Botanical for Cancer Tx side effects

Question 1

Arctium lappa; Asteraceae

Answer 1

Part— root, leaves (poultice); seed (TCM);
Constituents (root)— lignans– inulin, arctigenin; volatile oils; bitter; tannin; fiber;
Actions— alterative; digestive bitter; cholagogue;
Other— dry scaly skin– psoriasis, eczema, dandruff;
Posology— decoction 1 tsp/cup TID; ⌀ 20-60 gtt TID;
Pregnancy and Lactation— no data;
TCM— disperses wind heat; clears heat and relieves toxicity;

Question 2

Brassicaceae

Answer 2

Brassica carinata, B. juncea, B. oleracea, B. napus, B. nigra, B. rapa;
Part— aerial greens; root (turnip, rutabaga); seed (mustard, rapeseed);
Constituents— phenylthiocarbamide (bitter or tasteless); glucosinolates;
Actions— estrogen detoxification metabolism– phase I; antioxidant;
Posology— ad libitum;
Caution— hypothyroid; (cooking it more lessens this)

Question 3

Cannabis indica, S. sativa, C. ruderalis,Cannabinaceae

Answer 3

Part— flowering tops (female); seeds;
Constituents— > 500 known; > 100 phytocannabinoids– delta-9-tetrayhdrocannabinol (THC), cannabidiol (CBD); high genetic plasticity;
Actions— CB1 psychoactive; CB2 immune modulating;
Other— withdrawal from EtOH, opiates, barbiturates; nausea & vomiting of chemotherapy and radiotherapy; appetite stimulation;
Dose— ⌀ 10-20 gtt QD/BID/ TID; oil 0.5-10 mL; brownies (anything oral takes longer and usually people say they don’t feel anything and keep eating until they have hyperemesis); smoked;

Caution— Canada– ND only THC; MD CBD and THC are prescription; oral ingestion can have delayed reaction  nausea & vomit if over dosed;
Caution— USA– CBD OTC; THC prescription in some jurisdictions;
Education-– focus on constituents NOT species (Russo, MD)
Toxicity— risk of psychosis/schizophrenia in susceptible individuals;
TCM— moistens lungs; constipation in the elderly; absent mindedness;

Question 4

Chimaphila umbellata; Ericaceae

Answer 4

Part— aerial arts
Constituents— arbutin  hydroquinone + glycoside; organic acid; methyl salicylate;
Action— genitourinary antiseptic; KI tonic;
Other— prostatitis; inguinal lymphadenopathy; LUTS; scanty urine;
Posology— ⌀ 15-20 gtt Q 1-4 h, TID;
Caution— most effective in alkaline urine;

Question 5

Actea racemosa; Ranunculaceae

Answer 5

Nomenclature— Macrotys racemosa; Cimicifuga racemosa;
Part— root;
Constituents— triterpene glycosides; isoflavones; tannins; volatile oils;
Actions— estrogen mimetic; dysmenorrhea; menopause sx and mood change;
Indications— when estrogen is contraindicated;
Dose— ⌀ 20-60 gtt TID; standardized extract 2.5% triterpene glycoside 250 mg TID; dosage timing is sx based;

Caution— not alter or elevated estrogens;
Pregnancy and Lactation— historically used safely;
Combinations— Hypericum peforatum;

Question 6

Crataegus oxycantha; Rosaceae

Answer 6

Part— leaf; berry;
Constituents— flavonoids; proanthocyanidins; cardiac amines; minerals;
Actions— cardiac tonic;
Other— cardioprotective during chemo/radio therapy;
Dose— ⌀ 5-120 gtt TID; solid extract ¼ - ½ tsp BID, TID; standardized extract 1.8% vitexin-4-rhamnoside or 10% procyanidin 250 mg TID;
TCM— SP, ST, LV; warming;

Question 7

Gentiana lutea; Gentianaceae

Answer 7

Part— root;
Constituents— bitter glycosides; xanthones; volatile oils; phenolic acids;
Actions— bitter digestive; sialagogue; hepatic; cholagogue;
Indications— anorexia; weight loss;
Posology— ⌀ 1-5 gtt at start or immediately before meals;
Caution— irritable gastritis;

Question 8

Inula helenium; Asteaceae

Question 9

Passiflora incarnata; Passifloraceae

Answer 9

Nomenclature— P. coerulea;
Part— whole plant;
Constituents— alkaloids; cyanogenic glycosides; flavonoids; minerals;
Actions— binds GABA-A receptors; anxiolytic;
Other— insomnia from nervousness/worry; nervous headache; shock; opiate withdrawal; nervous exhaustion;
Posology— ⌀ 10-120 gtt TID; infusion 2g/150 mL;
Caution— 200 mg harmaline considered toxic;

