Herbs and Cancer: How Chinese Herbs Can Manage The Side Effects of Chemotherapy and Improve Cancer Outcomes
Someone you know has cancer. Now what?
While many people will experience the stress of a loved one going through cancer, or may go through cancer themselves, there is a fundamental question that comes up over and over again:
What else should I be doing to have the best odds of getting through this?
Integrative cancer care extends beyond targeting cancer to additionally help support a patient through cancer treatment. This support includes minimizing symptoms brought on by conventional treatments. Traditional Chinese herbs and Kampo formulas are tools utilized to reduce side effects and fight cancer growth.
There are numerous herbs that have been utilized for their anticancer properties for the past 2000 years in China and South East Asia. You may be familiar with many of these herbs including turmeric, ginseng, astragalus and licorice.
For example, Oldenlandia diffusa, known as Bai Hua She She Cao in Chinese, is an herb with several bioactive compounds including vanoxalic acid and 2-hydroxy-3-methyl-anthraquinone. These two compounds are tyrosinase inhibitors, which play a role in the fight against cancer.
Even turmeric, known as Jiang Huang in Chinese, can be a therapeutic tool against cancer. In vitro studies show turmeric’s activity against cancer is many pathways. Curcumin is the bioactive compound in turmeric that is the center of this activity.
An in vitro study in 2017 found curcumin to inhibit cell growth and support cancer cell death in pancreatic cancer.
Another herb to note is licorice, known as Gan Cao in Chinese. Licorice is commonly utilized for its antiviral, antibacterial, anti-inflammatory, and anti-cancer properties.
An in vivo study in mice found the addition of licorice to produce a gain in weight of the immune organs, which are usually compromised in a cancer patient. Further explorations are necessary to note this direct effect in humans.
Chinese Herbs for Chemotherapy Symptoms
Since chemotherapy targets fast-growing cells, quickly replicating healthy cells may be killed in addition to cancer cells. These healthy cells can include those found in the gut, leading to common side effects such as nausea and vomiting.
An analysis of four randomized clinical trials in 2005 found Chinese medical herbs to be effective in reducing chemotherapy side effects. The cancer patients received chemotherapy only, chemotherapy with anti-emetics, or chemotherapy with Chinese herbs. The Chinese herbs included a decoction of Huangqi compounds (Astragalus).
The focus of the analysis was to evaluate whether the herbs could significantly reduce common side effects of chemotherapy, which included nausea & vomiting. The analysis found a significant reduction in the number of participants who experienced nausea and vomiting in the group who received the herbs.
The analysis revealed notable heterogeneity in the studies but the results support the potential for these herbs’ therapeutic use.
Astragalus is a traditional Chinese herb with significant in vitro support for its role in anticancer pathways. For example, in a study in 2018, scientists found extracts of Astragalus membranaceous to inhibit cell growth and increase cancer cell death through the anti-tumor pathway PI3K/AKT/mTOR (p<0.05).
Oral ulcers can commonly appear as a side effect of chemotherapy. A randomized controlled trial in 2010 looked at Rhodiola algida’s potential for improving the immune system of breast cancer patients in the hopes of reducing the number of oral ulcers.
130 breast cancer patients from Huaxi Hospital of Sichuan University in China randomly either were in a control group or received Rhodiola algida for 14 consecutive days after each cycle of chemotherapy.
The white blood cell count, a reflection of the immune system, increased faster in the patients receiving the Rhodiola algida. Additionally, the participants who received the Rhodiola algida had smaller and fewer oral ulcers.
This study concluded that Rhodiola algida holds the potential to be used alongside chemotherapy to help strengthen a patient’s immune system and reduce the prevalence of oral ulcers.
Kampo, a Japanese traditional medicine utilizing Chinese herbal formulas, additionally holds formulas with effective cancer application. To explore the effectiveness of one formula alleviating chemotherapy-induced diarrhea, a study in 2003 randomized 44 non-small-cell lung cancer patients to either receive chemotherapy alone or chemotherapy with Kampo medicine Hangeshashin-to (TJ-14). This formula contained baicalin, a beta-glucuronidase inhibitor, which is theorized to reduce chemotherapy-induced diarrhea.
While both groups still experienced diarrhea, the group who received TJ-14 had reduced frequency and reduced severity of diarrhea.
Chinese Herbs Within the Fight Against Cancer
A meta-analysis of 19 randomized controlled trials found traditional Chinese medicinal herbs to increase efficacy and reduce the toxicity of chemotherapy for advanced non-small-cell lung cancer. The chemotherapy was an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI).
The group that received the herbs had statistically significant higher one-year and two-year survival rates and decreases in chemotherapy side effects. These side effects included nausea, vomiting, and diarrhea.
To evaluate whether Chinese herbs could enhance the effectiveness of chemotherapy, a meta-analysis in 2006 explored such an idea for advanced non-small-cell lung cancer. The analysis included 34 randomized studies, totaling 2,815 patients.
The analysis focused on astragalus as the utilized Chinese herbal medicine due to astragalus’ known immunological role. For example, astragalus has been shown to stimulate macrophage activity, a significant player in the immune system.
The analysis included studies that randomized patients to either receive platinum-based chemotherapy alone or the same chemotherapy with astragalus-based Chinese herbal medicine. Twelve of the studies (n=940 patients) reported a reduced risk of death at 12 months (RR=0.67). And thirty studies (n=2,472) reported improved tumor response data (RR=1.76).
A systematic review of 29 randomized controlled studies explored the effect of an injection of Chinese medicinal herbs, known as Shenqi Fuzheng, in non-small-cell lung cancer. The patients either received a Shenqi Fuzheng with platinum-based chemotherapy or just the chemotherapy alone for a control.
The study found that the herbs could increase efficacy and reduce toxicity of the chemotherapy. For example, there was a statistically significant higher tumor response and performance status (p=-.001, p<0.00001). Therefore, taking these herbs helped not only support the patient’s ability to tolerate the chemotherapy, but assisted the chemotherapy’s job!
Cancer treatment involves a team of support. Chinese medicinal herbs may play a role in that support whether it is from the direct fight against cancer or supporting the patient’s body to handle conventional treatment.