Using Chinese herbs either alone or in conjunction with chemotherapy may help protect a breast cancer patient’s bone marrow and immune system, as well as improving the woman’s overall quality of life.

Sixty per cent of women undergoing chemotherapy for breast cancer experience a range of significant short term side effects. These include nausea, vomiting and fatigue, as well as inflammation of the gut lining, decreased numbers of red and white blood cells and decreased numbers of blood platelets.

Chinese medicinal herbs include mixtures of herbal compounds or extracts from herbs, and they are prescribed to counteract the side effects of chemotherapy. This Cochrane Systematic Review set out to see if there is conventional evidence indicating that these medicines are safe and whether there is evidence that the medicines are effective.

The researchers identified seven randomised studies involving 542 patients with breast cancer. By analysing these data, the researchers concluded that there was no evidence that the Chinese medicinal herbal treatment caused harm, and some evidence that it might reduce side effects.

“Further trials are needed before the effects of traditional Chinese medicines for people with breast cancer can be evaluated with any real confidence,” says Assistant Professor Jing Li, who works at the Chinese Cochrane Centre in Chengdu, China.

Ginseng, one of the most widely used herbs in traditional Chinese medicine, may improve survival and quality of life after a diagnosis of breast cancer, according to a recent study by Vanderbilt-Ingram Cancer Center researchers.

Ginseng is a slow-growing perennial herb whose roots have been used in traditional Chinese medicine for more than 2,000 years. The two main classes of ginseng — red and white — have different biological effects, according to traditional Chinese medicine theory. White, or unprocessed, ginseng is used over long periods to promote general health, vitality and longevity. Red, or processed, ginseng provides a much stronger effect and is used for short periods to aid in disease recovery.

Both varieties of ginseng contain more than 30 chemicals, called ginsenosides, which have anti-tumor effects in cell culture and animal studies, suggesting that the herbs may provide specific benefits to cancer patients. In fact, ginseng use has been increasing among cancer patients in recent years, particularly in women diagnosed with breast cancer.

However, despite the encouraging laboratory findings, scientific analysis of ginseng’s health benefits in patient populations has been lacking. “There is a lot of skepticism about herbal medicine,” said Shu. “That is why we are taking the observational approach at this time to see whether there is any efficacy. If so, we can go to the next phase … and eventually go to clinical trials.”

Shu and colleagues assessed the effects of ginseng use in breast cancer survivors as part of a large epidemiological study, the Shanghai Breast Cancer Study, which has followed 1,455 breast cancer patients in Shanghai since 1996. For the current study, Shu and colleagues evaluated breast cancer patients for ginseng use both before and after their diagnosis of breast cancer. All patients who used ginseng had received at least one type of conventional cancer therapy (e.g., surgery, chemotherapy and/or radiotherapy).

Information on ginseng use prior to cancer diagnosis, which was available for every subject, was used to determine whether prior ginseng use predicted survival. At follow up — about three to four years after diagnosis — the researchers asked about ginseng use since diagnosis. That information, which was available only for survivors, was used to look at quality of life measurements — i.e., physical, psychological, social and material well-being.

Before diagnosis, about a quarter of patients (27.4 percent) reported using ginseng regularly. After diagnosis, that percentage jumped to 62.8 percent, the researchers found. They also found significant improvements in both survival and quality of life measures in patients who used ginseng. “When patients used ginseng prior to diagnosis, they tended to have higher survival,” Shu explained. “Ginseng use after cancer diagnosis was related to improved quality of life.”

The findings suggest that ginseng may provide tangible benefits to breast cancer survivors, but there are limitations to the study. The varieties and the methods of ginseng use and the use of other complementary and alternative therapies could not be fully accounted for in the analysis. Also, the quality of life measures exclusively relied on patient self-reporting.

Although side effects of ginseng use were not recorded in this study, Shu warned that the seemingly innocuous root can create problems when improperly used and should be taken with caution. “It’s not a ‘drug’ in terms of being managed by the FDA, but it was used as a drug in traditional Chinese medicine,” she said. “Any drug may have some side effects and may interact with other drugs. So, discuss with your primary care doctor before you decide to take ginseng roots or products.”

