A REPLY TO DR. KLAUSNER:
NATURAL PRODUCTS SHOULD BE
TESTED FIRST AGAINST CANCER

From The Cancer Chronicles #29
© Sept. 1995 by Ralph W. Moss, Ph.D.

Dr. Richard Klausner, the new NCI director, has called for the development of what he calls "non-natural products" to fight cancer (see p. 1). To us, this is moving NCI even further in the wrong direction. As some NCI scientists have already shown, there are compounds found in natural products that confirm their long folk usage in the fight against cancer. The NCI should step up its investigation of these agents, especially the non-toxic ones, not only for cytotoxic (cell-killing) ability, but even more importantly for their immune-enhancing ability. This should form a major portion of the NCI budget.

By now, almost everyone has heard about the anticancer activity of a few toxic plants. Taxol of course has been the wonder drug of the 90s—now largely run out of steam. It is derived from the bark of the Western yew tree (Taxus brevifolia) and is FDA approved for use in the treatment of ovarian and breast cancer.

Many readers will also be aware of the so-called vinca alkaloids (Vincristine and Vinblastine), which are derived from a European creeping plant, called the periwinkle (Vinca rosea).

In addition, drugs called epipodophyllotoxins (e.g., Etoposide and Teniposide) are derived from mandrake or Mayapple (Podophyllum peltatum).Many other anticancer drugs are products of the type of aerobic bacteria called Streptomyces. These include such well-known agents as Bleomycin and Doxorubicin.

PLANTS ARE USEFUL

So the principle that plant-derived chemicals can be useful against cancer is hardly controversial. And Dr. Klausner could plausibly argue that much of the work on these treatments was done at NCI. However, we would rejoin that all of these agents are bound by the limitations of chemotherapy. The agents all work by poisoning normal and cancer cells alike, and hopefully the cancer cells at a faster rate than the normal ones.

Predictably, all of these agents cause significant toxicity in patients, sometimes worse than that seen synthetic agents. This has long been known. In fact, records show that Mayapple was even used by some American Indians to commit suicide!

By contrast, most of the herbal treatments we discuss in this issue either work by mechanisms other than straight cytotoxicity, i.e., through immune enhancement, detoxification, or some unknown mechanism. They all lack the obvious, harmful side effects of cytotoxic drugs.

Contrary to current dogma, it is not necessary for a treatment to cause major toxicity in order for it to be of therapeutic benefit to cancer patients.

Furthermore, these non-toxic agents can often be administered by the patients themselves or by their primary care givers, and do not require the input of subspecialists at NCI-funded comprehensive cancer centers. In fact, sociologically, they move treatment in the opposite direction that NCI has opted for--towards greater patient empowerment. Could this be on of the reasons for the resistance of NCI to this type of development?

Yet despite NCI foot-dragging on natural agents, the exploration of healing plants, is now moving to the forefront of interest around the world. Although this may seem startling to scientists in the US, such treatments are and always have been favored by four-fifths of the world's population. Is everybody else crazy?

For example, in China and Japan the use of Traditional Chinese Medicine (T.C.M.) or kampo grows apace. There has also been a renaissance of interest in ancient Indian (Ayurvedic) concepts. In Canada, what treatments are more popular than Essiac tea or 714X (which is made, in part, from camphor). Pau d'arco and cat's claw are enormous popular in Latin America

MUSHROOM TREATMENTS

In addition, various kinds of mushrooms have been used medicinally since antiquity. In the fourteenth century, Chinese physician Wu Rui wrote that the common shiitake mushroom (now the second-best-selling mushroom in the United States) was a beneficial treatment for various kinds of malignancy.

According to the Hungarian scientist L. Réthy, mushrooms have long been used in what he called "shamanistic therapy." And one of their principle medicinal uses in this regard has been in treating tumors.

LANDMARK STUDY

In 1969, a landmark scientific study was performed by Dr. Tetsuro Ikekawa of Purdue University and his colleagues at the National Cancer Center Research Institute in Tokyo (the "Japanese NCI"). First they collected wild mushrooms in Japan, prepared water extracts, and then tested them for anticancer activity.

Mice, implanted with sarcoma cells were given injections of these water extracts. The results were quite astonishing. But although they came from an American university they were far more appreciated in Japan (e.g., 75.3 percent tumor inhibition with oyster mushrooms, 80.7 percent with shiitake and 81.1 percent with shiitake white powder. Cure rates were somewhat lower, but still impressive.)

