Open access peer-reviewed chapter - ONLINE FIRST
Abstract
This chapter comprehensively reviews numerous herbs and spices’ anticancer properties and mechanisms. Curcumin, derived from turmeric, exhibits cytotoxic, anti-proliferative, anti-invasive, and anti-metastatic effects against diverse cancer types by interacting with pathways controlling inflammation, survival, cell cycle, apoptosis, and angiogenesis. Ginger and its active compounds demonstrate antioxidant, anti-inflammatory, and anti-tumor activities in breast, skin, lung, and gastrointestinal cancer models, potentially through free radical scavenging, inhibiting inflammation, disrupting microtubules, and altering apoptotic gene expression. Garlic organosulfur compounds induce apoptosis, cell cycle arrest, and antioxidant activity in various malignancies by affecting signaling proteins like STAT3 and VEGF. Basil, caraway, cinnamon, clove, coriander, dill, cumin, rosemary, saffron, thyme, and oregano extracts restricted growth, prompted cell death and beneficially impacted proliferation, metastasis, and angiogenesis markers across numerous cancer cell lines. Black pepper, cayenne pepper, green tea, and milk thistle constituents displayed cytotoxic, immune-enhancing, and chemopreventive actions against diverse human cancer models through modulation of pathways connected to oxidative stress, chronic inflammation, detoxification, and malignant proliferation. The immunomodulatory herbs astragalus, ginseng, echinacea, St. John’s wort, and cat’s claw also exhibited direct anticancer effects in specific cellular and rodent experiments. Many dietary phytochemicals show promising anticancer potential, but more clinical trials are needed to substantiate therapeutic efficacy in humans.
Keywords
- anticarcinogenic agents
- phytochemistry
- plant extracts
- apoptosis
- herbal medicine
- curcumin
- garlic
- ginger
- capsaicin
1. Introduction
The use of herbal medicine and natural products to treat disease has a long history in many cultures worldwide. There is a growing interest in the potential anticancer effects of compounds derived from herbs, spices, fruits, vegetables, and traditional medicinal plants. This introduction will provide background on the historical use of botanicals in cancer treatment and discuss recent research on natural anticarcinogens derived from dietary sources. References to the use of herbs for cancer treatment date back to ancient Egyptian papyri from 1900 BC, which described using garlic, opium poppy, and “breast tumors” (likely breast cancer) [1]. Traditional Chinese medicine, Ayurvedic medicine from India, and traditional healing practices in the Americas, Europe, and Africa have long used various plant extracts for managing different disease states [2]. Throughout history, herbal preparations were among the primary forms of cancer treatment before modern medicine shifted towards synthetic drugs in the nineteenth and twentieth centuries [3].
A resurgence of interest in traditional herbal medicine for cancer began in the latter half of the twentieth century once conventional cancer therapies’ limitations and side effects became better recognized [4]. There is now considerable research interest in the potential anticancer effects of phytochemicals, biologically active compounds derived from plants. Dietary phytochemicals under scientific investigation include flavonoids from fruits and vegetables, curcumin from turmeric, resveratrol from red wine, genistein from soy, diallyl sulfide from garlic, and allicin from garlic [5]. These natural anticarcinogens are thought to suppress tumor growth by acting on various hallmarks of cancer, such as resisting cell death, enabling replicative immortality, inducing angiogenesis, activating invasion and metastasis, reprogramming energy metabolism, and evading immune destruction [6].
Numerous preclinical studies in cell culture and animal models have demonstrated the anticancer effects of herbal products and plant-derived compounds. For example, curcumin has anticancer properties in many types of cancer, including colorectal, pancreatic, breast, prostate, and lung cancers [7, 8]. Resveratrol exhibits anticancer effects in breast, stomach, and thyroid cancer models [9]. Many studies suggest that combinations of phytochemicals may have synergistic effects against cancer [10]. While the precise mechanisms of anticancer phytochemicals are still under investigation, they are thought to modulate molecular pathways and gene expression in cancer development and progression.
Despite promising preclinical data, there remains limited evidence from human clinical trials that definitively demonstrates the efficacy of many herbal medicines for cancer therapy [11]. Few clinical studies have shown the beneficial effects of some herbal preparations. For instance, combining herbal extracts decreased chemotherapy-induced toxicity in lung cancer patients [12]. Curcumin combined with chemotherapy improved the quality of life in advanced breast cancer [13]. However, more extensive rigorous trials are still needed. Challenges in advancing herbal extracts to mainstream cancer care include inconsistencies in herbal preparations, limited bioavailability, lack of profit incentive for drug development, and inadequacies in regulations governing herbal medicines [14].
Natural anticarcinogens from traditional medicinal plants are a promising area of cancer research. Phytochemicals have the advantages of low toxicity, low cost, and ease of availability. Preclinical studies demonstrate that numerous dietary agents have cancer-preventive and therapeutic effects mediated by various anticancer mechanisms. However, there remains a need for well-designed clinical studies to evaluate safety and efficacy in humans conclusively. Given the growing scientific basis supporting their anticancer properties, further research should continue to investigate botanical natural products’ multifactorial mechanisms and clinical potential for managing cancer.
