Eating pomegranates or drinking pomegranate juice may help prevent and slow the growth of some types of breast cancer. A new study shows a group of phytochemicals called ellagitannins found in abundance in pomegranates inhibited the growth of estrogen-responsive breast cancer in laboratory tests.

The abstract of the study says “Estrogen stimulates the proliferation of breast cancer cells and the growth of estrogen-responsive tumors. The aromatase enzyme, which converts androgen to estrogen, plays a key role in breast carcinogenesis. The pomegranate fruit, a rich source of ellagitannins (ET), has attracted recent attention due to its anticancer and antiatherosclerotic properties. On consumption, pomegranate ETs hydrolyze, releasing ellagic acid, which is then converted to 3,8-dihydroxy-6H-dibenzo[b,d]pyran-6-one (“urolithin”) derivatives by gut microflora. The purpose of this study was to investigate the antiaromatase activity and inhibition of testosterone-induced breast cancer cell proliferation by ET-derived compounds isolated from pomegranates. A panel of 10 ET-derived compounds including ellagic acid, gallagic acid, and urolithins A and B (and their acetylated, methylated, and sulfated analogues prepared in our laboratory) were examined for their ability to inhibit aromatase activity and testosterone-induced breast cancer cell proliferation. Using a microsomal aromatase assay, we screened the panel of ET-derived compounds and identified six with antiaromatase activity. Among these, urolithin B (UB) was shown to most effectively inhibit aromatase activity in a live cell assay. Kinetic analysis of UB showed mixed inhibition, suggesting more than one inhibitory mechanism. Proliferation assays also determined that UB significantly inhibited testosterone-induced MCF-7aro cell proliferation. The remaining test compounds also exhibited antiproliferative activity, but to a lesser degree than UB. These studies suggest that pomegranate ET–derived compounds have potential for the prevention of estrogen-responsive breast cancers.”

Researchers say the ellagitannins in pomegranates work by inhibiting aromatase, which is a key enzyme used by the body to make estrogen and plays a key role in breast cancer growth.

“We were surprised by our findings,” Chen says. “We previously found other fruits, such as grapes, to be capable of the inhibition of aromatase. But phytochemicals in pomegranates and in grapes are different.”

Researchers say pomegranates have recently been hailed for their potential anti-cancer and heart healthy benefits thanks to their high antioxidant content. But they say this is the first study to look at their effects on aromatase and breast cancer growth.

In the study, published in Cancer Prevention Research, researchers examined the impact of 10 ellagitannin-derived compounds from pomegranates on aromatase activity and breast cancer cell growth in laboratory tests.

The results showed that of those 10 compounds, urolithin B most significantly inhibited breast cancer cell growth.

Experts say further studies will be needed to determine whether eating or drinking pomegranate-derived products will have the same effect in humans, but these results are promising.

“More research on the individual components and the combination of chemicals is needed to understand the potential risks and benefits of using pomegranate juice or isolated compounds for a health benefit or for cancer prevention,” Powel Brown, MD, PhD, chairman of the clinical cancer prevention department at the University of Texas M.D. Anderson Cancer Center. Brown was not associated with the study.

Until then, researchers say people may consider eating more pomegranates to protect against cancer in the breast and perhaps other tissues and organs.

Cancer or the ‘Big C’, as it is fearfully referred to, is no longer considered a death sentence. The number of individuals who have survived cancer has considerably increased over the years. Certain adult cancers have a survival rate of 70% or more, while a few childhood cancers may boast of a greater cure rate.

Surviving cancer requires a great deal of strength, endurance and courage. While cancer can change lives for ever, it can also be viewed as an experience that may help an individual to grow in different ways. Appreciation of self and others is at the centre of this change and,in this context, cancer survivors learn to acknowledge their bodies and their health in a better way. It will be important for them to appreciate the new lease of life and to take better care of themselves, in all ways possible.

Most often treatments like radiation, chemotherapy and surgery are required to bring cancer under control; nevertheless, the root cause is never addressed. Besides, these treatments exhaust the patients and mar their quality of life. This is where naturopathy can help to bring relief from the ‘body–racking’ side effects and to restore the individual’s overall health.

Naturopathy is a complimentary branch of medicine that makes use of natural and safe therapies. It upholds detoxification as the first step towards recovery from cancer. Naturopathy recommends 5 natural steps, which are dealt with in the following sessions.

Stage 1 – Toxic Lifestyle

If fully / highly toxic, you need to get de- numbed,as toxicity often leaves people numb towards their reactions to the world.

• If you are smoking, work on stopping that habit.
• Avoid excessive alcohol /coffee consumption. These overload your liver
• Ensure enough sleep everyday
• Exercise regularly

Stage 2 – Healthy Eating

More attention must be paid to what you eat.

• Go for a fruit/ vegetable- rich diet. By adding more vegetables and fruits, you are giving your body fiber for detoxification and necessary nutrients for both detoxification and healing.
• Water is the medium that transports toxins out of the body and nutrients into the elimination organs.
• Most meat are full of antibiotics, hormones and pesticides, due to the manner in which they are bred and grown. Besides, the meat also contains stress chemicals secreted by the animals while being slaughtered.
• Allergens place the body in a constant fighting state; by definition, allergens are foreign substances that the body rejects. When your body constantly wastes energy fighting allergens, its energy stores will be depleted when time to heal or detoxify arrives.
• Avoid alcohol, coffee and regular tea; these will only help to over-load your liver (the major elimination organ).
• Avoid condiments sauces, mustard, ketchup, Worcester sauce, MSG, steak, BBQ, chili shrimp and soy sauce, pickled vegetables, relishes, salad dressings (unless homemade).

