Traditional Chinese herbal medicine alongside treatment
Herbal formulas are used by most cancer patients in China and by many elsewhere to reduce chemotherapy side effects. Trials number in the hundreds but are mostly small, unblinded and poorly reported, so Cochrane reviews cannot say whether they help, and some herbs interact with anticancer drugs or damage the liver.
Overview
Traditional Chinese medicine prescribes multi-herb decoctions individualised to the patient, which makes standard trials difficult. Cochrane reviews of Chinese herbal medicine for chemotherapy side effects in colorectal cancer and for other cancers found many small trials with methodological weaknesses, inconsistent formulas and a strong tendency to positive results only in the Chinese-language literature; they conclude that the evidence is insufficient. Individual constituents have been developed into drugs (arsenic trioxide for promyelocytic leukaemia, homoharringtonine, camptothecin analogues), showing the pharmacology is real, but that is different from decoctions improving outcomes. Safety concerns include hepatotoxicity, contamination with heavy metals or undeclared pharmaceuticals, aristolochic acid nephrotoxicity and carcinogenicity, and CYP3A4 interactions with tyrosine kinase inhibitors. Patients should tell their oncology team what they take.
How it works
Multi-component formulas are claimed to restore balance and reduce toxicity; specific constituents have measurable pharmacological actions, but formula-level efficacy is untested to modern standards.
- Source of several approved drugs
- Large patient demand, useful to discuss openly
- Trials small, unblinded, poorly reported
- Hepatotoxicity and contamination
- Interactions with oral anticancer drugs
Latest papers
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