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Herbs or Natural Products That
Protect Against Cancer Growth
Part Three of a Four-Part Series
Muriel J. Montbriand, PhD, RN
Key Points . . .
Purpose/Objectives: To provide evidence-based research information
about 47 herbs and natural products that have the potential to protect
against the development of cancer.
Some herbs and natural products may protect against cancer
Data Sources: Natural Medicines Comprehensive Database and
growth.
Lawrence Review of Natural Products­Monograph System. Information
about these herbs has been found in evidence-based studies cited in
The best protection against cancer may be a dietary pattern
the references.
that emphasizes fruits, vegetables, grains, and beans and limits
Data Synthesis: Early research shows that some herbs and natural
meats, dairy products, and high-fat foods.
products appear to have the potential to prevent cancer growth.
Oncology nurses can become better resources for healthcare
Conclusions: This preliminary evidence may be useful to healthcare
professionals and patients regarding herbs and natural products.
professionals or patients who are concerned about cancer.
Implications for Nursing: Oncology nurses who receive this infor-
mation can become resources for patients or other healthcare profes-
sionals.
against cancer growth. The target group for this article is
individuals who do not have cancer but are concerned about
C
onsumers and patients with cancer take numerous al-
its development.
ternative products to protect themselves from cancer.
As indicated in previous parts of this series, some overlap
Evidence indicates that use of alternative products is
in categories should be expected because early evidence (es-
as high as 89% among all patients and consumers (Eisenberg
pecially in vivo and in vitro evidence) often shows contrary
et al., 1993, 1998; Ernst, 2000a, 2000b; Ernst & Cassileth,
results. In Part I (Montbriand, 2004a), fish oils containing
1998; Montbriand, 1994, 1995a, 1995b, 1997, 2000b; Perl-
vitamins A and D and omega-3 fatty acids are indicated to
man, Eisenberg, & Panush, 1999; Sparber et al., 2000; Spar-
have a potential role in decreasing cancer growth. In this
ber & Wootton, 2001; White, 2002). Yet research has shown
article, vitamin A and D are indicated for their potential to
that only 3% (4 of 150) of nurses, doctors, and pharmacists
protect against cancer. The same will be found for soy in Part
believed that they had adequate information to give to patients
II (Montbriand, 2004b), which is focused on products with the
about alternative products (Montbriand, 2000a, 2000b). Con-
potential to increase cancer growth. Soy also appears in this
versely, 97% (146 of 150) of these healthcare professionals
indicated a willingness to be resources if they could have
evidence-based information that was available, succinct, and
Muriel J. Montbriand, PhD, RN, is an associate professor in the
in one place. This review article provides evidence-based
College of Nursing and a research associate in applied research/psy-
information from preliminary research to assist healthcare
chiatry in the College of Medicine at the University of Saskatchewan
professionals' endeavors as resources for patients as well as
in Saskatoon, Canada. During this work, the author was a recipient
others.
of two Health Services Utilization and Research Commission, Socio-
Health Grants, in Saskatoon. (Mention of specific products and opin-
This is the third article in a four-part series dedicated to
ions related to those products do not indicate or imply endorsement
providing information about herbs and natural products
by the Oncology Nursing Forum or the Oncology Nursing Society.)
for healthcare professionals in clinical oncology. The tar-
get herbs and natural products are those that may protect
Digital Object Identifier: 10.1188/04.ONF.E127-E146
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E127
article because it has the potential to protect against cancer.
linolenic acid in breast adipose tissues have a lower risk of
This overlap occurs because this series targets two specific
cancer, leading researchers to propose that this acid may have a
groups, individuals who have cancer (Parts I and II) and in-
protective effect (Klein et al.). However, high intake of this acid
dividuals who do not have cancer (Part III). For each target
may cause prostate cancer (Colditz, 2000; De Stefani, Deneo-
group, the aim is to identify herbs and natural products with
Pellegrini, Boffetta, Ronco, & Mendilaharsu, 2000; Freeman et
the potential for or against cancer growth. For example, if a
al., 2000; Gann et al., 1994; Giovannucci et al., 1998; Harvei et
woman with breast cancer takes soy, she increases her risk of
al., 1997; Ramon et al., 2000). Kolonel, Nomura, and Cooney
cancer growth. If a woman who does not have cancer takes
(1999) and Ramon et al. have speculated that prostate cancer
soy, she protects herself against cancer.
may be attributed to high animal fat intake and consumption of
For this article, the names of herbs and natural products have
red meat and dairy products, which contain alpha-linolenic acid.
been selected from listings in the Natural Medicines Compre-
Patients and consumers should not be concerned about moder-
hensive Database (2004) and Lawrence Review of Natural
ate dietary intake of alpha-linolenic acid. A daily diet containing
Products­Monograph System (Facts and Comparisons, 2001).
1.2­2 g of alpha-linolenic acid seems to prevent coronary heart
Evidence about these herbs has been found in the studies cited
disease (Ascherio et al., 1996; Christensen, Christensen, Toft,
in the references. Other products that interact positively with
Dyerberg, & Schmidt, 2000; Hu et al., 1999). Self-medication
cancer may exist; however, this review includes only herbs
beyond 1.2­2 g of alpha-linolenic acid to prevent breast cancer
and natural products recognized by the authors, professionals,
may impart a risk. See Table 2 for adverse effects.
American pawpaw has a scientific name of Asimina tri-
or advisory boards of these two sources.
Most of the studies cited are in vitro studies, performed
loba, which is synonymous with Annona triloba. According
in glass on tissue from a living organism, or in vivo studies,
to Gruenwald, Brendler, and Jaenicke (1998), this herb is used
performed on tissue not removed from a living organism
to treat fever, vomiting, and oral inflammation. Highly cyto-
(animal studies). Most studies have not advanced to clinical
toxic acetogenin constituents have been found in American
trials on humans. The few human studies cited are preliminary
pawpaw, and preliminary studies show that some acetogenins
clinical trials. Therefore, although results seem favorable or
have activity against certain lung and breast cancers (He et
unfavorable, treat these findings with caution.
al., 1997). Adverse reactions include nausea and urticaria
Neither the author nor publisher makes any medical
(Gruenwald et al.). No standard dosage is available (Natural
claims for any of the herbs or natural products in this
Medicines Comprehensive Database, 2004).
review or the tables. This is informational literature. Note
Apple has a scientific name of Malus sylvestris. Individuals
that some of the herbs described are deadly poisons and
use apples for many conditions from cleaning their teeth to
some are extremely dangerous.
treating diarrhea, constipation, fever, and cancer. The antioxi-
The American Cancer Society (ACS) 1996 Advisory Com-
dant flavonoid quercetin in apples seems to have a protective
mittee on Diet, Nutrition, and Cancer Prevention (1996) rec-
property against lung cancer. This finding was reported by
ommended the dietary intake of more fruits and vegetables to
Butland, Fehily, and Elwood (2000), who examined 2,512
lower the risk of cancer. ACS also indicated that no evidence
individuals' lung functions and diets, and by another group
supports the use of additional vitamin supplements to protect
of researchers who compared diet items of 582 individuals
against cancer. Remarkably, many of the herbs and natural
with lung cancer to diet items of 582 control participants
products currently investigated and indicated in this article
(LeMarchand, Murphy, Hankin, Wilkens, & Kolonel, 2000).
are common foods, reinforcing ACS's stance and providing
Although apples are considered safe when taken as a dietary
an update to the society's work.
fruit source, the seeds contain hydrogen cyanide that is re-
Table 1 provides names of herbs and natural products dis-
leased, generated, or liberated when mixed with saliva. Duke
cussed in the text. Common names as well as brand names
(1987) reported the death of a man who ingested a cup of
and manufacturers are included. Some products have numer-
apple seeds. Stones and seeds of fruit naturally contain two
ous brand names, making a complete listing prohibitive. The
parts glucose, one part benzaldehyde (mildly poisonous), and
number of brand names found also is included in the table.
one part cyanide (Herbert, 1981). The most common dose for
When a brand name contains only one ingredient, it often
self-medication appears to be 500 mg apple pectin capsules
bears the product's common name. Single-ingredient prod-
(Natural Medicines Comprehensive Database, 2004).
Asparagus has a scientific name of Asparagus officinalis.
ucts are identified in Table 1. Other brands with numerous
ingredients also are indicated. Products with single ingredi-
People often self-medicate with this vegetable for urinary con-
ents should be favored over those with multiple ingredients
ditions (Blumenthal et al., 1998). Fibers from asparagus have
because as the number of ingredients increases, so does the
a mutagen-absorbing (cancer-preventing) activity (Leung &
number of possible side effects. Table 1 can be used as a quick
Foster, 1996). Asparagus can cause mucous membrane irritation
reference to find product names or equivalent common names.
(Tyler, Brady, & Robbers, 1981). A typical dosage is prepared
The following provides additional information on each herb
as a tea using 40­60 g of cut asparagus root (Blumenthal et
or natural product.
al.). Self-medication doses have not been made available.
