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We discuss in complete detail everything you need to know about alternative and natural cancer treatments for cholangiocarcinoma cancer. Includes details of services offered, by leading doctors and contact information, including their address, and e-mails. We explain in plain English what the therapies are, how they work, why they work and most importantly the results.
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We describe complementary and alternative medicine CAM for cholangiocarcinoma cancer. CAM is the medical term used for products and practices that are not part of standard care. This book is detailed oriented. Both classic composite formula and experience composite formula are discussed and summarized in Table 2. It consist of 10 herbs; Mongolian milkvetch root, Cinnamon, ginseng root, largehead atractylodes rhizome, tuckahoe, liquorice root, Chinese angelica, radix rehmanniae root, white peony root, szechwan lovge rhizome.
TJ has been used extensively in medical practice in Asia even though their mechanism of action remains elusive. Tsuchiya et al. A significantly longer intrahepatic recurrence-free survival was observed in the TJ group even though most of the patients experienced recurrence of HCC [ 87 ]. Xiao-Chai-Hu-Tang TJ-9, Sho-saiko-to in Japanese , a classic herbal composite formula, is commonly administered to patients with chronic viral liver disease in order to improve their overall physical condition and to prevent the development of liver cancer. The crude extracts of TJ-9 consist of seven herbs: bupleurum root, pinellia tuber, scutellaria root, jujube fruit, ginseng root, glycyrrhiza root and ginger rhizome.
A prospective, randomized, non-blind controlled study was carried out by Oka et al. Two hundred and sixty patients with cirrhosis were randomly assigned to two groups, matched for age, sex, presence of hepatitis B surface antigen and the severity of liver damage. The patients in the trial group were given TJ-9 at a daily oral dose of 7.
They found that the survival curve for 5 years of the trial group without Hepatitis B antigen was significantly higher than that of the control group. They concluded that TJ-9 could help to prevent the development of HCC in patients with cirrhosis, particularly in patients with negative hepatitis B antigen [ 76 ]. The flaw in this study was that the hepatitis B antigen patients were a subset analysis and the study was underpowered and at risk for a type 1 error in it efficacy with hepatitis B patients.
A study from the same group further evaluated the potential of TJ-9 against HCC in pairs of patients matched for age, sex, presence of hepatitis B antigen and the scores of the severity of liver dysfunction from cirrhotic subjects. They concluded that TJ-9 may prevent or delay the emergence of latent HCC in patients with cirrhosis [ 88 ]. The limitation of this study is the concern for duplication of patients studied. These results came from the same authors, over the same time interval, and there is no mention that these two groups of patients were different.
Thus while TJ-9 may hold promise, further regulated studies are needed beyond a single institutional study to validate this initial encouraging results. Bu-Zhong-Yi-Qi-Tang BZYQT is a classic herbal composite formula in Chinese herbal medicine, it consist of eight herbs; Mongolian milkvetch root, liquorice root, largehead atractylodes rhizome, ginseng root, Chinese angelica, skunk bugbane rhizome, bupleurum root and tangerine.
Kao et al. The limitations of this study are the lack of pharmacokinetic distribution of BZYQT effects in HCC patients, which may be its major limitations in a larger clinical evaluation. The purpose for clinical use of experience herbal composite formula is to recover liver function, alleviate symptoms and to improve life quality. Most studies of use of experience herbal composite formula are retrospective, and the constituent of herbs in composite formula is not well defined.
The experience herbal composite formula usually combines with the conventional palliative treatment such as transcatheter arterial chemoembolization TACE and systemic chemotherapy Table 3. A retrospective study was undertaken by Chen et al. Forty-five HCC patients post-TACE were treated with a complex prescription of herbal crude, other 37 patients as the control group treated by routine therapy.
At the end of the therapy, both symptoms and hepatic function were improved. They concluded that the complex prescription of Chinese crude drug could benefit for HCC patients post-TACE by the recovery of liver function and improvement of the life quality [ 91 ]. Meng et al. In total, in 37 trials involving patients, the results showed that therapy I, compared with therapy II, improved patient survival, quality of life, alleviated symptoms and increased tumor response. Combining of complex prescription of Chinese crude drug with TACE are thus more therapeutically beneficial.
No serious adverse events were reported in therapy I group [ 89 ]. Shu et al. They applied random effects meta-analysis in 26 studies representing patients met the inclusion criteria. They found that Chinese herbal medicine combined with chemotherapy improved survival rate and tumor response compared with chemotherapy alone [ 90 ].
