Reliability of Herbal Medicine in Cancer Treatment

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Cancer is an acute condition where abnormal cells consecutively divide and spread into neighboring tissues, which endangers cell life if the spread is not controlled. According to World Health Organization (WHO) (2010), cancer causes 13% of all deaths in 2004, accounting for 7.4 million deaths which mostly spread across lung (1.3 million deaths/year), stomach (803,000 deaths), colorectal (639,000 deaths), liver (610,000 deaths) and breast (519,000 deaths) cancer. Moreover, WHO predicts deaths caused by cancer will increase up to 11.5 million deaths in 2030. Through 200 years of cancer research, the first significant increase in overall relative survival rate was in 2005 when the number reached 68% and despite the predecessor existence of herbal medicine, the first tool to combat against cancer was surgery; hence the question of herbal medication legitimacy to combat against cancer arise.

History of Herbal Medication

Herbal medicine, as per its definition by World Health Organization (WHO) is “naturally occurring, plant-derived substances with minimal or no industrial processing that have been used to treat illness within local or regional healing practices”. Contrast to conventional medicine, herbal medicine originally takes the form of crude drugs such as tinctures, teas, poultices, powders, and other herbal formulations. Throughout history, our ancestors seek for food and medicine from plants. Petrovska (2012) outlined a basic timestamp regarding herbal medicine throughout the centuries:

Up Until 200 BCE

The oldest written evidence of medicinal plants usage is a Sumerian clay slab from Napgur, dating back 5000 years ago. Circa 2500 BC, Pen T’Sao, written by Emperor Shen Nung informs of 365 drugs based off roots and grasses, many of which are still used today. The Ebers Papyrus (circa 1550 BC) presents a collection of 800 proscriptions in reference to 700 plant species. Homer’s epics (circa 800 BC), 63 plants were referred. Herodotus (500 BC) used natural ingredients for treatment, and similarly the works of Hippocrates (459-370 BC) contain 300 medicinal plants categorized by physiological action. ‘De Causis Plantarum’ and ‘De Historia Plantarum’, written by Theophrastus (371-287 BC) generated a classification of more than 500 medicinal plants known at the time.

Throughout the Common Era

‘De re medica’, written by Celcus (25 BC-50 AD) referred 250 medicinal plants. Dioscorides (circa 77 AD) dubbed as the ‘father of pharmacognosy’ wrote ‘De Materia Medica’, describing 657 plant-based drugs. Following his work, Pliny the Elder (23 AD-79) wrote approximately 1000 medicinal plants in ‘Historia Naturalis’. Galen (131 AD-200) introduced new plant drugs not mentioned previously. Following these discoveries, monasteries upheld and developed the knowledge well into the Middle Ages; Arabs and Indians trade pharmacotherapy, introducing the knowledge to Europe through trading. Though in the late 19th and early 20th century, the credibility of herbal medicine was questioned which inquires further of this essay’s main problem: is it reliable?

Medicine Development and Cancer

The first arguably credible and successful tool of treating cancer is through surgery and chemotherapy, seeing a 68% rise of survival rate in 2005 (DeVita & Rosenberg, 2012). Referring back to DeVita & Rosenberg (2012), surgery was also the first tool available. In 1809, Ephraim McDowell removed an ovarian tumor without the use of anesthesia and provided evidence that tumor masses could be cured by surgery. The next milestone in cancer treatment began in 1895 through the introduction of radiation, which was further encouraged by the discovery of radium by Pierre and Marie Curie. Following after was Paul Ehrlich by the 20th century, who first made a concerted effort to develop chemicals to cure cancer, where he coined the word chemotherapy. In 1975, Köhler and Milstein developed methods for producing antibodies by fusing cultured myeloma cells with normal B cells from immunized mice, which led to the successful development of therapeutic antibodies for cancer.

Presently, cancer treatment is based on surgery, radiation therapy, chemotherapy and immunotherapy which are based on synthetic drugs.