Barley, with a scientific name of Hordeum distychum or
Herbs and Natural Health Products
Hordeum vulgare, is used to prevent cancer. Barley also is
used for bronchitis, diarrhea, and gastrointestinal conditions
Alpha-linolenic acid, which has the same scientific name,
and to lower blood sugar, cholesterol, and lipid levels (Facts
is used to treat numerous conditions such as renal disease,
and Comparisons, 2001). Studies show a reduction of colon
migraine headaches, and skin cancer. Individuals also use it to
cancer risk in barley-fed rats (Facts and Comparisons). Bar-
prevent cardiovascular disease and other cancers (Klein et al.,
ley and barley dust can cause asthma and allergic reactions
2000; Simopoulos, 1999). Women with higher levels of alpha-
for sensitive individuals (Natural Medicines Comprehensive
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E128
Table 1. Herbs and Natural Products With the Potential to Protect Against Cancer Growth: Common and Brand Names
Herb or Natural Product
Brand Name and Manufacturer or Other
Alpha-linolenic acid
Flax Seed Oil 1,000 mg (Jamieson)a
Other names: ALA, essential fatty acid, LNA, n-3 fatty acid, n-3 polyunsaturated
Flax 1,000 mg (Jamieson)a
fatty acid, omega-3 fatty acid, omega-3 polyunsaturated fatty acid
Flax Seed Oil (Mass Quantities, Inc.)b
Complete Essential Fatty Acids (Source Naturals)  b
51 brand names found
American pawpaw
No brand names found
Other names: custard apple, dog banana, pawpaw
Apple
Apple Cinnamon Celebration­Revival (Physicians Laboratories)b
No other names
Blood Pressure (Nutrivention)b
Fruitplex (HealthWatchers System)b
Juice Plus + Orchard Blend (NSA International)b
Standardized Cider Vinegar With Apple Pectin (The Vitamin Shoppe)b
67 brand names found
Asparagus
Asparagus Extract (PhytoPharmica)a
Other names: Asparagi rhizoma root, Asperge, garden asparagus, sativari,
Herbaretic (Suddenly Slender)b
spargelkraut, spargelwurzelstock, sparrow grass
Yin-Yang Beautiful Lady (Flora, Inc.)b
Phytotality (PhysioLogics)b
22 brand names found
Barley
Blast of Grass (Green Foods Corp.)a
Other names: dietary fiber, Hordeum, mai yya, pearl barley, pot barley, Scotch
Berry Barley Essence (Green Foods Corp.)b
barley
Collect-All (Nature's Plus)b, c
91 brand names found
Beta-sitosterol
#132 Flx Vegetable Omega-3 Flax Seed Oil (Systemic Formulas)b
Other names: angelicin, beta sitosterin, beta sitosterol, betasitosterol, beta-
DHEAX (HealthWatchers System)b
sitosterol glucoside, beta-sitosterol glycoside, B-sitosterol 3-B-D-glucoside,
Earthmends Breast Health Program (Cancer Wellness Institute)b
B-sitosterolin, cinchol, cupreol, phytosterols, plant sterols, quebrachol,
Testosterone Fuel Booster (TwinLab)b
rhamnol, sitosterin, sitosterol, sitosterolins, sitosterols, sterinol, sterolins,
Wild Yam Extract (PhytoPharmica)b
24-ethyl-cholesterol
45 brand names found
Bifidobacteria
Acidophilus Super Strain (Jamieson)b
Other names: B. bifidum, bifido, bifidobacteria bifidus, bifidobacterium,
Friendly Flora (Nutri-Quest)b
bifidum, probiotics
From the Earth (The Vitamin Shoppe)b
Probacillus Plus (Allergon AB)b
26 brand names found
Black seed
No brand names found
Other names: ajenuz, ara uel, baraka, black caraway, black cumin, charnuska,
cominho negro, cominho-negro, fennel flower, fitch, love in a mist, nigelle de
cr te, nutmeg flower, Roman-coriander, schwarzk mmel, toute pice
Blond psyllium
Psyllium (Secrets of the Psyllium and Orange-Flavored Psyllium Powder)
Other names: blond plantago, dietary fiber, Englishman's foot, Indian plantago,
(Trader Joe's)a
ispaghula, ispagol, pale psyllium, Plantaginis ovatae semen, Plantagins ovatae
#14 Colon (Systemic Formulas)b
testa, psyllium, sand plantain, spogel
62 brand names found
Blueberry
PhytoFruit Concentrates (Now)b
Other names: highbush blueberry, hillside blueberry, lowbush blueberry, rab-
Glucoril (PhytoPharmica)b
biteye blueberry
Earthmends Total Health Program (Cancer Wellness Institute)b
Dia-Comp (Enzymatic Therapy)b
25 brands found
(Continued on next page)
This herb or natural product is the only ingredient in this brand.
a
This brand name is an example of a product in which the herb or natural product is included along with other herbs and products. Monitor for all possible side
b
effects of all ingredients in these products.
Safety of this product is a concern. The product contains animal material, possibly diseased animals that may harbor bovine spongiform encephalopathy (i.e.,
c
mad cow disease).
This product contains androstenedione that can increase estrogen levels. Side effects for men may include acne, behavior changes, testicular atrophy, and
d
gynecomastia (King et al., 1999). This product does not increase testosterone levels or significantly improve muscle strength (Brown et al., 2000).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E129
Table 1. Herbs and Natural Products With the Potential to Protect Against Cancer Growth: Common and Brand Names
(Continued)
Herb or Natural Product
Brand Name and Manufacturer or Other
Cabbage
Veg-Easy (Progressive Labs)b
Other names: colewort
Nature's Life Greens Capsule (Nature's Life)b
21 brand names found
Canthaxanthin
Astaxanthin Complex (Solgar)b
Other names: canthaxanthine, carophyll red, Cl food orange 8, color index
1 brand name found
number 40850, E161, roxanthin red 10
Chaparral
Chaparral and Red Clover (Dial Herbs)b
Other names: creosote bush, greasewood, hediondilla, jarilla, larreastat
Herp-EezeTM (Olympian Labs)b
Hoxsey Formula (The Herbalist)b
T-ACN (Dial Herbs)b
17 brand names found
Choline
#115 BSV Vitamin B Stress Complex (Systemic Formulas)b, c
Other names: choline bitartrate, choline chloride, intrachol, lipotropic factor
#150 PRO Nutro Protein (Systemic Formulas)b, c
#62 LS Liver Stimulant (Systemic Formulas)b, c
406 brand names found
Chrysanthemum
Earthmends Breast Health Program (Cancer Wellness Institute)b
Other names: florist's chrysanthemum, ju hua, mum
Immunoboost (Shawnee Moon)b
Red Dragon Cold and Flu Relief (Jamieson)b
Udo's Choice Beyond Greens (Flora, Inc.)b
12 brand names found
Conjugated linoleic acid
Conjugated Linoleic Acid 1,000 mg 70% (Now)a
Other names: CLA, linoleic
Tonalin 1,000 (Source Naturals)a
Ati-F (Atrium Inc.)b
Trim Advantage Weight Management Support Pack (Nutrilite)b
Myoplex Plus Deluxe (EAS)b
17 brand names found
Cranberry
Cranberry (Pharmanex)a
Other names: American cranberry, arandano Americano, arandano trepador,
Cranberry Juice Maximum Concentrate (Jamieson)a
European cranberry, goose moosebeere, kranbeere, moosebeere, mossberry,
Cranberry + (PhysioLogics)b
ronce d'Amerique, trailing swamp cranberry, tsuru-kokemomo
Cranberry (Aspen Group, Inc.)b
Cranberry Basic Nutrition (GNC)b
Cranberry (Leiner Health Products)b
Cranberry 1,000 mg Concentrated, GNC Herbal Plus (GNC)b
Cranberry Concentrate (Now)b
Cranberry Concentrate (Schiff)b
Cranberry Juice Concentrate 1,000 mg (Jamieson)b
CranExtra (Enzymatic Therapy)b
Ultra Cranberry 1,000 (Nature's Plus)b
78 brand names found
Folic acid
Folic Acid (GNC)a
Other names: B complex vitamin, folacin, folate, vitamin B9
Folic Acid 0.4 mg (Jamieson)a
Folic Acid 1 mg (Jamieson)a
Folic Acid 400 mcg, GNC A­Z (GNC)a
Folic Acid 800 mcg, GNC A­Z (GNC)a
B-Complex (Nutri-Quest)b
Folic Acid (Leiner Health Products)b
Folic Acid (Nature's Bounty)b
Folic Acid (Source Naturals)b
Folic Acid 400 mcg (Schiff)b
Folic Acid Dophilus Plus B-12 (Dial Herbs)b
Foltx (Pan American Laboratories, Inc.)b
826 brand names found
(Continued on next page)
This herb or natural product is the only ingredient in this brand.
a
This brand name is an example of a product in which the herb or natural product is included along with other herbs and products. Monitor for all possible side
b
effects of all ingredients in these products.
Safety of this product is a concern. The product contains animal material, possibly diseased animals that may harbor bovine spongiform encephalopathy (i.e.,
c
mad cow disease).
This product contains androstenedione that can increase estrogen levels. Side effects for men may include acne, behavior changes, testicular atrophy, and
d
gynecomastia (King et al., 1999). This product does not increase testosterone levels or significantly improve muscle strength (Brown et al., 2000).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E130
Table 1. Herbs and Natural Products With the Potential to Protect Against Cancer Growth: Common and Brand Names
(Continued)
Herb or Natural Product
Brand Name and Manufacturer or Other
Forskolin
Coleus Forskohlii Extract (Enzymatic Therapy)a
Other names: borforsin, colecus forskohlii, coleus forskohlii, coleus forskolii,
Forskolin Extract (PhytoPharmica)a
colforsin, colius forskolii, forscolin, HL-362, L-75-136B
Elemax (Naturodoc)b
16 brand names found
Fructo-oligosaccharides
Colon Cleanser Daily (Health Smart Vitamins)b
Other names: beta-D-fructofuranosidase, chicory inulin hydrolysate, FOS, fruc-
FOS Daily (Health Smart Vitamins)b
to oligo saccharides, fructooligosaccharides, inulin hydrolysate, oligofructose,
FiberWise (Melaleuca)b
oligosaccharides, prebiotic, SC-FOS, short chain fruto-oligosaccharides
62 brand names found
Garlic
Garlic (Olympian Labs)a
Other names: aged garlic extract, ail, ajo, allii sativi bulbus, allium, camphor
Garlic (Pharmanex)a
of the poor, clove garlic, garlic clove, poor man's treacle, rust treacle, stink-
Garlic Allicin-Rich (Life Brand)b
ing rose
Garlic Plus (Aspen Group, Inc.)b
Garlic Complex (Shaklee)b
Garlic EC (USANA Health Sciences)b
Garlite (Nature's Plus)b
239 brand names found
Glucomannan
Atri-Glucomannan (Arrium Inc.)a
Other names: konjac, konjac mannan
Glucomannan 500 mg (Natrol)b
Glucomannan+ (Swanson)b
Multi Fiber Complex (Naturade)b
23 brand names found
Green tea
Green Tea Extract (HealthWatchers System)a
Other names: Chinese tea, tea, teagreen
Green Tea Extract (PhytoPharmica)a
Green Tea Extract (Olympian Labs)a
Green Tea Extract (Nutraceutical Sciences Institute)a
Green Tea Formula GT80 (Jamieson)b
Green Max Power (Swanson)b
Green Tea Complex (Leiner Health Products)b
Green Tea Extract (Nature's Way)b
287 brand names found
Indole-3-carbinol
Andro-6 (EAS)b, d
Other names: indole, indole 3 carbinol, I3C, 3-(hydroxymethyl), 3-hydroxy-
Androbolic (ProLab)b
methyl indole, 3-(hydroxymethyl) indole, 3 indolylcarbinol
Andotesten (Muscletech)b, d
Mixed Vegetables (Nature's Plus)b
Solaray Indole-3-Carbinol (Nutraceutical Corp.)b
8 brand names found
Jiaogulan
New to traditional Chinese medicine, this plant grows wild in south central
Other names: adaptogen, amachazuru, dungkulcha, fairy herb, gynostemma,
China. Sometimes referred to as Southern ginseng, this plant is not of the
immortality herb, jiao gu lan, miracle grass, penta tea, Southern ginseng,
Ginseng genus (Natural Medicines Comprehensive Database, 2004).
xianxao
No brand names found
Lavender
Chaste Tree­Siberian Ginseng Virtue (Blessed Herbs)b
Other names: alhucema, common lavender, English lavender, French lavender,
Easy Now (Traditional Medicinals)b
garden lavender, Spanish lavender, spike lavender, true lavender
Happy Camper (Natural Balance)b
Kava Oasis (New Chapter, Inc.)b
Stomach Calm (Enzymes, Inc.)b
26 brand names found
(Continued on next page)
This herb or natural product is the only ingredient in this brand.
a
This brand name is an example of a product in which the herb or natural product is included along with other herbs and products. Monitor for all possible side
b
effects of all ingredients in these products.