2. Herbs and spices with potential anticancer properties
2.1 Curcumin (Curcuma longa L. )
Curcumin is a polyphenol derived from the spice turmeric. For centuries, curcumin has been used in traditional Indian and Chinese medicine for its wide range of therapeutic effects [15]. In recent decades, extensive research has revealed that curcumin possesses potent anti-inflammatory and antioxidant properties that give it anti-cancer effects against numerous cancers [16]. Curcumin exhibits cytotoxic effects against multiple human cancer cell lines, including cancers of the skin, breast, lung, pancreas, prostate, bladder, kidney, cervix, liver, blood, and brain [17]. Treatment with curcumin hindered growth and proliferation while inducing apoptotic cell death through various signaling pathways depending on the cancer cell models studied [16]. Curcumin also beneficially impacted the invasion, metastasis, and angiogenesis behaviors of diverse malignancy types in preclinical analyses [18]. Oral curcumin administration suppressed tumor formation, restricted solid tumor growth, prevented metastasis development, and increased survival in chemically induced or xenograft models of skin, liver, lung, adrenal, bladder, intestinal, and hormone-related cancers [17, 19]. Despite poor bioavailability, a few human trials exhibit direct anticancer effects, as detailed in the next section. Curcumin displays broad pharmacological activity against myriad cancers; warranting continued translational research.
Curcumin is believed to modulate numerous molecular targets and signaling pathways pivotal in malignant progression. By interacting with transcription factors, enzymes, receptors, microRNAs, and additional upstream regulators, curcumin administration alters the expression or functioning of growth factors, inflammatory cytokines, adhesion molecules, angiogenic factors, and apoptosis-related proteins in diverse cancer cell lines and animal models [18, 20]. For example, curcumin disrupted nuclear factor kappa B (NF-kB), Wnt/
Curcumin has been extensively studied as a cancer therapy for nearly every primary form of the disease. Research indicates curcumin has protective effects against gastrointestinal, genitourinary, gynecological, hematological, pulmonary, thyroid, breast, and skin cancers. Curcumin’s efficacy is most potent against bowel, stomach, liver, and skin cancers [21]. Colorectal cancer is one of the cancer types most sensitive to curcumin [8]. Curcumin suppresses intestinal tumor formation in rodent models of colorectal cancer and inhibits the proliferation of human colorectal carcinoma cell lines [27]. In human clinical trials, doses between 0.45 g and 3.6 g daily reduced proliferation rates of colorectal cells and adenomatous polyp formation [28]. Analogously, curcumin demonstrates chemopreventive and chemotherapeutic capacities against stomach cancer through similar anti-proliferative and pro-apoptotic mechanisms [29]. Curcumin also exhibits protective effects against hepatocellular carcinoma (HCC), the most common form of liver cancer. Curcumin administration reduces HCC tumor volume and metastasis in murine models [30]. A dose-escalation trial found that doses up to 8 g per day were well-tolerated in HCC patients and produced downregulation of NF-kB and COX-2 levels [31]. Additionally, curcumin is promising for preventing and treating skin cancers like melanoma and squamous cell carcinoma. Topical curcumin formulations have been shown to reduce lesion size and tumor burden in skin cancer models via anti-proliferative and pro-apoptotic effects [32].
The preclinical evidence supporting curcumin’s anti-cancer properties has prompted growing interest in clinical evaluation. Over 100 clinical trials are underway to investigate curcumin’s therapeutic use in cancer patients [17]. Ongoing and upcoming trials assess curcumin across nearly all cancer types as a standalone and adjuvant therapy. Several Phase I trials have recently studied escalating doses to evaluate safety and tolerability [33]. Doses up to 12 g per day did not produce dose-limiting toxicity, suggesting the feasibility of further clinical development. Phase II trials now employ more specific patient populations to gather efficacy data. For example, a current Phase II study tests curcumin with gemcitabine in pancreatic cancer. Researchers are also recruiting for Phase II gastric, brain, and breast cancer trials [34]. In addition to primary treatment, curcumin is being trialed as an adjuvant for boosting chemotherapeutic efficacy and mitigating toxicity. Co-administration of curcumin with first-line therapy like FOLFOX or FOLFIRI is undergoing examination in colorectal cancer [35]. Using curcumin to reverse drug resistance is also being explored in refractory cancers. These clinical evaluations will help substantiate curcumin’s role in cancer management.
Alongside treatment implications, routinely incorporating curcumin into diets or as a daily supplement may also boost cancer prevention. According to epidemiological data, higher antioxidant and anti-inflammatory compound consumption is associated with reduced cancer incidence [36]. Curcumin exhibits both antioxidant activity directly and enhances endogenous antioxidant defenses, which could mitigate DNA damage, enabling tumor promotion. It also beneficially regulates phase I and phase II detoxification enzyme expression to prevent the activation of procarcinogens [37] potentially. Curcumin administration prevented carcinogen-induced preneoplastic lesions and tumor development in rodent models’ colon, liver, pancreas, stomach, and prostate, indicative of early-stage chemopreventative effects [37]. Low-dose curcumin intake favorably impacts multiple cancer-related mechanisms that may interrupt pathological processes before malignant transformations.
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While curcumin shows promising benefits for health and disease prevention, it is essential to note some potential risks and contraindications to consider when taking curcumin supplements. Curcumin may act as a blood thinner, so it could interact with medications like warfarin, which are also blood thinners. This may increase bleeding risk, so those on blood thinners should speak to their doctor before taking curcumin [38]. Curcumin may also decrease the body’s absorption of certain oral drugs like contraceptives, diabetes medications, and chemotherapies. For this reason, anyone taking prescription medications should discuss curcumin use with their healthcare provider. Large doses of over 8 grams per day have caused side effects in some people, like nausea, diarrhea, and heartburn. Curcumin could also lower blood sugar, so diabetics may need monitoring [39]. Pregnant and breastfeeding women are advised to avoid curcumin supplements unless approved by a doctor due to the lack of research in these groups. In general, 400–600 mg per day is recommended for overall health, while 800–2000 mg daily divided into doses may benefit conditions like arthritis when taken under medical guidance. Doses over 2000 mg daily are not generally recommended without supervision from a health practitioner [40]. Most generally well-tolerated curcumin when taken as directed, but potential interactions and risks warrant caution, especially in those taking medications.
