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Table of Contents
Introduction..............................................................................................................................................2
Herbal Medications................................................................................................................................3
History:..................................................................................................................................................4
Progress in the use of herbs to cure cancer:..............................................................................5
The advantages of herbal medicine treatment:...........................................................................7
Issues with the herbal method:.......................................................................................................7
Modern methods:....................................................................................................................................8
Advantages of the current method:...............................................................................................8
Downsides of the modern method:................................................................................................9
Integrating herbal medicine with modern medicine:...................................................................10
Key Concerns:...................................................................................................................................12
Other potential concerns:...................................................................................................................14
More research needed:.......................................................................................................................15
Mechanisms of Action and Preclinical Pharmacology............................................................15
Studies on the Efficacy and Safety in Clinical Practice..........................................................16
CONCLUSION........................................................................................................................................17
References.............................................................................................................................................18

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Introduction

In addition to transformation, dysregulation of apoptosis, proliferation, invasion,

angiogenesis, and metastasis, cancer is a hyper proliferative illness. Alarming data

show that cancer kills more people yearly than HIV/AIDS, malaria, and TB

combined, with more than 7 million fatalities globally. (DeSantis, 2014) By 2020, it

is predicted that there will be 15 million new instances of cancer annually, 70% of

which will occur in emerging nations. Patients who get an advanced cancer

diagnosis must face the statistical fact that only a tiny percentage of these patients

may be cured with standard treatment. The desire of these patients to look into

complementary therapies, such as herbal medicine, is often greeted with the

doctor's skepticism.

When deciding how to include herbal medicine in modern medical practices,

especially cancer medicines, it is essential to consider the interconnected issues

of quality, safety, and efficacy. Therefore, it is crucial to utilize only high-quality

herbal products. Product quality ranges from very high to severely terrible due to

intrinsic, extrinsic, and regulatory factors. The lack of pharmacological and clinical

data on most herbal medicinal items is a critical hurdle in properly integrating

herbal medicines into mainstream medical practices. Plants with little to no

pharmacological or, more importantly, clinical evidence need to have research

undertaken. Adverse occurrences, such as drug-herb interactions, need to be

recorded if we're going to promote the secure incorporation of effective herbal

medicine into standard medical practices.

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Herbal Medications

Herbal therapy is a holistic approach that considers the patient's emotional,

mental, and spiritual well-being. All naturopathic methods include the whole

person, including physical, mental, and spiritual health. There are usually no "drug

effects" or harmful side effects associated with herbal medicines. Herbal remedies

are widely utilized, but some of them may be damaging to your health. When

cases of poisoning due to medicinal plants have been reported, it is usually

because the plants were misdiagnosed in their raw state or because they were

prepared and given incorrectly by inexperienced personnel. Several plant-based

therapies have therapeutic benefits that are comparable to those of

pharmaceuticals. Although laws in numerous countries, including Britain, restrict

the general public's access to the plants used by herbalists in medicinal

treatments, herbalists continue to utilize them. The plant digitalis is an example of

this, and it is rare. Most medicinal plants have antioxidant capabilities, but the

mechanisms by which they function are not well understood. Cancer, Alzheimer's

disease, atherosclerosis, diabetes, and other cardiovascular problems are only

some of the illnesses proven to benefit from this plant property. Due to their

antioxidant characteristics, herbal remedies may also mitigate the adverse effects

of drugs and other potentially dangerous substances.

History:

Traditional Japanese herbal medicine, known as Kampo, originated in Japan

but was imported to the country from China 1,500 years ago (Motoo et al., 2011).

Kampo medicines are covered by Japan's National Health Insurance and are

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prescribed by more than 80% of Japanese doctors. In recent years, researchers

have used both animal models and human clinical trials to examine the impact of

several Kampo medicines on the side effects of chemotherapy. In this article, we

discuss the current state of Kampo medicines and their underlying mechanisms for

treating or preventing chemotherapy-induced side effects.

More and more research suggests that Kampo medicines may help reduce or

eliminate some of the unpleasant side effects of chemotherapy. Because each

Kampo drug comprises several compounds, further basic research is needed to

determine which molecules are responsible for the therapeutic advantages and the

underlying mechanism of action. Even though defining acceptable and subjective

goals may be challenging, placing Kampo medicines in placebo-controlled,

double-blind, randomized clinical trials will give definitive evidence.