These will affect the liver and the kidneys, therefore slowly shutting down all your elimination apparatus.

Stage 3 – Organ Repair

This stage involves repair done to the 2 major detoxification organs which are affected by the medical procedures involved in treating cancer.

The liver, besides many other functions, is responsible for breaking down medications (anesthetics, chemotherapeutic, drugs, radiation effects, etc.). Once the liver gets clogged, it cannot continue detoxifying the body of all the remaining toxins.

The best way to balance and rejuvenate the liver is through 2 phases:

• By draining or cleaning up its toxins
• By strengthening and boosting its powers through Supportive Therapy.

The body’s ability to protect itself from toxic substances and the body’s ability to heal are both dependent on the integrity of the intestinal lining. Allopathic treatments often lead to intestinal damage, like increased intestinal permeability, thereby allowing increased absorption of pathogens, allergens and toxins. This process results in putting more stress on the immune system, decreasing its ability to focus on healing.

The intestinal damage is corrected in 2 stages:

• Eliminate/ clean up all pathogens (yeast, pesticides, pathogenic bacteria, etc.) and also all the damage caused by allopathic treatments.
• Restore the normal, friendly bowel flora

Once these stages are completed, you need to re- evaluate your medications for symptoms such as pain or depression.

Are they all necessary?

Remember: Drugs are chemicals that need to be metabolized by the liver; they cause side effects because the end products of their metabolism are toxins.

One example of over -prescribed medications are antibiotics.

Considering that most infections are viral, antibiotics are none other than toxins!, There are many natural alternatives(homeopathics, herbs, nutritional supplements), that work by addressing the cause of your problem.

Eliminating Toxins -Stage 4.

This stage of your natural recovery involves preparation of emunctories (=elimination organs). Before pouring toxins out of the cells into the blood, the patient must “open the gates “; so the toxins will leave the body completely.

If the toxins continue being circulated in the blood, they cause degeneration, or get deposited in fat tissues.

Restoring Detox Organs- Stage 5

Restoring the liver and the intestine may be done by re directing toxin elimination through the skin rather than through the usual route

In this stage, it must be ensured that the elimination organs are strong enough to handle all toxicity and that they continue keeping up with the body’s demands.

The best way to support the major detoxification organs is:

• By giving them a rest. This can be done by re- directing toxin elimination through the skin rather than the usual route.
• Saunas, sweat inducing exercises (aerobic) and niacin therapyare some methods by which this can be achieved.
• Another way of “resting” your digestive elimination organs is by mimicking a fast. Digestive enzymes will help you digest without the digestive organs actually working very hard.
• By using supportive supplementation – including fibre, vitamin C , chlorophyll, other anti-oxidants and different herbs such as garlic, red clover, cayenne.

Detoxification is your first step towards cancer recovery. As a cancer survivor, remember you are a winner already! Keep going and enjoy life!

The fabulous five are research superstars

The British journal Acta Pharmacalagia Sinica, reports a study by the Cancer Biomarkers and Prevention Group at the University of Leicester in the UK. Researchers noted that intake of these phytochemical compounds is typically studied in artificial (in vitro) environments using high-dose single treatments. However, in humans (in vivo) the exposure to the compounds is persistent low-doses. They designed their study to reflect human exposure by investigating anti-tumor activity of these five phytochemicals in breast cancer cells exposed in long-term culture to typical low doses.

They found that curcumin, EGCG and I3C inhibited clonogenic growth by 55% to 60% and induced 1.5- to 2-fold higher levels of the basal caspase-3/7 activity. No changes in expression of cell cycle-related proteins or survivin were found; however, I3C reduced epidermal growth factor receptor expression, contributing to apoptosis (appropriate programmed cell death). Because some phytochemicals are shown to inhibit DNA histone modification, modulation of expression by the agents in a set of genes was compared with changes induced by inhibitors of DNA methylation or histone deacetylation. The phytochemicals modified protein and/or RNA expression of these genes, with EGCG eliciting the least and DIM the most changes in gene expression. DIM and curcumin decreased activator levels correlated with increased cell motility. Curcumin, DIM, EGCG, and genistein reduced cell sensitivity to radiation-induced DNA damage without affecting DNA repair.

The researchers concluded that this model has revealed that apoptosis and not arrest is likely to be responsible for growth inhibition. It also implicated new molecular targets and activities of the phytochemicals under conditions relevant to human exposure.

What are these compounds?

Each of these compounds is a phytochemical component of a superfood that has been found to confer great overall health benefits to those who consume it.

DIM and I3C

Diindolylmethane (DIM) and indole-3-carbinol (I3C) are components of cruciferous vegetables such as broccoli and cabbage, kale, cauliflower, radish, collard greens, Chinese cabbage, Brussel sprouts, kohlrabi, bok choy, turnip greens, rutabaga, arugula, water cress, rapeseeds and mustard seeds.

DIM has been documented as effective against cancer through several actions. It stops tumors from establishing their own blood supply necessary for their continuation of growth. It reduces cancer cell viability and causes cell growth inhibition and apoptosis. DIM down regulates both the ligand and the receptor in breast cancer cells as well as in ovarian cancer cells at the transcriptional level and in an estrogen-independent manner. The potential for chemotaxis and invasion is inhibited by DIM, thereby lowering the invasive and metastatic potential of cancer cells. DIM us able to act independently of Her-2 or estrogen receptor status. It has been shown to be a preventative and/or therapeutic agent in prostate cancer, and is able to induce the release of pro-inflammatory mediators in macrophages.