Shu hopes to confirm and expand the current findings through continued collection of data in this patient population, from another ongoing study of 4,000 breast cancer patients, and eventually, in randomized clinical trials. Scientific study of complementary and alternative medicines is tricky though, said Shu. “Chinese traditional medicine is very individualized. It gives you different drugs based on your symptoms and your overall health. There is much to be learnt.”

 The large epidemiological study, led by Xiao-Ou Shu, M.D., Ph.D., was published online recently in the American Journal of Epidemiology.

Other authors on the paper were Yong Cui, M.D., Hui Cai, M.D., Ph.D., Meng-Hua Tao, M.D., and Wei Zheng, M.D., Ph.D., from Vanderbilt and Yu-Tang Gao, M.D., from the Shanghai Cancer Institute. The research was supported by grants from the National Cancer Institute.

Warren L. Cargal, L. Ac.

Recently, I attended the Society for Integrative Oncology fifth international conference. There were many excellent research orientated studies demonstrating the positive effects of some Chinese herbals to inhibit cancer angiogenesis.

However what was most interesting to me were the presentations by several of the large teaching Universities, many of whom are now setting up in-house nutritional counselors to advise their patients during and after cancer treatments.

One revealing statistical statement was that if patients beginning cancer treatment were not taking supplements (herbs included), that by the end of their treatment 95 % of them would be taking some form of supplement.

Another statement made by one of the presenters was that she had lost count of how many patients show up in her office with a large bag of supplements wanting to know which one they should or should not be taking during or after their cancers treatments.

Currently most cancer treatments have no provisions for nutritional or botanical support and in effect most Oncologists either don’t understand or don’t support their use.

There is an extensive body of research demonstrating the ability of botanicals to inhibit angiogenesis, to activate protective properties of the body and stimulate regenerative processes.

Furthermore the use of some botanicals has been shown to decrease the toxic effects of chemotherapy, radiation and improve drug tolerance.

I thought it may be helpful to identify our basic post cancer treatment protocol and its rationale. Additions will be made based on the type of cancer and treatment modalities used. When approaching a disease like cancer it is important to formulate a balanced protocol that addresses (1) current weaknesses of the person (either pre or post cancer) (2) type of cancer and characteristics and (3) exogenous factors such as diet, lifestyle, and environment.

PectaSol Modified Citrus Pectin
Chemically, pectin is what’s known as a long-chain polysaccharide, a string of molecules comprised primarily of sugar (about two-thirds of its molecular structure closely resembles the sugar galactose). Given its constitution, pectin is particularly attractive to molecules that bind with galactose—and among these molecules is a class of carbohydrate-binding proteins called galectins.

Cancer cells carry a disproportionate number of these galectins—specifically galectin-3.

Hundreds of studies have pointed to the role of galectins in cancer development over the years—the most recent have exposed galectin-3 as a key player in the growth and spread of cancer within the body.

Galectin-3 promotes cancer progression in three interconnected ways:
• It allows cancer cells to attach to one another, forming groups that can survive in
your bloodstream and migrate to other parts of your body.
• Once cancer cells have formed a main tumor, galectins allow the cells to attach
themselves to new sites as well, forming secondary tumors.
• Lastly, galectin-3 nourishes malignant tumors by stimulating new blood vessel
growth (even where there was no blood supply before) to feed the tumor. This process is called angiogenesis.

Modified Citrus Pectin has a high affinity for galectins, binding these cells and preventing their spread and growth.

One study (published in the prestigious Journal of the National Cancer Institute) showed that administration of MCP reduced tumor metastasis by a remarkable 90 percent. These incredible results were supported two years later, in a follow-up study that demonstrated a similar decrease in melanoma cell adhesion—a phenomenon that the study authors attributed to MCP’s superior galectin-3 binding capabilities.

Platt D, Raz A. “Modulation of the lung colonization of B16-F1 melanoma cells by citrus pectin,” J Natl Cancer Inst, 1994; 84(6):438-42.

