Information regarding the current naturalistic options that have a proven benefit.

1. Are There Proven Herbal
Approaches to Cancer??*
J. David Pitcher, Jr., MD
*Referencing a lecture given by
Veronika Butterweck, PhD

2. Herbal Products
60,000,000 adults in the U.S. used
herbal products in 2002
$54.00/person average cost
Approx. 3 ¼ billion $ U.S.
Perception of the public as safer, less
caustic, and lower cost

3. Herbal Products
Used by cancer patients:
Attempting to prevent cancer
Attempting to treat cancer
Attempting to treat adverse effects
associated with other cancer treatments

4. Herbal Products
Plants useful in preventing cancer:
tomatoes, garlic, green tea, soy beans
More research needed for:
mistletoe
Chemotherapy induced nausea and
vomiting effectively treated with:
ginger

5. Lycopenes
Abundant in several fruits including guava,
watermelon, pink grapefruit, rosehips, and
tomatoes
Tomato products (tomato sauce, tomato
paste, ketchup) are the major dietary
source of lycopene
A carotenoid
A powerful antioxidant that has shown
beneficial activity in several diseases
(cardiovascular, cancer, Alzheimer’s
disease, multiple sclerosis)

6. Carotenoid Biosynthesis
Lycopene undergoes cyclization of
one or both end groups
alpha-carotene
beta-carotene
delta-carotene
gamma-carotene

7. Proven Anti-Cancer Activity??
Epidemiologic and case-control studies have
associated increased consumption of tomato
products and greater blood concentrations of
lycopene with a reduced risk of mortality from
several cancers, including prostate and lung
cancers
In prostate cancer a reduction in risk of 33% was
found among men who consumed > 10 servings of
tomato products per week (30-50mg per day)
(Giovanucci, 1995, JNCI 87:1767)
Levels of serum PSA were found to decline in
patients who received lycopene tomato extract
(Kucuk, 2001, Cancer Epidemiol Biomarkers Prev
10:861
15 mg lycopene 2 x daily 3 weeks before radical
prostatectomy: smaller tumors (80% vs 45%), less
involvement of surgical margins (Kucuk, 2002, Exp
Biol Med 227:881)

8. Lycopene or tomato sauce?
66 patients diagnosed by biopsy with
prostate carcinoma were given either
tomato sauce pasta entrees or lycopene
(30 mb/day) or no tomato sauce for 3
weeks before prostatectomy
Tomato sauce consumption appeared to
increase cell death in carcinomas,
compared with controls (Kim, Nutrition
Cancer, 2003, 47:40)

9. Anything else in the tomato?
Beta-carotene, gamma-carotene,
epsilon-carotene, phytoene, and
phytofluene are all shown to
accumulate in prostate tissue upon
dietary inclusion of the tomato
Acycloretinoic acid has been shown
to be an oxidative product of
lycopene in pig and human liver
fractions

10. Garlic

11. Sulfur Compounds in Garlic
Alliin (major cysteine sulfoxide
in Garlic) +
Alliinase (an enzyme in fresh,
whole Garlic or correctly dried Garlic
powders)
→ Allicin, the active antibiotic
compound
Allicin → sulfides, ajoene, dithiins,
etc.

12. Garlic and Cancer
Ancient Egyptians, Indians, and Greeks all
used garlic externally to treat tumors
Dietary intake of garlic is associated with
significant, dose-dependent reductions in
risk of specific cancers, including colon and
stomach cancer (Boon & Wong, Expert
Opinion in Oncol, 2004, 5:2485)
Consumption of aqueous garlic extract
significantly lowered total and free PSA
values; and significantly improved urinary
frequency and flow (Durak, Nutrition Res,
2003, 23, 199)

13. Chemoprotective Properties
Induction of phase II detoxification
enzymes
glutathione transferases, quinone reductase,
epoxide hydrolase…
Antioxidant activity = cancer prevention
Free radicals => lipid peroxidation =>
carcinogenesis and reduction of
endogenous antioxidant levels
Garlic reduces lipid peroxidation and
increases levels of vitamins C and E,
superoxide dismutase, catalase, etc.