Safety of this product is a concern. The product contains animal material, possibly diseased animals that may harbor bovine spongiform encephalopathy (i.e.,
c
mad cow disease).
This product contains androstenedione that can increase estrogen levels. Side effects for men may include acne, behavior changes, testicular atrophy, and
d
gynecomastia (King et al., 1999). This product does not increase testosterone levels or significantly improve muscle strength (Brown et al., 2000).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E131
Table 1. Herbs and Natural Products With the Potential to Protect Against Cancer Growth: Common and Brand Names
(Continued)
Herb or Natural Product
Brand Name and Manufacturer or Other
Lutein
Lutein (Nutraceutical Sciences Institute)a
Other names: xanthophyll, zeaxanthin
86 brand names found that contained other ingredients, except for the above
Lycopene
Lycopene (Nature's Life)b
Other names: all-trans lycopene, psi-psi-carotene
Lycopene (Olympian Labs)b
Lycopene Rich Tomato Concentrate (Jamieson)b
Xtend-Life Total Balance (Xtend-Life Nutraceuticals Inc.)b
66 brand names found
MGN-3
MGN3 (MGN-3, MGN 3) (LaneLabs)b
Other names: biobran hemicellulose complex with arabinoxylane
1 brand name found
Microalgae
BioAstin (Nutrex, Inc.)a
Other names: astaxanthin
Alphastat Rx Prostate (Nature's Plus)b
Astaxanthin Complex (Solgar)b
Earthmends Prostate Health Program (Cancer Wellness Institute)b
8 brand names found
MSM
MSM 1,000 (Jamieson)a
Other names: crystalline DMSO, dimethyl sulfone, DMSO2, methylsulfonyl
Arthrimin Joints + Bones (Glucosamine/Condroitin/MSM/Hyaluronic Acid)
methane, methyl sulfonyl methane, optiMSM, sulfonyl sulfur
Effervescent Drink Crystals Complex (Jamieson)b
Cardio EDTA Chelate (Olympia Nutrition)b
Glucosamine Condroitin Complex With MSM (Source Naturals)b
Xtend-Life Total Balance (Xtend-Life Nutraceuticals Inc.)b
82 brand names found
Olive oil
Olive oil may be purchased in grocery stores.
Other names: monounsaturated fatty acid, n-9 fatty acid, Olivae oleum, omega-
48 brand names found, all with additional ingredients
9, omega-9 fatty acid, salad oil, sweet oil, unsaturated fatty acid
Peanut oil
Vitamin D 1,000 IU (Jamieson)b
Other names: arachis, earth-nut oil, groundnut oil, monkey nut oil
1 brand name found
Propolis
Propo-Mune (Atrium Inc.)b, c
Other names: bee glue, bee propolis, hive dross, propolis balsam, propolis
Royal Bee Power (Nature's Plus)b
resin, propolis wax, Russian penicillin
Bee Pollen Complex (Puritan's Pride)b
55 brand names found
Quercetin
Quercetin (Metabolic Response Modifiers)a
Other names: citrus bioflavonoid, meletin, sophretin
Xtend-Life Total Balance (Xtend-Life Nutraceuticals Inc.)b
265 brand names found
Rice bran
Rice Bran Oil (Progressive Labs)a
Other names: dietary fiber, ricebran oil, stabilized rice bran
RiceMucille (NutraStar)a
RiSolubles (NutraStar)a
143 brand names found
Shark cartilage
Shark Cartilage (Olympian Labs)a
Other names: AE-941, MSI-1256F, shark cartilage extract, shark cartilage
Shark Cartilage (Leiner Health Products)b
powder
27 brand names found
Soy
Soy Extract (PhytoPharmica)a
Other names: daidzein, edamame, frijol de soya, genistein, haba soy, hydro-
Cayenne (Now)b
lyzed soy protein, isoflavone, isoflavones, legume, miso, natto, phytoestrogen,
Soy Essentials (Health From the Sun)b
plant estrogen, shoyu, soja, sojabohne, soy fiber, soy milk, soy protein, soy-
Soy Preventive (GNC)b
protein, soy protein extract, soya, soybean, soybean curd, tempeh, texturized
362 brand names found
vegetable protein, tofu
(Continued on next page)
This herb or natural product is the only ingredient in this brand.
a
This brand name is an example of a product in which the herb or natural product is included along with other herbs and products. Monitor for all possible side
b
effects of all ingredients in these products.
Safety of this product is a concern. The product contains animal material, possibly diseased animals that may harbor bovine spongiform encephalopathy (i.e.,
c
mad cow disease).
This product contains androstenedione that can increase estrogen levels. Side effects for men may include acne, behavior changes, testicular atrophy, and
d
gynecomastia (King et al., 1999). This product does not increase testosterone levels or significantly improve muscle strength (Brown et al., 2000).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E132
Table 1. Herbs and Natural Products With the Potential to Protect Against Cancer Growth: Common and Brand Names
(Continued)
Herb or Natural Product
Brand Name and Manufacturer or Other
Spinach
Life's Greens (Puritan's Pride)b
Other names: spinaciae folium, spinatblatter
Source of Life Oxygenic (Nature's Plus)b
Veg-Easy (Progressive Labs)b
69 brand names found
Tragacanth
Ambrotose AO (Mannatech)b
Other names: goat's thom, green dragon, gum dragon, gum tragacanth, gummi
Manna-C (Mannatech)b
tragacanthae, hog gum, Syrian tragacanth, tragacanth gum
19 brand names found
Turmeric
CurcuMax (PhytoPharmica)b, c
Other names: cucuma, Curcumae longae rhizoma, curcumin, Indian saffron,
Curazyme (Enzymatic Therapy)b
tumeric, turmeric root
Tumeric Extract (Nature's Way)b
159 brand names found
Vitamin A
Vitamin A (Jamieson)a
Other names: antixerophthalmic vitamin, axerophtholum, dehydroretinol,
Vitamin A (Puritan's Pride)a
oleovitamin A, retinoids, retinyl acetate, retinyl palmitate, 3-dehydroretinol,
Vitamin A 10,000 IU (Jamieson)a
vitamin A1, vitamin A2, vitaminum A
Vitamin A (Nature's Way)b
Vitamin A (Nature's Bounty)b
Vitamin A Basic Nutrition (GNC)b
Vitamin A in a Water-Soluble Base (Nature's Bounty)b
A-25 Plex (Progressive Labs)b
Beta Carotene 25,000 IU (Rexall-Sundown)b
Beta-Carotene 25,000 IU (Schiff)b
Renatrate (Progressive Labs)b, c
Triple Cod Liver Oil (GNC)b
324 brand names found
Vitamin D
Vitamin D 1,000 IU (Jamieson)a
Other names: Alfacalcidol: 1 alpha (HO)D3, 1-alpha-hydroxycholecalciferol
Vitamin D 400 IU (Jamieson)a
Calcifediol: 25-HCC, 25-hydroxycholecalciferol, 25-hydroxyvitamin D3, 25-
Vitamin D (Puritan's Pride)b
OHCC, 25-OHD3
Cod Liver Oil (Puritan's Pride)b
Calcipotriene: calcipotriol
Vitamin D Basic Nutrition (GNC)b
Calcitriol: 1,25-DHCC, 1,25-dihydroxycholecalciferol, 1,25-dihydroxyvitamin
Vitamin D 1,000 IU (Jamieson)b
D3, 1,25-diOHC, 1,25(OH)2D3
553 brand names found
Cholecalciferol: activated 7-dehydrochelesterol, colecalciferol, vitamin D3
Dihydrotachysterol: DHT, dichysterol, dihydrotachysterol 2
Ergocalciferol: activated ergosterol, calciferol, ergocalciferolum, irradiated
ergosterol, visterol, vitamin D2
Paricalcitol: 19-nor-1,25-dihydroxyvitamin D2
Vitamin K
Estroven Joint and Bone (Amerifit Nutrition)b
Other names: Vitamin K1: 4-naphtoquinone, methylphytyl naphthoquinone,
Vitamin K 100 mcg, GNC A­Z (GNC)b
phylloquinone, phytomenadione, phytonadione, 2-methyl-3-phytyl-1
Vitrin (Nutraceutics Corp.)b
Vitamin K2: menaquinone, menatetrenone, MK-1, MK-2, MK-4, MK-5, MK-6,
214 brand names found
MK-7, MK-8, MK-9, MK-10, MK-11, MK-12, MK-13
Vitamin K3: 4-naphthoquinone, menadione, menadione sodium bisulfide,
2-methyl-1
Vitamin K4: menadiol diacetate, menadiol sodium diphosphate, menadiol
sodium phosphate, menadiolum solubile methylnaphtohydroquinone
Vitamin K5: 2-amino-2-methyl-1-naphthol
Wheat bran
CholesFiber (Source Naturals)b
Other names: bran, dietary fiber
Fiber Plan Daily Mix (Shaklee)b
Thinz Back-to-Nature (Alva-Amco Pharmacal Co., Inc.)b
21 brand names found
(Continued on next page)
This herb or natural product is the only ingredient in this brand.
a
This brand name is an example of a product in which the herb or natural product is included along with other herbs and products. Monitor for all possible side
b
effects of all ingredients in these products.