Progress in the use of herbs to cure cancer:

Dioscorea bulbifera leaves were collected at Endau Rompin, Johor, Malaysia,

and analyzed for their secondary metabolites, antioxidant, and anti-proliferative

activity by M. M. Mainasara. The results showed that the plant extracts exhibited

cytotoxicity and good antioxidant activity against the breast cancer cell lines MCF-

7 and MDA-MB-231. Cell cycle arrest and apoptosis are implicated in the

mechanism of action. The team found that the plant contains at least 39

metabolites, some of which may enhance bioactivity when combined.

Berberine (BBR), an isoquinoline alkaloid, possesses anticancer effects, as

reported by C. Zhu et al. BBR has been demonstrated to have several positive

health effects. These include antibacterial, cardioprotective, and anti-diabetic

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properties. They look at the suppressive effects of BBR on MCF-7 and MDA-MB-

231 breast cancer cells and provide evidence for the miR-214-3p-based

mechanisms behind them. Researchers found that BBR may inhibit stem cell

transplant by increasing miR-214-3p expression and lowering the molecule's

growth-promoting activity in MCF-7 and MDA-MB-231 breast cancer cells (SCT).

Because of its role in BBR's anti-cancer effects, the miR-214-3p/SCT axis might

be a valuable therapeutic target.

T. Tuy-on et al. investigated the efficacy of many traditional Thai cancer

remedies in inhibiting the growth of breast, cervical, and ovarian cancer cells in a

laboratory dish extracts were clustered into groups using hierarchical cluster

analysis ps according to their cytotoxicity (HCA). So that they could foretell how

the plant's bioactive components would interact with the plant's biological

activities, they devised this method. Almost two-thirds of the extracts tested

showed activity against all cell lines, and eleven plants often used in TTM were

demonstrated to be active against at least one cancer cell type. The TTM theory

suggests that even if the other plant extracts are not considered active, they may

be necessary as supportive treatment. They advocated for more investigation (in

vivo study) to determine the exact efficacy of the herbal remedies.

Herbal remedies' primary goals are:

 Cancer primary prevention is crucial for those with a significant family history of

the disease.

 The goal for this group is consequently to avoid a cancer recurrence due to

secondary presentation.
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 increase the body's defense mechanisms

 To lessen the adverse effects brought by standard treatments like chemotherapy

or radiation therapy

 Many people are forced to turn to alternative remedies in the latter stages of

cancer after traditional therapy has failed.

Herbal medicine fights cancer very differently from traditional chemical

treatments since there is no DNA mutation in the survivor cell. Natural substances

combat cancer by boosting the immune system, detoxifying the body, preventing

further toxin buildup, squelching free radicals that cause mutational changes

resulting in cancer formation, and supporting all targeted organs, especially those

directly impacted by cancer. The optimal environment in the body produces a high

level of oxygen and temperature, a metabolism rate, low sugar levels, and a high

alkalinity space, which is another advantage of herbal medications in addition to

producing an unfavorable environment for cancer development.

The advantages of herbal medicine treatment:

One of the oldest and most widely used alternative medicine systems, Chinese

medicine (TCM), dates back more than three thousand years and is still widely

practiced today.

According to TCM, yin represents "the earth," "the cold," and "the feminine,"

whereas yang represents "the sky," "the heat," and "the masculine." When yin and

yang are balanced, health results.

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Traditional Chinese Medicine (TCM) may be 3,000 years old, yet it is still

evolving and gaining popularity worldwide, used for disease prevention and

treatment.

Herbal medicine is a big part of traditional Chinese medicine (TCM), but it also

uses many other uses. Manyingko Biloba and garlic are the three most widely

used herbs.

Issues with the herbal method:

Herbs used in TCM may cause adverse reactions in certain persons. There are

also less safeguards in place to assure the safety of herbs. For instance, any

medication you purchase from a pharmacyergone rigorous testing to ensure it is

both practical and safe for use; practically no way you can be so sure about your

natural cures.