DIM is nature’s hormone modulator. The metabolism and growth promoting activity of estrogen is modified by the intake of milligram amounts of dietary indoles from cruciferous vegetables. DIM is formed from its precursor indole, indole-3-carbinol (I3C), after the enzymatic release of I3C from parent glucosinolates found in these vegetables. DIM is unique among the phytonutrients with regard to its ability to favorably modify estrogen metabolism in the direction of greater 2-hydroxy estrogen production. Improper metabolism of estrogen allows damage to DNA and cancer promotion to take place.

Societies with low consumption of cruciferous vegetables have a high prevalence of estrogen related diseases, particularly breast and prostate cancers. Supplementing with DIM can restore and maintain a favorable estrogen metabolism and greatly lessen the risk for breast and other cancers. Addition of a DIM supplement ensures the hormones used in bioidentical hormone replacement are metabolized down the proper metabolic pathways. DIM has no estrogenic activity. It balances the natural response to estrogen. In dividing cells the growth promoting signal from estrogen is limited by the reduction of the activity level of the estrogen receptor system.

Supplements of I3C are available, but the compound is unstable in the body. I3C is a precursor indole, with little action in the body until it is converted to DIM by stomach acid.

DIM is the better choice for pre and post menopausal women and men interested in supplementing rather that getting these compounds directly from food. Although obtaining nutrients from food is always preferred, the amount of cruciferous vegetables needed to provide the benefits of DIM frequently make supplementation a better choice. Although there are several DIM products available, BioResponse DIM complex, a patented from of DIM offers enhanced bioavailability. DIM-Plus, the version of DIM made by Nature’s Way, contains BioResponse DIM and is an economical choice, offered online at Vitacost.

ECGC

Epigallocatechin-3-gallate (ECGC) is a particular type of polyphenol found in green tea, a substance shown to be a cure and preventative for many of the ills of mankind. In addition to being a powerful agent in the prevention and cure of cancer, it is an antioxidant, promoter of glucose tolerance, protector of the liver and detoxification system, and benefactor of the cardiovascular system.

Recent research has documented a 54% reduction in risk of ovarian cancer in women who reported drinking green tea. Another study found green tea to have therapeutic cancer effects through induction of apoptosis in colorectal cancer. It is also one of the few effective treatments for pancreatic cancer. As a preventative for all cancers, ECGC is able to penetrate the body’s cells and shield DNA from the potent free radical hydrogen peroxide.

Green tea also lowers cholesterol levels, and reduces the clotting tendency of blood. It shows promise as a weight-loss aid that can promote the burning of fat and the regulation of insulin levels and blood sugar.

There are many green tea supplements on the market. Some of these contain the whole plant, while others contain extracts. Whole plant supplements are usually preferable because they are backed by the integrity of the whole plant. Many green tea extract supplements are standardized to provide a quantified amount of ECGC.

Curcumin

Curcumin is the active ingredient in the bright yellow spice turmeric. It is one of nature’s most powerful healers, having revealed its wonders over centuries. Numerous studies have shown curcumin to be as potent against inflammation as hydrocortisone, phenylbutazone, and over the counter NSAID drugs like Motrin, without the side effects. Its powerful antioxidant effects make it a popular natural therapeutic agent for diseases such as arthritis, where free radicals cause joint inflammation and damage. Studies have linked frequent use of turmeric to lower rates of breast, prostate, lung and colon cancer. It can prevent tumors from forming, and can slow the progression of cancer that is already present. Recent studies have documented that curcumin can slow the spread of breast cancer cells to the lungs. Turmeric acts as a transcription factor, a master switch for gene regulation. When genes are switched off, the growth and invasion of cancer cells is halted.

Curcumin is even being used effectively to treat Alzheimer’s disease due to its ability to cross the blood-brain barrier. Alzheimer’s disease is thought to occur when a fragmented protein accumulates in brain cells producing oxidative stress and inflammation, and forming plaque between nerve cells in the brain that disrupt function. Turmeric may prevent the oxidation of cholesterol in the body, thereby preventing damage to blood vessels and causing build up of plaque that can result in heart attack or stroke.

Dried turmeric is widely available. Organically grown turmeric is preferable. Frequently spicing your cooking with turmeric is one option for consuming curcumin. It can be easily mixed with rice, egg salad or into the cottage cheese flax oil mixture that is the basis of the Budwig diet. Turmeric capsules are available. Nature’s Way makes a turmeric capsule that is free of magnesium stearate, but it’s not organic. Organic turmeric can be found in the spice department of health food stores such as Whole Foods, or ordered online in powered or capsule forms. Most naturopaths suggest starting with a dose three times the normal dosage suggested in order to quickly bring inflammation under control. Then proceed with the standard dose to maintain.

Genistein

Genistein is an isoflavone found primarily in soybeans and traditional foods produced from soybeans like tofu and miso. In addition to being an antioxidant, genistein is a phytoestrogen, a plant compound that mimics the actions of estrogen and interacts with estrogen receptor in the human body.

Genistein removes damaging free radicals and reduces lipid peroxidation. By preventing the oxidation of LDL cholesterol, genistein helps reduce the risk for arteriosclerosis, and prevents the formation of heart attacks and strokes by acting as an anti-clotting agent. It increases the activity of other antioxidant enzymes such as glutathione peroxidase, superoxide dismutase (SOD), and glutathione reductase. It can also influence the growth of cells that are not hormone-dependent. Genistein inhibits the rate of cell growth through its ability to inhibit tyrosine kinase.