Safety of this product is a concern. The product contains animal material, possibly diseased animals that may harbor bovine spongiform encephalopathy (i.e.,
c
mad cow disease).
This product contains androstenedione that can increase estrogen levels. Side effects for men may include acne, behavior changes, testicular atrophy, and
d
gynecomastia (King et al., 1999). This product does not increase testosterone levels or significantly improve muscle strength (Brown et al., 2000).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E133
Table 1. Herbs and Natural Products With the Potential to Protect Against Cancer Growth: Common and Brand Names
(Continued)
Herb or Natural Product
Brand Name and Manufacturer or Other
Whey protein
Actisyn (SportPharma)b
Other names: bovine whey protein concentrate
Athletic Strength (Vidafit)b
Triple Whey Fuel (TwinLab)b
Wheyfit 2,000 (Young Living Essential Oils)b
#32 GB Pituitary (Systemic Formulas)b, c
#150 Pro Nutro Protein (Systemic Formulas)b, c
81 brand names found
Yucca
Arth-Rid Us (The Herbalist)b
Other names: Adams's needle, aloe yucca, bear grass, dagger plant, Joshua
Joint Essentials (Swanson)b
tree, Mohave yucca, our-Lord's-candle, soapwead, Spanish bayonet
Yucca-AR Formula (Nature's Way)b
36 brand names found
This herb or natural product is the only ingredient in this brand.
a
This brand name is an example of a product in which the herb or natural product is included along with other herbs and products. Monitor for all possible side
b
effects of all ingredients in these products.
Safety of this product is a concern. The product contains animal material, possibly diseased animals that may harbor bovine spongiform encephalopathy (i.e.,
c
mad cow disease).
This product contains androstenedione that can increase estrogen levels. Side effects for men may include acne, behavior changes, testicular atrophy, and
d
gynecomastia (King et al., 1999). This product does not increase testosterone levels or significantly improve muscle strength (Brown et al., 2000).
Database, 2004). Gruenwald et al. (1998) indicated that me-
carcinoma (Badary, Al-Shabanah, Nagi, Al-Rikabi, & Elmazar,
dicinal preparations and combination products are made from
1999; Salomi, Nair, Jayawardhanan, Varghese, & Panikkar,
barley malt extract. No suggested dosage is available.
1992). Other in vitro studies examined the potent enzyme glyc-
Beta-sitosterol has scientific names of 22,23-dihydrostig-
eraldehyde-3-phosphate dehydrogenase from Ehrlich ascites
masterol; 24-beta-ethyl-delta-5-cholesten-3beta-ol; 24-ethyl-
carcinoma cells (Bagui, Ray, & Ray, 1999) and concurred with
cholesterol; and 3-beta-stigmast-5-en-3-ol. Self-medication
Badary et al.'s and Salomi et al.'s findings. No typical dosage is
with beta-sitosterol is for numerous conditions from asthma
given in Natural Medicines Comprehensive Database (2004).
and allergies to preventing colon or cervical cancer, the
No adverse effects from oral use of black seed have been re-
common cold, and tuberculosis (Natural Medicines Compre-
ported. In use for at least 1,400 years, black seed was found in
hensive Database, 2004). In vitro, beta-sitosterol can inhibit
King Tutankhamen's tomb (Facts and Comparisons).
Blond psyllium has the scientific name of Plantago ovata,
human colon cancer cells (Awad, Chen, Fink, & Hennessey,
1996; Awad, von Holtz, Cone, Fink, & Chen, 1998). Beta-
which is synonymous with Plantago decumbens and Plantago
sitosterol typically is well tolerated, but it can cause nausea,
isphagula. People self-medicate with blond psyllium for
indigestion, flatulence, diarrhea, or constipation (Berges, Win-
numerous gastrointestinal disorders, hypercholesterolemia,
deler, Trampisch, & Senge, 1995; Klippel, Hiltl, & Schipp,
hyperglycemia, and cancer (Natural Medicines Compre-
1997; Micromedex Inc., 2004). Typical doses of beta-sitos-
hensive Database, 2004). Initial research has indicated that
terol used for benign prostatic hyperplasia and prostatitis are
psyllium seems to preserve normal colon cell proliferation
60­130 mg divided into two or three daily doses (Martindale,
and possibly decrease absorption of carcinogens and uncon-
1999; Micromedex Inc.).
jugated estrogens (Alabaster, Tang, Frost, & Shivapurkar,
Bifidobacteria has scientific names of Bifidobacterium
1993; Gerber, 1996). Commonly used doses for laxative
adolescentis and Bifidobacterium bifidum. Bifidobacteria is
properties range from 7­40 g per day, taken in two or three
used to replenish normal flora of the bowel when patients
doses (Blumenthal et al., 1998; Gruenwald et al., 1998).
have diarrhea during radiation, chemotherapy, or antibiotic
Individuals self-medicating with blond psyllium should
therapy, for example. Preliminary research shows that bifido-
start with the lowest dose and gradually increase the dose
bacteria may protect the body against cancer by decreasing
as needed. They should consume at least 240 ml of water
fecal enzymes that metabolically activate some mutagens
for every 5 g ingested (Schneider, 1989). Blond psyllium
and carcinogens (Roberfroid, 2000). No adverse effects have
may cause allergic symptoms such as rhinitis, sneezing,
been reported (Natural Medicines Comprehensive Database,
conjunctivitis, urticarial rash, and asthma (Freeman, 1994;
2004). The strength of the preparation is dependent on the
Suhonen, Kantola, & Bjorksten, 1983). Caution patients
number of living organisms per capsule. The typical dose is 1
against using blond psyllium found in the wild. Chewing
billion­10 billion viable cells daily, divided into three or four
or crushing psyllium wild seeds releases a pigment that can
doses (Murray & Pizzorno, 1998).
damage renal tubules (Leung & Foster, 1996).
Black seed, with a scientific name of Nigella sativa, is used
Blueberry has a scientific name of Vaccinium angustifo-
in self-medication for gastrointestinal conditions and as an im-
lium. People self-medicate with blueberry for eye conditions,
munoprotectant against cancer (Facts and Comparisons, 2001).
ulcers, urinary tract infections, multiple sclerosis, fever,
Preliminary studies show that black seed is an anticancer agent,
varicose veins, hemorrhoids, and constipation (Duke, 1997;
inhibiting stomach tumors, carcinoma, and Ehrlich ascites
Robbers & Tyler, 1999). The antioxidant effects of blueberry
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E134
Table 2. Herbs or Natural Products With Toxic or Negative Side Effects
Herb or Natural Product
Major Adverse Reaction or Toxicity
Alpha-linolenic acid
Self-medication beyond 1.2­2 g to prevent breast cancer may increase the risk of heart disease, myocardial infarc-
tion, or cancer.
American pawpaw
Nausea and urticaria
Apple
The seeds contain hydrogen cyanide that is released, generated, or liberated when mixed with saliva.
Asparagus
Mucous membrane irritation
Barley
Sensitive individuals may develop asthma and allergic reactions from barley or barley dust.
Beta-sitosterol
Nausea, indigestion, flatulence, diarrhea, or constipation
Blond psyllium
Allergic symptoms such as rhinitis, sneezing, conjunctivitis, urticarial rush, and asthma; wild psyllium seeds can
cause damage to renal tubules.
Canthaxanthin
Large amounts can cause orange discoloration of body secretions and skin, as well as diarrhea, nausea, and stomach
cramps. One death from oral ingestion of canthaxanthin for tanning purposes has been reported.
This is an unsafe herb. Ingestion has been known to cause serious poisoning, acute hepatitis, liver and kidney damage,
Chaparral
and irreversible renohepatic failure. Two liver transplants, resulting from use of chaparral, have been reported.
Choline
The risk of adverse effects, including sweating, fish-like body odor, vomiting, and diarrhea, increases with doses of
more than 3.5 g per day.
Chrysanthemum
Photosensitivity and contact dermatitis
Conjugated linoleic acid
Gastrointestinal disturbances and fatigue
Cranberry
Chronic ingestion of more than 1 L of cranberry juice per day increases the risk of renal calculus.
Folic acid
Excessive amounts can exacerbate or precipitate neuropathy in patients with a vitamin B12 deficiency.
Fructo-oligosaccharides
If more than 10 g are ingested daily, expect adverse effects such as abdominal pain, belching, bloating, and flatu-
lence.
Garlic
Garlic has anticoagulant properties; therefore, use caution when combined with other anticoagulant and antiplatelet
herbs, natural products, and prescriptions.
Glucomannan
The tablet form of glucomannan has caused esophageal and gastrointestinal obstruction.
Green tea
Heavy consumption of green tea is linked to esophageal cancer because of the caffeine constituents. Adverse effects
include headache, diuresis, anxiety, insomnia, tremor, tachyrhythmias, premature heartbeat, nausea, vomiting,
diarrhea, ringing in the ears, elevated blood sugar, delirium, and convulsions.
Indole-3-carbinol
High doses of more than 400 mg per day can cause dysequilibrium symptoms, tremor, and nausea.
Jiaogulan
Oral use has resulted in severe diarrhea and nausea.
MSM (Methylsulfonylmethane)
Nausea, diarrhea, and headaches
Olive oil
Individuals with gallstones could experience biliary colic.
Peanut oil
Severe allergic reactions can result from using peanut products.
Propolis
Those individuals who are allergic to bees or bee stings may have allergic reactions to propolis. Oral ulcerations are
possible from lozenges containing propolis.
Quercetin
Headaches and tingling in the extremities
Rice bran
Flatulence, abdominal discomfort, and erratic bowel habits; rice bran could reduce absorption of some prescription
drugs, herbs, or supplements.
Shark cartilage
Nausea, vomiting, dyspepsia, constipation, hypotension, dizziness, hyperglycemia, hypercalcemia, altered conscious-
ness, decreased motor strength, general weakness, and fatigue; watch for signs of acute hepatitis, including low-
grade fever, jaundice, yellowing of the eyes, right upper-quadrant tenderness, and liver enzymes elevation.
