Nelle Moriarty says she's grateful for new
breast cancer drugs like Herceptin.
But like most patients in
cancer therapy, Moriarty, 55, says the
medication often leaves her exhausted and
struggling to concentrate. That's why Moriarty,
a marriage-and-family therapist from Rochester,
Minn., says she volunteered for a clinical trial
about treating cancer-related fatigue in a new
way: ginseng capsules.
Ginseng has been used in
Chinese medicine to promote health for 2,000
years. A National Cancer Institute survey in
2004 found that 36% of adults use ginseng or
some other form of complementary or alternative
medicine. But scientists have never before
studied ginseng's potential to ease cancer
fatigue in such a carefully controlled way, says
lead author Debra Barton of the Mayo Clinic in
Minnesota.
Barton's research is one
of a trio of studies, all financed by the cancer
institute, on complementary and alternative
cancer medicines presented Sunday at the
American Society of Clinical Oncology meeting in
Chicago. The studies are part of a growing
effort to bring scientific scrutiny to popular
folk remedies and natural products.
In Barton's pilot study
of 282 patients, researchers randomly assigned
patients to take either a placebo or one of
three daily doses of ginseng: 750 milligrams,
1,000 milligrams or 2,000 milligrams.
After eight weeks,
roughly 27% of those who took the two highest
ginseng doses rated their fatigue as
"moderately" or "very much" better, she says.
Only 10% of those who took placebos or the
lowest ginseng dose improved that much.
One-third of those on the highest two doses were
satisfied with treatment, compared with 24% of
those on low-dose ginseng and 13% of those on
placebos. Ginseng didn't appear to cause any
side effects, Barton says. The study didn't
address whether ginseng controlled patients'
cancer.
Moriarty, who later
learned that she had been given the lowest
ginseng dose, says the capsules helped keep her
focused in the afternoon. She has opted to
continue using the plant. "I've never
experienced anything quite like this," Moriarty
says. "It clears your head."
The design of Barton's
study — considered the gold standard of medical
evidence — makes its results reliable, says
Andrea Barsevick, director of nursing research
at Fox Chase Cancer Center in Philadelphia.
Although researchers have produced at least 20
previous studies of ginseng and cancer,
Barsevick says, all were small, lacked
comparison groups or had other problems that
made them less reliable.
Barsevick notes that
cancer patients and survivors desperately need a
better way to treat fatigue, which affects most
of those getting chemo and up to 35% of patients
who finish treatment. The only proven way to
relieve cancer-related fatigue, she says, is
exercise.
Yet Barton says she can't
yet recommend that cancer patients start taking
ginseng. Researchers need to confirm the results
in a larger study. Barton notes commercial
ginseng may not provide the same benefit found
in the study. Because plants such as ginseng are
sold as nutritional supplements, they aren't
regulated as drugs, Barton says. That means that
some ginseng pills may contain higher doses than
others. Scientists who have analyzed a variety
of herbal supplements have found that
ingredients listed on the label may be different
from those found in the product, she says.
Ginseng tea also may not
be as effective as the ginseng capsules given to
study patients, Barton says. Her study used
American ginseng, known scientifically as
Panax quinquefolius and sometimes marketed
as Canadian, Wisconsin or North American
ginseng. The ginseng was extracted from the
roots of plants grown by a farmer in Wisconsin.
A lab confirmed its content and quality.
Barsevick says patients
should consult with their doctors before using
anything that could interact with other
important medications. Experts note that
patients should be cautious about any unproven
therapy. "This is a vulnerable population," says
Charles Lu of M.D. Anderson Cancer Center, who
led a shark cartilage trial. "They're willing to
believe a lot and spend money on a lot of
things."