Question 10

Prunus africana; Rosaceae

Answer 10

Nomenclature— Pygeum africana;
Endangered— as of 1995;
Part— bark;
Constituents— phytosterols; fatty acids; organic acids;
Actions— shrink enlarged prostate; induce prostate apoptosis;
Other— anti-androgen in T  DHT (inhibits 5-alpha-reductase); inhibits IGF-1; blocks leukotriene synthesis; dysuria;
Posology— ⌀ 20-50 gtt TID; standardized to 14% triterpenes, 0.5% N-docosanol 75-200 mg QD;

Question 11

Ricinis commununis; Eophorbiaceae

Answer 11

Part— der-ricin oil from seed;
Constituents— fixed oils; protein; alkaloids; lectins;
Action— constipation; wound healing; cysts; lymphadenopathy;
Other— post surgical scar therapy; GI discomfort; MSK inflammation; dry eyes; cysts; swellings;
Posology— oil 5-20 mL oral for purgation; oil 5-10 gtt topical QD + low heat; 1 gtt per eye at bed;
Combinations— 5% Lugol (50 gtt in 50 mL oil); mixed tocopherols in oil;

Toxicity— no known antidote to ricin (toxalbumin);  severe gastroenteritis and death over 2-5 d;

Question 12

Scutellaria baicalensis; Lamiaceae

Answer 12

Part— aerial when flowering;
Constituents— flavonoids; volatile oils;
Actions— anti-inflammatory; respiratory infections; hepatoprotective;
Other— antiviral; nervine;
Cell lines— prostate, breast, hepatocellular, colon, and blood cancers;
Posology— infusion 1-2 g TID; 100 – 2800 mg TID; ⌀ 20-40 gtt TID;
Toxicity— may cause diarrhea over time;

Question 13

Serenoa repens; Palmaceae

Answer 13

Part— fruit (date);
Constituents— steroidal saponins;
Actions— anti-BPH; androgen excess (PCOS);
Other-– female complications of chemo/radiotherapy;
Posology— standardized to 85-95% fatty acids 320 mg BID, TID, QID;
Caution— may upset empty stomach so take with food;

Question 14

Silybum marianum; Asteraceae

Answer 14

Part— seed;
Constituents— flavolignans– silymarin; bitter; sterols;
Actions— hepatoprotective; cholagogue; bitter; galactagogue;
Other— hepatitis; cirrhosis; fatty liver; EtOH withdrawal; hepato-splenomegaly; acetaminophen overuse;
Dose— standardized 80% silymarin 175-600 mg QD/BID; decoction poorly extracts silymarin;
Caution— ⌀ impractical due to high EtOH required for effective extractions;

Question 15

Taraxacum officinale; Asteraceae

Answer 15

Part— leaf; root;
Constituents—
leaf– sesquiterpene lactones; bitters; carotenoids; flavonoids;
root– sesquiterpene lactones; triterpenes; bitters; vitamins; minerals;
Actions—
leaf– diuretic (K+ sparing); choleretic; nutrient aperient;
root– choleretic; cholagogue; bitter digestive; aperient; antirheumatic; leukemic cancers;
Posology—
leaf– infusion 1-2 tsp/cup TID; ⌀ 20-120 gtt TID;
root– decoction 2-3 tsp/ cup TID; ⌀ 2- 60 mL TID; 25g equivalent TID;
caution— impacted gall stones; many GI CI/Cautions are speculative and not case based;

Question 16

Urtica dioica; Urticaceae

Answer 16

Part— leaf; root;
Constituents— organic acids; flavonoids; formic acid– histamine;
Actions— BPH; anti-inflammatory; allergic rhinitis;
Other— CNS relaxant;
Posology— ⌀ 5-40 gtt TID; decoction1-3 tsp /cup TID;
Toxicity— formic acid causes dermatitis– red, raised, irritated;

Question 17

Valeriana officinalis; Valerianaceae

Answer 17

Part— root;
Constituents— volatile oils; valepotriates; organic acids; monoterpenes;
Actions— sedative; anodyne;
Other— despondency; insomnia; depression; hypochondria; nervous headache; binds GABA-A receptors;
Posology— ⌀ 15-60 gtt TID, for insomnia divide into dinner and bedtime doses, repeat a dose if awakens; standardized extract 0.8% valerenic acid or valepotriate 1-1.5% 160 mg BID;

Caution— may stimulate alertness in some; centrally CNS medications;

Question 18

Verbascum thapsus; Scrophulariaceae

Answer 18

Part— leaf year 1 or 2; flower in second year;
Constituents— bioflavonoids; essential oils; saponins; mucilage; resin;
Actions— antitussive; respiratory demulcent; mild expectorant;
Other— dry cough; hoarseness; irritated GI/GU; in oil for otitis media; topical macerated for rheumatic joints, piles, mumps, sore throat, tonsillitis; asthma; TB;
Posology— ⌀ 10-60 gtt TID;

Caution— smoking for asthma may case vertigo with Datura stramonium; KNO3 ;

Question 19

Zingiber officinalis; Zingiberaceae

Answer 19

Part— root;
Constituents— volatile oils; oleoresins; starch; protein;
Actions— warming stimulant; digestive stimulant; carminative;’
Other— weak digestion; colic; post-operation nausea, vomiting;
Posology— ⌀ 5-30 gtt TID; infusion 1 tsp/cup; dried/preserved root chewed PRN;
Caution— contact dermatitis in some;

Question 20

Which botanical is indicated for shrinking an enlarged prostate and inducing prostate apoptosis?

