Natural Health Products for Anti-Cancer Treatment: Evidence and Controversy

Overview

Journal J Pers Med

Date 2024 Jul 27

PMID 39063939

Authors

Valeria Conti

Giovanna Polcaro

Emanuela De Bellis

Danilo Donnarumma

Federica De Rosa

Berenice Stefanelli

Graziamaria Corbi

Francesco Sabbatino

Amelia Filippelli

Affiliations

Soon will be listed here.

Abstract

Natural Health Products (NHPs) have long been considered a valuable therapeutic approach for the prevention and treatment of various diseases, including cancer. However, research on this topic has led to inconclusive and often controversial results. This review aims to provide a comprehensive update of the effects and mechanisms related to the use of NHPs, to describe the results of randomized clinical trials (RCTs) on their effects in cancer patients, and to critically discuss factors influencing clinical outcomes. RCTs available in the literature, even those studying the same NHP, are very heterogeneous in terms of indications, doses, route and timing of administration, and outcomes evaluated. Silymarin, ginsenoside, and vitamin E appear to be useful in attenuating adverse events related to radiotherapy or chemotherapy, and curcumin and lycopene might provide some benefit in patients with prostate cancer. Most RCTs have not clarified whether NHP supplementation provides any real benefit, while harmful effects have been shown in some cases. Overall, the available data suggest that although there is some evidence to support the benefits of NHPs in the management of cancer patients, further clinical trials with the same design are needed before their introduction into clinical practice can be considered.

References

Chung M, Kim D, Ahn Y, Choi J, Kim E, Son Y . Randomized Trial of Vitamin C/E Complex for Prevention of Radiation-Induced Xerostomia in Patients with Head and Neck Cancer. Otolaryngol Head Neck Surg. 2016; 155(3):423-30. DOI: 10.1177/0194599816642418. View

Cascinu S, Ligi M, Del Ferro E, Foglietti G, Cioccolini P, Staccioli M . Effects of calcium and vitamin supplementation on colon cell proliferation in colorectal cancer. Cancer Invest. 2000; 18(5):411-6. DOI: 10.3109/07357900009032811. View

Martin A, Tomasin R, Luna-Dulcey L, Graminha A, Naves M, Teles R . [10]-Gingerol improves doxorubicin anticancer activity and decreases its side effects in triple negative breast cancer models. Cell Oncol (Dordr). 2020; 43(5):915-929. DOI: 10.1007/s13402-020-00539-z. View

Luciano A, Liguori L, Polcaro G, Sabbatino F, Pepe S . Evaluation of Potential Predictive Biomarkers for Defining Brain Radiotherapy Efficacy in Non-Small Cell Lung Cancer Patients with Brain Metastases: A Case Report and a Narrative Review. Clin Pract. 2023; 13(6):1549-1560. PMC: 10742049. DOI: 10.3390/clinpract13060136. View

Zhao H, Zhu H, Huang J, Zhu Y, Hong M, Zhu H . The synergy of Vitamin C with decitabine activates TET2 in leukemic cells and significantly improves overall survival in elderly patients with acute myeloid leukemia. Leuk Res. 2018; 66:1-7. DOI: 10.1016/j.leukres.2017.12.009. View

Kciuk M, Alam M, Ali N, Rashid S, Glowacka P, Sundaraj R . Epigallocatechin-3-Gallate Therapeutic Potential in Cancer: Mechanism of Action and Clinical Implications. Molecules. 2023; 28(13). PMC: 10343677. DOI: 10.3390/molecules28135246. View

Karamali M, Nourgostar S, Zamani A, Vahedpoor Z, Asemi Z . The favourable effects of long-term selenium supplementation on regression of cervical tissues and metabolic profiles of patients with cervical intraepithelial neoplasia: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2015; 114(12):2039-45. DOI: 10.1017/S0007114515003852. View

Campbell E, Vissers M, Wohlrab C, Hicks K, Strother R, Bozonet S . Pharmacokinetic and anti-cancer properties of high dose ascorbate in solid tumours of ascorbate-dependent mice. Free Radic Biol Med. 2016; 99:451-462. DOI: 10.1016/j.freeradbiomed.2016.08.027. View

Ryan J, Heckler C, Ling M, Katz A, Williams J, Pentland A . Curcumin for radiation dermatitis: a randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patients. Radiat Res. 2013; 180(1):34-43. PMC: 3998827. DOI: 10.1667/RR3255.1. View

10.