Studies have shown that genistein reduces the risk for the hormone related cancers, breast and prostate, by binding with estrogen receptors, preventing estrogen from binding. Consumption of traditional soybean products in China and Japan is linked with low incidence of these cancers. And since genistein imitates estrogen, it may be protective against osteoporosis. It is frequently used to ease menopause symptoms such as hot flashes.

Before genistein can act, it must be released from its precursor. This normally happens in the stomach and intestine through hydrolysis. Some genistein supplements contain genistein that has been hydrolysed in processing.

Introduction

Cancer is one of the most dreaded diseases of the 20th century and spreading further with continuance and increasing incidence in 21st century. In the United States, as the leading cause of death, it accounts for 25% of all the deaths in humans presently. It is considered as an adversary of modernization and advanced pattern of socio-cultural life dominated by Western medicine. Multidisciplinary scientific investigations are making best efforts to combat this disease, but the sure-shot, perfect cure is yet to be brought into world medicine. Recently, a greater emphasis has been given towards the researches on complementary and alternative medicine that deals with cancer management. Several studies have been conducted on herbs under a multitude of ethno botanical grounds. For example, Hartwell [1–9] has collected data on about 3000 plants, those of which possess anticancer properties and subsequently been used as potent anticancer drugs [10]. ‘‘Ayurveda’’ as it means in Sanskrit (the ancient language of India) – ‘ayus’ (life) and ‘ved’ (knowledge) is often translated as science of life and is a 5000 years old system of Indian medicine. It emphasizes prevention of disease, rejuvenation of body systems and extension of lifespan. It has been successful from very early times in using these natural drugs and preventing or suppressing various tumours using various lines of treatment.
This article reviews the available literature regarding researches on anti-cancerous ayurvedic herbs and also includes a summary of treatment strategies for various cancers. It is written with an intention to raise awareness and encourage implementation of ayurvedic therapies for fighting cancer and suggesting an integrated approach in tumour management and treatment.

Ayurvedic Concept Of Cancer

Charaka and Sushruta samhitas, two well-known Ayurvedic classics, describe cancer as inflammatory or non-inflammatory swelling and mention them as either Granthi (minor neoplasm) or Arbuda (major neoplasm). Ayurvedic literature defines three body-control systems, viz., the nervous system (Vata or air), the venous system (Pitta or fire), and the arterial system (Kapha or water) which mutually coordinate to perform the normal function of the body. In benign neoplasm (Vataja, Pittaja or Kaphaja ) one or two of the three bodily systems are out of control and is not too harmful because the body is still trying to coordinate among these systems. Malignant tumours (Tridosaja) are very harmful because all the three major bodily systems lose mutual coordination and thus cannot prevent tissue damage, resulting in a deadly morbid condition .

Fundamental Classification

Ayurvedic classification of neoplasm depends on various clinical symptoms in relation to Tridoshas. Group I: Diseases that can be named as clear malignancy, which includes arbuda and granthi, e.g. mamsarbuda (melanoma) and raktarbuda (leukaemia), mukharbuda (oral cancer), etc. Group II: Diseases that can be considered as cancer, such as incurable ulcers with e.g. tridosaj gulmas (abdominal tumours like carcinomas of the stomach and liver or lymphomas). Group III: Diseases with the possibility of malignancy, e.g. Visarpa (erysipelas), asadhya kamala (incurable jaundice) and nadi vrana (sinusitis).

Etiology

According to Sushruta, the fundamental cause of major neoplasm is the pathogens that affect all parts of the body. He called the sixth layer of the skin as ‘Rohini,’ (epithelium) and pathogenic injuries to this layer in muscular tissues and blood vessels caused by lifestyle errors, unhealthy foods,  poor hygiene and bad habits results in the derangement of doshas, which leads to the manifestation of tumours . Excess of water or fat in the corpus of the tumour and the stability and rigid confinement of the doshas in a particular place were described as reasons for the non-infectious and non-suppurative nature of these abnormal growths. Cancer in each person differs according to the person’s exposure to pathogens and genetic constitutions which make each of them to react differently to the same diet. The factors responsible for the vitiation of doshas are discussed here .

1. Vata aggravating factors: excessive intake of bitter, pungent, astringent, dry foods and stressful conditions.
2. Pitta aggravating factors: excessive intake of sour, salty, fried foods and excessive anger.
3. Kapha aggravating factors: excessive intake of sweet, oily food and sedentary nature.
4. Rakta aggravating factors: excessive intake of acid or alkali containing foods. Fried and roasted foods, alcoholic beverages, sour fruits are some examples. Excessive anger or severe emotional upset, sunbathing or working under scorching sun or near fire and hot conditions, etc. are some other causes.
5. Mamsa aggravating factors: excessive use of exudative foods like meat, fish, yoghurt, milk and cream. Behaviours leading to exudation like sleeping during the day and overeating are some of the causes for pathogens invading the fatty tissues.
6. Medo aggravating factors: excessive intake of oily foods, sweets, alcohol and lazy attitude.