A. Serenoa repens (Saw Palmetto)
B. Prunus africana (Pygeum)
C. Urtica dioica (Stinging Nettle)
D. Chimaphila umbellata (Pipsissewa)

Answer 20

Answer: B. Prunus africana (Pygeum)
Rationale:

Correct Answer (B): Prunus africana contains phytosterols and fatty acids, which are known to shrink the prostate, induce apoptosis, and inhibit 5-alpha-reductase, reducing DHT levels.
A (Serenoa repens): While also effective in managing BPH symptoms, its primary action is through androgen modulation rather than apoptosis.
C (Urtica dioica): Primarily used for anti-inflammatory effects in BPH but lacks direct evidence of inducing apoptosis.
D (Chimaphila umbellata): More commonly used as a genitourinary antiseptic and lymphatic support, not specifically for prostate apoptosis.

Question 21

Which herb is hepatoprotective and indicated for liver conditions such as hepatitis and fatty liver disease?

A. Silybum marianum (Milk Thistle)
B. Arctium lappa (Burdock)
C. Gentiana lutea (Gentian)
D. Scutellaria baicalensis (Baikal Skullcap)

Answer 21

Answer: A. Silybum marianum (Milk Thistle)
Rationale:

Correct Answer (A): Silybum marianum contains silymarin, which is a potent hepatoprotective compound that aids in liver regeneration and detoxification.
B (Arctium lappa): While alterative and mildly supportive of detoxification, its focus is broader on skin and systemic elimination.
C (Gentiana lutea): A digestive bitter that supports liver function but is not specifically hepatoprotective.
D (Scutellaria baicalensis): Though hepatoprotective, it is more commonly associated with anti-inflammatory and antiviral properties.

Question 22

Which herb is primarily indicated for nausea and vomiting related to chemotherapy?

A. Zingiber officinale (Ginger)
B. Cannabis sativa (Cannabis)
C. Passiflora incarnata (Passionflower)
D. Taraxacum officinale (Dandelion)

Answer 22

Answer: B. Cannabis sativa (Cannabis)
Rationale:

Correct Answer (B): Cannabis sativa contains CBD, which has anti-emetic properties, particularly useful in chemotherapy-induced nausea.
A (Zingiber officinale): Effective for general nausea and vomiting but less potent for chemotherapy-related cases.
C (Passiflora incarnata): Used primarily as a nervine and anxiolytic, not for nausea.
D (Taraxacum officinale): Supports digestion but is not indicated for nausea.

Question 23

Which herb is known for its cardio-protective effects during chemotherapy?

A. Crataegus oxycantha (Hawthorn)
B. Eleutherococcus senticosus (Siberian Ginseng)
C. Panax ginseng (Asian Ginseng)
D. Astragalus membranaceus (Astragalus)

Answer 23

Answer: A. Crataegus oxycantha (Hawthorn)
Rationale:

Correct Answer (A): Crataegus oxycantha is a cardiac tonic with evidence supporting its role in protecting the heart during chemo/radiotherapy.
B (Eleutherococcus senticosus): Adaptogen but not specifically cardioprotective.
C (Panax ginseng): While it has immune-modulating properties, it is not used for cardio-protection.
D (Astragalus membranaceus): Known for immune support, not specific to heart health.

Question 24

Which herb acts as an androgen modulator, beneficial for conditions like PCOS and BPH?

A. Serenoa repens (Saw Palmetto)
B. Scutellaria baicalensis (Baikal Skullcap)
C. Chimaphila umbellata (Pipsissewa)
D. Ricinus communis (Castor Bean)

Answer 24

Answer: A. Serenoa repens (Saw Palmetto)
Rationale:

Correct Answer (A): Serenoa repens modulates androgens by inhibiting 5-alpha-reductase, reducing DHT and androgen excess, beneficial in PCOS and BPH.
B (Scutellaria baicalensis): Anti-inflammatory and hepatoprotective but not an androgen modulator.
C (Chimaphila umbellata): Focused on genitourinary antiseptic properties.
D (Ricinus communis): Primarily used for wound healing and lymphatic support, not androgen modulation.