Why medical community still doubts herbal remedies

English: Herbal remedies for sale in San Juan ...

English: Herbal remedies for sale in San Juan de los Lagos, Mexico (Photo credit: Wikipedia)

We have all heard it:  herbal remedies can’t be wrong, they have been used for thousands of years.  In fact, it’s true…many cultures, tribes, medicine men, etc. have been using and in essence prescribing natural plant based herbal remedies for many many years….in fact, much longer than that of modern medicine/pharmaceuticals.
So why then is the medical community reluctant to embrace herbal medicines and remedies.  Although it’s fun to poke fun of doctors, medical administrators, insurance companies, and pharmaceutical executives, the universal distrust in these types of remedies is not unfounded.  Here is a small list of reasons: 1) Many herbal remedies were found to have good affects on one particular ailment (such as stomach discomfort) and then prescribed and suggested to work in other organ system (the liver, lungs, etc.) with little or no evidence.  2) Many herbal remedies have been linked to visual cues in how they were assigned to work.  For example, it is common to find that red fruits or seed products are often given to women for bleeding conditions as blood is red and so is the remedy.  3) Many herbal remedies over the years are assigned to work on various parts of the bodies as they were harvested in certain ways- functional links.  For example, the Cantonese believe that eating pig brain will make you smart, or if you have impotency- eating of dried and ground up ox testicles will help.  Although these are not plant remedies, these types of functional or anatomical links have dominated traditional remedies.  4) The vast majority of remedies, even though many have commonalities from independent groups around the world and have been used by millions, have no properly controlled studies to show that they actually work. 5) They are prescribed and administered in widely varying fashion. The list goes on and on and these objections are fair.  That does not mean that herbal remedies don’t work, it just means we have a long way to go before modern practitioners will embrace them.

The last time that a medical compound was successfully derived from a plant and used in clinical medicine was in 1967.  That agent/drug was Taxol.  That was a long time ago?  For a while people just stopped looking for them.  However, many are now pursuing this newly popular science; namely plant medicinal chemistry with newer techniques.  Who knows, maybe one of our next blockbusters will come from a herb, plant or natural product.   It might not only save lives but also teach us identify the chemical component that works in the plant itself.

Alternative forms of cancer- part IV (specifics)

The kelp forest exhibit at the Monterey Bay Aq...

Image via Wikipedia

Before I launch into the specific form of Alternative cancer therapy that I will focus on in todays’ blogs it is important to cover a few more additional issues about this form of anti cancer therapy in general. If you have ever come across any product that is considered a form of alternative cancer therapy you will notice one very common thing.  All the products must have a warning sign that says something like this, “These statements or these products have not been evaluated by the Food and Drug administration.  XYZ is not intended to cure, prevent, or diagnose any disease”.  It might also say something like, “this information is provided for your information only and is not directly associated with XYZ”.  XYZ is the specific product name.  I think both of these statements need some clarification.  Why are they on the products in the first place (and usually ont he web site where the product is being sold or promoted)?  This is because it is illegal in the US and in many other countries to sell products that claim to have anti cancer properties and that are to be ingested without the approval of the major drug regulators in the US.  Actually, any products which claim to provide medical benefits and can be classified as a drug needs approval.  Getting this approval requires many years of indirect study (and most of the common alternative medical products do have this) but they also need to have close to five years of specific and direct study in humans and animals of the products effectiveness, side effects, and so forth.  This studies are rarely conducted as they are VERY expensive and take a lot of time and work.  They might be done by a slightly different (but sometimes quite similar) product, but the FDA requires the exact formulation to be tested extensively.  European regulators also have their own strict rules.  Thus, in order to sell these products one has to say the above things or they can be sued or shut down by drug regulators, etc. 

Now let me bring up a specific therapy that is available on the market.  In this blog I will focus on just one and later I will focus on others. Fucoidan is a polysaccharide (or type of starch) found in common brown alge found in Japan.  Kambu, Mozuku, and Mekabu are different kinds of algae or kelp that are commonly eaten in large amounts by the Japanese living in the Okinawan area.  This material is what makes up the slimy texture of the algae and is full of L-Fucose and sulphated ester groups that are thought to be healthy.  How did this become of interest for cancer.  It is because it is believed that the Okinawan’s who have some of the longest lived individuals in Japan and the some of the lowest rates of cancer  in the country.  Japan as a whole is considered on of the healthiest amongst the advanced countries.  Thus, through studies over the years the brown algae diet and lower cancer rates link was made.  There are many studies on Fucoidan, but many of them are not related directly to its anti cancer properties.  However, those that are do show in the laboratory that the sea weed product seems to induce some types of cancer cells to die (something called apoptosis or programmed cell death).  There are even some studies that show exactly what mechanisms Fuciodan is working to kill the cells. It may also act as a natural antioxidant and anticoagulant.  This means that in some cases, this agent helps to remove harmful reactive oxygen species which leads to tissue damage, aging and a host of other things and that they can help thin the blood and improve clotting, etc. There are even some reports that seem to suggest that they help break apart adipocytes (cells that make fat).  The idea that oxidation of fats and generation of reactive species which are damaging and then finding agents that clean up the reactive oxygen free radicals (or things that are potent antioxidants) is very popular at the moment.  And it seems as if there is quite a bit of data to support this concept for fucoidan. 

There are some very important studies that are missing however.  They may not be absent but just don’t appear in major english based science/medical journals.  These have to do with human clinical trials. Studies that determine in reality that what is shown in the laboratory actually works in the human body.  It is common for claims to be made based on thousands of different studies that something will work in humans with cancer.  Many compounds DO NOT work the same way as they do int he laboratory. The simple reason for this is that one can control almost everything in the laboratory, such as the cell line, the nutrients that the cells get, the PH, the temps, etc.  There are no detoxification mechanisms in the lab, no body buffering systems, no bioavilibity issues in the lab, etc.  So, often the drugs do more harm than good when the go into the human body.  So, human clinical trials with the EXACT formulation that will be sold is absolutely essential before it can be used as treatment.  However, this agent is being sold as a anti cancer product. In this case it is sold as capsules, drink solution, and powder. 

I will end now and continue with more product ideas later.  I think it is important to know about what cancer is in general first before one takes any product if possible.  So, please do check out my website cancer made simple when you have some time.  Soon I will be offering some very simple but effective tutorials on cancer. 

 Dr. C

Cure

This figure shows the heterogeneity of cancer ...

Image via Wikipedia

 

So, what do you think a cure means to you?  It probably means something like…not having cancer for the rest of your life after a particular treatment…or something like that?  Is that right?  Isn’t that what a patient who has cancer might think if he/she was talking about a cure?  Well, unfortunately this is not the case in medical terms and what scientific publications mean when they talk about cure.  When clinical folks talk about cures…they are referring to the ability of a certain treatment to extend the life of a patient without any symptoms of the disease for five years.  Not for life!  Thus, progression free survival for five years defines a cure.  Why do I bring this up?  It is because a patient should know this when they talk to an oncolgist or read scientific literature and not assume that a cure means for life.  Actually, what we in the medical community should do is replace the word ‘cure’ with something else.  We should not use that term if we don’t mean what people on the street mean.  I think many in the media are also not aware and thus, they report on cure for this and that without really being accurate in any way.  So, please be careful about using the word cure…please don’t allow expectations to be too great in terms of cures for most cancers.  We are working on it but we are not there yet!