Is There Any Other Anti-Cancer Botanical Compound As Exciting As Curcumin?

Curcumin ResearchCurcumin is one of the hottest plant polyphenol extracts being researched, today. Until recently, I was unaware of the extensive history of curcumin research…dating back over 170 years!  In the last 10-years, alone, there have been over 4,600 scientific papers published on curcumin.  Many of these studies suggest that this compound could be useful in the prevention and treatment of a wide spectrum of medical conditions and physiologic processes (i.e. cancer, inflammatory diseases, cystic fibrosis, Alzheimer’s disease, etc.) 

Curcumin is derived from the roots of Curcuma longa, a member of the ginger family. Curcumin is the major component of the Indian spice turmeric, and is responsible for giving turmeric its bright orange-yellow color.

  • **It turns out that whole turmeric may be even more potent than curcumin extract. Read the bottom of the blog post to learn more.**

Why Do I Love Curcumin?

curcuminWhen Mother Nature designed curcumin, she gave it the ability to target numerous critical mechanisms essential for the development, growth and progression of  most cancers.

Most pharmaceutical drugs are designed to work only a single target (i.e. a cellular receptor, gene, protein, etc.) or physiologic pathway (i.e. inflammation, glucose metabolism, immune modulations, etc.) However, the more we learn about cancer, the more we recognize that in most cases each cancer is driven by a complex array of hundreds-to-thousands of targets and pathways. It is due to this complexity that (aside from some rare exceptions), scientists have been unable to discover a “silver bullet” cure for most cancers. 

What Targets and Pathways Does Curcumin Hit?

Curcumin Anti-Cancer Targets

FIGURE 1

Figure 1 shows how curcumin hits multiple targets and pathways that are critical for cancer survival and growth. Most drugs (colored ‘light blue-green’ in the figure), on the other hand, only hit single targets. To me, this figure clearly shows why I consider curcumin to be one of nature’s wonder ‘drugs.’ 

Below is a summary of some of the more important anti-cancer activities of curcumin:

  • Inhibition of cancer cell division
  • Increases cancer cell death 
  • Decreases cell growth 
  • Inhibition of cell survival 
  • Inhibits growth of blood vessels to tumors 
  • Decreased metastasis 
  • Anti-inflammatory 
  • Antioxidant
  • Inhibition of carcinogens

Curcumin Inhibits NF-kB

NF-kB and Cancer

Perhaps one of curcumin’s most important activities is its ability to inhibit activation of NF-kB, a potent driver of chronic inflammation. NF-kB is a protein that acts as a crucial switch, turning on inflammation by activating genes involved in the production of inflammatory compounds. As NF-kB activation has been implicated in almost every stage of cancer development, progression and recurrence (as well as playing a key role in most chronic diseases), blocking this protein has tremendous health implications.

Curcumin Acts Synergistically With Chemotherapy and Radiation Therapy:

  • Increases tumor cell sensitivity to chemotherapy and radiation therapy
  • Protects normal tissues (liver, kidney, mucous membranes, heart, etc.) from radiation and chemotherapy injury
    • One recent study demonstrated a significant reduction in radiation dermatitis (skin inflammation) in patients who received curcumin during their radiation therapy for breast cancer. Patients received either oral curcumin (2 gram tablets, taken 3 times per day) or a placebo. The authors reported that the patients taking the curcumin had dermatitis reactions that were on average 31% less than those taking placebo. One of the most impressive findings in this study was that the women taking curcumin had a marked reduction in their risk of developing severe skin reactions (called “moist desquamation”) compared with those taking the placebo; 28.6% (curcumin) versus 87.5% (placebo).

Cancer Prevention:

Preclinical studies have found that curcumin is able to inhibit the development of chemically-induced cancers of the:

  • mouth
  • stomach
  • liver
  • colon

Human studies have shown that curcumin (up to 8 grams per days for three months) is able to to reduce the progression of precancerous lesions of the:

  • mouth (leukoplakia)
  • cervix (high grade cervical intraepithelial neoplasia)
  • skin (squamous carcinoma in situ)
  • stomach (intestinal metaplasia)

Cancer Treatment:

Curcumin has been shown to have anti-cancer activity against numerous cancer types in preclinical studies (see Figure 2)…and unlike most conventional therapies, curcumin is completely non-toxic to normal cells.