Ten Mushroom Formula
As immune stimulants, mushrooms can be used to help treat cancer and fight infections by initiating an immune response which results in higher levels of white blood cells, cytokines, antibodies and complement proteins. The cell walls of these mushrooms contain large polysaccharides called 1,3 ß-D-glucans linked to the chitin framework. These polysaccharides can also have smaller branching chains called 1,6 ß-D-glucans. Each mushroom has a different arrangement and degree of branching, which results in a different immune response. In addition, some mushrooms have 1,6 ß-D-glucans with 1,3 ß-D-glucan branching. A fragment of a mushroom ß-glucan serves as an antigen which a macrophage will display on its surface and present to T-helper cells. These T-helper cells will in turn release a variety of immune stimulating substances, cytokines, which will result in a cascade of immune responses. Cytokines released by both the macrophage and T-helper cells will cause a proliferation of T cells and B cells and stimulate production of complement proteins. Certain mushrooms, especially reishi, maitake and multi-mushroom blends, also dramatically increase the activity of natural killer cells and facilitate apoptosis of cancer cells resulting in the reduction of tumors. Macrophages and neutrophils will increase their levels of antimicrobial substances. These substances include antimicrobial enzymes and toxins, such as superoxide radical, hydrogen peroxide, hydroxyl radical, hydrochloruous acid and nitric oxide. These substances are produced in membrane-bound sacs, lysosomes, so they do not enter the cytoplasm of the white blood cell. When a macrophage or neutrophil envelopes a bacterium or virus, the microbe is enveloped within another membrane bound sac, a phagosome, which separates it from the cytoplasm of the phagocyte. Once a lysosome and phagosome merge, the toxins are released onto the microbe and destroy it (Delves 2006). The ß-glucan fragments thus serve to charge the immune system into an activated state making response to disease and infection much swifter and more effective.

Beta 1,3 Glucan
Numerous studies report that beta-1, 3-D glucan has anti-tumor and anti-cancer activity.[1],[2] In one study, intralesional administration of beta-1, 3-D glucans resulted in rapid tumor shrinkage. [3] In another study with mice, beta-1, 3-D glucan in conjunction with interferon gamma (INF-gamma) inhibited both the establishment of tumors and liver metastasis.[4] In some studies, beta-1, 3-D glucans enhanced the effects of chemotherapy. In studies on bladder cancer with mice, administration of cyclophosphamide, in conjunction with beta-1, 3-D glucans derived from yeast resulted in reduced mortality.[5] In human patients with advanced gastric or colorectal cancer, the administration of beta-1, 3-D glucans derived from shiitake mushrooms, in conjunction with chemotherapy (mitomycin C + 5-Fluorouracil) resulted in prolonged survival times compared to a control group receiving identical chemotherapy.[6]

Elevated cholesterol: Beta-glucans appear to be the major cholesterol lowering agents in oat bran fiber. Studies reveal that soluble glucans in oat bran can lower total cholesterol and LDL cholesterol levels in patients with hypercholesterolemia.[7],[8] Similar cholesterol lowering effects are reported in studies where barley is the source of beta glucans.[9]
Prevention of infection: 41 patients with multiple trauma (but no infections) were admitted to a double-blind trial to receive beta-1, 3-D glucan or a placebo. 11 of 20 controls contracted pneumonia vs only 2 of 21 treated with beta-1, 3-D glucan. Sepsis developed in 35% of controls vs 9.5% of those treated with glucan; deaths due to infection and general mortality in controls was 30% and 42.1% compared to 4.8% and 23.5% in the beta-1, 3-D glucan-treated group.[10]

Radiation exposure: In animal experiments, therapy with beta-1, 3-D glucans reportedly enhances recovery after radiation exposure and results in improvements in the bone marrow, spleen and white blood count.[11] ,[12]

Septic shock: Toxins from either external or internal (infections) sources cause leukocytes to release pro-inflammatory cytokines that can produce a series of biochemical events that ends in septic shock. Administration of soluble beta-1, 3/1/6 glucans reduces the production of pro-inflammatory cytokines, most notably Tumor Necrosis Factor-alpha (TNF-alpha), which reduced mortality.[13]

Surgery: In mice, treatment with beta-1, 3-D glucans either pre-or post-surgically reduced the production of nuclear factor-kappa B (NF-kappa B) and nuclear factor interleukin 6 (NF-IL6), which increased long-term survival approximately 40%.[14]

Wound healing: Macrophage activity is known to play a key role in wound healing from surgery or trauma. In both animal and human studies, therapy with beta glucan has provided improvements such as fewer infections, reduced mortality, and stronger tensile strength of scar tissue.