Lin et al. Tumor size, patients' symptoms, serum level of AFP, and some immune parameters were evaluated. SQM also improved the survival rate and symptoms such as hepatic region pain, fever, weakness, poor appetite and jaundice [ 82 ]. The in vitro anti-HCC activity of herbal composite formula with either indefinite constituent or definite constituent has been studied widely. Chao et al.
Chang et al. We discuss C. First, according to Chinese herbal medicine, sometimes single herb can be a composite formula, that is, Ginseng Decoction is content of only ginseng. Secondly, C. There could be hundreds compounds in the extracts of C. They concluded that C. Instead of directly adding herbal agent into culture media, they used serum pharmacologic method, serum loaded with herbal ingredients to treat cells.
TJ-9, as a typical classic composite formula, has been investigated regarding its anti-HCC effect. The ingredients from this classic composite formula have been also evaluated widely to explore more efficient l compounds against HCC. Yamashiki et al. Okita et al. Cell-cycle analysis was carried out with flow cytometry and the bromodeoxyuridine BrdU -labeling method. They found that baicalein, baicalin and saikosaponin-a inhibited cell proliferation dose-dependently. In addition, saikosaponin-a possesses a strong cell-killing effect, however, saikosaponin-c, ginsenoside Rb1 and ginsenoside Rg1 had no effect on cell proliferation [ 77 ].
Yano et al. They found that TJ-9 composite formula suppressed significantly the proliferation of KIM-1cells compared with any individual ingredient from TJ-9 composite formula. TJ-9 composite formula reduced the number of preneoplastic cells [ 78 ].
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The crude extracts of SGYMT consist of 11 herbs: bupleurum root, dragon's bone, rhubarb, pinellia tuber, scutellaria root, cassia twig, rhubarb, jujube fruit, ginseng root, glycyrrhiza root and ginger rhizome. Ha et al. The inhibitory effect on the invasion of SK-Hep1 cells using matrigel precoated transwell chambers showed that SGYMT effectively inhibited the invasion of SK-Hep1 cells as compared to the control groups. Chen et al. The results indicated that treatment with the QHF formula was efficient not only in inhibiting the growth of HCC cells, but also in prolonging the life of the HCC mice.
In addition, QHF combined with cisplatin can ameliorate cisplatin-induced leucopenia, spleen and thymus atrophy and other toxic reactions [ 84 ]. Yin et al. They observed survival rate, volume of tumors, and intrahepatic metastasis. The results indicated that FJD significantly increased the total survival rate and decreased tumor intrahepatic metastasis. Immunohistochemistry showed that an increased intensity of phosphatase and tensin homolog deleted on chromosome ten PTEN staining in tumor tissue treated with FJD.
They concluded that FJD can prolong the survival and decrease tumor intrahepatic metastasis. Tumor value, growth index and apoptosis were evaluated.
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They found that Star can decrease the tumor size, and increase apoptotic index significantly. Qian et al. They found that application of B. Importantly, the survival rate of HCC rats was also significantly improved. They concluded that B. There are some in vivo studies regarding the classic herbal composite formula. They found that TJ inhibited the development of liver tumors along with the reduced oxidative DNA damage, inflammatory cell infiltration and cytokine expression [ 87 ].
Shiota et al. They concluded that TJ-9 prevents hepatocarcinogenesis in association with inhibition of 8-OHdG formation [ 96 ]. Although TJ-9 has been showed encouraging effect for anti-HCC in most studied in clinical patient and cell culture, some disagreement also exist. Watanabe et al. TJ-9 was administered from 6 weeks of age until the rats were sacrificed at 76 weeks, at which time most of the non-treated animals were known to have HCC.
However, in regard of HCC, the percent area, number of areas, and mean size of area staining positively for GST-P revealed no significant differences between the groups. They concluded that long-term administration of TJ-9 did not reduce the risk of hepatocarcinogenesis in LEC rats [ 80 ]. Through centuries of clinical practices in herbal medicine, there could be a number of candidate drugs derived from the herbs or herbal composites formulae for chemoprevention and chemotherapeutic strategy against HCC.
Certain herbal compounds and herbal composite formula have been studied through in vitro and in vivo as an anti-HCC agent for many years, enhancing our knowledge about their biologic functions and targets. Despite studies for decades as well as advancement of our understanding of the molecular targets, there are still some concerns of herbal medicine.
