Phytotherapy and Nutritional Supplements on Breast Cancer 用于乳腺癌治疗的植物疗法和营养补充剂

To elaborate this review, PubMed (indexed for MEDLINE) and ISI Web of Science were searched using the following key words: breast cancer; phytotherapy; supplements; CAM; integrative medicine; Echinacea;Tabebuia impetiginosa; Salvia; Uncaria; Allium sativum L., Linum usitatissimum; Curcuma; Camellia sinensis; Ginseng; Cimicifuga racemosa; Viscum album; vitamins; antioxidants; vitamin A; β-carotene; vitamin C; vitamin E; vitamin D; selenium, calcium; B complex; omega 3. For plants, both Latin designations and common trivial names were considered for search strategy. Additionally, text books were explored and reference lists from pertinent reviews were scrutinized. The literature search was confined to the period between 2000 to March of 2017. Systematic reviews, meta-analyses, and in vivo and relevant cell line studies were considered for this review.

3. Phytotherapy

Among CAM used in cancer patients, herbal preparations or phytotherapy is the most commonly and the oldest used group of treatment [30]. Most of time, patients use plant products for self-medication. It uses products derived from all or parts of plants and is a common practice in all civilizations around the world including Asia, Africa, Europe, and America. Herbal preparations may have superior risk of adverse effects and therapy interactions than other complementary therapies due to the potential active ingredients of various plants. Despite this, phytotherapeutic products are not tested with the scientific rigor required of conventional drugs nor are controlled by any purity and potency certificate [3].

The recognition of medicinal plants as effective and inexpensive sources of synthetic novel chemotherapeutic compounds is increasing in the last decades and many researchers focus their research on this promising area [31]. In the cancer domain, the biological effects of herbal medicinal products could be diverse such as [7] defence from malignancy by increasing detoxification or cleaning, modification of the action of some hormones and enzymes, reduction in side effects and complications of chemotherapy and radiotherapy, and improvement of the function of the body’s immune cells (i.e., stimulates the production of cytokines including interleukin, interferon, tumour necrosis factor, and colony stimulating factor).

The reasons for using phytotherapeutic products include [3] to lessen symptoms of disease and to prevent disease (e.g., garlic contains high levels of organosulfur compounds that have been experimentally proven to prevent cancer in animals [32]).

In a prospective study using an exploratory analysis, the authors found that some evidence that phytotherapeutic products use among long-term breast cancer survivors (for at least 10 years) was associated with inferior survival rates and a poorer physical component score [30]. The most frequent phytotherapeutic products used among long-term (at least 10 years) breast cancer survivors who participated in this study wereEchinacea, herbal teas, and ginkgo biloba. Authors reported limitations in the study such as few deaths for mortality analysis and lack of information on when phytotherapeutics use was initiated, duration, or application. In another study, McLay et al. [33] reported that 38% of treated breast cancer patients (in a total of 360 questionnaires) use herbal preparations (Echinacea, pomegranate, peppermint, chamomile, grapefruit, garlic, and ginseng) that have the potential to interact with adjuvant endocrine therapies (e.g., tamoxifen, anastrozole, letrozole, and exemestane). Garlic, gingko, and Echinacea were the most frequently phytotherapeutic products among African Americans (Black Women’s Health Study) [34].