbalists is maintained on the American Herbalists Guild's professional member referral list at http://www.healthy.net/herbalists. Similarly, a local acupuncturist may be found at the American Association of Oriental Medicine at http://www.aaom.org and naturopathic physicians can be located through the American Association of Naturopathic Physicians at http://naturopathic.org.

How are herbal supplements regulated?

All supplements, including herbs, vitamins, minerals, etc., must conform to Federal regulations that control their manufacture, labeling, and advertising. In order to sell an herbal supplement, a manufacturer must meet many different Federal (and sometimes state) regulations, and must also adhere to state and local health and business regulations. Since supplements are legally classified as a specifically defined type of food, all supplements are required to be manufactured to the same high standards that are required of all foods. These mandated good manufacturing practices (20) establish basic guidelines to assure that supplements are manufactured under sanitary conditions that result in properly identified products that are not contaminated or adulterated, and that are fit for consumption. Any supplement that does not conform to these basic guidelines is subject to regulatory action by FDA. In addition, all supplement products are required by law to provide certain information about their formulation.

Like foods, supplements must provide consumers with nutritional information. Unlike foods, supplements must state the quantity of each of the contained ingredients, or of the "proprietary blends" that make up a product. All herbal products are required to identify the parts used of each of the plant ingredients, and to label them with their commonly accepted names. One of the areas of the most detailed Federal regulation of supplements is in the area of product claims, whether on product labels or in advertising. The Food and Drug Administration specifies exactly what kind of claims are allowed, and prohibits the use of any statement that would brand the product as a drug (21). Herbal supplements are not allowed to make statements regarding prevention, cure, mitigation or treatment of diseases. Instead, their claims are limited to statements that are legally defined as "statements of nutritional support" or "structure/function statements."

Unfortunately, some uninformed writers have published statements that infer that the entire supplement industry is unregulated. Although this unfortunate "fact" has been broadly reported, it is absolutely false. While the details noted above provide some response to this misrepresentation, perhaps the most compelling refutations are in the form of statements made by Dr. Jane Henney, the current Commissioner of FDA. In testimony before Congress last year (22), Dr. Henney stated that "FDA has tools at its disposal to take enforcement actions against dietary supplements found to have safety, labeling, or other violations...," and also that she believes that current law "...provides FDA with the necessary legal authority to protect the public health."

What about interactions with drugs?

Humans have been learning about the diverse effects of ingesting plants throughout our evolution. We have, by trial and error, found both good and bad effects that are related to specific plants, some of which we use as food, and others that are used for therapeutic purposes. The introduction of synthetic and highly purified drugs is an extremely modern development. As researchers observe the interactions that drugs have with common foods and herbs, surprises continue to surface. For example, less than 10 years ago it was found that drinking grapefruit juice increases the serum drug concentration when patients take certain drugs (23). This effect, which can last for up to (24) hours after consumption, is now thought to inhibit specific enzymatic activities responsible for breaking down the drugs 24. Similarly, both avocado and leafy vegetables that are high in vitamin K can diminish the effectiveness of blood-thinning drugs (25). These concerns are not widely known by the public, but now that medical professionals are aware of these effects, they can routinely monitor their patients to assure effective treatment.

Similar information has surfaced about some of the herbs that we use. For example, we now know that the use of an extract of St. John's wort (Hypericum perforatum) may cause certain prescription medications to be eliminated more quickly (26, 27), leading one researcher to caution that, "As with grapefruit juice, a food product, physicians should also be aware of potential drug-herb interactions" (26). In response to this new information, the American Herbal Products Association has recommended that products containing St. John's wort be labeled to suggest that the advice of your prescribing physician be requested if you are taking any prescription drugs. Speculation on the exact mechanism of St. John's wort has led to reports that the use of this herb might affect oral contraceptives, leading to ineffectiveness and unwanted pregnancies. To date, there have been no reports of any such actual occurrence. Nevertheless, women taking oral contraceptives such as ethinyl estradiol and desogestrel should be aware that, if you experience break-through bleeding, you might experience a reduction in protection against pregnancy.

As can be seen by the above examples, the effect of a drug can be either increased or decreased in the presence of other factors in the diet, including herbal use. Although it is likely that most such factors have little or no influence on drug metabolism, continued research will add to our knowledge of such interactions and responsible food and supplement manufacturers will be expected to inform their customers of any new findings. There is now an ongoing interest in other drugs that are suspected of interacting with certain specific herbs, with most contemporary emphasis on the use of herbs with blood-thinning drugs such as warfarin. Although the current concerns are either conceptual or based on isolated and inconclusive reports, it is advisable to inform your prescribing physician or pharmacist that you are using herbs when undergoing any drug therapy. As close monitoring of the effect of warfarin is an established standard of medical practice, this additional information will assist your physician in maintaining good supervision of your drug levels. In order to understand the potential for an herbal product to interact with prescription drugs, it may also be useful to consult with a qualified herbal expert. You can find a regional list of herbalists the American Herbalists Guild's professional member referral list at http://www.healthy.net/herbalists, or your local acupuncturist at the American Association of Oriental Medicine http://www.aaom.org. A similar database of naturopathic physicians is maintained by the American Assoc. of Naturopathic Physicians at http://naturopathic.org.