Muecke R, Schomburg L, Glatzel M, Berndt-Skorka R, Baaske D, Reichl B . Multicenter, phase 3 trial comparing selenium supplementation with observation in gynecologic radiation oncology. Int J Radiat Oncol Biol Phys. 2010; 78(3):828-35. DOI: 10.1016/j.ijrobp.2009.08.013. View

11.

Cameron E, PAULING L . Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer. Proc Natl Acad Sci U S A. 1976; 73(10):3685-9. PMC: 431183. DOI: 10.1073/pnas.73.10.3685. View

12.

Chaiworramukkul A, Seetalarom K, Saichamchan S, Prasongsook N . A Double-Blind, Placebo-Controlled Randomized Phase IIa Study: Evaluating the Effect of Curcumin for Treatment of Cancer Anorexia-Cachexia Syndrome in Solid Cancer Patients. Asian Pac J Cancer Prev. 2022; 23(7):2333-2340. PMC: 9727370. DOI: 10.31557/APJCP.2022.23.7.2333. View

13.

Hanson M, Ozenci V, Carlsten M, Glimelius B, Frodin J, Masucci G . A short-term dietary supplementation with high doses of vitamin E increases NK cell cytolytic activity in advanced colorectal cancer patients. Cancer Immunol Immunother. 2006; 56(7):973-84. PMC: 11030861. DOI: 10.1007/s00262-006-0261-4. View

14.

Chen A, Martin A, Choy B, Fernandez-Penas P, Dalziell R, McKenzie C . A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention. N Engl J Med. 2015; 373(17):1618-26. DOI: 10.1056/NEJMoa1506197. View

15.

Shah S, Rath H, Sharma G, Senapati S, Mishra E . Effectiveness of curcumin mouthwash on radiation-induced oral mucositis among head and neck cancer patients: A triple-blind, pilot randomised controlled trial. Indian J Dent Res. 2021; 31(5):718-727. DOI: 10.4103/ijdr.IJDR_822_18. View

16.

Walfisch S, Walfisch Y, Kirilov E, Linde N, Mnitentag H, Agbaria R . Tomato lycopene extract supplementation decreases insulin-like growth factor-I levels in colon cancer patients. Eur J Cancer Prev. 2007; 16(4):298-303. DOI: 10.1097/01.cej.0000236251.09232.7b. View

17.

Dovinova I, Kvandova M, Balis P, Gresova L, Majzunova M, Horakova L . The role of Nrf2 and PPARgamma in the improvement of oxidative stress in hypertension and cardiovascular diseases. Physiol Res. 2021; 69(Suppl 4):S541-S553. PMC: 8603703. View

18.

Lee J, Han Y, Wang W, Jo H, Kim H, Kim S . Phytochemicals in Cancer Immune Checkpoint Inhibitor Therapy. Biomolecules. 2021; 11(8). PMC: 8393583. DOI: 10.3390/biom11081107. View

19.

Wirbel J, Pyl P, Kartal E, Zych K, Kashani A, Milanese A . Meta-analysis of fecal metagenomes reveals global microbial signatures that are specific for colorectal cancer. Nat Med. 2019; 25(4):679-689. PMC: 7984229. DOI: 10.1038/s41591-019-0406-6. View

20.

Lin S, Chang C, Hsu C, Tsai M, Cheng H, Leong M . Natural compounds as potential adjuvants to cancer therapy: Preclinical evidence. Br J Pharmacol. 2019; 177(6):1409-1423. PMC: 7056458. DOI: 10.1111/bph.14816. View