[1]Luzio N.R. Williams D.L. et al, “Comparative evaluation of the tumor inhibitory and antibacterial activity of solubilized and particulate glucan,” Recent Results Cancer Res 75:165-172. 1980.
[2] Morikawa K, Takeda R, Yamazaki M, et al., Induction of tumoricidal activity of polymorphonuclear leukocytes by a linear beta-1, 3-D-glucan and other immunomodulators in murine cells, Cancer Res. 1985 Apr; 45(4): 1496-501.
[3] Mansell PW, Ichinose H, Reed RJ, et al., “Macrophage-mediated destruction of human malignant cells in vivo,” J Natl Cancer Inst. 1975 Mar; 54(3): 571-80.
[4]Sveinbjornsson B, Rushfeldt C, Seljelid R, et al., “Inhibition of establishment and growth of mouse liver metastases after treatment with interferon gamma and beta-1, 3-D-glucan,” Hepatology. 1998 May; 27(5): 1241-8.
[5]Thompson IM, Spence CR, Lamm DL, et al., “Immunochemotherapy of bladder carcinoma with glucan and cyclophosphamide,” Am J Med Sci. 1987 Nov; 294(5): 294-300.
[6] Wakui A, Kasai M, Konno K, et al., “Randomized study of lentinan on patients with advanced gastric and colorectal cancer. Tohoku Lentinan Study Group,” Gan To Kagaku Ryoho. 1986 Apr; 13(4 Pt 1): 1050-9.
[7]Davidson MH; Dugan LD; Burns JH, et al., “The hypocholesterolemic effects of beta-glucan in oatmeal and oat bran. A dose-controlled study,” JAMA, 1991 Apr 10, 265:14, 1833-9.
[8]Braaten JT, Wood PJ, Scott FW, et al., “Oat beta-glucan reduces blood cholesterol concentration in hypercholesterolemic subjects,” Eur J Clin Nutr. 1994 Jul; 48(7): 465-74.
[9]McIntosh GH; Whyte J; McArthur R, et al., “Barley and wheat foods: influence on plasma cholesterol concentrations in hypercholesterolemic men,” Am J Clin Nutr, 1991 May, 53:5, 1205-9.
[10]de Felippe Junior J, da Rocha e Silva Junior M, Maciel FM, et al., “Infection prevention in patients with severe multiple trauma with the immunomodulator beta 1-3 polyglucose (glucan),” Surg Gynecol Obstet. 1993 Oct; 177(4): 383-8.
[11] Patchen ML; DiLuzio NR; Jacques P, et al., “Soluble polyglycans enhance recovery from cobalt-60-induced hemopoietic injury,” J Biol Response Mod, 1984 Dec, 3:6, 627-33.
[12]Petruczenko A, “Glucan effect on the survival of mice after radiation exposure,” Acta Physiol Pol. 1984 May-Jun; 35(3): 231-6.
[13]Soltys J, Quinn MT, “Modulation of endotoxin- and enterotoxin-induced cytokine release by in vivo treatment with beta- (1,6)-branched beta- (1,3)-glucan,” Infect Immun. 1999 Jan; 67(1): 244-52.
[14] Williams DL, Ha T, Li C, et al., “Inhibiting early activation of tissue nuclear factor-kappa B and nuclear factor interleukin 6 with (1–>3)-beta-D-glucan increases long-term survival in polymicrobial sepsis,” Surgery. 1999 Jul; 126(1): 54-65.

Resveratrol
Resveratrol is known for its ability to protect plants from bacteria and fungi. Purified versions have been described in scientific journals as potential anti-cancer, anti-inflammatory and anti-atherogenic agents, and for their ability to modulate cell growth.

Scientists found that Resveratrol apparently helps turn off a protein in the body that prevents cancer cells from being killed, as they should. The protein, called NF-kappa B, attaches to DNA inside cell nuclei and turns genes on and off like a switch.

In vitro resveratrol interacts with multiple molecular targets (see the mechanisms, and has positive effects on the cells of breast, skin, gastric, colon, esophageal, prostate, and pancreatic cancer, as well as leukemia.