Tragacanth
If taken without sufficient fluids, obstruction of ileum or esophagus can occur.
Turmeric
Overuse can cause gastrointestinal complaints.
Vitamin A
High doses or chronic use can cause blood cell changes, anemia, and liver damage.
Vitamin D
Use this vitamin in recommended nutritional doses only. Toxic effects from high does are hypercalcemia, osteoporosis,
serum electrolyte imbalances, cardiac dysrhythmias, and irreversible calcification of soft tissue.
Wheat bran
In daily doses of more than 20­40 g, wheat bran has a tendency to cause flatulence and gastrointestinal discom-
fort.
Whey protein
With high doses, expect increased stools, nausea, thirst, bloating, cramps, reduced appetite, fatigue, and head-
ache.
Yucca
Stomach irritation, nausea, vomiting, and a bitter taste
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E135
extracts may have anticancer activities, according to prelimi-
Comprehensive Database, 2004); however, no studies have
nary research (Bomser, Madhavi, Singletar, & Smith, 1996).
substantiated this claim.
Choline has scientific names of Trimethylethanolamine and
Blueberry seems to have no adverse effects (Natural Medicines
Comprehensive Database, 2004). Blueberry must not be con-
beta-hydroxyethyl trimethylammonium hydroxide. Individuals
fused with bilberry, which has a scientific name of Vaccinium
are known to self-medicate with choline for many psycho-
myrtillus (Robbers & Tyler). Three tablespoons of dried blue-
logical and brain-related conditions such as schizophrenia,
berries or a decoction of crushed fruit is a typical dose for
dementia, and Tourette syndrome. Some athletes take choline
diarrhea (Natural Medicines Comprehensive Database).
for endurance (Natural Medicines Comprehensive Database,
Cabbage has a scientific name of Brassica oleracea.
2004). Preliminary research has found that choline has a po-
Although cabbage has a history in self-medication for
tential role in cancer prevention (Albright et al., 1997; Yen,
gastrointestinal disorders, asthma, morning sickness, and
Mar, & Zeisel, 1999; Zeisel, 1992). The typical North Ameri-
preventing osteoporosis, individuals also use it to prevent
can diet supplies 200­600 mg of choline daily (Covington,
lung, stomach, colorectal, breast, and other cancers (Natural
1996) in liver, muscle meats, fish, nuts, beans, peas, and eggs
Medicines Comprehensive Database, 2004). Constituents in
(Gennaro, 1995). Adults self-medicating with doses exceeding
cabbage are released when it is chewed, and these constituents
3.5 g per day put themselves at risk for adverse effects (Yates,
may change the way that estrogen is metabolized. Therefore,
Schlicker, & Suitor, 1998), such as sweating, a fish-like body
cabbage may have anticarcinogenic properties (Bradlow, Mi-
odor, vomiting, and diarrhea (Covington).
Chrysanthemum has several scientific names: Anthemis
chnovicz, Telang, & Osborne, 1991; Grubbs et al., 1995; He,
Friesen, Ruch, & Schut, 2000; Michnovicz, 1998; Michnovicz
grandiflorum, Anthemis stipulacea, Chrysanthemum mori-
& Bradlow, 1990; Yuan et al., 1999). As an augmentation to
folum, Dendranthema morifolium, and Matricaria morifolia.
diet, cabbage has been pressed into juice, and as much as 1 L
Initial tests show that a product called hua-sheng-ping (chry-
has been consumed daily with no adverse effects (Gruenwald
santhemum, licorice, and Panax notoginseng) may reverse
et al., 1998).
precancerous gastrointestinal lesions (Yu, 1993). However,
Canthaxanthin has scientific names of 4,4-diketo-beta-
chrysanthemum causes photosensitivity and contact dermatitis
carotene and Beta, beta-carotene-4,4-dione. Individuals ingest
(Bleumink, Mitchell, Geismann, & Towers, 1996; de Jong,
canthaxanthin to produce an artificial tan (Martindale, 1999;
Vermeulen, van Wijk, & de Groot, 1998; Kuno, Kawabe,
Micromedex Inc., 2004). In several in vivo and in vitro animal
& Sakakibara, 1999; Paulsen, Sogaard, & Andersen, 1998).
studies, canthaxanthin inhibited tumor growth and transforma-
To make an extract of chrysanthemum, 300 mg of the dried
tion of tumor cells (Huang, Odeleye, & Watson, 1992; Vainio
flower in 500 ml water are allowed to concentrate by conden-
& Rautalahti, 1998). However, large amounts of canthaxan-
sation (time is not given). A typical dose of 25 ml can be taken
thin can cause orange discoloration of body secretions and
up to three times daily (Huang, 1999).
Conjugated linoleic acid has scientific names of cis-9,
skin (Natural Medicines Comprehensive Database, 2004) as
well as diarrhea, nausea, and stomach cramps (Micromedex
trans-11 conjugated linoleic acid and trans-10,cis-12 conju-
Inc.). One death from ingestion of canthaxanthin for tanning
gated linoleic acid. Individuals self-medicate with conjugated
purposes has been reported (Bluhm, Branch, Johnston, &
linoleic acid for atherosclerosis, bodybuilding, cancer, obesity,
Stein, 1990). A typical dose for tanning is 120 mg per day for
and other conditions (Natural Medicines Comprehensive
several days (Micromedex Inc.). Canthaxanthin is in nonpre-
Database, 2004). Conjugated linoleic acid seems to enhance
scription drugs sold in Canada for tanning purposes.
immune function and inhibit cyclooxygenase and lipoxy-
Chaparral has two scientific names, Larrea divaricata
genase pathways in tumor cells (O'Shea, Stanton, & Devery,
and Larrea tridentata, which are synonymous with Larrea
1999; Sebedio, Gnaedig, & Chardigny, 1999). This acid may
mexicana and Zygophyllum tridentatum. Chaparral is used to
modulate cellular response to tumor necrosis (Pariza, Park,
treat conditions such as arthritis, cancer, the common cold,
& Cook, 1999). Gastrointestinal disturbances and fatigue are
tuberculosis, and venereal disease (Newall, Anderson, & Phil-
the most common adverse effects (Blankson et al., 2000). A
pson, 1996). Preliminary research has found that a constituent
typical dose is 2­7 g per day (Blankson et al.).
Cranberry has numerous scientific names such as Vaccinium
of chaparral, nordihydroguaiaretic acid, has the potential for
anticarcinogenic and antimutagenic activity (Anesini, Ferraro,
macrocarpon, which is synonymous with Oxcycocus macro-
Lopez, & Borda, 2001; McDonald et al., 2001).
carpos. Additional species have either genus name. Popular
Chaparral is considered unsafe, causing serious poisoning,
as a self-medication in preventing urinary infections or as an
acute hepatitis, liver and kidney damage, and irreversible
antibiotic in treating urinary infections (Harkins, 2000; Jackson
renohepatic failure. Multiple reports have cited liver and
& Hicks, 1997), cranberry also is used to treat or prevent cancer
kidney damage requiring at least two liver transplants (Batch-
(Natural Medicines Comprehensive Database, 2004). Cranber-
elor, Heathcote, & Wanless, 1995; Estes et al., 2003; Gordon,
ry's proanthocyanide fraction may have anticarcinogenic activ-
Rosenthal, Hart, Sirota, & Baker, 1995; Katz & Saibil, 1990;
ity (Bomser et al., 1996). Animal models show that cranberry
Newall et al., 1996; Sheikh, Philen, & Love, 1997). These
products and juice can reduce the number of breast cancer tu-
researchers also indicated chaparral's potential interaction
mors, delay tumor development, and slow metastases of cancer
with hepatotoxic herbs and drugs and liver function tests and
to lungs and lymph nodes (Natural Medicines Comprehensive
exacerbation of liver disease. No typical dose is available
Database). Oral intake of cranberry usually is well tolerated.
for this toxic herb. Chaparral and red clover are components
Chronic ingestion of more than 1 L of cranberry juice per day
of Jason Winters tea, a popular alternative therapy cancer
can increase the risk of renal calculus (Jackson & Hicks).
Folic acid has scientific names of Pterolglutamic acid, Pte-
remedy. The manufacturer of Herp-EezeTM (Olympian Labs,
Scottsdale, AZ) claims that its chaparral product is rendered
roylmonoglutamic acid, and Pterolpolyglutamate. Often used
nontoxic by the manufacturing process (Natural Medicines
in self-medication to prevent folate or vitamin B12 deficiency,
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E136
it also is used to prevent colon cancer (McKevoy, 1998; Mic-
medicate with green tea for headaches, for gastrointestinal
romedex Inc., 2004). Folic acid also is known as vitamin B9.
conditions, to maintain remission of Crohn's disease (Alic,
Early studies indicate that folic acid may protect patients with
1999), and to prevent prostate, colon, and gastric cancers
ulcerative colitis against cancer (Lashner, 1993). Excessive
(Gupta, Ahmad, & Mukhtar, 1999; Taylor & Wilt, 1999;
amounts of folic acid can exacerbate or precipitate neuropathy
Tsubono et al., 2001). Green tea also is used to prevent skin
for patients with a vitamin B12 deficiency (Natural Medicines
cancer or damage from ultraviolet radiation (Katiyar, Ahmad,
Comprehensive Database, 2004). The recommended daily
& Mukhtar, 2000). Catechins in green tea, especially epigal-
dose for individuals older than age 13 is 400 mcg (Yates et al.,
locatechin-3-gallate, seem to reduce the risk of some cancers
1998). Health and Welfare Canada (1990) advised a dose of
by preventing blood vessel growth in tumors (Cao & Cao,
217 mcg for a 70 kg man and 170 mcg for a 55 kg woman.