As these statistics indicate, the cure rate was highest with shiitake. The doctor isolated what he felt was the active component of the mushroom—a white powder containing non-toxic chemicals called polysaccharides. This powder performed even better than crude mushrooms, actually curing a total of 66 percent of the mice tested!

One of these polysaccharides was isolated in the following year. It was dubbed Lentinan, after the Latin botanical name of this mushroom, Lentinus. This has became one of the top-selling anticancer agents in Japan, where it is approved as an adjuvant treatment for stomach cancer. And in fact, as little as 1 milligram per kilogram body weight of Lentinan totally regressed tumors in 100 percent of the mice.

Although results in humans have not been this good, it still remains a useful agent. Lentinan was very actively researched in Japan after this. Scientists found that Lentinan works by stimulating T cells (thymus-mediated cells); these in turn activate another kind of defense cell, the macrophage (Shikoku Acta Medica 1984;40:473-478). Because of this ability, Lentinan has been used routinely in Japan to protect carp from lethal bacterial infections.

Lentinan has also been found to stimulate natural killer (NK) cell activity. According to a large body of research, NK cells can puncture the outer membrane of cancer cells through their production of an enzyme called perforin. This puncturing leads to the death of the unwanted cancer cell, as was neatly illustrated a few years ago in Scientific American (Jan 1988:38-44). And, unlike interleukins or tumor necrosis factor, Lentinan can kill cancer cells without causing any serious side effects in the patient.

Lentinan, however, is not available in the US. However, since lentinan is just one polysaccharide out of many found in the shiitake (and polysaccharides themselves are just one class out of many natural chemicals in medicianal mushroom) patients can obtain the same or better effects by consuming whole mushrooms, or by taking more balanced extracts. These are widely available.

Another branch of mushroom research has centered around the maitake (or "dancing") mushroom. Our friend Dr. H. Nanba of Tokyo has published data in peer-reviewed journals showing that taken orally maitake has even greater anticancer activity than shiitake. In recent years, he has focussed his activity on developing the so-called "D fraction" of maitake, which may be the single most potent polysaccharide found to date in the anti-cancer mushrooms. These are now in clinical trial at a midwestern cancer center.

PLANTS OF FIELDS AND WOODS

There are a great many herbs found in fields, forests, roadways, wastelands—probably even in the Maryland backyards of some NCI researchers—that have been explored for their anticancer potential.

Of course, NCI has a well-publicized Natural Products Division. But despite some important work done, most of the products already known to have anticancer activity have never really been clinically tested. And when they are, those tests can be pathetic.

For instance, pau d'arco tea is a well-known Andean cancer treatment. NCI scientists focussed their attention on one purified chemical found in pau d'arco, lapachol. Finally, after years of activity, they got to the point of conducting a clinical trial. But the trial was cancelled when the drug didn't show effects after just five days!

By contrast, when Latin American scientists studied lapachol, they did so for years, understanding that it works by methods more subtle than rapid cytotoxicity. They showed that in advanced cancer it took a full two years for lapachol to have significant activity, as it did in three out of eight patients. Tests of natural products must be conducted with understanding, sympathy, and sensitivity to how such agents are used by folk healers.

How could NCI seriously respect Asian or Latin American practices, however, when they have never shown even the most passing interest in our own North American folk traditions? They have joined with the AMA and the ACS in branding these are mere quackery.

For almost 100 years they have condemned the multi-herb formula of the late Harry Hoxsey. The now-departed Office of Technology Assessment (little mourned in these parts) once tried to suppress a contract report on Hoxsey which pointed to the positive data on these herbs. Yet his formula contained pokeweed root (Phytolacca americana), source of a well-known immune modulator. Isn't it interesting that the governor of colonial New York wrote to Benjamin Franklin that he had found pokeweed root to be the traditional Mohawk Indian treatment for cancer?

Does it intrigue them that Japanese scientists have independently isolated a powerful "antimutagenic B factor" in burdock? Enough to do some serious research?

Dr. Klausner, our advice would be that before you start your search for millions of "nonnatural natural" agents, you carry out an independent clinical trial of what is still the nation's oldest established cancer treatment, the Hoxsey herbal remedy. Perhaps you yourself would lead a site visit to the Hoxsey clinic in Tijuana, and the other clinics down there, to at least listen to patient stories. Such a trip would be an earnest of your sincerity for years to come.

And what about Essiac? This is a mixture of four common herbs from the Ojibwa Indians of Canada, given to nurse named Rene Caisse in the 1920s as a cancer remedy. Dr. Klausner, thousands of North Americans are now taking this. Can you say whether it works? There are no published, clinical studies on this mixture, although I have seen some preliminary NCI studies on both cancer and HIV infection that look promising. So before we go off looking for millions of new compounds, how about a sympathetic yet independent study of Essiac tea conducted by qualified scientists?