FIGURE 2

FIGURE 2

To date, most of the clinical studies on curcumin have been “phase 1 trials,”  which were designed to determine the bioavailability, safety, and early evidence of the efficacy of curcumin. One study demonstrated that curcumin is poorly absorbed across the bowel and into the systemic circulation, but is able concentrate in intestinal tumors quite well (in patients with advanced colorectal cancer who took 3.6 grams/day of curcumin orally for seven days.) 

  • If curcumin is so poorly absorbed into the blood, how could it be effective outside of the gastrointestinal tract? (Read the “epigenetic modulation” section, below, for one hypothesis.)

In a “phase 2 trial” (designed to investigate the effectiveness of curcumin in larger numbers of people, and to further evaluate its short-term side effects and safety) of patients with advanced pancreatic cancer, investigators reported some anti-cancer activity (albeit limited.)

  • Read a nice review of this study by Tina Kaczor, ND, FABNO (11/2010)

Other phase 2 trials with curcumin are either completed or actively recruiting patients with breast cancer, colorectal cancer, pancreatic cancer, and head and neck cancer.

epigenetic modulation“Epigenetic Modulation”:

Epigenetic changes (also known as “modulation”) are changes to DNA that are due to either the addition of chemical groups (i.e. DNA methylation) or protein modifications (i.e. histone modifications) that impact how the DNA is processed. Epigenetic changes, such as these, can make it very easy or very hard to turn on or off various genes.

  • Anti-cancer epigenetic changes are those that turn off (or impair the function) of cancer promoting genes, or those that turn on cancer inhibitory genes.

In addition to all of the anti-cancer mechanisms illustrated in Figure 1 (above), new research suggests that curcumin (and other botanical compounds: EGCG, resveratrol, genistein, etc.) exerts some of its biological activities through anti-cancer “epigenetic” modulation. Investigators hypothesize that epigenetic modulation may help to explain how curcumin is able to affect so many biological processes despite the fact that curcumin is poorly absorbed into the systemic circulation. Epigenetic modifications only require very small concentrations of a compound to have a significant impact on gene expression.

Risks, Side Effects and Interactions:

Curcumin is considered to be a safe supplement, food additive and spice (by the U.S. FDA.) That said, there are still potential side effects, drug interactions and contraindications that you should know about:

  • Doses up to 10g daily of curcumin have not been found to be associated with any signs of toxicity.
  • Curcumin may cause an upset stomach. Dosages of 6g daily have been associated with minor flatulence and a yellowing of the stool.
  • There is a risk of exacerbating existing gallbladder disease. 
  • May cause uterine stimulation (caution is recommended during pregnancy)
  • May increase the risk of bleeding (due to platelet inhibition) when combined with other medications or botanicals such as, aspirin, anticoagulants (blood thinners), antiplatelet drugs, non-steroidal anti-inflammatory drugs, Gingko biloba, garlic, saw palmetto.
  • May decrease the effectiveness of cyclophosphamide and camptothecin.
  • Curcumin may also interact with drugs that are metabolized by the cytochrome P450 enzymes. Check this list of drugs that are also metabolized by cytochrome P450 enzymes. 
  • Patients with gastrointestinal disorders or predisposed to kidney stone formation should also use this supplement with caution.

How Do You Take It?

  • Oral curcumin is poorly absorbed from the bowel. However, the absorption of curcumin can be increased when administered with piperine (an extract from black pepper.) Simply adding piperine to curcumin has been shown to increase curcumin absorption by 2000%!
  • Newer formulations of curcumin are available with greater absorption characteristics (i.e. complexed with piperine, nanoparticles, liposomal formulations, etc.)
  • Taking curcumin with meals can increase its absorption (especially fatty/oily foods: olive oil, avocado, fish oil, milk, seeds, etc.)
  • Curcumin is rapidly cleared from the blood (within 1-4 hours of ingestion, most of it is cleared.) To maintain blood levels of curcumin, it is best to take it in divided doses throughout the day. Dr Andrew Weil recommends taking it three times per day.
  • Dosage: Unfortunately, we don’t know the optimal dosing. That said, doses from 500-3600 mg of curcumin per day have been used in recent studies. For cancer prevention: 400-500 mg per day (The “Curcumin Guru,” Dr Bharat Aggarwal, says he takes 500 mg per day.) During and after cancer treatment: 800-3000 mg per day (divided dose, with meals.) 
    • If you want to take turmeric instead of curcumin, how much turmeric powder would you need to take per day? 1 tablespoon of dried turmeric powder weighs 6.8 grams. The average amount of curcumin (by weight) in turmeric powder is 3.4%. So, 1 tablespoon of turmeric powder is equal to 6.8 grams x 3.4% = 0.231 grams or 231 milligrams. Therefore, if you want to take 500 milligram of curcumin per day, you will need to consume approximately 2 tablespoons of dried turmeric powder.
  • As with any supplement, please first discuss your interest in using curcumin with your oncology team before you start taking it.