Resveratrol interferes with all three stages of carcinogenesis — initiation, promotion and progression. Experiments in cell cultures of varied types and isolated subcellular systems in vitro imply many mechanisms in the pharmacological activity of resveratrol. In vitro, resveratrol “inhibited the proliferation of human pancreatic cancer cell lines.” In some lineages of cancer cell culture, resveratrol has been shown to induce apoptosis, which means it kills cells and may kill cancer cells. Resveratrol also possesses antioxidant and anti-angiogenic properties.

CoQ 10
The body also uses coenzyme Q10 as an antioxidant. An antioxidant is a substance that protects cells from chemicals called free radicals. Free radicals can damage DNA (deoxyribonucleic acid). Genes, which are pieces of DNA, tell the cells how to work in the body and when to grow and divide. Damage to DNA has been linked to some kinds of cancer. By protecting cells against free radicals, antioxidants help protect the body against cancer.

Low blood levels of coenzyme Q10 have been found in patients with myeloma, lymphoma, and cancers of the breast, lung, prostate, pancreas, colon, kidney, and head and neck.

Small studies have been done on the use of coenzyme Q10 after standard treatment in patients with breast cancer:
• In a study of coenzyme Q10 in 32 breast cancer patients, it was reported that some signs and symptoms of cancer went away in 6 patients. Details were given for only 3 of the 6 patients. The researchers also reported that all the patients in the study used less pain medicine, had improved quality of life, and did not lose weight during treatment.
• In a follow-up study, two patients who had breast cancer remaining after surgery were treated with high doses of coenzyme Q10 for 3 to 4 months. It was reported that after treatment with high-dose coenzyme Q10, the cancer was completely gone in both patients.
• In a third study led by the same researchers, 3 breast cancer patients were given high-dose coenzyme Q10 and followed for 3 to 5 years. The study reported that one patient had complete remission of cancer that had spread to the liver, another had remission of cancer that had spread to the chest wall, and the third had no breast cancer found after surgery.

Alpha Lipoic Acid
Free radical damage can promote the activity of a particular cell protein called NF kappa B. (NF-kB) NF-kB works to promote inflammation and genetic changes that have been linked with the development of cancer. Studies at the University of California at Berkley have found that when cells are bathed in ALA, NF-kB is inhibited thus preventing cell mutations from replicating. Researchers believe that this has significant implications in inhibiting the formation of cancerous tumors.

In various ways, lipoic acid appears to help restore a cellular “signaling” process that tends to break down in older blood vessels. It reduces mitochondrial decay in cells, which is closely linked to the symptoms of aging. With age, glutathione levels naturally decline, making older animals more susceptible to both free radicals and other environmental toxins – but lipoic acid can restore glutathione function to near normal. And the expression and function of other genes seems to come back to life.

Studies have shown that mice supplemented with lipoic acid have a cognitive ability, behavior, and genetic expression of almost 100% detoxification and antioxidant genes that are comparable to that of young animals.

Green Tea (ECGC extract from Green Tea)
Laboratory cell culture studies show that green tea polyphenols are powerful triggers of apoptosis (cell suicide) and cell cycle arrest in cancerous but not in normal cells. (Cell cycling is the process cells go through to divide and replicate.)
These anticancer actions have been assumed to be due to the powerful antioxidant effects of green tea’s catechins, especially epigallocatechin-3-gallate (EGCG). This is a reasonable assumption, given that a number of studies have shown that green tea possesses remarkable antioxidant properties. In one study published in the November 2004 issue of Mutation Research, EGCG’s protective antioxidant effects against several carcinogens were found to be 120% stronger than those of vitamin C.
One of these mechanisms is green tea’s ability to inhibit angiogenesis, the development of new blood vessels. Cancer cells, which are constantly attempting to divide and spread, have an endless appetite that can only be temporarily quieted by decreasing the number of blood vessels that supply them with nutrients. By inhibiting angiogenesis, green tea helps starve cancer.
Studies also show that green tea works at the genetic level, shutting off genes in cancerous cells that are involved in cell growth, while turning on those that instruct the cancer cells to self-destruct. EGCG has even been found to work as a pro-oxidant or free radical, but just inside cancer cells, where it causes so much damage that the cancer cells’ self-destruct mechanisms are triggered.