2.2 Ginger (Zingiber officinale roscoe )
Ginger (
Laboratory models have revealed that ginger’s anti-tumoral effects are likely due to multiple mechanisms. Both crude ginger extracts and specific compounds within ginger have demonstrated the ability to neutralize free radicals and enhance the body’s antioxidant defense systems, potentially reducing DNA damage, a critical factor in the initial stages of cancer [46]. Moreover, ginger’s compounds have anti-inflammatory properties, evidenced by their inhibition of enzymes like COX and reduction of specific cytokines that facilitate malignant growth. Other potential mechanisms include the disruption of tumor angiogenesis signaling, inhibition of metastasis-related enzymes, and alteration of cell cycle and apoptosis regulators, including proteins such as p53, NF-kB, and members of the Bcl-2 family, as well as markers of cancer stem cells [47]. Ginger’s habitual consumption may offer protective effects against cancer development. Epidemiological evidence links higher dietary intake of antioxidant-rich plants to lower risks of various epithelial cancers. As a whole food, ginger contains vitamins, minerals, flavonoids, and phenolics that neutralize carcinogens and mitigate cellular damage [46]. Animal studies have shown that oral ginger can inhibit DNA damage and enhance detoxification enzymes in tissues exposed to carcinogens, suggesting a reduced risk of cancer-initiating mutations. Additionally, ginger has demonstrated the ability to suppress colon carcinogenesis in rat models, indicating potential chemopreventive properties [48].
People taking blood thinners or diabetes medications should use ginger cautiously due to potential additive effects. Some people may also experience heartburn, diarrhea, irritation, or nausea with high ginger intake [49]. The recommended dosage of ginger supplements depends on the intended therapeutic use, with most studies examining doses between 250 mg and 1 g per day of powdered ginger root. As a frame of reference, doses on the lower end of this range may provide antinausea effects. In contrast, anti-inflammatory effects are more commonly seen in studies using 1 g or more [50]. Ginger tea can be made by steeping 1–2 grams of fresh ginger in hot water and consumed 2–3 times daily.
2.3 Garlic (Allium sativum L. )
Garlic (
The anticancer properties of garlic constituents are linked to their modulation of various cellular pathways critical to cancer proliferation and spread. Organosulfur compounds in garlic have shown potent abilities to neutralize free radicals and enhance cellular antioxidant defenses, thereby protecting against DNA damage that can lead to carcinogenesis. These compounds also affect tumor formation and angiogenesis through pathways like STAT 3 and receptor tyrosine kinase, potentially reducing tumor growth capacity [54]. Diallyl sulfides in garlic have been observed to influence cell cycle progression, stimulate immune cells, modulate arachidonic acid metabolism, and regulate histone activity, all contributing to inhibiting cancer-promoting processes [55].
Garlic can also have some risks and contraindications. Garlic can increase bleeding risk, so people with bleeding disorders or taking anticoagulant medications should use caution with garlic supplements. Some people may also experience heartburn, nausea, vomiting, diarrhea, or other gastrointestinal discomfort. The recommended daily dosage of garlic supplements for adults is 400–1200 mg of standardized allicin potential, approximately equal to the consumption of 1–2 fresh garlic cloves [56]. Consumption through dietary sources is generally recognized as safe, but garlic supplements have a higher allicin yield and, therefore, possibly a higher risk of side effects [57].
2.4 Basil (Ocimum basilicum L .)
Basil (
Different extracts and compounds from basil have been shown to influence multiple mechanisms involved in cancer progression, including cell cycle arrest, apoptosis induction, inhibition of cell proliferation, migration, and metastasis, restricting blood vessel growth, and reducing inflammation [60]. Alcohol extracts from basil leaves inhibited cell growth and induced cell death in the mouth, cervical, prostate, and skin cancer cell lines [59]. Ursolic acid from basil inhibited cell proliferation in skin cancer, slowed tumor growth in melanoma, and prevented lung metastasis of skin cancer in mice. These effects appear to result from basil compounds modulating gene expression and signaling pathways associated with cancer [61]. Certain compounds in basil, such as rosmarinic acid, linalool, and eugenol, have demonstrated antioxidant activities that may help protect cells against DNA damage that can promote tumor growth. Inflammation plays a crucial role in cancer development, and basil extracts and isolates have reduced inflammatory signaling molecules like NF-kB in cancer cell lines [62].
Basil can also have some risks and contraindications. Due to its effects on blood clotting, people with bleeding disorders or taking anticoagulant medications should exercise caution when using basil supplements [63]. Basil essential oils or supplements could interact with other medicines like sedatives or hypoglycemics. Some people may experience side effects like low blood pressure or liver damage [64]. There is no established recommended daily dosage for basil. Basil is generally recognized as safe when used in average culinary amounts. However, concentrated supplements or essential oils extracted from basil provide higher levels of active compounds and have a higher risk of side effects and interactions [65]. Using fresh or dried basil leaves from dietary sources is typically not a safety concern for healthy adults, but the risks increase when taking concentrated basil supplements.
2.5 Caraway (Carum carvi L. )
Caraway (
The use of caraway may pose risks, mainly when consumed in excessive amounts or by individuals with certain health conditions. Adverse effects of caraway are generally rare, but it can interact with certain medications and health conditions. For instance, caraway oil’s emmenagogue properties may pose risks during pregnancy. Additionally, individuals with a history of gallstones should exercise caution, as certain compounds in caraway can stimulate gallbladder contractions [67]. Regarding dosage, the recommended daily intake of caraway varies based on the form and purpose of use. In culinary uses, caraway seeds are generally considered safe when used in typical food amounts. Standardized extracts are often used for medicinal purposes, and dosages may vary. For example, in the form of an essential oil, a typical dose might range from 0.1 to 0.3 mL [69]. However, due to different product variations in strength and concentration, it’s crucial to follow specific manufacturer recommendations or consult with a healthcare professional for appropriate dosing tailored to individual needs and health conditions.