Pathogenesis Of Tumours

According to Ayurvedic principles, the disease cannot be named on its own because it differs between persons in terms of illness, clinical presentation and also the treatment required. Thus, pathogenesis in Ayurveda is explained on the basis of Tridoshas. Agni or Pitta, which is present in each and every cell, is responsible for digestion and metabolism in human body. The decrease in agni is inversely proportional to the related tissue and therefore in arbuda, the decreased state of dhatwagni (deranged metabolism) will result in excessive tissue growth. Vata can be correlated with the anabolic phase of growth whereas kapha to the catabolic phase. Cancer originates due to a metabolic crisis, i.e. aggravation of vata forces and suppression of kapha forces, both interacting with one another resulting in proliferation. However, the abnormal cancerous growth at a specific organ (Ekadesavriddhi) is managed by compensation from other parts of the body (Anyasthaniyakshaya), e.g. body weight loss (cachexia). Sushruta has proposed six stages in the pathogenesis of all diseases but his concept suits more to the pathology of the tumour than pathogenesis itself.

1. Sanchaya: early stages of localized neoplastic changes.
2. Prakopa: transformation of primary growths into metastatic tumours.
3. Prasara: metastasis.
4. Sthana samsraya: complete metastasis and secondary growth.
5. Vyakti: clinical signs and symptoms are expressed.
6. Bheda: the stage where differentiation of growth occurs on the basis of histopathology.

Cancer Therapy—A Practical Dilemma

Any practical solution in combating this dreadful disease is of paramount importance. An alternative solution to western medicine embodied with severe side effects is the use of medicinal plant preparations to arrest the insidious nature of the disease. Many herbs have been evaluated in clinical studies and are currently being investigated phytochemically to understand their tumouricidal actions against various cancers. Thus, cancer patients who already got crippled with this disease, further burdened by drug-induced toxic side effects have now turned to seek help from the complementary and alternative medicine hoping for a better cure. Ayurvedic therapy was found to be able to cure these chronic diseases better, which were previously not amenable to treatment by western medical practices. This traditional Indian medicine with its evolution through centuries has always fascinated practitioners and researchers for its applications in cancer treatment on a scientifically proven research background.

Principles Of Ayurvedic Treatment

Abuse of nature’s law upsets the human system and ends up in disease like cancer. It is again the nature, the foremost physician who brings the cure. The Ayurvedic system of medicine was well founded on the basic principles of nature and its elements after a careful and thorough study of human physiology. This is the first system to emphasize health as the perfect state of physical, psychological, social and spiritual component of a human being. The therapeutic approach of Ayurveda has been divided into four categories as Prakritisthapani chikitsa (health maintenance), Roganashani chikitsa (disease cure), Rasayana chikitsa (restoration of normal function) and Naishthiki chikitsa (spiritual approach) [18]. Finding the cause of an illness is the basic goal of ayurvedic therapy. It classifies disease development into six stages that include aggravation, accumulation, overflow, relocation, build-up in a new location, and manifestation into a recognizable disease. Ayurvedic physicians can diagnose an illness at even initial stages of body imbalance and their therapeutic approach maintains a balance by supplying deficient substances as well as reducing the excessive ones. Surgery is considered only for advanced cases.

Ayurvedic Texts About Cancer Treatment

During the 7th century BC, Atreya and Dhanwantari used herbal medicines for treating the early stages of cancer and surgery in advanced cases. In the 8th century AD, Vagbhata, a Buddhist physician composed two texts: Astanga Hrdaya  and Astanga sangraha where new methods for cancer treatment were introduced. Other Ayurvedic texts of internal medicine, viz., Chakradatta composed by Chakrapani (10th century AD), the Sarangadhara Samhita by Sarangadhara (14th century AD), the Bhavaprakasha Samhita by Bhavamisra (15th century AD), the Satmya Darpan Samhita by Viswanath (16th century AD), the Vaisajya Ratnabali by Binoda Lala Sen Gupta (18th Century AD), the Rasatarangini by Sadananda Sharma (19th century AD), etc. explain numerous remedies to treat internal and external neoplasms.

Treatment Modalities

Sodhana chikitsa (purification process), which eliminates vitiated doshas, have been primarily used for medical management of cancer. When both internal and external medications were given then it is called as panchakarma chikitsa. The other type of curative therapy is called somana chikitsa, which pacifies dosha and gradually relieves the disease. However, this treatment is prescribed only to weaker patients for whom sodana chikitsa is contraindicated. In Rasayana prayoga (immunotherapy), certain poisonous plants, mercury like metals and animal products were rendered non-toxic and harmless by the use of alchemy and are used as rejuvenating drugs. Other methods of treatment include, dhatwagni chikitsa (correction of metabolic defects), vyadhipratyanika chikitsa (specific anti-cancerous drugs) and lakshanika chikitsa (symptomatic treatment) [24]. When medical treatment practices fail, then the case was left to surgeons. Surgical cancer management in Ayurveda include the principles of fomentation by means of external application, cleansing by internal medication, treatment to liquefy the contents of the swelling, opening the tumour surgically for evacuation of its contents, cauterisation to avoid recurrence and post-operative care for healing the wound [15]. Cauterisation with alkalis and acids and other surgical procedures were performed with herbal and mineral medicines. Arbuda is excised completely from its deep root seat and cauterisation done to destroy any of the remaining cell particles.

Classical Drugs Claimed In Ayurvedic Texts

Traditional line of treatment: Traditional methods employed in treatment of various cancers were given in Table 1. In addition to these traditional methods, various herbal combinations mentioned in Ayurvedic texts are listed in Table 2. The main objective of these tables is to support the physicians and researchers to utilize these traditional methods as well as herbal drugs for an effective cancer treatment.

