dang gui and cancer

January 30, 2008

Hi All,

Guy Sedan wrote:

> Blue Poppy has an article on the subject:

http://www.bluepoppy.com/cfwebstorefb/index.cfm?fuseaction=feature.dis

play & feature_id=66

Bob Flaws' article is very well researched. However, Bob admits that

he does not treat patients with cancer.

He emphases that, in China, Danggui often is used in formulas to

treat people with cancer, especially if they also have Blood Vacuity

or Blood Stasis

He also says that even if Danggui were shown to trigger cancer under

experimental conditions, its use in formulas (polypharmacy) could

have quite different outcomes because other herbs in the formulas

could modulate the effect of angelica.

A quick Google suggests that the possible role in estrogen-sensitive

cancers of phytoestrogens / herbs with oestrogenic-like effects is

controversial. Some websites mention that Danggui is contraindicated

in (or may trigger recurrence of) estrogen-sensitive cancers.

However, a Medline search for the profile:

(danggui OR " dang gui " OR " tang kuei " OR " angelica sinensis " OR

angelica OR angelicae) AND (mammary cancer OR breast cancer ) AND

(contraindic* OR trigger OR triggering)

or for the profile:

(danggui OR " dang gui " OR " tang kuei " OR " angelica sinensis " OR

angelica OR angelicae) AND (cancer OR neoplasia OR neoplasms ) AND

(contraindic* OR trigger OR triggering)

provided no hits.

One abstract says:

Piersen CE Phytoestrogens in botanical dietary supplements:

implications for cancer. Integr Cancer Ther. 2003 Jun;2(2):120-38.

UIC/NIH Center for Botanical Dietary Supplements Research in the

Program for Collaborative Research in the Pharmaceutical Sciences,

University of Illinois at Chicago, College of Pharmacy, 60612, USA.

cpiersen Phytoestrogens are plant constituents that possess

either estrogenic or antiestrogenic activity. Although their

activities are weak as compared with human endogenous estrogens, the

consumption of phytoestrogens may have clinically significant

consequences. A number of botanicals, or the compounds contained

therein, have been identified as putative estrogenic agents, but

consensus in the biomedical community has been hampered by

conflicting data from various in vitro and in vivo models of

estrogenic activity. Phytoestrogens may serve as chemopreventive

agents while at the same time being capable of promoting growth in

estrogen receptor positive cancer cell lines. Furthermore, they may

exert their estrogenic influence through receptor-dependent and/or

receptor-independent mechanisms. These findings have led to

speculation that phytoestrogen intake might be ill advised for

patients at an increased risk for hormone-dependent cancers, cancer

patients, or cancer survivors. This article will attempt to sort out

discrepancies between various experimental models and establish

whether certain herbs possess estrogenic activity. The review will

focus on 5 popular botanical dietary supplements: Trifolium pratense

(red clover), Cimicifuga racemosa (black cohosh), Humulus lupulus

(hops), Angelica sinensis (dong quai), and Glycyrrhiza glabra

(licorice). It will address their mechanisms of action, clinical

evidence bases, and implications for use in cancer. PMID: 15035899

[PubMed - indexed for MEDLINE]

Therefore, as Bob concluded in his article, there is insufficient

published work to conclude whether or not Danggui is contraindicated

in estrogen-sensitive cancers. He said: " Unfortunately, there is not

enough scientific data at this time to answer this question " (i.e.

does Danggui trigger breast cancer) " with a simple yes or no " .

Best regards,

January 31, 2008

Hello,

I am a new member and a student at PCOM. After reading Bob Flaws article I was

curious to see if there had been any recent biomed studies published on this.

The search was - dang gui and estrogen dependent cancer. It returned 2 studies,

which I've pasted in below.

1: Menopause. 2005 Nov-Dec;12(6):734-40. Epub 2005 Nov 8. Links

Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal

symptoms in women with breast cancer: is it appropriate? Lau CB, Ho TC, Chan

TW, Kim SC.

School of Pharmacy, The Chinese University of Hong Kong, Shatin, NT.

claralau

OBJECTIVE: Regarding the growing use of alternative therapies for peri- or

postmenopausal symptoms, we evaluated the effect of a water extract of Angelica

sinensis (dong quai), used for peri- or postmenopausal relief, on the

proliferation of estrogen receptor-positive (MCF-7) and negative (BT-20) breast

cancer cells in vitro. DESIGN: The present study was designed to investigate the

growth-modulating effect of dong quai water extract, alone or in the presence of

17beta-estradiol and 4-hydroxytamoxifen, on MCF-7 and BT-20 cell cultures using

MTT proliferation assay. RESULTS: The water extract of dong quai

dose-dependently and significantly stimulated the proliferation of MCF-7 cells

with a weak estrogen-agonistic activity in the presence of 17beta-estradiol, as

evidenced by the significant suppression by 4-hydroxytamoxifen. Meanwhile, the

extract significantly exerted a growth-stimulating effect on BT-20 in a

dose-dependent manner with or without 17beta-estradiol. No

obvious difference was found in the growth of BT-20 cells treated with the

extract in the presence of 17beta-estradiol or 4-hydroxytamoxifen. CONCLUSIONS:

The water extract of dong quai stimulated the growth of MCF-7 cells, possibly

dependent of weak estrogen-agonistic activity, and augmented the BT-20 cell

proliferation independent of estrogen receptor-mediated pathway. The present

study provides data regarding the estrogen-like activity of dong quai, which

might assist in decision making on herbal therapy use by women at risk for both

estrogen-sensitive and insensitive breast cancer. Because of the lack of

clinical data demonstrating the potential side effects of dong quai, its use in

herbal preparations for the treatment of peri- or postmenopausal symptoms,

especially in women with breast cancer, warrants caution pending further study.

PMID: 16278617 [PubMed - indexed for MEDLINE]

1: Menopause. 2002 Mar-Apr;9(2):145-50. Links

Estrogenic activity of herbs commonly used as remedies for menopausal

symptoms. Amato P, Christophe S, Mellon PL.

Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston,

Texas 77030, USA. pamato

OBJECTIVE: Women are increasingly turning to herbal therapies in an effort to

manage their menopausal symptoms. In this study, we investigate the estrogenic

activity of four selected herbs commonly used in menopause, namely dong quai,

ginseng, black cohosh, and licorice root. DESIGN: We investigated the effect of

these selected herbs on cell proliferation of MCF-7 cells, a human breast cancer

cell line. We also assessed their estrogenic activity in a transient gene

expression assay system using HeLa cells co-transfected with an

estrogen-dependent reporter plasmid in the presence of human estrogen receptor

ER alpha or ER beta cDNA. Finally, we investigated the estrogenic activity of

these herbs using a bioassay in mice. RESULTS: Dong quai and ginseng both

significantly induced the growth of MCF-7 cells by 16- and 27-fold,

respectively, over that of untreated control cells, while black cohosh and

licorice root did not. The herbs tested failed to show transactivation of

either hER alpha or hER beta and had no effect on uterine weight in vivo when

administered orally to mice for a period of 4 days. CONCLUSIONS: Our studies

show that dong quai and ginseng stimulate the growth of MCF-7 cells independent

of estrogenic activity. Because of the lack of efficacy and the potential for

adverse effects, use of these herbs in humans warrants caution pending further

study.

PMID: 11875334 [PubMed - indexed for MEDLINE]

To me these articles raised more questions than they answer, but they are out

there.

Respectfully,

Ellen Ona

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