2.6 Cinnamon (Cinnamomum cassia L. )
Cinnamon is a commonly used spice derived from the inner bark of trees from the Cinnamomum genus. The most widely used species are
Cinnamaldehyde altered microtubule functioning to block cell division and induce apoptotic cell death in human leukemia and lymphoma cells. It also exhibited immunomodulatory effects by enhancing natural killer cell activity against myeloma cells [72]. Animal studies further support cinnamon’s antitumor influences. Orally administered cinnamon extract reduced tumor cell proliferation markers, increased cancer cell death through disrupted angiogenesis and blood flow, and decreased growth of melanoma and lymphoma tumors in mice [73]. Lab experiments indicate that cinnamon alters signaling proteins that regulate cell proliferation, survival, angiogenesis, adhesion, migration, and apoptosis in different cancer cell types [74]. Particular compounds like cinnamaldehyde modulate tumor necrosis factor, vascular endothelial growth factor, matrix metalloproteinases, and interleukin secretion from cancer cells. The observed antioxidant capacities of cinnamon extracts may also contribute by protecting against oxidative damage and suppressing chronic inflammation involved in malignant transformations [75].
Cinnamon, especially Cassia cinnamon, also contains coumarins, which can have risks and contraindications at high doses. High coumarin intake may negatively affect liver health, and caution people taking anticoagulant medications due to coumarin’s blood thinning effects [76]. Generally, Ceylon cinnamon has a lower coumarin content than Cassia cinnamon. The recommended daily dosage of cinnamon supplements for adults is approximately 120–360 mg of a cinnamon extract standardized to 5–6% flavonoids. This equals approximately 1–3 g of cinnamon powder [77]. Intake above this level increases the risk of liver toxicity and negative interactions. High levels of coumarin intake have been associated with liver toxicity and damage in sensitive individuals [78]. Therefore, caution is advised, especially for those with pre-existing liver conditions or using medications that affect liver function.
2.7 Clove (Syzygium aromaticum L .)
Cloves are the aromatic flower buds of the
One study provided 200 mg of an ethanolic clove extract containing 40% eugenol to 41 patients with oral submucous fibrosis, a premalignant lesion [82]. After up to 3 months of supplementation, patients taking clove extract had reduced burning sensations and increased mouth opening, and 71% demonstrated partial to complete clinical response, indicating anti-inflammatory benefits [83]. The abundance of eugenol in cloves has been found to influence gene expression of vascular endothelial growth factors, matrix metalloproteinases, and pro-inflammatory cytokines like NF-kB and COX2 in various cancer cell models [84]. Eugenol arrested cell division, prompted cancer cell death through p53 activation, caspase, and PARP cleavage, and disrupted mitochondrial functioning in human melanoma cells. The antioxidant capacity exhibited by eugenol and clove extracts may provide additional cancer-preventative influences by reducing DNA damage from oxidative stress [80]. Cloves contain polyphenols, flavonoids, and vitamin C that mitigate cellular damage from oxidation and resulting inflammation tied to malignant growths [85].
Compounds found in clove, such as eugenol, have some risks and contraindications, especially when taking clove essential oil. Clove may interfere with blood clotting and should be avoided by people with bleeding disorders or taking anticoagulant medications. Clove may also cause liver damage at high doses. Other side effects can include digestive upset [86]. The recommended daily dose of clove varies depending on the form of consumption and purpose of use. In a culinary context, clove is generally safe when used in average food amounts. As a supplement or medicinal remedy, the dosage needs careful consideration. A standard therapeutic dose for clove oil might range from 0.15 to 0.3 mL [87]. However, due to its potent nature, it is often diluted or used in a compound formulation. For whole or ground cloves, dosages are less well-defined but are considerably lower than those of the essential oil. Given the potency and potential risks of clove, it is advisable to start with minimal amounts and consult a healthcare professional for guidance on appropriate dosing, especially for therapeutic use. This is particularly important for individuals with pre-existing health conditions, those who are pregnant or breastfeeding, and young children.
2.8 Coriander (Coriandrum sativum L. )
Coriander (
Multiple mechanisms likely contribute to coriander’s reported anticancer activities in laboratory models. Experiments indicate the modulation of essential signaling proteins connected to cancer cell proliferation, survival, inflammation, progression, and apoptosis after treatment with coriander extracts in various cancer cell lines [91]. Essential bioactive chemicals found abundantly in coriander seeds and leaves, including linalool, quercetin, and chlorogenic acid, have antioxidant and anti-inflammatory properties that may underlie the observed antiproliferative influences [92]. Coriander leaf extracts boosted the activity of carcinogen detoxification enzymes like glutathione-S-transferase and increased antioxidant status markers in liver cancer animal models, which could additionally block tumor promotion stages [93].
There are potential risks and contraindications associated with coriander use. Coriander can cause allergic reactions in some individuals, which may manifest as skin rashes, respiratory symptoms, or gastrointestinal upset. People with allergies to other members of the Apiaceae family, such as fennel or anise, may be more susceptible to a coriander allergy [94]. Additionally, coriander seeds’ hypoglycemic effect might pose a risk for individuals with diabetes, especially when consumed in conjunction with diabetes medication, as it can potentially lead to hypoglycemia. The recommended daily dose of coriander varies depending on its form (fresh herb, dried seeds, or oil) and the intended use. In culinary applications, coriander is generally safe in standard food preparation amounts. For medicinal purposes, there is no universally established dosage, but typical recommendations might include:
Fresh coriander leaves 1.5 to 5 grams per day.