14. Green Tea (Camellia sinensis L.)
Flavanols, flavonols, lignans,
ellagitannins
Antioxidants, anti-inflammatories
Helps prevent cancers,
atherosclerosis, arthritis, Alzheimer’s
disease

15. Flavonols in Green Tea
Antioxidant, anti-carcinogenic & anti-
inflammatory flavonols contribute to
Green Tea’s therapeutic effects
quercetin
myricetin

16. Green Tea & Cancer
A total of 20 studies reported that green tea
decreases the general risk of cancer
incidence, cancers of the breast, GI
system, lungs, ovaries, prostate, and
urinary system (Boon & Wong, Expert
Opinion in Oncol, 2004, 5:2485)
Amount of green tea: 1-200 g/month or
85.7 ml/day (approx 10 cups)
A follow-up case control study found a
significant improvement of the 5-year
survival rate of bladder cancer patients
who consumed green tea (Wakai, Jpn J
Cancer Res, 1993, 84:1223)

17. Soy Products
Major compounds:
genistein
daidzein
glycitein
glucosides: denistin, daidzin, glycitin
acetlyglucosides & malonylglucosides

18. Cancer preventive
Soy appears to have a protective effect for a
variety of cancers. The evidence is not generally
definitive for any specific dose or cancer type
A total of 17 case-control and cohort studies
reported that intake of soy decreased the
occurrence of breast, lung, stomach,
endometrium, prostate, and thyroid cancer (Boon
& Wong, Expert Opinion in Oncol, 2004, 5:2485)
The doses reported ranged from 0.1-0.5 g/day to
140 g/day
Anti-angiogenic effects of genistein, daidzein, and
biochanin A may contribute to antitumor activity

19. Cancer treatment
Prostate cancer: controversial results
Soy protein supplementation (2 x daily 57
mg soy isoflavones, 3 months) lead to a
trend towards longer PSA doubling time
(Spentzos, Clin Can Res 2003, 9:3282
No significant difference between baseline
and post-treatment serum levels of total
PSA (12 weeks treatment, 60 gm genistein/
day)(Kumar, Prostate, 2004, 59:141)
Strong antioxidants in in vitro assays

20. Mistletoe (Viscum album L.)
Immunostimulant
Contains lectins (Specialized
proteins); ML I or viscumin, ML II &
ML III that are cytotoxic to human
leukemia cells
Also has viscotoxins, proteins that
have some anticancer effects
Flavonoids, lignans

21. Mistletoe & Cancer
Patients with pancreatic cancer had better survival
times, compared with stage-related survival
reported in literature (Schafferm eyer,
Complement The Med, 1998, 6:172)
Several studies of cancer patients including
carcinoma of the GI tract, breast, and lung cancer
indicated that the mean survival time was ~ 40%
longer than in the control groups (Grossarth-
Maticek, Altern Ther Health Med, 2001, 7:57)
In colorectal cancer patients who had undergone
surgery treatment with chemotherapy + mistletoe
extract had better survival rates compared with
those patients receiving chemotherapy alone
(Cazacu, Cancer Biother Radiopharm, 2003,
18:27)

22. Ginger (Zingiber officinale Roscoe)
One of ginger’s primary usage is as
an antiemetic for motion sickness,
postoperative nausea and vomiting,
and intense morning sickness

23. Ginger
Gingerols make up the resinous
fraction – the main pungent
constituents
Anti-inflammatory
COX-2 inhibitors
Antiemetic
Antioxidant

24. Treatment of nausea
Encapsulated ginger given over a 2-day
period (dose not provided) significantly
decreased severity and duration of nause
in leukemia patients (Pace, Dissertation
Abstracts International, 1986, 47:3297)
Powdered ginger toot, metoclopramide,
ondansetron: The antiemetic efficacy of
ginger was found to be equal to that of
metoclopramide but ondansetron was
found to be superior to both (Sontakke,
Indian J Pharmocol, 2003, 35:32)
Proposed mechanism: 5-HT3 antagonism

25. Summary & Conclusion
Overall decreased risk of cancer associated with
taking garlic, green tea, soy, and tomatoes
Mimimum dose associated with decreased cancer
risk has not been clearly defined
There is no guarantee that patients will not
develop cancer if they ingest any (or all) of these
herbs
Herbal medicines will not replace conventional
medicines
The reviewed herbs have no significant adverse
effects and do not interact negatively with
conventional treatments