Herbs that relieve chemotherapy and radiation therapy adverse side effects

Author: Rositsa Tashkova, Master of Molecular Biology and Microbiology

Cancer is extremely prevalent and is one of the leading causes of death in the world. The most common treatments are chemotherapy and radiation therapy. But unfortunately, they have many and severe side effects that worsen, albeit temporarily, the quality of life of patients and are a major reason for refusing treatment.

Fortunately, some natural products can alleviate the side effects induced by chemotherapy and radiation therapy:

• oral mucositis (inflammation and mouth ulcers),
• gastrointestinal toxicity (nausea, vomiting),
• hepatotoxicity (liver),
• nephrotoxicity (kidneys),
• damage to the hematopoietic system (blood formation),
• cardiotoxicity (heart),
• neurotoxicity (nervous system).

In this article, you will find information on the topic based on research. We hope it will be useful for you or your relatives and acquaintances suffering from oncological disease.

Natural products, including raw extracts enriched with bioactive components and pure compounds derived from herbs, as well as herbal formulas, can effectively reduce the strength of chemotherapy and radiation therapy induced side effects mainly due to their antioxidant and anti-inflammatory actions.

In addition, certain natural products are able to [ref.1]:

• suppress the oral mucositis induced by chemotherapy and radiation therapy by not allowing the occurrence of an infection,
• mitigate gastrointestinal toxicity by regulating the intestinal microflora,
• limit liver damage by protecting mitochondria,
• suppress kidney damage by modulating immunity,
• reduce damage to the blood-creating process by improving the hematopoietic microenvironment,
• reduce cardiotoxicity by balancing energy metabolism,
• prevent neurotoxicity by protecting the nervous system.

Oral mucositis is a common negative side effect of chemo and radiation therapy, especially at larger doses or in the treatment of cancerous formations in the head area. It is characterized by edema, soreness and the appearance of ulcers in the mouth, and can alter the course of treatment if it worsens.

It is due to oxidative stress and inflammation caused by theset herapies.

Medicinal plants, which are evidenced to help with oral mucositis, are:

• Broadleaf plantain (Plantago major) - is effective in the treatment of wounds as it has anti-inflammatory, antibacterial, antiviral and antioxidant properties. A randomised triple-blind phase III clinical trial shows that broad-field plantain extract, in combination with sodium bicarbonate (baking soda) solution 5%, can effectively control oral mucositis in cancer patients [ref.2].

• Chamomile (Matricaria chamomilla) - according to some studies, chamomile extract, used as mouthwash, slows down the appearance of oral mucositis and reduces its strength if it appears. [ref.3]
• Aloe vera - according to some studies, the intake of aloe vera juice or rinsing the mouth with 5 ml of aloe vera solution for two minutes, three times a day, for 14 days [ref.5] improves the condition of sufferers of oral mucositis as a result of chemo- or radiation therapy.
• Marigold (Calendula officinalis) - there is evidence that calendula extract can prevent or relieve oral mucositis. Probably this is due to the content of the strong antioxidant quercetin in this herb. [ref.4]

• Other natural remedies reported to have given positive results are: turmeric (not to be taken in treatment with paclitaxel, since the combination can damage the liver), ginger, mulberry molasses, honey and propolis, but the latter should not be used in severe cases of oral mucositis. [ref.1]

The most common manifestations of gastrointestinal toxicity caused by chemotherapy and radiation therapy are nausea, vomiting and diarrhea. One of the causes is the disruption of the balance in the intestinal flora or so-called dysbiosis. There is a deterioration in digestion and absorption of nutrients, as well as inflammation of the esophagus (esophagitis) and intestines (enteropathy).

There are many studies that have checked the effects of various medicinal plants against the gastrointestinal toxicity of chemo- and radiation therapy. Here we will look at those who have shown effectiveness in humans:

• Ginger (Zingiber officinale) - has been found to suppress nausea and vomiting and restore appetite in cancer patients;
• Ginseng (Panax ginseng) - according to a randomized double-blind placebo-controlled study from 2017, ginseng reduces the symptoms of nausea, vomiting, shortness of breath and fatigue, and its efficacy and safety can improve the quality of life of patients [ref.7];

• Aloe vera - it has anti-inflammatory effect;
• Green tea (Camellia sinensis) - has a good effect due to the antioxidant, antibacterial and anti-inflammatory properties of catechins in it, as well as its property to suppress intestinal motility.

Liver damage can occur both under the influence of chemotherapy and with improper use of herbs. Therefore, it is important to keep in mind that plants are not necessarily harmless and control by a specialist is an important part of the herbal treatment.