1999; L'Allemain, 1999). Green tea also seems to reduce
Forskolin has scientific names of 17beta-acetoxy-8,13-ep-
oxidative DNA damage, lipid peroxidation, and free radical
oxy-1alpha and 6beta,9alpha-trihydroxylabd-14-en-11-one.
generation, which appears to decrease mutigenic activity for
Individuals self-medicate with forskolin for gastrointestinal,
smokers (Lee et al., 1997). In addition, green tea appears to
urinary, and cardiac conditions, as well as cancer. Preliminary
prevent ultraviolet radiation-induced immunosuppression and
studies show that the product has the potential for blocking
protect against skin cancers (Katiyar et al.).
tumor cell-induced human platelet aggregation, preventing
Alternatively, heavy consumption of green tea has been
growth of tumor cells, and preventing metastases (Agarwal
linked to esophageal cancer (Facts and Comparisons, 2001)
& Parks, 1983; Tzanakakis, Agarwal, & Vezeridis, 1990). No
because of the caffeine constituent of tea. Adverse reac-
adverse effects have been reported for oral use of forskolin,
tions include headache, diuresis, anxiety, insomnia, tremor,
and no typical dose has been made available.
tachyrhythmias, premature heartbeat, nausea, vomiting,
Fructo-oligosaccharides have the scientific name of Beta-
diarrhea, ringing in the ears, elevated blood sugar, delirium,
D-fructofuranosidase. A self-medication for constipation,
and convulsions (Facts and Comparisons; Gruenwald et al.,
fructo-oligosaccharides appear to protect against colon cancer
1998; Hardman & Limbird, 1996; Schulz, Hansel, & Tyler,
(Pierre et al., 1997). Side effects of abdominal pain, belching,
1998). Doses of green tea vary but often range from 1­10
bloating, and flatulence tend to be more severe when fructo-
cups daily (Fetrow & Avila, 1999). Table 1 shows brand
oligosaccharides are taken in amounts of 10 g or more daily
names of green tea in tablet and capsule form. According
(Circosta et al., 1984; Stone-Dorshow & Levitt, 1987).
to the Natural Medicines Comprehensive Database (2004),
Garlic has a scientific name of Allium sativum. Self-medi-
these tablets contain standardized extracts of as much as
cation with garlic is for the treatment of numerous conditions
97% polyphenols, which is equivalent to drinking four cups
including cardiovascular atherosclerosis, HIV drug-induced
of green tea. No typical or safe dose is available, except to
lipid disorders, cancer prevention, colds and the flu, and
follow Tyler's (1993, 1994) guide to consume no more than
tick bite prevention (Bloch, 2000; Blumenthal et al., 1998;
250 mg of caffeine per day. A 6 oz cup of tea has 10­50 mg
Micromedex Inc., 2004; Newall et al., 1996). Humoral and
of caffeine.
Indole-3-carbinol has a scientific name of indole-3-
cellular immunity seems to be stimulated by garlic (Sato &
Miyata, 2000). Another constituent in garlic seems to be active
methanol. Individuals self-medicate with indole-3-carbinol
against erythroleukemia as well as breast and prostate cancer
to prevent all types of cancer, including breast and colon
cells (Efendy, Simmons, Campbell, & Campbell, 1997; Ide
cancers. Self-prescription is carried out to maintain hormonal
& Lau, 1997, 1999; Imai et al., 1994; Moriguchi, Saito, &
balance, detoxify the bowels and liver, and boost the immune
Nishiyama, 1996; Sigounas, Hooker, Anagnostou, & Steiner,
system (Natural Medicines Comprehensive Database, 2004).
1997; Zhang, Moriguchi, Saito, & Nishiyama, 1998). Anti-
Researchers suspect that indole-3-carbinol is one of several
coagulant properties of garlic call for caution in its use with
vegetable components that may be protective against breast,
other anticoagulant and antiplatelet herbs and products such
cervical, endometrial, and colorectal cancers (Grubbs et al.,
as ginkgo, ginseng, and vitamin E and with anticoagulant and
1995; He et al., 2000; Kojima, Tanaka, & Mori, 1994; Wong
antiplatelet agents such as warfarin sodium. Most clinical
et al., 1997; Yuan et al., 1999). Research findings are con-
studies use a standardized dose of garlic powder containing
troversial; some research has shown that indole-3-carbinol
1.3% alliin (Auer et al., 1990; Holzgartner, Schmidt, & Kuhn,
may be helpful against hormone-dependent cancers such as
1992; Jain, Vargas, Gotzkowsky, & McMahon, 1993; Sato &
breast cancer (Bradlow et al., 1991; Grubbs et al.; Kojima et
Miyata; Silagy & Neil, 1994). Alliin is the medicinal ingre-
al.; Michnovicz, 1998; Michnovicz & Bradlow, 1990; Yuan
dient in garlic. Four grams of fresh garlic contain 1% alliin
et al.). However, other research raises concerns that indole-
(Natural Medicines Comprehensive Database, 2004).
3-carbinol may increase the carcinogenicity of certain toxins
Glucomannan, a polysaccharide, is found in the tubers
(Bailey et al., 1991; Dashwood, 1998; Kim et al, 1997; Pence,
(underground stems) of a plant with the scientific name of
Buddingh, & Yang, 1986). Whether indole-3-carbinol in-
Amorphophallus konjac. Self-medication with glucomannan is
creases or decreases cancer risk may depend on duration and
usually for constipation, control of blood glucose, or reduction
timing of exposure to this component in addition to dietary
of serum cholesterol (Facts and Comparisons, 2001). A Chinese
factors. High doses of indole-3-carbinol (i.e., more than 400
study (Luo, 1992) found that glucomannan protected mice
mg per day) can result in dysequilibrium symptoms, tremor,
against clinically induced lung cancer. The tablet form of gluco-
and nausea (Rosen, Woodson, Thompson, Hengesteg, &
mannan has caused esophageal and gastrointestinal obstruction
Bradlow, 1998). Bell et al. (2000) reported the use of 200 mg
(Luo; Martindale, 1999). Typical doses are approximately 3 g
for cervical dysplasia. Rosen et al. reported the use of 300
daily (Walsh, Yaghoubian, & Behforooz, 1984).
mg per day for breast cancer prevention. Typically, 20­120
Green tea has the scientific name of Camellia sinensis,
mg of indole-3-carbinol are in a daily dietary intake (Natural
which is synonymous with Camiellia thea. Individuals self-
Medicines Comprehensive Database).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E137
Jiaogulan has a scientific name of Gynostemma pentaphyl-
3 is produced by hydrolyzing rice bran using enzymes from
mycelia of shitake, kawaratake, and suehirotake mushrooms.
lum, which is synonymous with Gynostemma pedatum.
Some studies show that MGN-3 can increase natural killer
Jiaogulan is used for the self-medication of numerous condi-
cell activity and production of tumor necrosis factor-alpha
tions such as cardiovascular and gastrointestinal disorders,
(Natural Medicines Comprehensive Database). Small studies
cancer, diabetes, and obesity, as well as strengthening the
comparing healthy individuals and individuals with cancer
immune system. It also is used as an anti-inflammatory agent,
suggest that use of MGN-3 increases the activity of natural
antioxidant, or detoxifying agent (Natural Medicines Compre-
killer cells (Ghoneum, 1998). No adverse effects have been
hensive Database, 2004). This herb seems to have anticancer
reported, but the dose used in human tests was 3 g per day
activity and immunostimulatory abilities (Facts and Com-
(Natural Medicines Comprehensive Database).
parisons, 2001); however, severe diarrhea and nausea have
Microalgae has scientific names of 3,3'-dihydroxy-4,4'-dik-
resulted from oral use of jiaogulan (Facts and Comparisons).
eto-beta-carotene; 3S, 3'S-astaxanthin; 3'R-astaxanthin; and
An extract of 10 mg three times daily is noted by Natural
3R,3'S-astaxanthin. This product is used in self-medication
Medicines Comprehensive Database, but this is not indicated
to protect against cancer, reduce cholesterol, aid in stroke re-
as a safe or typical dose.
Lavender has the scientific name of Lavandula angus-
covery, and prevent macular degeneration in the eyes (Natural
Medicines Comprehensive Database, 2004). A constituent of
tifolia, which is synonymous with Lavandula officinalis.
microalgae, astaxanthin (a reddish carotenoid pigment) is a
Individuals self-medicate with lavender to treat cancer and
powerful antioxidant that stimulates immunity (Chew, Park,
numerous other conditions such as insomnia, loss of appetite,
Wong, & Tong, 1999; Chew, Wong, Park, & Wong, 1999)
gastrointestinal disorders, headache, and nervousness. In vitro
and has the potential to protect against mammary, liver, blad-
and animal studies have shown some anticancer activity for
der, or oral cancers (Chew, Wong, et al.; Gradelet, Le Bon,
this herb (Facts and Comparisons, 2001). Considered a safe
Berges, Suschetet, & Astorg, 1998; Tanaka et al., 1994, 1995).
food additive (Leung & Foster, 1996), the typical oral dose is
Adverse reactions have not been reported, and the typical
one cup of tea several times a day (Bisset & Wichtl, 1994).
Lutein has a scientific name of beta, epsilon-carotene-
dose is 2.5 mg per day (Natural Medicines Comprehensive
Database).
3, 31-diol. Individuals self-medicate with lutein to prevent
MSM has scientific names of methylsulfonylmethane and
age-related macular degeneration and colon cancer (Natural
Dinethylsulfone. Individuals self-medicate with MSM for
Medicines Comprehensive Database, 2004). Epidemiologic
numerous conditions, such as breast and colon cancer, chronic
studies by Slattery et al. (1997) and Steinmetz and Potter
pain, arthritis, scar tissue, wrinkles, eye inflammation, aller-
(1991) have indicated that carotenoids seem to decrease the
gies, gastrointestinal and cardiovascular conditions, obesity,
risk of cancer. Lutein typically is present in two carotenoids,
Alzheimer disease, snoring, headaches, and hangovers (Her-
stereoisomer and zeaxanthin; both are found in a pigment of
schler, 1986). O'Dwyer et al. (1988) found that MSM delayed
human macula and retina (Snodderly, 1995). No adverse reac-
the onset of chemically induced colon cancer in animals.
tions have been noted when lutein is ingested. Chasan-Taber et
MSM also delayed the onset of chemically induced mammary
al. (1999) and Pratt (1999) indicated that 44 mg of lutein are
tumors in rats (McCabe et al., 1986). If taken orally, MSM
in a cup of cooked kale, 26 mg are in a cup of cooked spinach,
can cause nausea, diarrhea, and headaches (Natural Medicines
and 3 mg are in a cup of broccoli. Corn, orange peppers, kiwi
Comprehensive Database, 2004). Typically, MSM is taken in
fruit, grapes, orange juice, zucchini, and some squashes also
oral doses of 1,000­3,000 mg daily with meals or 250­500
are rich in lutein and other carotenoids (Sommerburg, Keunen,
mg daily as a dietary supplement (Natural Medicines Com-
Bird, & van Kuijk, 1998).
