Investigating the Effects of Oral Ginseng on the Cancer-Related Fatigue and Quality of Life in Patients with Non-Metastatic Cancer
Background: Cancer affects the physical, psychological, and social aspects of the patients’ life. Cancer-related fatigue (CRF) is the most common and severe condition among cancer patients. Ginseng has long been used as an efficient treatment for CRF and improvement of quality of life (QOL). The present study aims to assess the efficacy of Panax Ginseng (PG) in reducing CRF in patients with non-metastatic cancer. In addition, the safety of the medication is evaluated.
Materials and Methods: This was a prospective clinical trial conducted on the patients (n=113) suffering from non-metastatic colon cancer (age range: 20-70 years old) referring to the Shafa Hospital, Ahvaz, Iran for chemotherapy treatment. After the chemotherapy sessions, the patients were randomly divided into two groups. The first group received daily dose of 100 mg PG for 30 days and the second group received placebo medication. The demographic information and clinical parameters of the patients including age, sex, weight, symptoms of fatigue, depression, sleep disturbances, and pain were measured pre and post intervention. Afterwards, the variables were compared in each group and between the groups.
Results: Results of study showed that the ginseng improved the quality of life and mood in the subjects. (P<0.0001) and no difference was observed in the placebo group (P=0.887).
Conclusion: The use of ginseng may can effective on reducing CRF and the associated symptoms in the patients with cancer, but further studies should be conducted for the evaluation of comprehensive therapeutic efficacy.
An I-S, An S, Kwon KJ, Kim YJ, Bae S. Ginsenoside Rh2 mediates changes in the microRNA expression profile of human non-small cell lung cancer A549 cells. Oncology reports. 2013;29(2):523-8.
Helms S. Cancer prevention and therapeutics: Panax ginseng. Alternative Medicine Review. 2004;9(3).
Tanaka O, Kasai R. Saponins of ginseng and related plants. Fortschritte der chemie organischer naturstoffe/Progress in the chemistry of organic natural products: Springer; 1984. p. 1-76.
Jin Y, Hofseth AB, Cui X, Windust AJ, Poudyal D, Chumanevich AA, et al. American ginseng suppresses colitis through p53-mediated apoptosis of inflammatory cells. Cancer Prevention Research. 2010;3(3):339-47.
Kang A, Hao H, Zheng X, Liang Y, Xie Y, Xie T, et al. Peripheral anti-inflammatory effects explain the ginsenosides paradox between poor brain distribution and anti-depression efficacy. Journal of neuroinflammation. 2011;8(1):100.
Yang CS, Ko SR, Cho BG, Shin DM, Yuk JM, Li S, et al. The ginsenoside metabolite compound K, a novel agonist of glucocorticoid receptor, induces tolerance to endotoxin‐induced lethal shock. Journal of cellular and molecular medicine. 2008;12(5a):1739-53.
Bae E-A, Han MJ, Choo M-K, Park S-Y, Kim D-H. Metabolism of 20 (S)-and 20 (R)-ginsenoside Rg3 by human intestinal bacteria and its relation to in vitro biological activities. Biological and Pharmaceutical Bulletin. 2002;25(1):58-63.
Molassiotis A, Zheng Y, Denton-Cardew L, Swindell R, Brunton L. Symptoms experienced by cancer patients during the first year from diagnosis: patient and informal caregiver ratings and agreement. Palliative & supportive care. 2010;8(3):313-24.
Purcell A, Fleming J, Bennett S, McGuane K, Burmeister B, Haines T. A multidimensional examination of correlates of fatigue during radiotherapy. Cancer. 2010;116(2):529-37.
Lawrence DP, Kupelnick B, Miller K, Devine D, Lau J. Evidence report on the occurrence, assessment, and treatment of fatigue in cancer patients. Jnci Monographs. 2004;2004(32):40-50.
Teunissen SC, Wesker W, Kruitwagen C, de Haes HC, Voest EE, de Graeff A. Symptom prevalence in patients with incurable cancer: a systematic review. Journal of pain and symptom management. 2007;34(1):94-104.
Beijer S, Kempen GI, Pijls‐Johannesma MC, de Graeff A, Dagnelie PC. Determinants of overall quality of life in preterminal cancer patients. International journal of cancer. 2008;123(1):232-5.
Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M. It's not over when it's over: long-term symptoms in cancer survivors—a systematic review. The International Journal of Psychiatry in Medicine. 2010;40(2):163-81.
Arndt V, Stegmaier C, Ziegler H, Brenner H. A population‐based study of the impact of specific symptoms on quality of life in women with breast cancer 1 year after diagnosis. Cancer. 2006;107(10):2496-503.
Bower JE, Ganz PA, Desmond KA, Bernaards C, Rowland JH, Meyerowitz BE, et al. Fatigue in long‐term breast carcinoma survivors. Cancer. 2006;106(4):751-8.
Cruciani RA, Dvorkin E, Homel P, Culliney B, Malamud S, Lapin J, et al. L-carnitine supplementation in patients with advanced cancer and carnitine deficiency: a double-blind, placebo-controlled study. Journal of pain and symptom management. 2009;37(4):622-31.
Lesser GJ, Case D, Stark N, Williford S, Giguere J, Garino LA, et al. A Randomized double-blind, placebo-controlled study of oral coenzyme Q10 to relieve self-reported treatment related fatigue in newly diagnosed patients with breast cancer. The journal of supportive oncology. 2013;11(1):31.
Barton DL, Liu H, Dakhil SR, Linquist B, Sloan JA, Nichols CR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. Journal of the National Cancer Institute. 2013;105(16):1230-8.
Bower JE, Ganz PA, Aziz N. Altered cortisol response to psychologic stress in breast cancer survivors with persistent fatigue. Psychosomatic Medicine. 2005;67(2):277-80.
Bower JE, Ganz PA, Aziz N, Fahey JL. Fatigue and proinflammatory cytokine activity in breast cancer survivors. Psychosomatic medicine. 2002;64(4):604-11.
Thornton LM, Andersen BL, Blakely WP. The pain, depression, and fatigue symptom cluster in advanced breast cancer: Covariation with the hypothalamic–pituitary–adrenal axis and the sympathetic nervous system. Health Psychology. 2010;29(3):333.
King ML, Murphy LL. American ginseng (Panax quinquefolius L.) extract alters mitogen-activated protein kinase cell signaling and inhibits proliferation of MCF-7 cells. Journal of experimental therapeutics & oncology. 2007;6(2).
Budzinski J, Foster B, Vandenhoek S, Arnason J. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine. 2000;7(4):273-82.
Blumenthal M. Therapeutic guide to herbal medicines. 1998.
Attele AS, Wu JA, Yuan C-S. Ginseng pharmacology: multiple constituents and multiple actions. Biochemical pharmacology. 1999;58(11):1685-93.
Dharmananda S. Panax ginseng: a clinical study of its effects on risk factors of cardiovascular diseases. Bull Oriental Healing Arts Inst. 1983;8:1-13.
King ML, Adler SR, Murphy LL. Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activation. Integrative Cancer Therapies. 2006;5(3):236-43.
Lee N-H, Son C-G. Systematic review of randomized controlled trials evaluating the efficacy and safety of ginseng. Journal of acupuncture and meridian studies. 2011;4(2):85-97.
Kim H-G, Cho J-H, Yoo S-R, Lee J-S, Han J-M, Lee N-H, et al. Antifatigue effects of Panax ginseng CA Meyer: a randomised, double-blind, placebo-controlled trial. PloS one. 2013;8(4):e61271.
Lee N-H, Yoo S-R, Kim H-G, Cho J-H, Son CG. Safety and tolerability of Panax ginseng root extract: a randomized, placebo-controlled, clinical trial in healthy Korean volunteers. The Journal of Alternative and Complementary Medicine. 2012;18(11):1061-9.
Barton DL, Soori GS, Bauer BA, Sloan JA, Johnson PA, Figueras C, et al. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Supportive Care in Cancer. 2010;18(2):179.
Younus J, Collins A, Wang X, Saunders M, Manuel J, Freake C, et al., editors. A double blind placebo controlled pilot study to evaluate the effect of ginseng on fatigue and quality of life in adult chemo-naïve cancer patients. Proc Am Soc Clin Oncol; 2003.
Kim JH, Park CY, Lee SJ. Effects of Sun Ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot. J Clin Pharm Ther. 2006 Aug; 31(4): 331-4.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.