Scientific Principles Of Ayurvedic Anticancer Drugs

Herbal decoctions consisting of multiple herbs each possessing tremendous potential for a cancer cure are commonly used in Ayurveda. These formulations are reported to work on multiple biochemical pathways and are capable of influencing several organ systems simultaneously. The benefit of an herbal decoction is that it can nourish the body as a whole by supporting various organ systems. Many of the herbs mentioned below have scientifically-proven anti-cancerous properties and are used for the treatment of various cancers.

Andrographis paniculata

The extract and isolated diterpenes (andrographiside and neoandrographolide) from this plant are proved to be beneficial against tumourigenesis by their anti-lipoperoxidative action and by enhanced carcinogen detoxification action.

Annona atemoya/muricata

Bullatacin, an acetogenin isolated from the fruit of Annona atemoya, induces apoptosis, preceded by chromatin margination and tumour cells condensation [30].  Several other annonaceous acetogenins, e.g. muricins A–G, muricatetrocin A and B, longifolicin, corossolin, and corossolone are also showed to be significantly selective in bringing in vitro cytotoxicities to tumour cells.

Phyllanthus niruri/amarus

An aqueous extract of P. amarus increases the life span of the tumour bearing rats and normalizes glutamyl transpeptidase activity. It plays a major role in disruption of HBsAg mRNA transcription and post-transcription which could be beneficial against viral carcinogenesis.

Piper longum

Piperine, an active alkaloid extracted from this plant has been used as an ingredient of ayurvedic anticancer formulations because of its anti-oxidative potency in both in vitro and in vivo conditions.

Podophyllum hexandrum Linn. (Podophyllin)

It is a powerful anticancer drug against various cancers for e.g. sarcomas, adenocarcinoma and melanoma. Podophyllin and its active principle, podophyllotoxin are known for their cytotoxic effect by virtue of their properties of mitotic inhibition, nuclear fragmentation, impaired spindle formation and they are also found to be karyoplastic. The mechanism of action has been suggested as necrosis and is a direct consequence of its cytotoxic effect on tumour tissues. These derivatives have been analysed in cancer chemotherapeutic  studies and the methods of preparation of these compounds are patented. In recent days, chemically modified podophyllotoxins are widely used in cancer therapeutics. VP-16 (etoposide), a podophyllotoxin derivative has been tested against in vitro and in vivo cancer cells and been used against hepatic cancers for more than a decade. It has proved its efficacy in combination with epirubicin in phase II studies. By this combination therapy at least 3% of the patients had complete cure and 36% had partial response. P-glycoprotein, a drug efflux pump, seems to be less effective in reducing VP-16 concentration in cancer cell lines and hence this drug proves to be more efficient in these cells. It is also safe even above therapeutic dosage without much toxic effects.

Tinospora cordifolia

The active principles from T. cordifolia enhance host immune system by increasing immunoglobulin and blood leukocyte levels and by the stimulation of stem cell proliferation. It has the ability to reduce solid tumour volume by 58.8%, which is comparable to cyclophosphamide, a known chemotherapeutic agent. These immuno stimulating properties can be used in the prevention of tumour mediated immuno suppression and hence could be a drug choice for various cancers.
Semecarpus anacardium

In Ayurveda classics, numerous references are available on the anticancer properties of Semecarpus anacardium nuts. An extensive review describes the phytochemical and pharmacological properties of S. anacardium. The chloroform extract of S. anacardium nut possess antitumour action with increased life span against leukaemia, melanoma and glioma. The milk extract of S. anacardium produces regression of hepatocarcinoma by stimulating host immune system and normalizing tumour markers including alpha-fetoprotein levels. This preparation stabilizes the lysozomes, and normalizes glycoprotein and mineral content in the body during cancer progression. It also corrects hypoglycaemia and controls abnormal lipid peroxidation by the maintenance of antioxidant defense status. In the microsomes, it acts as a bifunctional inducer of both phase I and II biotransformation enzymes and prevents tumour initiation by preventing carcinogen activation. Histologically, on treatment with the S. anacardium extract to hepatocarcinoma animals,
the liver sections showed almost a normal architecture. The nodules become completely regressed and further cell necrosis was prevented. Anacartin forte, another preparation from S. anacardium has been used for several decades as an anticancer drug since it is giving health improvement with alleviation or disappearance of troublesome symptoms. It provides clinical benefit with an extension of survival time in various cancers including oesophageal, chronic myeloid leukaemia, urinary bladder and liver cancer. Another Ayurvedic drug containing S. anacardium, Amura rohitaka, Glycyrrhiza glabra and copper powder were reported to inhibit breast tumour development in mice by significantly extending the survival period. This drug was also found to be efficient in clinical trials.
Ayurvedic herbs, which are widely used and scientifically proven of their anticancer properties, are presented in Table 3. Smit et al. have also elaborately listed ayurvedic herbal drugs with anticancer activity. Some of these herbs are shown to enhance the therapeutic efficacy and/or reduce the toxicity of anticancer drugs used in chemotherapy. Also few of them possess radiosensitising effect too (see Table 4). Pharmacological details of ayurvedic herbs like therapeutic dosage, side effects, and comments about safety and herb-drug interactions were given in Table5.
Benefits Of Ayurveda In Cancer Cachexia