How can I choose the herbal product that is right for me?

Single herb or combination product? Capsule, tablet, extract or tea? Which brand? Standardized or not? Sometimes it seems that there are just too many choices!! Some of these choices are ultimately matters of personal choice. The issue of product form is one example - are you attracted to the rich history of herbal extracts and decoctions? ...or do you have trouble swallowing tablets and capsules? Then you may want to try a liquid extract or tea product. On the other hand, if you can't bear the taste of valerian or echinacea, or if you like the convenience of non-liquid forms, you might choose a tablet or capsule. Similarly, there are separate values attached to both single herb products and to herbal formulas. You might appreciate the experience and knowledge that many manufacturers have brought to designing combination products, with a goal toward attaining a higher synergy for the intended use. Multi-ingredient formulas have been the standard in Asian and Indian herbal traditions for centuries. Then again, you might prefer the simplicity of taking only one herb at a time, an approach that has more historical acceptance in the West (28).

With regard to choosing a brand, one recommendation is to only purchase products from companies who are members of the National Wellenss Association (NWA). All of NWA's members agree to abide by a Code of Ethics that requires adherence not only to established regulations, but also to meaningful industry policies. Thus, certain business practices that are not mandated by any government agency are expected of all of these companies. It is also generally recommended that you buy your herbal product from a reputable company. If the claims made on a particular product are outrageous and unbelievable, especially when compared to other products with the same or similar ingredients, that may be an indication to try another brand. Consider the advice of your retailer, and always feel free to contact the marketer. Those who are selling high quality products will be happy to answer all of your questions and provide you with the assurances that you, their customer, deserve.

Finally, if you have purchased a product that works for you and that provides the promised benefits, stick with it, whether it's a tablet, tincture or tea, whether a single herb or a complex formulation of several herbs. And remember - a brand that is remarkably less expensive than other products with the same or similar ingredients is not always the best bargain.

What are "standardized" herbs?

The U.S. herbal marketplace has seen the introduction of a number of "standardized" botanical extracts. The purpose of standardization is commonly believed to be control of the content of one or several "marker" compounds (29), which are perceived of as those constituents in the plant that are responsible for its therapeutic activity. In fact, standardization - when properly performed - entails a lot more than merely controlling the content of a particular marker compound. Rather, standardization consists of the body of information and manufacturing steps that ensure product consistency from one batch to the next. As such, it comprises a wide variety of raw material and process controls, as well as use of a consistent recipe.

The goal in standardizing an extract is to control the complete chemical composition of the extract, rather than one particular identified constituent or group of constituents. The heightened interest in standardized products is due to the belief that standardization is directly related to the potency of the extract. This is not necessarily the case and can unfortunately lead to a "more is better" perception. It is important to know that the use of marker compounds is not essential to the production of quality botanical products and that many companies market high quality and consistent herbal extracts without reference to these. In addition, any manufacturing process that is too specifically concentrated on maximizing one constituent may place an undue emphasis on that single compound. On the other hand, there can be value in a manufacturing process that implements measures to control the entire spectrum of an herb's constituents and that also includes attention to marker compounds. Consumers should understand that label information about markers is usually provided to communicate product consistency and a degree of quality control rather than potency.

Should I tell my Doctor that I'm using herbs?

Of course you should! And because your doctor is, ideally, your primary partner in managing your health, you should insist that your doctor, no matter their degree of training in herbs, receive that information respectfully. In telling your doctor of your decision to use an herbal product, however, don't be surprised to find that your knowledge of herbs is more advanced than theirs. You might suggest (again, respectfully) that they expand their education by using some of the internet resources listed below, or by purchasing and studying some of the written references identified there. At the same time, remember that your prescribing physician has a responsibility to safely oversee your use of any prescription drugs. If your doctor is concerned that a pharmaceutical substance might interact with an herbal product, it is prudent to accept such advice.

Where can I learn more?

If you have additional questions about the herbs you use, forward these to either of the organizations that prepared this information, at the email addresses listed below.

American Herbal Products Association, 8484 Georgia Avenue, Suite 370, Silver Spring, MD 20910, ph: (301) 588-1171, fax: (301) 588-1174, email: ahpa@ahpa.org

American Herbal Pharmacopoeia, PO Box 5159 Santa Cruz, CA 95063, ph: (831) 461-6318, fax: (831) 475-6219, email: ahpadmin@got.net