The first is the use of composite formula usually mixed extracts with uncertain ingredients could result in dramatically different outcome for clinical trials and experimental studies. To address this issue, the biologically active substances in herbs need to be defined and standardized. Simplifying the herbal compounds to several biologically active compounds could be a way to standardized clinical trails and experimental studies. However, the biologically active effects of herbal composite formulas could be from the interactions between herbs and compounds, and one should be cautious to avoid eliminating the compound s within from the herbal composite formula even though the compound s may not have any biologically active effect by themselves itself.
The second issue is the relationship between clinical studies and experiments in test tubes and in animals. Many clinical trials in China focusing on the anticancer effects of herbal composite formulas have been conducted. There is a lack of randomized, placebo-controlled clinical studies regarding the use of both herbal compounds and composite formula. High-quality, rigorously controlled clinical trials are needed to avoid the overstated effect of herbal compounds and composite formula.
Thus future clinical trials should evaluate a dedicated defined reproducible herbal compound to allow for standardizing therapy and efficacy. The third is concern about the safety of herbal remedies. Traditional medical doctor, or herbal pharmacists recommend the traditional forms of herbs that are organic, unadulterated, unprocessed and prepared in traditional ways, just like any dietary ingredient, the processing methodologies are described in Chinese, Japanese, Korean Pharmacopoeias.
They simply trust the wisdom of the body to recognize and make use of herbs. However, the reports of the herbal toxic effects contradict the popular view that herbals are natural and harmless. Among the herbal toxic effects, hepatotoxicity is the most frequent. The investigation of compounds and composite formula regarding safety and toxicity is needed before definitive clinical guidelines can be made.
Thus in summary herbal compounds have been shown to be efficacious and safe in small single center studies in the treatment and prevention of HCC and cirrhosis. However, on going standardization of the preparation, purity, and active compounds in conjunction with natural constituents should be specified for quality control aspects and must be established in order for future Phase 2 and Phase 3 trials can be created to verify these intriguing and optimistic results in this devastating disease. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
National Center for Biotechnology Information , U. Evid Based Complement Alternat Med. Published online Feb Martin, II. Robert C. Author information Article notes Copyright and License information Disclaimer. Received Jan 25; Accepted Apr 9. Li and R. Martin II. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Use of herbal medicine in the treatment of liver cancer has a long tradition.
Introduction 1. Herbal Medicine Generally, the description of herbal medicine is the use of medicinal herbs, preparation made from a plant or plants, to prevent and treat diseases and ailments or to promote health and healing. Methods In this article, for the sake of clarity, we divided the herbal medicine into effective herbal compounds and herbal composite formula to discuss their anticancer properties against HCC. Open in a separate window.
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Figure 1. Herbal Compounds There are a number of molecular compounds derived from the herbs that have been proven to be effective against HCC. Figure 2. Table 1 Summary of anti-HCC herbal compounds. Curcumin Curcumin diferuloylmethane , a compound extracted from Curcuma aromatica widely used as a spice and coloring agent in food, possesses potent antioxidant, anti-inflammatory and anticarcinogenic properties. Resveratrol Resveratrol, a polyphenol found in grape skins, peanuts, berries and red wine, has been shown to possess potent growth inhibitory effects against various human cancer cells including HCC.
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Silibinin Silibinin, a polyphenolic flavonoid, is the major biologically active compound of milk thistle. Other Reported Compounds Beside these widely investigated compounds, some other potential compounds for the chemopreventive effect against HCC have been also evaluated. Herbal Composite Formula Besides these promising molecule compounds isolated or derived from herbals, there is a number of herbal complex formulas prescribed by Chinese medicine practitioners defined as either a traditional medical doctor or an herbal pharmacists for treating and preventing HCC. Table 2 Summary of anti-HCC herbal composite formula.
Table 3 Summary of clinical reports using herbal medicines to treat patients with HCC. For up to 6 years Inhibiting tumors growth. For up to 2. Alleviating symptoms. Experimental Studies of Herbal Composite Formula Cell Culture Studies — The in vitro anti-HCC activity of herbal composite formula with either indefinite constituent or definite constituent has been studied widely.
Future Study and Safety Through centuries of clinical practices in herbal medicine, there could be a number of candidate drugs derived from the herbs or herbal composites formulae for chemoprevention and chemotherapeutic strategy against HCC. References 1. Weiss R. What is Herbal Medicine. Beaconsfield, UK: Beaconsfield Publishers; Liu G. Development of Formulas of Chinese Medicine. Fundamentals of Formulas of Chinese Medicine.
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