Cancer cachexia is a common clinical problem that substantially impacts upon the quality of life and survival of cancer patients. The pathophysiology of this syndrome implicates tumour induced metabolic changes and immune responses. Clinical manifestations include anorexia, chronic nausea and change in body image. Among several potential benefits of ayurvedic medicine, relief from cancer cachexia is especially valuable. Ayurvedic herbs used in cancer therapy results not only in total healing, but also reduces the side effects and cancer associated complications. It also avoids the need for supplemental therapy to manage cancer cachexia. Each herbal product contains multiple active principles that may operate synergistically, producing therapeutic benefits and lowering the risks on adverse effects. The anorexia or weight loss could be effectively managed by Withania somnifera, Sida cordifolia, Asparagus racemosa, Vitis vinifera, Plumbago zeylenica, Tinospora cordifolia, Zingiber officinale, Coptidis rhizoma, etc. These herbs have been shown to improve appetite, food intake, malnutrition, fatigue and sensation of well-being which could elicit bodyweight gain. These herbs might stimulate the flow of digestive juices, thereby improving digestion and increasing the appetite. Aegle marmelos, Holarrhena antidysenterica, Punica granatum, Cyperus rotundus, Emblica officinalis, and Plumbago zeylanica can be used as anti-diarrhoeals when diarrhoea becomes one of the complications of cancer cachexia. Terminalia chebula could be useful against chronic constipation and digestive disorders which are common in cancer patients resulting in loss of appetite. Eclipta prostrata, Emblica officinalis, Withania somnifera, Piper longum can be directed to correct nausea and vomiting. Among the above-mentioned herbs, Withania somnifera and Tinospora cordifolia are also proven to be powerful immunostimulants, which could increase body resistance power during cancer associated immunosuppression. Ayurvedic anticancer therapy includes recommendations for lifestyle and use of specific foods and herbs which are very helpful not only in preventing the progression of the disease but also makes the patients feel better and comfortable overcoming the symptoms. Allium sativum (garlic) could be helpful to manage pain and ache. Bacopa monniera strengthens mental faculties and helps to manage insomnia or sleeplessness due to stress [62]. An herbal combination of Withania sominifera, Asparagus racemosa, Hydrocotyle asiatica, Nardostachys jatamamsi, Elettaria cardamomum, Tribulus terrestris, Zingiber officinalis and Eclipta alba could also be useful in the treatment of anxiety, tension and insomnia. Ocimum sanctum is beneficial against stress and depression during cancer. Curcuma longa, Zingiber officinale, Glycyrrhiza glabra, Terminalia chebula, Ocimum sanctum and Adhatoda vasica are used to control cough and shortness of breathe especially for lung cancer patients. Thus, ayurvedic therapeutic regimen rejuvenates thebody tissues, tones up the systems and act as a tonic to the body against cancer cachexia. This kind of orientation toward total healing and health promotion makes ayurvedic treatment approach to cancer therapy promising.

Cancer Therapy In Ayurveda—Future Prospects

Because large population use ayurvedic medicine worldwide, there is an urgent need for additional, carefully conducted, high-quality intensive research to evaluate its efficacy and to develop this discipline to meet ever-new challenges of modern medicine in the field of oncology. The most rigid evaluation should take place with gold standards for clinical research—the randomized controlled clinical trial (RCT). Priority for research funding should be given to clinical investigations in Ayurveda involving well-designed studies with encouraging results especially for diseases like cancer to which conventional medicine has been shown to be less effective. Attention should be given not only to the evaluation of safety and examination of effectiveness in treatment strategy, but also to the consideration of community practice settings, patient expectations, compliance and cost effectiveness. Standardization and quality production of herbal products may allow us to develop low cost therapies with reduced risk over pharmaceuticals. In any case, studies on anticancer ayurvedic drugs will be popular from the economy point of view because cancer is becoming the major cause of death.

Ayurveda is considered to be a form of complementary and alternative medicine (CAM) within the western world, where several of its methods, such as the use of herbs, massage, and Yoga as exercise or alternative medicine, are applied on their own as a form of CAM treatment.

Ayurveda is grounded in a metaphysics of the ‘five [great] Elements’ ([महा] पञ्चभूत; earth, water, fire, air and ether)—all of which compose the Universe, including the human body. Chyle (called Rasa dhatu), blood (called Rakta dhatu), flesh (called Mamsa dhatu), fat (called Medha dhatu), bone (called Asthi dhatu), marrow (called Majja dhatu), and semen (called Shukra dhatu) or female reproductive tissue (called Artava dhatu) are held to be the seven primary constituent elements (सप्तधातु) of the body. Ayurveda stresses a balance of three substances: vata (wind/spirit/air), pitta (bile) and kapha (phlegm), each representing divine forces. According to Ayurveda, these three regulatory principles—Doshas (त्रिदोश)—are important. Traditional beliefs hold that humans possess a unique constellation of Doshas. In Ayurveda, the human body perceives attributes of experiences as 20 Guna (गुण, meaning qualities). Surgery and surgical instruments are employed. It is believed that building a healthy metabolic system, attaining good digestion, and proper excretion leads to vitality. Ayurveda also focuses on exercise, yoga, meditation, and massage. Thus, body, mind, and spirit/consciousness need to be addressed both individually and in unison for health to ensue.