Dried coriander seeds: 0.5 to 1 gram per day.
Coriander seed oil: Because of its concentration, this form should be used sparingly, and exact dosages should follow product-specific guidelines or healthcare professional advice.
Pregnant or breastfeeding women should exercise caution and seek medical advice before consuming coriander for medicinal purposes [95].
2.9 Dill (Anethum graveolens L. )
Due to potential effects on hormone and blood sugar levels, people with diabetes, endocrine disorders, or related medications should exercise caution with dill supplements. Dill may also cause sensitivity reactions in some people [101]. Additionally, due to its antispasmodic properties, dill might interact with medications that affect the central nervous system. Individuals with low blood sugar levels or those on diabetes medication should also exercise caution, as dill can have hypoglycemic effects [101]. The recommended daily dose of dill varies based on the form and purpose of use:
For culinary purposes, using fresh or dried dill leaves in cooking is generally safe in typical amounts.
In a medicinal context, there are no well-established dosage guidelines for dill. However, when used as an herbal tea, a standard preparation might include 1 to 2 teaspoons of dried dill per cup of hot water, steeped for 5 to 10 minutes.
For dill oil, due to its concentrated nature, only a tiny amount (a few drops) is typically used, and it should be diluted if applied topically.
2.10 Cumin (Cuminum cyminum L. )
Despite these positive attributes, cumin has potential risks and contraindications. Overconsumption of cumin, especially in its concentrated oil form, can lead to digestive upset, such as heartburn or stomach pain. It may also lower blood sugar levels, a concern for individuals with diabetes or those on medications that affect blood sugar [107]. No established recommended daily intake levels are specifically for culinary spices like cumin. Regular usage of cumin seeds or powder to season foods is generally considered safe by the U.S. Food and Drug Administration. As a spice, up to 1–3 grams of cumin powder per day is commonly used.
2.11 Rosemary (Rosmarinus officinalis L. )
Rosemary (
Rosemary’s bioactive compounds, especially ursolic acid, have been extensively studied for their antitumor properties. These compounds exhibit various anticancer effects, including the induction of apoptosis (programmed cell death) in cancer cells, cell proliferation inhibition, and metastasis prevention. For instance, ursolic acid has been shown to induce apoptosis in various cancer cell lines, including breast, prostate, and colon cancers [111]. Cancer cells often exhibit altered metabolism, which supports their rapid growth and survival. Compounds in rosemary have been found to interfere with these metabolic pathways, thereby exerting antiproliferative effects on cancer cells [111]. Rosemary extracts have been studied for their potential to enhance the efficacy of conventional chemotherapy drugs. This synergistic effect is particularly significant as it may lead to more effective cancer treatments with lower doses of chemotherapeutic agents, thereby reducing their side effects [111]. A study by Gonzalez-Vallinas et al. [110] demonstrated that rosemary extracts enhanced the efficacy of 5-fluorouracil, a standard chemotherapy drug, in colon cancer cells.
Rosemary supplements may interact with anticoagulant or antihypertensive medications. High doses of some rosemary essential oil components like camphor can cause nausea, vomiting, and muscle spasms [112]. High doses of rosemary oil can cause gastrointestinal irritation and kidney damage and may lead to seizures if consumed in excessive amounts. Due to its potent effects, rosemary oil should be avoided by pregnant women and those with epilepsy or high blood pressure. Additionally, rosemary can affect iron absorption and should be used cautiously by individuals with iron deficiency. In culinary uses, rosemary is generally safe in standard seasoning amounts [113]. For medicinal purposes, a typical dose might include 4–6 grams of dried rosemary leaves.
2.12 Saffron crocus (Crocus sativus L. )
Saffron (
Saffron supplements may interact with anticoagulant, antihypertensive, or antidepressant medications. High doses can cause nausea, dizziness, and vomiting [119]. Pregnant women should avoid saffron supplementation due to uterine stimulation effects. In culinary uses, saffron is typically safe when used in small quantities for flavoring and coloring, generally a few strands or less than 0.5 grams. For medicinal purposes, studies often use dosages ranging from 15 to 30 milligrams per day. However, these dosages are specific to certain conditions and should not be generalized. Due to its potential influence on mood and the nervous system, individuals with mood disorders or those taking antidepressants should use saffron cautiously. Saffron may also lower blood pressure and should be used with care by individuals with hypotension or those on blood pressure medications.
2.13 Thyme (Thymus vulgaris L. )
Thyme (
Multiple mechanisms likely contribute to the observed anticancer effects of thyme extracts. Thyme polyphenols and essential oils have been found to interact with cell signaling, controlling inflammation, proliferation, angiogenesis, invasion, and survival in diverse human cancer cell culture models. For instance, the compound thymol targets molecules like NF-kB, PARP, and Bcl-2 proteins to prompt apoptosis and restrict growth signaling in various cancer types [124]. Thyme extracts also activated cellular antioxidant defense mechanisms in experiments, which could prevent initial carcinogenic damage.
Thyme may also have risks and uncertainties at higher supplementary doses. Thyme compounds can increase bleeding risks, so those with bleeding disorders or taking anticoagulant medications should avoid concentrated thyme supplements [125]. Other side effects may include digestive upset, headache, and dizziness. The recommended daily dose of thyme varies depending on its form and intended use. In culinary applications, thyme is generally safe when used in typical cooking amounts. For medicinal purposes, a standard dosage is 1–2 teaspoons of dried or 2–3 teaspoons of fresh thyme, which can be steeped in hot water to make tea. This can be consumed 1–3 times a day [120].