There are several herbs that have shown a positive effect against the toxic effects of chemo- and radiation therapy on the liver:

• Milk thistle (Silybum marianum) - the effect is due to the antioxidant and anti-inflammatory properties of the plant, as well as its ability to suppress fibrosis;

• Shiitake (Lentinula edodes) - the extract of the mycelium of the shiitake fungus contains an active hemicellulose component (AHCC), which can reduce hematotoxicity and hepatotoxicity and improve the quality of life of patients with advanced cancer during chemotherapy [ref.8].

Nephrotoxicity is one of the most serious side effects of treatment with the chemotherapeutic cisplatin , and the kidneys are very sensitive to radiation. 

In studies involving cancer patients, a positive effect was observed with honey, royal jelly and the substance lycopene, which is found in tomatoes, grapefruit and watermelon.

In experimental animals, the alcoholic extract of marjoram (Origanum majorana, in cisplatin treatment), sweet flag (Acorus calamus), quercetin, grape seed extract, ginger extract, also showed a good effect. [ref.1]

Myelosuppression with leukocytopenia, erythrocytopenia and thrombocytopenia are serious and frequent side effects during cancer treatment. In patients with myelosuppression due to chemotherapy and radiotherapy, infections and inflammations are often observed.

Antioxidant natural products can lower the amount of free radicals produced as a result of chemotherapy and radiation therapy, preventing them from killing white blood cells and bone marrow suppression.

In humans, positive effects have been found with the use of ginseng, as well as some herbal formulas from Traditional Chinese medicine (TCM):

• Shuanghuang Shengbai - in the form of granules, contains astragalus (Astragalus membranaceus), Rhizoma polygonati (root of a plant of the genus Polygonatum), Rhizoma drynariae (fern root of the species Drynaria roosii), Fructus ligustri (fruits of Ligustrum lucidum), Radix trichosanthis (root of a plant of the genus Trichosanthes) and Herba epimedii [ref.9];
• Danggui Buxue - decoction, which contains roots of astragalus and dong quai or female ginseng (Radix astragali and Radix Angelicae sinensis).

The imbalance of energy metabolism and oxidative stress leads to cardiotoxicity induced by chemotherapeutic agents, and cardiac damage from radiation therapy is a major problem for those struggling with cancer.

The following herbs might be hepful: parsley oil, black grape juice, flaxseed oil, green tea and Chinese herbal formula Sheng-Mai-San, which contains: ginseng root, monkey grass (Liriope spicata) and Chinese magnolia-vine fruits (Schisandra chinensis).

Neurotoxicity is a common adverse effect of chemotherapy and radiation therapy of cancer and causes excruciating pain to patients. These therapies lead to peripheral neuropathy.

Helpful herbs are: St. John's wort (Hypericum perforatum), green tea, grape seed oil, turmeric, astragalus root.

Before taking these herbs, please discuss it with your health care provider due to the specifics of the treatment of each individual patient. Some herbs interact adversely with specific medicines and whether they are suitable can only be judged by a specialist.

What are the possible side effects of chemotherapy?

Fatigue is one of the most common side effects of chemotherapy. Other side effects can be:

• Feeling sick,
• Hair loss,
• Infections,
• Anemia,
• Bruises and easy bleeding,
• Inflammation of the mouth, sores, mucosal ulcers,
• Loss of appetite,
• Dry, itchy, red skin,
• Brittle nails,
• Insomnia,
• Problems with memory and concentration,
• Diarrhea and constipation,
• Impaired libido and infertility,
• Emotional problems, stress, anxiety.

What are the recommendations after chemotherapy?

It is advisable to better your mouth hygiene, as chemotherapy can lead to unpleasant sores in the mouth: brushing your teeth 2-3 times a day, for 2-3 minutes, with fluoride toothpaste and a soft toothbrush. Do not use mouthwash that contains alcohol. It is good to rinse your mouth with a solution of soda and table salt 4 times a day (2.5 g of soda + 2.5 g of salt in 240 ml of water).

Avoid sugar, including in chewing gum and candy. Special attention should be paid to food and its safety to avoid infections.

Avoid crowds, do not receive sick guests (cold, flu, coronavirus) at home, wash hands very often, avoid contact with soil, cats and animals that have not been vaccinated, do not smoke, be careful with exposure in the sun, maintain physical activity through walks.

Are there forbidden foods after chemotherapy?

Due to the increased risk of infection after chemotherapy, it is important not to consume uncooked or spoiled foods, raw or semi-raw meats, fish and eggs, unpasteurized cheeses and milk, raw vegetables that are difficult to wash well (eg lettuce and other leafy vegetables).

Avoid sugar, sugary and sweetened foods and beverages.

Avoid red meat, white flour, trans fats, alcohol.