Lycopene has scientific names of all-trans-lycopene and
prehensive Database).
Olive oil has a scientific name of Olea europaea. People
psi-psi-carotene. Self-medication typically is intended for
self-medicate with olive oil to prevent cardiovascular condi-
preventing atherosclerosis and cancer. The red color of fruits
tions (Trevisan et al., 1990) or treat diabetes (Keys et al.,
and vegetables comes from the pigment lycopene (Rao &
1986). Although some individuals take it to treat breast cancer
Agarwal, 1998, 2000). Lycopene has no vitamin A activity,
(la Vecchia et al., 1995), others take it to prevent colorectal
yet it is a carotenoid (Rao & Agarwal, 1998, 2000). Rao and
cancer (Stoneham, Goldacre, Seagroatt, & Gill, 2000). Inges-
Agarwal (1998, 2000) have studied lycopene's potential in
tion of olive oil seems to reduce a bile acid, deoxycholic acid,
cancer prevention. Some evidence shows that when serum or
involved in mucosal changes and polyp formation prior to co-
tissue lycopene concentrations are low, the risk of prostate
lon cancer (Stoneham et al.). Individuals with gallstones may
cancer is increased (Clinton et al., 1996; Gann et al., 1999;
experience biliary colic if they consume olive oil (Blumenthal
Giovannucci, 1999; Giovannucci et al., 1995; Tzonou et
et al., 1998; Brinker, 1998; Gruenwald et al., 1998). A dose
al., 1999). No adverse effects have been reported (Natural
of 30­40 g per day (1.2­1.6 oz) of extra virgin olive oil is
Medicines Comprehensive Database, 2004). At least 6 mg of
used as a diet supplement therapy for hypertension (Ferrara
lycopene per day from food is needed to protect against pros-
et al., 2000).
tate cancer (Giovannucci et al., 1995), and at least 12 mg of
Peanut oil has a scientific name of Arachis hypogaea. Pea-
lycopene per day from food is needed to protect against lung
nut oil often is used to lower cholesterol, aid in weight loss, or
cancer in nonsmoking men (Michaud et al., 2000). A cup of
prevent heart disease or cancer (Natural Medicines Compre-
tomato juice contains about 23 mg of lycopene.
MGN-3 has no scientific name, but it also is known as bio-
hensive Database, 2004). Beta-sitosterol and resveratrol may
contribute to the cardiovascular and cancer protective activity
bran hemicellulose complex with arabinoxylane. Individuals
of peanuts (peanut oil) (la Vecchia et al., 1995). However,
self-medicate with MGN-3 to treat and prevent cancer and to
severe allergic reactions can result from ingestion of peanut
treat AIDS, hepatitis, diabetes, and chronic fatigue syndrome
products (Eigenmann, Burks, Bannon, & Sampson, 1996).
(Natural Medicines Comprehensive Database, 2004). MGN-
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E138
The typical dosage for peanut oil is not available (Natural
tagenic, antioxidant, anti-inflammatory, and analgesic activities
Medicines Comprehensive Database).
(Fontenele, Araujo, de Alencar, & Viana, 1997; Fontenele,
Propolis has no scientific name. The resinous material
Viana, Xavier-Filho, & de-Alencar, 1996; Gomes, Souto, &
from poplar and conifer buds, propolis is used to treat nu-
Felzenszwalb, 1996). Adverse effects include nausea, vomiting,
merous infections such as tuberculosis and those of bacteria,
dyspepsia, constipation, hypotension, dizziness, hyperglyce-
fungal, and protozoal origins. Individuals also self-medicate
mia, hypercalcemia, altered consciousness, decreased motor
with propolis for nasopharyngeal carcinoma (Foster & Tyler,
strength, general weakness, and fatigue (Lane & Comac; Miller
1993). Propolis contains caffeic acid phenethyl ester, which is
et al.). Other adverse effects found by Ashar and Vargo (1996)
thought to have cancer chemopreventive activities (Lee et al.,
are signs of acute hepatitis, including low-grade fever, jaundice,
1999). Allergic reactions to propolis are possible, especially in
yellowing of the eyes, right upper-quadrant tenderness, and
those who are allergic to bees or bee stings. Oral ulcerations
elevated liver enzymes. Typical doses suggested by commercial
may occur from propolis-containing lozenges (Facts and
product manufacturers range from 500 mg­4.5 g, divided into
Comparisons, 2001; Hay & Greig, 1990). No typical doses
two to six doses per day (Fetrow & Avila, 1999). These doses
have been reported.
cannot be considered as recommended or safe.
Quercetin has a scientific name of 3,3',4'5,7-Penthydoxy-
Soy has a scientific name of Glycine max, which is synony-
flavone. Individuals self-medicate with quercetin to treat al-
mous with Glycine soja. Some people use soy products as a
lergies, atherosclerosis, cataracts (Li, Blacklock, & Garside,
substitution for cow's milk in diets, but soy also is taken for
1985), coronary heart disease, diabetes (Lean et al., 1999),
numerous illness conditions, as well as prevention of breast
inflammation, asthma, gout, and viral infections and to pre-
or prostate cancer. Soy also is used commonly to treat hot
vent cancer (Natural Medicines Comprehensive Database,
flashes caused by breast cancer treatments. Diets that are
2004). The antioxidant and anti-inflammatory activities of
high in soy products appear to be related to a reduced risk
this product seem to inhibit division and growth of T cells
of prostatic disease and cancer (Evans, Griffiths, & Morton,
and some cancer cells (Shoskes, Zeitlin, Shahed, & Rajfer,
1995). However, a controversy about the action of soy exists.
1999). Quercetin may inactivate malignant precursors or
Some scientists have reported that soy may increase the risk
inhibit carcinogenesis (Li et al.). According to a preliminary
of breast cancer, whereas others believe that soy may have
study conducted by El Attar and Virji (1999), various kinds
some protective effect for breast cancer (Hakkak et al., 2000;
of cancers, including breast, leukemia, colon, ovary, oral
McMichael-Phillips et al., 1998; Petrakis et al., 1996). Women
squamous cell, endometrial, gastric, and non-small cell lung,
with breast cancer or with a history of breast cancer should
may be inhibited by consuming this product. Quercetin also
avoid therapeutic doses of soy products especially if they are
has an antiestrogenic effect in cultures of breast cancer cells
taking tamoxifen (Facts and Comparisons, 2001; Massey,
(Miodini, Floravanti, Di Fronzo, & Cappelletti, 1999). Huang,
Palmer, & Horner, 2001; Montbriand, 2004b; Smolinske,
Fasco, and Kaminsky (1997) found that quercetin inhibits
1999). Two or more glasses of soy milk daily have been
estrone sulfatase and estrogen synthesis in liver cells. If taken
suggested to reduce the risk of prostate cancer (Jacobsen,
orally, this product can cause headaches and tingling in the
Knutsen, & Fraser, 1998). Safe therapeutic doses of soy vary
extremities (Shoskes et al.). A common dose is 400­500
from 20­60 g per day for adults (Natural Medicines Com-
mg three times daily (Natural Medicines Comprehensive
prehensive Database, 2004).
Spinach has a scientific name of Spinacia oleracea. People
Database).
Rice bran has a scientific name of Oryza sativa. Rice bran
self-medicate with spinach to treat gastrointestinal complaints
is taken to treat diabetes and hypertension, induce weight
and fatigue, induce blood building, and stimulate the appetite
loss, and prevent cardiovascular disease or cancer (Natural
(Blumenthal et al., 1998). Ahn (1997) found that consump-
Medicines Comprehensive Database, 2004). Increasing fecal
tion of fresh spinach, not supplements that include spinach,
bulk appears to decrease the risk of bowel cancer because sec-
is associated with a decreased risk of human stomach cancer.
ondary bile acids are eliminated from the body more quickly
Notably, more than 60 products were found with spinach as
(Weisburger et al., 1993). Rice bran has the ability to increase
an ingredient. No adverse reactions or typical doses have been
stool size, but it can cause flatulence, abdominal discomfort,
found (Natural Medicines Comprehensive Database, 2004).
Tragacanth has a scientific name of Astragalus gummifera.
and erratic bowel habits (Covington, 1996). McKevoy (1998)
indicated that the use of rice bran may result in a tendency
Tragacanth is used to treat diarrhea (Facts and Comparisons,
to slow or reduce absorption of some prescription drugs,
2001); conversely, it also is used as a laxative (Gruenwald et
herbs, or supplements. Typical doses range from 12­84 g of
al., 1998). Early studies indicate that tragacanth may inhibit
rice bran per day or 4.8 g of rice bran oil per day (Gerhardt
cancer cell growth (Leung & Foster, 1996). If this herb is
& Gallo, 1998; Ohkawa, Ebisuno, Kitagawa, Morimoto, &
taken with insufficient amounts of fluids, obstruction of the
Miyazaki, 1983; Ohkawa et al., 1984; Watkins, Geller, Kooy-
ileum or esophagus can occur (Gruenwald et al.). No typical
enga, & Bierenbaum, 1999).
dose has been identified.
Shark cartilage has a scientific name of Squalus acanthias.
Turmeric has the scientific name of Curcuma longa, which
Individuals self-medicate with shark cartilage to prevent and
is synonymous with Curcuma domestica. Individuals self-medi-
treat cancer (Hunt & Connelly, 1995; Lane & Comac, 1992;
cate with turmeric to ease gastrointestinal discomfort and to
Miller, Anderson, Stark, Granick, & Richardson, 1998). Some
treat colorectal cancer (Gruenwald et al., 1998). This herb may
preliminary evidence shows that shark cartilage may have
have bile-stimulating, liver-protectant, antioxidant, and antican-
some anticancer properties. Researchers hypothesized that this
cer effects (Facts and Comparisons, 2001; Gruenwald et al.). Its
cartilage may prevent the new vessel growth that is required
overuse may cause gastrointestinal complaints (Gruenwald et
for solid tumor proliferation (Hunt & Connelly). Preliminary
al.; Robbers & Tyler, 1999). A typical dose is as much as 1.5­3
research has revealed that shark cartilage has possible antimu-
g per day, according to Blumenthal et al. (1998).