2.14 Oregano (Origanum vulgare L. )
Oregano is an aromatic herb used for culinary and medicinal purposes. The most abundant phytochemicals identified in oregano include polyphenolic compounds like rosmarinic acid, flavonoids, and volatile oils such as thymol, carvacrol, limonene, linalyl acetate, linalool, and geranyl acetate [126]. Experiments indicate inhibited proliferation, cell cycle, and proliferation signaling disruption, apoptotic cell death induction, reduced adhesion, invasion, angiogenesis, and inflammation in colon, lung, breast, liver, bladder, cervical, blood, and thyroid cancer models. Carvacrol and rosmarinic acid compounds exhibited antiproliferative, cytotoxic, and anti-metastatic actions across ovarian, oral, prostate, and skin cancer cells [127]. The well-reported anticancer effects of oregano extracts in preclinical models have been attributed to the modulation of numerous cellular pathways integral to malignant proliferation. Oregano polyphenols and essential oils demonstrated potent free radical scavenging and cyclooxygenase enzyme inhibition, protecting against oxidative damage and inflammation and enabling carcinogenesis [128]. Additionally, oregano compounds affected cell cycle arrest, apoptosis induction, tumor suppressor genes, and cell proliferation/survival signaling in various cancer cell culture experiments [129].
Oregano due to its influence on blood clotting, those with bleeding disorders or taking anticoagulant medications should avoid concentrated oregano supplements. Other side effects can include gastrointestinal upset and irritation when applied to the skin. Oregano, particularly in its essential oil form, can irritate the skin and mucous membranes when used in high concentrations [56]. It may also interact with certain medications, such as anticoagulants, due to its potential to inhibit blood clotting. Individuals with bleeding disorders or those preparing for surgery should exercise caution. Additionally, the high phenol content in oregano may cause digestive discomfort if consumed in large amounts [130]. The recommended daily dose of oregano depends on its form and intended use: In culinary applications, oregano is generally safe when used in typical seasoning amounts. There is no standard dosage for medicinal purposes, but a general guideline is 1–2 teaspoons of dried oregano, which can be used to make tea. This can be consumed up to three times daily.
2.15 Sage (Salvia officinalis L. )
Sage (
The anticancer effects of sage extracts in preclinical models have been attributed to the modulation of numerous cellular pathways integral to malignant proliferation. Sage polyphenols demonstrated potent free radical scavenging and anti-inflammatory activities, which protect against oxidative damage, enabling carcinogenesis [134]. Additionally, sage compounds exhibited regulatory effects on signaling proteins influencing cell cycle progression, apoptosis, nitrogen signaling species generation, and tumor invasion markers in various cancer cell culture experiments [135].
Sage may also have risks and contraindications, especially concerning components like α-thujone and β-thujone. The thujones may interact with medications due to influences on GABA and serotonin. High doses of thujones can potentially cause seizures, vomiting, and kidney damage [136]. Due to its potential estrogenic effects, sage is also advised to be used cautiously in individuals with hormone-sensitive conditions, such as certain types of breast cancer. Pregnant and breastfeeding women are typically advised to avoid high doses of sage due to the lack of safety data. Using sage in regular cooking is generally considered safe for culinary purposes. In a medicinal context, the appropriate dose can vary. As a general guideline, 4–6 grams of dried sage leaf or 1–2 teaspoons of sage leaf infusion (tea) taken once or twice daily can be used [131].
2.16 Fennel (Foeniculum vulgare mill )
Fennel (
Fennel may also have some uncertainties and contraindications related to its effects and safety, especially in supplemental forms. One of the primary concerns with fennel, especially in its essential oil form, is the presence of estragole and anethole, which, in high doses, could be toxic and have been linked to potential carcinogenic effects. Due to its phytoestrogen content, fennel may interact with hormone-sensitive conditions, such as certain types of breast cancer or endometriosis [140]. Pregnant women are often advised to avoid excessive use of fennel due to a lack of conclusive safety data. Additionally, individuals with allergies to carrots or celery, which are in the same family as fennel, might also be allergic to fennel. Fennel may also interact with medications changed by the liver. Side effects can include sun sensitivity, gastrointestinal issues, or allergic reactions [141]. The recommended daily dose of fennel varies depending on the form and intended use. In culinary uses, fennel seeds and bulbs are generally safe when consumed in typical food amounts. Medicinally, the typical dosage for fennel seeds is 5 to 7 grams per day, which can be taken as an infusion (tea), tincture, or in capsule form.
2.17 Black pepper (Piper nigrum L. )
Black pepper (
Excessive consumption of black pepper can lead to gastrointestinal irritation, including dyspepsia and gastroesophageal reflux. Individuals with ulcers or digestive tract inflammation should use black pepper cautiously. Piperine may inhibit medication breakdown, leading to potential overdoses of certain drugs, leading to adverse reactions. Monitoring for adverse reactions is crucial, and medical advice should be sought in case of any adverse symptoms or concerns [146]. There are no established standardized recommended daily intake levels specifically for black pepper. Using black peppercorn or powder to season food in small culinary amounts is generally safe.