The practice of Panchakarma (पंचकर्म‌) is believed to eliminate toxic elements from the body. Eight disciplines of Ayurveda treatment, called Ashtanga (अष्टांग), are given below:

1. Surgery (Shalya-chikitsa)
2. Treatment of diseases above the clavicle (Salakyam)
3. Internal medicine (Kaaya-chikitsa)
4. Demonic possession (Bhuta vidya): Ayurveda believes in demonic intervention and—as a form of traditional medicine—identifies a number of ways to counter the supposed effect of these interferences. Bhuta vidya has been called psychiatry.
5. Paediatrics (Kaumarabhrtyam)
6. Toxicology (Agadatantram)
7. Prevention and building immunity (rasayanam)
8. Aphrodisiacs (Vajikaranam)

History

AyurVeda is referenced in the literature from the Vedic period between 4000-2000 B.C.E. The four Vedas; Brahmanas, Upanishads, Mahabharata and the Puranas refer to concepts of AyurVeda . Rig Veda contains Indira, Agni and Soma relating to Vata, Pita and Kapha, the three doshas (biological humors) of AyurVeda. Yajur Veda introduces the AyurVedic ideas of the organs and dhatus (tissues). Sama Veda contains chants related to health of the body, mind and spirit while Atharva Veda contains reference to herbs, disease treatments and systematic knowledge of Ayurveda. Since Atharva Veda contains a lot of references to AyurVeda, sometimes AyurVeda is considered to be an Upaveda or branch of AyurVeda. The Brahmanas mention the five pranas (life-force) and the seven dhatus in detail. The Upanishads teach the mental and spiritual aspect of AyurVeda. The Mahabharata discusses doshas and their effects on health and diseases. The Puranas describe the patron deity of AyurVeda, Lord Dhanvantari, as ‘King of Kashi.’

At the end of the Vedic Period, between 2000-300 B.C., AyurVedic knowledge was preserved, reformulated and systemically arranged and compiled into Samhitas . The three authentic Samhitas that we have today are Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya. These three Samhitas are collectively called Brihattrayi. Charaka Samhita and Sushruta Samhita were written during this period while Ashtanga Hridaya was written around 600 AD.

Current Status

Within India

In 1970, the Indian Medical Central Council Act was passed by the Parliament of India, which aims to standardize qualifications for Ayurveda and provide accredited institutions for its study and research. In India, over 100 colleges offer degrees in traditional Ayurvedic medicine. The Indian government supports research and teaching in Ayurveda through many channels—both at the national and state levels—and helps institutionalize traditional medicine so that it can be studied in major towns and cities.[35] The state-sponsored Central Council for Research in Ayurveda and Siddha (CCRAS) is the apex institution for promotion of traditional medicine in India.[36] The studies conducted by this institution encompass clinical, drug, literary, and family welfare research.

Many clinics are run by professionals who qualify from these institutes—both in the urban and the rural areas. Mukherjee & Wahile cite World Health Organization statistics to demonstrate the popularity of traditional medicine, on which a significant number of the world’s population depends for primary health care. In Sri Lanka the number of traditional Ayurveda practitioners is greater than trained modern medicine professionals. The manufacture and marketing of Ayurvedic medicine has been commercially successful for several pharmaceutical companies. Old manufacturing companies such as Vaipa Pharmaceutical Works,Arya Vaidya Sala, Arya Vaidya Pharmacy, IMIS Pharmaceuticals, Dabur, Baidyanath have maintained the classical range, while also patenting certain own formulations, such as Gyncocalm, Jeevani, Eosinophal, Dabur Pancharishta. Similarly, MNCs like Hindustan Unilever Limited, in collaboration with Arya Vaidya Pharmacy, has been promoting its chain of Ayurvedic Massage Therapy Centres in the Brand name of [Ayush Therapy Centre],with two of the major centers located at Kalyan and Vashi.

Outside India

Ayurveda gained recognition in the Western world as medical scholars, notably , Frank John Ninivaggi MD of Yale University School of Medicine, researched and outlined its various postulates in one major textbook form suitable to Western academic science. In the United States of America, the NIH NCCAM expends some of its $123 million budget on Ayurvedic medicine research. In addition, the National Institute of Ayurvedic Medicine, established by Dr. Scott Gerson, is an example of a research institute that has carried out research into Ayurvedic practices. Gerson has published part of his work on the antifungal activities of certain Ayurvedic plants in academic journals. The postulates and history of Ayurveda have also been outlined by foreign scholars—such as Dominik Wujastyk in the United Kingdom.

Journal

A variety of peer reviewed journals focus on the topic of ayurvedic medicine, including the Theoretical and Experimental Journal of Ayurveda and Siddha (TEJAS; published between 1981 and 2008 as Ancient Science of Life), the Journal of Research & Education in Indian Medicine (JREIM), AYU (published quarterly) and The International Journal for Ayurveda Research (published quarterly).

Patents

In December 1993, the University of Mississippi Medical Center had a patent issued to them by United States Patent and Trademark Office on the use of turmeric for healing. The patent was contested by India’s industrial research organization, Council for Scientific and Industrial Research (C.S.I.R), on the grounds that traditional Ayurvedic practitioners were already aware of the healing properties of the substance and have been for centuries, making this patent a case of bio-piracy. The Government of India had become involved in promoting traditional medicine by 1997.

“In India the government became involved in traditional drug production when the Central Drug Research Institute patented two new drugs from ancient Ayurvedic formulas. One, a mixture of black pepper, long pepper, and ginger, allows for the dosage of the antibiotic rifampicin to be halved in the treatment of tuberculosis and other mycobacterial infections. The other is a memory tonic produced from the traditional plant called brahmi. Overseas patenting of turmeric and products of the neem tree caused controversy in India and other nations. In August the U.S. Patent and Trademark Office canceled a U.S. patent on the wound-healing properties of turmeric when the Indian government proved that records had existed for this use for centuries.”