Modern methods:

These pathways and characteristics are essential for discovering new cancer

treatments or creating drugs that target certain tumor types. Chemotherapy is

often regarded as the most effective and standard method of treating cancer,

whether done alone or in combination with radiation. Chemotherapy drugs typically

destroy tumor cells by generating reactive oxygen species. Hormonal therapies

are commonly used for cancer malignancies and are cytostatic because they

inhibit tumor growth by reducing the hormonal growth factors that act via the

hypothalamic-pituitary-gonadal axis (HPGA), blocking hormone receptors, and

reducing the production of adrenal steroid hormones.

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Medical professionals, such as "physical therapists, physician assistants,

psychologists, and registered nurses," also engage in what is known as "modern

medicine" or "mainstream medical therapy," which is often provided by an MD or a

doctor of osteopathic medicine (a DO).

Advantages of the current method:

The rapid development of contemporary medicine is remarkable. As you relax

on the couch, you may notice an increase in commercials for new treatments;

these medicines have contributed to decreases associated with cancer,

cardiovascular disease, and stroke. The truth is that the death rate from

cardiovascular disease has dropped by 60% since 1970 due to advances in

treatment. The death rate from AIDS-related causes has fallen by more than 75%

since 1995, when it was at its peak.

Downsides of the modern method:

However, opponents of modern medicine are eager to point out that there is a

pill for just about every ailment. We can rapidly develop new therapies, and the

improvements in health brought about by these medicines have extended our

lifespans. Nonetheless, do our lives improve?

Because of developments in medicine, we now have access to surgeons

trained to use robotic equipment. Our cardiothoracic surgeons can do open heart

surgery with a little incision. Urologists, cardiologists, nephrologists, oncologists,

and podiatrists are all on staff.

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The toxicity of chemotherapy drugs is an issue that must be addressed when

using allopathy or traditional medicine to treat cancer. Several potential

medications for cancer treatment and many of these uses have been suggested.

There are now four classes of plant-based anticancer drugs: the vinca alkaloids

(vinblastine, vincristine, and vindesine), the epipodophyllotoxins (etoposide and

teniposide), the taxanes (paclitaxel and docetaxel), and the camptothecin

derivatives. Natural chemicals found in plants have shown promise as potential

chemoprotective agents against cancer and as starting points for new therapeutic

approaches. Many plant-based compounds with potential anti-cancer activities

have been suggested by Taneja and Qazi.

Integrating herbal medicine with modern medicine:

When deciding how to include herbal medicine in modern medical practices,

especially cancer medicines, it is essential to consider the interconnected issues

of quality, safety, and efficacy. Therefore, it is crucial to utilize only high-quality

herbal products. Product quality ranges from very high to severely terrible due to

intrinsic, extrinsic, and regulatory factors. Species variation, organ specialization,

diurnal and seasonal changes, and other inherent factors may all affect the

qualitative and quantitative accumulation of active chemical components in the

source medicinal plants. Environmental factors, field collection practices (such as

cultivation, harvest, post-harvest transportation, and storage), manufacturing

processes (such as accidental contamination and replacement and intentional

adulteration), and so on all have an impact on the quality of herbal medicinal

products. Source plant materials, including bacteria, microbial toxins, heavy

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metals, environmental pollutants, and finished goods containing foreign hazardous

plants or synthetic therapeutic compounds, may both lead to undesirable effects.

Medically useless products may have done so because of poor quality raw

materials or manufacturing. Herbal medication quality may also be associated with

the regulatory processes involved in their production. In many countries, the

quality of herbal remedies varies widely since the industry is not controlled.

Product quality can be improved by implementing controls, beginning with the

procurement of medicinal plants using Good Agricultural Practices (GAPs),

continuing through the production of finished botanical products using Good

Manufacturing Practices (GMPs), and continuing through post-marketing quality

assurance surveillance. The lack of pharmacological and clinical data on most

herbal medicinal items is a critical hurdle in properly integrating herbal medicines

into mainstream medical practices. Plants with little to no pharmacological or,

more importantly, clinical evidence need to have research undertaken. Adverse

occurrences, such as drug-herb interactions, need to be recorded if we're going to

promote the secure incorporation of effective herbal medicine into standard

medical practises.

Incorporating herbal medicine into modern medical practises, such as cancer

therapy, should be done rationally and on a scientific basis to address the

interconnected problems of quality, safety, and efficacy.