2.18 Cayenne pepper (Capsicum annuum var. annuum L. )
Cayenne pepper is a hot chili from the Capsicum family that has been used as a spice and herbal medicine for centuries. The main bioactive components identified in cayenne include capsaicin, capsanthin, luteolin, and piperine [147]. In particular, the capsaicin, capsanthin, and luteolin compounds prompted apoptosis and restricted growth signaling proteins across leukemia, melanoma, gastric, bladder, and glioma cancer cells. Though limited in number, some rodent experiments support the idea that oral capsaicin administration suppressed lung tumor incidence and growth in mice without apparent toxicity [148]. Experiments indicate compounds like capsaicin can alter nuclear factor-kB (NF-kB) and other inflammatory signaling pathways, enabling runaway malignant cell proliferation. Additional proposed pathways include selective cancer cell toxicity through increased oxidative stress, cell cycle, and apoptosis regulator modulation, disruption of microtubule assembly dynamics, and inhibition of angiogenesis, invasion, and metastasis enzymes [149]. Oral administration of capsaicin and pepper extracts also prevented carcinogen-induced pulmonary and colon tumors in rodent models, indicative of protective influences during pathogenesis [150].
Ingesting cayenne can result in stomach pain, cramps, or diarrhea in sensitive individuals. When handling the peppers, skin irritation, and burns are also risks. It can also cause skin irritation when applied topically. Due to its potent nature, individuals with sensitive digestive systems, irritable bowel syndrome, or hemorrhoids should use cayenne pepper cautiously. Additionally, capsaicin can interact with certain medications, such as blood thinners and stomach acid reducers [151]. Currently, no standardized recommended daily intake levels are explicitly established for cayenne pepper. Using small culinary amounts of cayenne powder or flakes to add heat and flavor to dishes is generally considered safe for most healthy adults. For medicinal purposes, dosage recommendations can vary. A typical dosage for cayenne pepper supplements is between 30 and 120 mg, taken up to three times daily. Topical applications of capsaicin-containing creams usually contain 0.025–0.1% capsaicin and are applied several times daily [152].
2.19 Green tea (Camellia sinensis L. )
Green tea is produced from the leaves of the
High intake of green tea, especially in the form of supplements or concentrated extracts, can lead to liver toxicity and other adverse effects due to its high catechin content. Individuals with liver disorders should exercise caution or avoid high concentrations of green tea. Green tea also contains caffeine, which can cause insomnia, nervousness, irritability, and increased heart rate and blood pressure in sensitive individuals or when consumed in large amounts [156]. Additionally, the tannins in green tea can inhibit iron absorption, which concerns individuals at risk of iron deficiency. Green tea may also interact with certain medications, including blood thinners, stimulants, and certain chemotherapy drugs, due to its caffeine content and ability to affect drug metabolism. Pregnant and breastfeeding women are advised to limit their caffeine intake, including that from green tea [157]. Green tea beverages are safe for most when consumed reasonably, but extracts have more potential interactions and toxicity risks with inappropriate doses or sensitive individuals.
2.20 Milk thistle (Silybum marianum L. )
Milk thistle (
Milk thistle oil provides high concentrations of active silymarin compounds through seed extraction and concentration. Milk thistle oil may be used in supplement form and is often incorporated into dietary regimens for its potential benefits in supporting liver health, reducing inflammation, and providing antioxidant support [164]. This oil can be taken orally in capsules, similar to other extracts. However, research on these various milk thistle preparations’ efficacy, safety, and pharmacokinetics requires further robust investigation in humans.
The most common side effects include gastrointestinal upset, diarrhea, and bloating. Less common effects can include rash, headaches, and muscle pain. High doses may have a blood sugar-lowering effect, so those with diabetes or on anti-diabetic medications should use caution and monitor closely when taking milk thistle [165]. There is also a lack of safety research on milk thistle in pregnant or breastfeeding women, so supplementation should be avoided. There currently needs to be standardized dosage recommendations for milk thistle due to insufficient evidence regarding efficacy and long-term safety in humans. Most studied doses range between 140 and 800 milligrams of silymarin daily, but clinical outcomes vary widely in the existing literature. Standardized milk thistle extract, typically 70–80% silymarin, is commonly used in doses ranging from 140 to 210 mg taken 2 to 3 times daily [166]. For milk thistle tea, 1 to 2 teaspoons of crushed seeds steeped in hot water for 5 to 10 minutes is a standard preparation, which can be consumed up to three times daily.
2.21 Astragalus (Astragalus membranaceus (fisch.) bunge )
A few trials investigated adjuvant use of astragalus injections alongside conventional therapy, primarily in reducing chemotherapy toxicity [170]. Case series data also associates astragalus usage with symptom relief, improved immune responses, and possibly increased survival times as an adjunct in advanced cancer patients. However, placebo-controlled confirmation still needs to be improved [171]. Experiments indicate astragalus saponins and polysaccharide fractions modulate cytokine secretion, T cell activity, and other aspects of immune functioning vital to early cancer defense [172]. Extracts also exhibited direct inhibitory effects on growth, invasion, angiogenesis, proliferation, survival, and apoptosis evasion pathways across multiple cancer cell models. The antioxidant capacity and activation of phase II detox enzymes noted with specific isolates like astragalosides may additionally prevent carcinogenic mutations [173]. As an adaptogenic herb, astragalus contains various polysaccharides and flavonoids that help counter oxidative damage, DNA mutations, and aberrant methylation patterns tied to carcinogenesis. Studies also reveal that specific isolates prevented chemical induction of preneoplastic liver lesions and reduced lung tumor incidence and severity when provided before and during carcinogen exposure in rodents [174, 175].
Astragalus may also have some risks and uncertainties with supplementation. It may interact with immunosuppressant medications due to possible immune-boosting effects. Also, it can interact with blood pressure medications due to potential diuretic effects [167]. There are currently no standardized dosing recommendations for astragalus supplements or extracts. Most studied doses for specific conditions range widely from 0.5–60 grams of root powder per day. As a standardized extract, dosages often range from 250 to 500 mg, taken three to four times daily [176].