Is Whole Turmeric More Potent Than Curcumin Extract?

Synergy of curcumin plus  capecitibine

Synergy of curcumin plus capecitibine

In a personal communication with Dr Bharat Aggarwal, he shared with me some of his unpublished research that helps to shed some light on this question. (As with all unpublished data, it is important to await the results in a peer reviewed journal.)

Study Design:

His researchers implanted a colon cancer tumor into the intestines of a group of mice, waited for 7 days (for the tumors to grow) and then gave the mice (by mouth) either turmeric (at a dose of 0.1 g/kg per day) or curcumin (at a dose of 1 g/kg per day) for 28 days. The curcumin and turmeric were administered with extra virgin olive oil to improve their absorption. To test the possibility of synergy with chemotherapy, he also tested a separate group of mice with either olive oil (“vehicle”), curcumin, capecitibine (a commonly used chemotherapy agent) or curcumin with capcetibine. The mice were euthanized on day 29 and autopsied to measure the tumors.

He repeated the same experiment with a different group of mice, but this time implanted a pancreatic cancer tumor in the mice. He also tested for possible synergistic effects with another commonly used chemotherapy, gemcitibine, employing the same design: olive oil, curcumin, gemcitibine, gemcitibine with curcumin. (results not shown for space constraints)

Synergistic anti-cancer activity

Synergistic anti-cancer activity

Results:

  • Both turmeric and curcumin suppressed the growth of the implanted colorectal and pancreatic cancers however, the turmeric dose required to suppress growth was 1000% smaller than the curcumin dose!
  • The combination of curcumin with the chemotherapy drugs was the most effective in slowing tumor growth for both colon and pancreatic tumors (this demonstrates the synergistic effect.)

In Conclusion:

Both curcumin and turmeric have significant anti-cancer activity against colon and pancreatic cancer in this preclinical study. Curcumin acts synergistically with two commonly used chemotherapy drugs for colon and pancreatic cancers. These data are exciting and if you are undergoing cancer treatment they are worth sharing with your cancer care team to see if taking curcumin or turmeric makes sense and is safe for you.

Here Is My Favorite Curcumin Supplement: 

Additional References:

Curcumin (Linus Pauling Institute)

Curcumin Research (curcuminresearch.org)

Curcumin (research review and references; Examine.com)

Curcumin and Cancer Research (Ajay Goel, PhD, director of epigenetics and cancer prevention at Baylor Research Institute discusses research and controversies surrounding curcumin; 15 minute audio interview by Karolyn A. Gazella, May 2012.)

Turmeric and Frankincense in Inflammation: An Update (Study examines botanical remedies as treatments for various inflammatory conditions; by Jeremy Appleton, ND, September 2011.)

Videos:

Curcumin (Life Extension)

 

Prevention and Treatment of Lung Cancer “Naturally”, Dr Bharat B. Aggarwal, PhD (February 23, 2012)

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About Brian D. Lawenda, M.D.

I am an integrative oncologist. I trained at Massachusetts General Hospital (Harvard Medical School) in radiation oncology and through Stanford-UCLA (Helms Medical Institute) in medical acupuncture. I am the founder of IntegrativeOncology-Essentials.

Comments

  1. Hey Dr L – great summary, thanks. I do take curcumin, but only 2 times per day. Will shift to 3 times per day starting tomorrow! I have a question. Do you know of a researcher or lab that might test whether curcumin affects MTC cancer cells? My cancer is so rare that I know no studies will likely be done on it, but I know that one way they test potential compounds is to test in test tubes/dishes with cancer cells. Not sure who I might inquire about this? I would even pay for the test (and know it is not a proper study).
    I have plenty of tumor tissue and would be happy to donate… :-/

  2. NewAdventuresAhead says:

    I was disappointed to learn that this potential wonder-drug will likely not be a viable option for me since I am scheduled to begin Tamoxifen in three weeks.