The People's Republic of China has long defended its medical education

system, which requires Western-trained doctors to take an official course in

traditional Chinese medicine (TCM) to ensure they are conversant with the

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necessary TCM practises while providing Western pharmaceuticals. However,

further research is needed before it may be used successfully in therapeutic

settings. Over the past two to three decades, Western countries like the United

States, Australia, Canada, and members of the European Union have increasingly

turned to herbal medicine as a form of complementary and alternative medicine

(CAM) or phytomedicine. This has spawned a multibillion-dollar industry,

professional and trade organizations, national and international practice and

research conferences, and specialized integrated medicine practices and clinics.

As a result of these shifts, discussions regarding how to include complementary

and alternative medicine (CAM), especially herbal treatments, into mainstream

medicine have been ongoing across the globe over the last several years.

However, using an evidence-based approach, most herbal treatments have not

been shown to be efficacious or safe. The scientific, cultural, educational,

economic, and legal communities all face obstacles that must be overcome. Its

chapter addresses the current status of herbal medicine's incorporation into

medical treatment and the significant scientific problems or components that

impact this integration.

Key Concerns:

Herbal medicine is being utilized, either on its own or in combination to

conventional medication, to enhance patients' health and well-being. Twenty-five

percent of adults in the Australian state of Victoria used herbal medicine between

2006 and 2007, according to a recent demographic study of 2526 people. These

findings were published in 2008 (Zhang et al.). About one-fifth, or an estimated

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38.2 million people, used herbs and supplements in the United States in 2002, as

reported by the National Health Interview Survey, which polled 31,044 members of

the civilian noninstitutionalized population. As Kennedy (2005) notes. To date, 44

academic medical centres in the United States and Canada are members of the

Consortium of Academic Health Facilities for Integrative Medicine, which was

established in 1999. The Integrative Medicine Research Consortium (IMRC) has

been working hard to establish norms for CAM research and methods for

integrating CAM knowledge (including herbal medicines) into medical school

curricula.

There are currently thousands of different herbal medicines available as

therapeutic agents from TCM and other CAM traditions across the world.

However, few of these products have undergone randomized clinical trials (RCTs)

to determine their efficacy and/or safety in accordance with the ICH Good Clinical

Practice Guidelines. As with multicomponent herbal treatments, randomized

controlled trials have been documented in the literature more often in recent years

than they were in the past (World Health Organization 2004). Most of the clinical

research on herbal medications that has been published to far has had

questionable quality due to a number of factors that have cast doubt on the validity

of the findings. An assessment of 206 RCTs on herbal medicine published in

Medline between 1966 and 2003 found that important methodological features of

RCTs, such as allocation concealment, formulation of the allocation sequences,

and intention-to-treat analyses, were underreported. About 25% of the trials in

these studies adequately reported blinding, while only 10% adequately reported

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producing random allocation sequences. A prior study of 2938 randomized

controlled trials (RCTs) on TCM published between 1980 and 1997 also indicated

that the majority of these studies had methodological errors. Less than one-fifth of

the trials blinded participants, most included fewer than 300 patients, utilized

inadequate controls, measured outcomes quantitatively, and had limited time for

analysis.

Numerous in vitro and in vivo studies have corroborated the traditional

therapeutic claims of herbal treatments. However, there are no thorough

assessments of the study procedures or the data validation and analysis.

Additionally, the transfer of an herbal medicine's biological/pharmacological impact

shown in vitro and/or in vivo to human therapeutic usage may fail on account of

species differences or other mitigating variables.

As with the preclinical biological or pharmacological issues, the quality of the

herbal products may affect the clinical findings, which in turn may affect their

effective adoption into EBM. Depending on the maker and the environment, herbal

remedies might have widely varying levels of quality. Inherent features such as

species differences, organ specialization, diurnal and seasonal changes, and more

may affect the quality and quantity of the physiologically or pharmacologically

active chemical components created and/or stored in the plant. Extrinsic variables

that affect herbal medicine quality include environmental conditions, cultivation

and field collecting methods, post-harvest handling, storage, production,

accidental contamination, substitution, and purposeful adulteration.