Herbal Medication and Cancer

Argumentatively, herbal medicine does do its bidding in treating sickness, even one such as cancer. Nie et al. (2015) argues that as cancer is now widely recognized as a systemic humoral disease, the function of herbal medicine is to modulate the whole body in a more holistic way. Cancer is also the development which involves multiple genes and proteins and the complex biology of cancer development requires relatively complex approaches, which is why Hu et al. (2016) believes that the inclusion of herbal medicine is advantageous to combat cancer.

Furthermore, there are numerous studies that exhibits herbal medicine as workable treatments for cancer as source of vitamin and compounds that are able to suppress effect on carcinogenesis and cancer metastasis, increase anti-cancer activities as well as induce apoptosis in cancer treatment. In addition, herbal medicine can also treat cancer alongside chemotherapy while acting as adjuvant treatment as well, and can even help treat cancer chemotherapy-induced side effects. Though one study finds that such accompaniment of herbal-drug medicine combinations results in almost no impression and can even become hazardous.

The Rising Trend of Herbal Medication

Wachtel-Galor & Benxie (2011) mentioned that over the past 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still rely on traditional practitioners and herbal medicines for their primary care. Wachtel-Galor & Benxie (2011) further explains that 90% of the population in Africa and 70% in India still depend on traditional medicine. Furthermore, in China, traditional medicine accounts for around 40% of all health care delivered and more than 90% of general hospitals in China have units for traditional medicine. Wachtel-Galor & Benxie (2011) further highlights the trend in other countries. For example, in the United States in 2007, about 38% of adults and 12% of children were using some form of traditional medicine. A survey conducted in Hong Kong in 2003 reported that 40% of the subjects surveyed showed marked faith in TCM compared with Western medicine. Herbal medicine, more specifically as complementary medicine (CM) is widely used among cancer patients throughout the world. In Europe, CM was used by between 15% and 73% of cancer patients. In Switzerland, two studies showed a prevalence of CM use of 26.5% and 39%. Swiss mandatory basic health insurance has covered four CM methods since 2012 (traditional Chinese medicine, homeopathy, herbal medicines, and anthroposophical medicine).

Herbal Medication Vs Conventional Medication

Despite such elucidation in support of herbal medicine, the use of herbal medicine by patients with cancer may result in potentially negative effects that can impact the efficacy and safety of conventional anticancer treatment (Ben-Arye et al., 2015). Within the study Ben-Arye et al. (2015) also informs safety-related concerns that are posed by herb-drug interactions: “CYP induction can cause a reduction in bioavailability and subsequently the effectiveness of anti-cancer agents, whereas enzyme inhibition can increase the risk of toxicity, such as that observed with etoposide, paclitaxel, vinblastine and vincristine”. Also previously referred, Alsanad et al. (2016) states that there is a possibility of herbal medication becoming hazardous.

Zhang et al. (2015) discussed in ‘The Complexity of Safety of Herbal Medicine: From Prejudice to Evidence’ a number of causes of adverse events to herbal medicines. Zhang et al. (2015) stated that there are both direct and indirect reason. The former refers to the intrinsic toxicity at normal therapeutic dosage or in overdose whereas the latter refers to the adverse effects associated with herbal medicines, which may result from contamination of products with toxic metals, adulteration, misidentification, or substitution of herbal ingredients, or improperly processed of prepared products. Zhang et al. (2015) also mentions about wrong indication of herbal medicine which leads to inappropriate use of herbal medicines as well as the danger of herb-drug interaction which are associated with nearly 60% of the risk of adverse outcomes — users of medicinal herbs are usually suffering from chronic conditions for which they are likely to take prescribed concomitantly. This, in turn, further increases the potential of herb-drug interaction.

Conclusion

Regarding herbal medicine, there are still many variables unknown and much to discover. Previous research has shown us great advancements in understanding the ability of herbal medicine in treating cancer, how beneficial the natural ingredients are towards the human immunity system. Though said, there are yet to be any cumulative statistical data of the success rate regarding herbal medicine in treating cancer. Herbal medicine may be the answer to alternative and healthier cancer treatment method, but we still need to observe its abilities and reliability in this field.

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