Three Unconventional Cancer Therapies

July 1998; Volume 1: 83-84

Source: Kaegi E. Unconventional therapies for cancer: 1. Essiac. 2. Green Tea. 3. Iscador. Can Med Assoc J 1998;158: 897-902;1033-1035;1157-1159.

These three analyses are the first in a series of six that reviews the safety and effectiveness of unconventional therapies commonly used by Canadian cancer patients. A multimodal search process was developed to supplement traditional search techniques. Reference lists can be found on the Canadian Breast Cancer Research Initiative's web site (www.breast.cancer.ca); annotated bibliographies are also available. Dr. Kaegi was Director of Medical Affairs and Cancer Control of the National Cancer Institute of Canada and the Canadian Cancer Society from 1993 to 1996.

Essiac

Essiac is an herbal mixture of burdock root, Indian rhubarb, sheep sorrel, and the inner bark of slippery elm. Originally administered as a tea and as an injection, it has been modified with the addition of four more herbs--watercress, blessed thistle, red clover, and kelp--and re-named Flor-Essence. As a tea, it is taken 1-3 times daily on an empty stomach; it is no longer injected. Adverse effects have not been reported, although its components may cause allergic dermatitis and diarrhea.

No published laboratory or clinical studies were identified, but a 1978-1982 government review of the care of 87 patients given essiac showed no ill effects. Interestingly, both burdock root and Indian rhubarb have high concentrations of anthraquinones; adriamycin, among other chemotherapeutic drugs, is an anthraquinone derivative. The weak evidence of Essiac's effectiveness comes from laboratory studies of its individual components; "the principal danger is that (Essiac) may delay the diagnosis and conventional treatment of serious disease."

Green Tea

Green tea, unlike black and oolong teas, is not oxidized; it is usually steamed or pan fried and then dried. Five to ten mL of the dried herb is steeped in a cup of boiling water, up to three times daily, without addition of milk or sugar. Tea drinking does not present a carcinogenic risk, and a cup may hold up to 80 mg of caffeine.

Green tea is chock full of phytochemicals, especially polyphenols (36%) such as flavonols (e.g., catechins), flavonoids, and flavondiols. Polyphenols are thought to be responsible for the chemopreventive effects, acting as antioxidants, inhibiting enzymes involved in cellular replication, or interfering with adhesion.

Epidemiologic studies suggest that green tea "moderately decreases the risk of cancer, especially cancers of the upper digestive tract." There are no human studies, however, about the treatment of cancer with green tea. Some animal systems data do suggest that green tea and its extract have reduced metastatic potential and suppressed chromosomal abnormalities.

Iscador

Iscador is the trade name of the most commonly available brand of an extract. It is made by fermenting an aqueous extract of the whole mistletoe plant with the bacterium Lactobacillum plantarum. The plant is then mixed and filtered to remove the bacteria before being standardized and packaged in ampules for injection subcutaneously into the abdominal wall, near the tumor site, if possible. Proponents believe that it may improve survival in patients with cancer of the cervix, ovary, breast, stomach, colon, and lung. A standard course of treatment means (individually adjusted) injections 3-7 times weekly in the morning over several weeks, administered before surgery.

Importantly, local inflammation at the site of the injection can be accompanied by constitutional symptoms; ingestion of the plant or intravenous administration of some of its constituents has caused death.

Laboratory evidence of biologic activity of this extract is abundant. Clinical data also exist, but the quality of this evidence is poor; there are reports of improved immune function, quality of life, and survival.

Recommendation

There are no data for essiac. Green tea likely helps to prevent specific neoplasms, but there are no data on treatment. Iscador has biologic activity but unknown clinical effectiveness. Later this year, the Canadian Medical Association Journal will evaluate hydrazine sulfate; vitamins A, C and E; and 714-X.