  3. debora stav says:

    hi, thanks for the information. i have small cell lung cancer and was treated with chimotherapy and radiation.
    i was told by my physician that they dont have now any possibility to erradicate this kind of cancer.
    anyway i would try to use the tumeric but i didnt understand how much and wich way to take.
    i would really appreciate to receive an answer about this and also if you have any kind of idea about my condition.
    thanks

    • Hi Debora, We are very sorry to hear about your diagnosis. Unfortunately, no one knows the exact amount of curcumin or turmeric to recommend for each individual. Generally, for those with a cancer diagnosis, the range of doses of curcumin to take each day are 800-3000 mg per day (divided doses, with meals.) Make sure to discuss this with your oncology team before you start taking curcumin.

      • debora stav says:

        dr lawenda, thanks for your prompt response. i will talk with my oncology doctor but i dont think i would get any specific answer. he is a very good doctor but he allready told me that he can”t advice me about treatments that dont have a scientific research done. he said to me that to try anything that is not harmfull is ok, but he doesnt know the possible outcome. thanks, and i would really appriciate to hear from you because with this type of cancer any idea will be wecome.
        thanks again

  4. Nadine Wood-Peters says:

    I know from my own research curcumin is something I will take for my Breast Cancer.
    Is there any other supplements I should know about?
    Nadine

    • Hi Nadine. Curcumin is one of my favorite supplements, but there are many others with anti-cancer activity (i.e. EGCG from green tea, medicinal mushroom extracts, vitamin D3, baby aspirin, and many others.) That said, each person has to assess the specifics of their medical history, cancer, staging, other medicines and supplements they are taking, quality/supplier/dose of the supplements and numerous other factors. It’s important to discuss these issues with your cancer care team before you start taking a new supplement. I also recommend that you consider a consultation with an integrative oncologist or other specialist who is very knowledgeable about all of these factors.

  5. alyshia says:

    Is it okay to take both Berberine and Turmeric at the same time? Is it necessary, or, which is more beneficial? I just started taking Berberine as a preventative for several diseases. I am thinking of taking Turmeric, as well. Turmeric spice sprinkled on his food daily has kept my dachshund alive and well after a heartworm diagnosis 2 years ago. It also healed a tumor that came up between his toes and split his foot open. The medication from the vet did not faze it…
    Thank you!

  6. Bertil says:

    If the “vehicle” combo shows the most anti-cancer activity in the picture, then why does the text say that the
    “combination of curcumin with the chemotherapy drugs was the most effective” ???

  7. Laura Loria says:

    Would the interaction of vinblastine and curcumin be considered beneficial to TCC treatment? If taking Deramaxx, would curcumin supplementation be contraindicated? I am asking because my dog is currently undergoing Tx for TCC, and since it’s very similar to human Tx but much less effective, I’m looking for ways to improve his treatment regimen. Thank you!

  8. Guilherme Moreira says:

    I would like to know about curcumin in treating kidney inflammation.

    Thank you in advance.

    Guilherme, from Brazil.

  9. Guilherme Moreira says:

    Can I take curcumin and pentoxiflyline at the same time ?
    They are antiinflamatory and immunosuppressant substances.

    Thank you..

    Guilherme

  10. Lynda says:

    Is it ok to take cucumin while also taking strong antibiotics?

  11. Ann says:
  12. zee says:

    Hi Dr. Lawenda
    I have uterine papillary serous carcinoma. Stage 1. Had total hysterectomy in 2011 but came back in my lymph nodes in Sep. 2013. I have been treated at Sloane Kettering in New York. The doctor used cisplatin and Taxol. After three treatments and a CT scan, she said that I am cancer free. But will have to go through all six cycles of chemo.
    I have been taking turmeric capsules (95%) 450 mg. since four five years., twice a day. zyflamend whole body two morning two evening. Green tea extract two morning two evening. Cat’s claw one morning one evening. Astraglus two morning. Rodialia two morning.. Aloe Arborescens three table sp. three times a day. IP6 two in morning. D3 6000 IU, B complex 100, once. I started all these since Sep. 2013 when I was told that I had cancer.
    In the maintains and preventive phase I would like to continue with these and will add Matiak D Fraction mushoom from next week two morning two evening.
    I would greatly appreciate any recommendations

  13. Ed Dinnage says:

    Hi Dr L.

    I just want to thank you SO MUCH that you are giving your time and expertise to folks who are going through a very rough time answering complex questions for free. You truly are an inspiration and an example of what it is to be not just an excellent doctor and researcher but a truly committed healer and human being.

    Thanks.

    Ed, England.

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