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Other potential concerns:

Further safety considerations affecting the incorporation of herbal medicine into

modern medicine include cultural and behavioral contexts, as well as good

communication on its use among patients, conventional medical practitioners, and

herbal medicine practitioners. As time has progressed and more scientific

research data has been published, we have begun to see promising evidence that

meets the EBM requirement. Therefore, some conventional doctors may have

negative opinions and false beliefs regarding herbal medicine. However, clinicians

have serious concerns about the fact that many people who use herbal

medications also use conventional therapy without informing their doctors. Herb-

drug interactions may occur due to misunderstandings that may have been

avoided with better communication.

Half of herbal remedy users in the aforementioned study of 2526 Australian

adults used more than one remedy on the same day. About half of those people

who used herbal medicines really told their physicians about it. It's hardly shocking

that this happened; in the United States, only about a third of people who use

herbal supplements tell their doctors about it (Kennedy, Wang, and Wu 2008). In

addition, this study found that people of colour are more prone to keep their

supplement and herbal medicine usage a secret (Kennedy, Wang, and Wu 2008).

The safe incorporation of herbal medicine into evidence-based medical therapy

may benefit from a greater understanding of the reasons of nondisclosure, and

clinicians may be able to offer better care for patients as a result.

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More research needed:

Using quality assurance and control measures, herbal medication quality may

be standardized.

The "ground-to-table" method of quality assurance (QA) for herbal medicine

used in integrative medicine encompasses the whole process, from the collection

of the source material through the development of the therapeutic formulation.

Therefore, whenever a certain plant component is acquired by GACP, either

cultivation or field collection, it should undergo a quality assurance/quality control

research.

Mechanisms of Action and Preclinical Pharmacology

Panax ginseng is only one example of a plant with several pharmacological

properties. Thus, it has been proposed that quality-assured standardization be

mandated for all future clinical and laboratory studies (Harkey et al. 2001).

Preclinical pharmacological screening for safety and efficacy is necessary for

herbal treatments being researched for integrative therapy, just as it is for single-

molecule pharmaceutical therapies. However, a chemical that is active in animals

but absolutely inert in humans may not have the same biological response to a

therapeutic substance. However, acute and/or chronic toxicity models in animals

serve as reliable indicators of a drug's safety. Animal models are often employed

in modern practice for toxicity testing, both acute and chronic. There is a need for

the development of reliable toxicity testing protocols before herbal compounds and

the products made from them can be evaluated adequately. Many plants have

been discovered to collect harmful heavy metals including lead, mercury, and

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arsenic; thus, it is important to require testing for their presence in herbal

remedies. Therefore, preclinical, pharmacological, and safety investigations are a

critical step in the scientific integration of herbal medicines into the paradigm of

evidence-based healthcare.

Studies on the Efficacy and Safety in Clinical Practice

Clinical studies on the efficacy and safety of herbal medicine should essentially

adhere to the context-specific elaborations of the CONSORT statement (Gagnier

et al. 2006a, b). While it is important to record the standard elements of RCTs

(such as randomization, blinding, and analysis) that are known to influence the

evaluation of treatment effects, additional considerations must be taken to meet

the unique difficulties of completing trials including herbal medicines.

However, it is important to consider the unique qualities of herbal medications

while conducting a systematic review and meta-analysis of the clinical data. There

is a wide range of herbal medications available, each with its own unique

processing, source (including soil and climate), composition, dose, and storage

factors.

CONCLUSION

It was announced that "the two systems of traditional and Western medicine

need not compete" during the 2008 World Health Organization Congress on

Traditional Medicine in Beijing, China (World Health Organization 2008). At the

Congress, the WHO and other interested parties were pushed to implement

national health systems that embrace TM. Integrating herbal therapy into modern

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clinical practice, however, requires an EBM approach. Before conducting a clinical

evaluation of any herbal medicine, be it a single compound, a combination of

herbal ingredients, or a complex herbal formula based on historical evidence of

use, the quality assurance and quality control (QA/QC) in the source material

acquisition, processing, and manufacturing of the products under GMP must be

addressed to ensure efficacy and reproducibility. In addition to utilizing

scientifically incontestable efficacy measurements, clinical studies should monitor

and report adverse events, such as suspected drug-herb interactions. Once the

safety and efficacy of herbal medicine is shown in accordance with accepted

scientific standards, it will likely be included into evidence-based clinical practice.

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