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E139
Vitamin A has no scientific name. People self-medicate
prevents cell damage and reduces the risk of colon cancer
with vitamin A for numerous conditions such as cataracts,
(Govers, Gannon, Dunshea, Gibson, & Muir, 1999). Wheat
acne, cold sores, diabetes, and gastrointestinal disorders, as
bran has a tendency to cause flatulence and gastrointestinal
well as the treatment or prevention of cancer (McKevoy, 1998;
discomfort; however, McRorie et al. (2000) found no gas-
Micromedex Inc., 2004). Vitamin A is made up of a 20-carbo-
trointestinal discomfort in a carefully controlled study with
structure molecule with various chemical groups at 15 carbon
participants taking 20­40 g of wheat bran daily. This result
positions. Different forms of vitamin A, called retinoids, are
also was found by Sauvaire et al. (1998).
Whey protein has no scientific name. Individuals self-
formed at variations of these 15 positions. Several in vitro
studies have suggested that retinoids in vitamin A may help
prescribe whey protein to prevent colon cancer (McIntosh,
prevent cancer (Sporn, 2000; Widschwendter et al., 2000). High
1993), to treat metastatic carcinoma (Kennedy, Konok, Boun-
doses or chronic use of vitamin A can cause blood cell changes,
ous, Baruchel, & Lee, 1995; Papenburg, Bounous, Fleiszer,
anemia, and liver damage among other less severe symptoms
& Gold, 1990), or as a substitute for milk if they are lactose
(McKevoy; Micromedex Inc.). The recommended daily dose
intolerant. Whey protein also is known as bovine whey protein
of vitamin A is 800­1,000 retinol equivalents for adults aged
concentrates. Researchers are interested in whey protein as
19 and older (Health and Welfare Canada, 1990).
a potential cancer prevention because when gamma-gluta-
Vitamin D has scientific names of calcifediol; 25-hydroxy-
mylcsteine, a component of whey protein and a precursor of
cholecalciferol; calcitrol; 1,25-dihydroxycholecalciferol;
glutathione (GSH), is introduced to tissue, GSH substrates
cholecalciferol; dihydrotachysterol; ergocalciferol; calcipot-
increase (Bounous, Batist, & Gold, 1991). Kennedy et al.,
riene; paricalcitol; and alfacalcidol. Vitamin D is used to
who used a dose of 30 g in their study, postulated that whey
build bones, protect against bone loss and muscle weakness,
protein may exert antitumor effects on cells by increasing
promote strong teeth, and decrease the risk of breast, colon,
GSH, thus making cells more vulnerable to chemotherapy.
and prostate cancers (McKevoy, 1998). Preliminary negative
Other researchers have reported that dietary whey protein
evidence suggests that vitamin D may be associated with in-
may protect against certain cancers (Hakkak et al., 2000;
creased risk of colon, breast, and prostate cancers (McKevoy).
McIntosh; Papenburg et al.). Whey protein usually is well
However, Gesensway (2000) reported that vitamin D may
tolerated, but with high doses (i.e., 2­6.5 g/kg daily), con-
have an antiproliferative effect on colon, breast, or prostate
sumers should expect increased stools, nausea, thirst, bloat-
cancer. Symptoms of vitamin D toxicity are similar to those
ing, cramps, reduced appetite, fatigue, and headache. Whey
of hypercalcemia: osteoporosis, serum electrolyte imbalances,
protein also increases blood urea nitrogen (Natural Medicines
cardiac dysrhythmias, and irreversible calcification of soft tis-
Comprehensive Database, 2004).
Yucca has a scientific name of Yucca glauca. Yucca is used to
sues (McKevoy; Micromedex Inc., 2004). The recommended
nutritional dose for vitamin D is 400 units or 10 mcg daily
treat arthritis, hypertension, headaches, diabetes, and gastroin-
(Micromedex Inc.; Yates et al., 1998). Health and Welfare
testinal conditions (Leung & Foster, 1996; Newall et al., 1996).
Canada (1990) recommended a nutritional dosage of 5 mcg
The polysaccharides in yucca exhibit antitumor activity against
for individuals aged 13 or older.
B16 melanoma but not against L1210 and P388 leukemias in
Vitamin K has scientific names of phytonadione (K1),
mice (Facts and Comparisons, 2001; Foster & Duke, 1990;
menaquinone (K2), menadione (K3), menadiol acetate (K4),
Leung & Foster; Newall et al.). Yucca can cause stomach irrita-
and 4-amino-2methyl-1-naphthol (K5). Self-medication is
tion, nausea, and vomiting, and it has a bitter taste (Gruenwald
based on the vitamin's number. For example, vitamin K1
et al., 1998). No typical dosage has been identified (Natural
is used for vitamin K deficiency or to decrease bleeding or
Medicines Comprehensive Database, 2004).
hemorrhage. Vitamin K2 is used to treat osteoporosis or lower
Conclusion and Implications
cholesterol in patients on dialysis. Vitamin K3 is used in com-
bination with vitamin C to treat or prevent breast and prostate
This review article provides information about 47 herbs
cancers. Vitamin K4 is used to treat poor absorption of vitamin
and natural products that have the potential to protect humans
K. Natural Medicines Comprehensive Database (2004) reported
against cancer. The majority of these herbs and natural prod-
that recent evidence has shown that a combination of vitamins
ucts are fruits, vegetables, animal or fish products, grains,
K3 and C may have potential in the treatment of prostate and
and molecular components of plants or herbs that are found
breast cancers. Few adverse effects have been reported for oral
in human diets. Therefore, findings in this review are similar
use of vitamin K (McKevoy, 1998; Micromedex Inc., 2004). No
to the ACS 1996 Advisory Committee on Diet, Nutrition, and
typical dose has been identified (Health and Welfare Canada,
Cancer Prevention's (1996) conclusions that the best protec-
1990). McKevoy suggested that doses be individualized and
tion against cancer is a dietary pattern that emphasizes fruits,
used under medical supervision.
vegetables, grains, and beans and limited amounts of meat,
Wheat bran has a scientific name of Triticum aestrivum.
dairy, and high-fat foods.
Individuals self-medicate with wheat bran to prevent colon
Another one of the ACS 1996 Advisory Committee on
cancer and other colon conditions (Foster & Tyler, 1993).
Diet, Nutrition, and Cancer Prevention's (1996) conclusions
Some people use it to prevent breast cancer ("Consensus
was that no conclusive evidence is available to support taking
Statement on Cereals, Fibre and Colorectal and Breast Can-
supplements to reduce the risk of cancer. Alternately, consider
cers," 1998). Wheat bran may reduce the risk of cancer by
the healthy food choices available that give protection against
lowering plasma estrogen levels. This action seems to involve
cancer. Notice the choices in this review. Alpha-linolenic acid
interference with enterohepatic circulation and an increase
is found in red meat and dairy products. Choline is abundant in
in the rate of fecal estrogen excretion (Bouhnik et al., 1992).
liver, muscle meats, fish, nuts, beans, peas, and eggs. Eggs and
Digestion of grains and starches reduces ammonia produced
fatty fish such as herring, mackerel, sardines, and tuna are rich
by fermentation of foods high in fat and sugar; this possibly
ONCOLOGY NURSING FORUM ­ VOL 31, NO 6, 2004
E140
in vitamin D. Many foods are fortified with vitamin D. Vitamin
instances when supplements contain other ingredients along
D also is available to the body when the skin is exposed, in mod-
with the herb or product found potentially useful in this re-
eration, to the sun. However, McKevoy (1998) indicated that
view. When additional ingredients are in the supplement, the
excessive sun exposure results in photodegeneration of vitamin
potential for adverse effects is even higher.
D. Vitamin K2 is available in meat and cheese.
Healthcare professionals will find exceptions in this re-
Several grains such as barley, rice bran, and wheat bran
view that are not in the human diet. Some herbs and natural
(outer hull of wheat found in whole wheat bread) protect
products are only available in plant form or supplements. Fur-
against cancer. Various vegetables, fruits, and plants also
thermore, some individuals will continue to take supplement
show promise as protection against cancer: apple, asparagus,
forms of products instead of dietary forms. When individuals
blueberry, cabbage, cranberry, green tea, lavender tea, olive
approach healthcare professionals about these products, the
oil, peanut oil, and spinach.
information about possible dosage may be useful. In some
Molecular components available in vegetables and animal
cases, such as chaparral, advise potential users of the herb or
products have the potential to protect against cancer. For
product's toxicity and encourage avoidance.
example, folic acid is available in all vegetables and animal
Questions for healthcare professionals to ask consumers
products, especially liver, leafy vegetables, fruit, pulses, and
include the following. Why seek protection from cancer
yeast. Indole-3-carbinol is found in vegetables such as brussels
by taking supplements that have not shown the potential to
sprouts, cabbage, collards, cauliflower, kale, kohlrabi, mustard
decrease the risk of cancer in evidence-based research? Why
greens, rapeseed, turnips, and rutabagas. All red-colored fruits
take products with the potential for many adverse side effects
and vegetables contain the pigment lycopene, a protection
that may destroy your present good health? Why take supple-
against cancer. Corn, orange peppers, kiwi fruit, grapes, orange
ments when enjoying a nutritious diet that is rich in fruit and
juice, zucchini, and some squashes are rich in lutein. Green
vegetables can be your best protection against the risk of
and yellow vegetables, especially carrots, are rich in vitamin
cancer? With the information available in this review article,
A. Brussels sprouts, plant oil, and margarine also are rich in
healthcare professionals have an opportunity to encourage
vitamin K1, a possible protection against cancer.
safer and healthier ways to protect against cancer.
Individuals who are concerned about cancer have a rich
The author gratefully acknowledges the continuing support of Carl D'Arcy,
array of potential cancer protection available to them in a
PhD, director of applied research/psychiatry at the University of Saskatch-
healthy diet. More importantly, the risk of overdose or adverse
ewan in Saskatoon, Canada.
side effects is considerably less or nonexistent when individu-
als seek cancer protection through a healthy diet. Conversely,
Author Contact: Muriel J. Montbriand, PhD, RN, can be reached
the potential for adverse health risks and side effects are
at montbriand@skyway.usask.ca, with copy to editor at rose_
high when taking supplements. Table 1 provides numerous
mary@earthlink.net.
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