DOZENS OTHERS SHOW PROMISE

In addition to these famous formulas, Dr. Klausner should be aware that there are quite a few other promising developments in the herbal field. Around the world, thousands of people are already taking these treatments. So why not find out what is happening to them? Many of these have potential as anticancer agents. Some of them have been in use for millennia. Don't they now deserve some serious attention from NCI?Many examples can be found in the standard literature.

I would suggest that Dr. Klausner study a book in the celebrated Peterson's Field Guides' series, Eastern/Central Medicinal Plants by Steven Foster and James A. Duke (1990). This is a tremendous work of scholarship and offers suggestions of the tremendous scope from the world's herbal and natural traditions. (Readers should be aware that many herbs and plants are TOXIC. Refer to the above book for particulars.) As examples:

  • Soapweed (Yucca glauca) is a blue-green perennial growing from 2 to 4 feet on dry soils from Iowa to Texas. Indians used the poulticed soapweed root on inflammations and water extracts have anticancer activity against a type of melanoma (B16). No clinical trials performed.
  • Jimsonweed (Datura stramonium) is a folk remedy for cancer. But reader, beware! It is violently toxic and causes severe hallucinations. Promising as a drug.
  • Horseradish, the condiment, experimentally has shown anticancer activity "as science has come to expect from the mustard family" say Foster and Duke.
  • Common nightshade (Solanum nigrum L.), in leaf-juice preparations, have been used in folk lore as an external remedy for tumors. Some varieties contain solanine, which is poisonous.
  • Bloodroot (Sanguinaria canadensis L.) is a member of the poppy family. It is one of the herbs in the aforementioned Hoxsey formula. Its alkaloid sanguinarine has been shown to have anticancer activity.
  • Indian Hemp (Apocynum cannabinum L.) contains cymarin and apocymarin, which have shown anti-tumor activity. The latter compound raises blood pressure.This plant contains cardiotoxic glycosides and is poisonous.
  • Common Plantain (Plantago major L.) The leaves and seeds, widely used around the world, are a folk remedy for cancer in Latin America. It is said to stimulte healing.
  • Pale Indian Plantain (Cacalia atriplicifolia L.), found in dry woods and openings from Jersey to Georgia,was used by Indians as a poultice for external cancers.
  • Field or wild mustard (Brassica rapa L.) are used on burns. This contains factors, such as isothiocyanates, that NCI itself suggests may prevent certain cancers.
  • Greater celandine (Chelidonium majus L.) Found in waste places. (I once found it growing as a decorative plant in an NIH office—the scientist had no idea of its medicinal value.) This is a prominent folk remedy for cancer in Russia and neighboring countries. Conjugated with the drug thiotepa, it becomes Ukrain, an experimental European anticancer medication of promise.
  • Elecampane (Inula helenium L.) found in fields and roadsides, it is used in China to treat certain cancers. A strong sedative, it contains alantolactone, which happens to be a good, less-toxic deworming agent.
  • Sneezeweed (Helenium autumnale L.) was used as snuff by American Indians. Helenalin, a lactone, was found to have significant anti-cancer activity by NCI itself.
  • Wild ginger (Asarum canadense L.) whose root was used by American Indians for indigestion. It contains the antitumor compound aristolochic acid.
  • Common Milkweed (Asclepias syriaca L.) is a folk cancer remedy, potentially toxic. should be used with care.
  • Wild or spotted geranium (Geranium maculatum L.) found in the woods from Maine to Georgia. The root is used externally as a folk remedy for cancer.

Dr. Klaunser, these are just examples of dozens of such potentially useful treatments in the natural world. A more intensive discussion of a few of these is given in the following pages [i.e., on this Web site].


Ralph W. Moss, Ph.D. is director of the The Moss Reports for cancer patients. Dr. Moss is the author of eleven books and three documentaries on cancer-related topics. He is or has been an advisor on alternative cancer treatments to the National Institutes of Health, the National Cancer Institute, the American Urological Association, Columbia University, the University of Texas, the Susan G. Komen Foundation and the German Society of Oncology. He wrote the first article on alternative medicine for the Encyclopedia Britannica yearbook. He is listed in Marquis Who's Who in America, Who's Who in the World, Who's Who in the East, and Who's Who in Entertainment (as a film documentarian). This Web site does not advocate any particular treatment for cancer. We urge you to always seek competent medical advice for all health problems, especially cancer. Before consulting our site please read our full Disclaimer statement.



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