American ginseng may reduce cancer-related fatigue



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August 3, 2007  
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CM NEWS – American ginseng, a traditional medicinal herb long used as a tonic and a booster to the immune system, has been proven to improve fatigue in cancer patients, a pilot ginseng study finds.

The study was done by North Central Cancer Treatment Group researchers, based at Mayo Clinic in Rochester, Minn. The results of their scientifically rigorous pilot study, the first to evaluate the Wisconsin species of American ginseng, or hua qi shen (???), as a possible therapy for cancer-related fatigue, were presented June 3 at the annual meeting of the American Society of Clinical Oncology.

What is American ginseng? Both American and Asian ginsengs belong to the species Panax and are similar in their chemical composition. Siberian ginseng or Eleuthero ( Eleutherococcus senticosus ), although part of the same plant family called Araliaceae , is an entirely different plant and does not contain ginsenosides, the active ingredients found in both Asian ( Panax ginseng ) and American ginseng ( Panax quinquefolius ).

The root of American ginseng is light tan and gnarled, sometimes resembles the human body. Panax means all illness, and ginseng has been used across the ages in many different cultures as a “cure-all.”

Many studies on ginseng have been performed using Panax ginseng (Asian ginseng). There have been positive reports of using Asian ginseng to treat cancer, heart disease, respiratory problems, fatigue, as well as to boost energy and mental performance and to improve quality of life.

However, both American and Asian ginsengs contain ginsenosides, and research does exist on this component. Laboratory studies in animals have reported that American ginseng was effective in boosting the immune system, as an antioxidant, protection against heart attacks and protection against kidney damage caused by methamphetamine use.

Many cancer patients face extreme fatigue after diagnosis and during treatment. Getting more sleep or rest often does not relieve the fatigue, nor is it related to activity levels. Other than exercise, there isn’t a good solution available for these patients.

“We hope that Wisconsin ginseng may offer us a much-needed treatment to improve our patients’ quality of life, and we look forward to further evaluation,” says Debra Barton, Ph.D., a registered nurse, Mayo Clinic cancer researcher and the study’s primary investigator.

“Cancer-related fatigue is one of the most profound and distressing issues patients face,” she says. This unique type of fatigue can have dozens of causes, and for patients who have completed cancer therapy, fatigue is among their foremost concerns, second only to fear of disease recurrence.”

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Traditional Chinese medicine and current understanding of ginseng’s function both point to its characteristics as an adaptogen — a substance that helps the body overcome the effects of environmental stress. Since cancer patients have stressors ranging from the psychological stress of diagnosis to the physiological stresses of chemotherapy and radiation, if ginseng helps, the researchers think it would be a valuable addition to currently available therapies.

What is adaptogen? An adaptogen produces a non-specific response in an organism; i.e., an increase in power of resistance against multiple stressors including physical, chemical, or biological agents.

An adaptogen has a normalizing influence on physiology, irrespective of the direction of change from physiological norms caused by the stressor.

An adaptogen is incapable of influencing normal body functions more than required to gain non-specific resistance.

Adaptogens with a significant level of scientific research confirming their use include: Ashwagandha (Withania somnifera), Cordyceps (Cordyceps sinensis), Dang Shen (Codonopsis pilosula), Eleuthero (Eleutherococcus senticosus), Holy Basil (Ocimum sanctum), Ginseng (Panax ginseng), Guduchi (Tinospora cordifolia), Jiaogulan (Gynostemma pentaphyllum), Licorice (Glycyrrhiza glabra), Maca (Lepidium meyenii), Reishi (Ganoderma lucidum), Rhaponticum (Rhaponticum carthamoides or Stemmacantha carthamoides), Rhodiola (Rhodiola rosea), Schisandra (Schisandra chinensis), Chaga mushroom (Inonotus obliquus) and Shilajit (Ashphaltum bitumen).

Panax ginseng is an example of an adaptogen that has demonstrated an “overall normalizing effect.” Among the active ingredients found in Panax Ginseng are substances called ginsenosides. The herb contains ginsenosides Rg1, which can stimulate the nervous system, and ginsenosides Rb1, which calms it. However ginsenosides alone do not determine the active strength of ginseng and some preparations with higher ginsenosides have lower activity, indicating that cofactors are necessary to potentiate the adaptogenic properties of ginseng.

“With animal data indicating the possibilities of ginseng with respect to increased swimming endurance, and the availability and verified product quality of Wisconsin ginseng, we decided to move forward with a pilot study,” says Dr. Barton.

The investigators enrolled 282 patients in a randomized, placebo-controlled trial, averaging 71 patients per each of four arms, with between 39 and 48 patients in each arm completing the eight weeks of treatment. Treatment arms consisted of placebo, and three different daily doses of Wisconsin ginseng — 750, 1,000 and 2,000 milligrams.

Of the four treatment arms, patients receiving the placebo and the lowest dose of ginseng reported very little improvement in fatigue or other areas of physical or psychological well-being. The patients receiving the larger doses showed improvements in overall energy levels, reporting higher vitality levels and less interference with activity from fatigue. They also reported an improvement in overall mental, physical, spiritual and emotional well-being.

Because this was a pilot trial designed to pinpoint which aspects of fatigue ginseng might help alleviate, determine likely dosage options, and identify possible side effects, Dr. Barton cautions against immediate addition of ginseng supplements to any patient’s therapeutic regimen.

“While results were promising, we have more research to conduct,” she says. “And besides, it’s just not a good idea to grab the nearest bottle on the supermarket shelf — consumers need to research the company and the product. Because there is less federal regulation of dietary supplements, there is no consistency in currently available products. In fact, some research has shown various supplements to contain little or no amount of the ingredient on the label, and sometimes even harmful contaminants.”

Dr. Barton’s research team hopes to open a new clinical trial in 2008 looking at a specific dose of Wisconsin ginseng versus placebo and trying to better refine the results, in hopes of a confirming a new treatment option for cancer-related fatigue.

According to the National Center for Health Statistics, Americans spend between $36 billion and $47 billion per year on complementary and alternative therapies, including herbal supplements. A recent study authored by Mayo Clinic resident Aditya Bardia, M.D., reports that two-thirds of people who use herbs do not use any scientific evidence-based information to guide their purchases. To aid consumers in their decision-making process, Mayo Clinic recently published a book addressing current knowledge regarding a number of complementary and alternative therapies. The Mayo Clinic Book of Alternative Medicine dispels myths and sheds light on therapies that have been scientifically studied for safety and effectiveness.