2.22 Ginseng (Panax ginseng L. )
Ginseng refers to the roots of plants in the Panax genus, which have been used in traditional Chinese medicine for centuries. The most common bioactive constituents in ginseng include ginsenosides, polysaccharides, peptides, polyacetylene alcohols, and fatty acids. Considerable research in recent decades indicates that ginseng extracts and isolates exhibit immunomodulating, anti-inflammatory, antioxidant, and possible anticancer effects based on preliminary cellular and animal studies [177].
Experiments indicate that ginseng saponins exhibit direct antiproliferative, cytostatic, and cytotoxic effects in various cancer cell models. According to cell line data, extracts also beneficially modulated signaling pathways connected to apoptosis, cell cycle regulation, angiogenesis, invasion, inflammation, and multidrug resistance mechanisms [183]. The antioxidant effects demonstrated by some ginseng isolates like gintonin may provide additional preventative influences by reducing DNA damage that can enable carcinogenesis [184]. As an herbal adaptogen, ginseng’s polysaccharides, oligopeptides, phytosterols, and flavonoids help counter oxidative stress, inflammation, and hormonal dysregulation, enabling pathogenesis.
Ginseng may also have some risks, such as causing insomnia, nervousness, and hypertension in some people due to its stimulatory effects. Ginseng can interact with several medications, including blood thinners, antidepressants, antidiabetic drugs, and stimulants, potentially altering their effects. Due to its weak phytoestrogenic activity, individuals with hormone-sensitive conditions, such as breast, uterine, or ovarian cancers, should use ginseng cautiously. Ginseng’s immune-stimulating properties may interfere with immunosuppressive therapy; thus, it should be used cautiously by individuals undergoing such treatments [185]. There are currently no standardized dosing recommendations for ginseng supplements or extracts to guide consumers. Asian ginseng doses studied typically range from 1 to 10 grams daily of powdered root and 200–500 mg daily for ginseng extract standardized to 4–7% ginsenosides content.
2.23 Echinacea (Echinacea purpurea L. )
Echinacea is a genus of flowering plants used medicinally for centuries. The most studied species include
Clinical data examining echinacea’s potential to impact cancer outcomes or development remains scarce. A few small trials explored echinacea’s ability to alleviate complications associated with conventional chemotherapy and radiation therapy in cancer patients. However, they provided limited evidence around efficacy for outcomes like leukopenia, nausea, fatigue, or other symptoms [191]. Experiments indicate that specific echinacea isolates inhibit activators of cancer-promoting inflammatory pathways involving NF-kB and cytokines. According to cancer cell line investigations, extracts also beneficially impacted proliferation, cell survival, and apoptosis evasion pathways [192]. Some echinacea constituents’ antioxidant and possible immune modulation effects may provide additional preventative influences but require further elucidation. Characterizing primary bioactive and metabolic dynamics can strengthen translational development into practical pharmacological applications as adjuvants or standalone therapies (Manali. As an immunomodulatory herb, echinacea’s alkamides, polysaccharides, and flavonoids exhibit systemic anti-inflammatory influences that could defend against chronic inflammation, enabling pathogenesis [192].
Echinacea may cause allergic reactions in sensitive individuals—rashes, hives, facial swelling. It may interact with immunosuppressant medications or liver medications. Most studies use doses ranging from around 300–6000 mg of total echinacea daily, either in three to four divided doses using liquid extract or two divided doses using tablets or capsules. Prolonged use of Echinacea (beyond 8 to 10 weeks) is generally not recommended, as it may lead to reduced effectiveness and potential immune suppression [193].
2.24 St. John’s wort (Hypericum perforatum L. )
St. John’s wort (
Multiple mechanisms may contribute to the observed anticancer effects of St. John’s wort extracts in preclinical analyses. Experiments indicate that certain constituents like hypericin exhibit photosensitizing and photodynamic activities that prompt targeted apoptosis and necrosis of cancer cells when exposed to specific wavelengths and doses of light [202]. St. John’s wort extracts also impeded proliferation, angiogenesis, and cell signaling pathways related to growth and spread in cultured cancer cell investigations [203]. The monoamine oxidase and cytokine modulation effects of hyperforin and other components may provide additional immunomodulating influences, though the dynamics involved require further elucidation [204]. As an herb with demonstrated antidepressant effects in humans, St. John’s wort holds monoamine-modulating compounds that may mitigate systemic inflammation, which can drive the pathogenesis of migraines, Alzheimer’s, and malignancies [205]. Compounds also beneficially regulated detoxification enzymes and protected DNA from free radicals according to rodent and cell analyses, though human chemopreventive applications require significant further inquiry [206]. Nonetheless, the pleiotropic pharmacological profile supports its potential as a safe, affordable prophylactic supplement that future investigations could help substantiate. Routine usage could still plausibly aid primary and secondary prevention of certain inflammation-linked cancers over the years through multiple protective pathways that placebo-controlled trials can help substantiate.
St. John’s wort does have associated risks and contraindications, one of which is photosensitivity. Photosensitivity refers to increased sensitivity to sunlight, leading to a greater risk of sunburns or skin rashes when exposed to the sun. This reaction is primarily due to hypericin, a constituent of St. John’s wort [207]. St. John’s wort is known to interact with a wide range of medications due to its influence on enzymes involved in drug metabolism. This can lead to decreased effectiveness of many drugs, including birth control pills, antidepressants, anticoagulants, and immunosuppressants, among others. It may interfere with the effectiveness of anesthetics and other medications used during and after surgery. Standardized dosing recommendations are difficult to firmly establish due to wide variability in St. John’s wort preparations and conflicting evidence in the literature. The most common doses studied range between 500 and 1200 mg daily of St. John’s wort extracts standardized to hypericin content.
2.25 Cat’s claw (Uncaria tomentosa (Willd. Ex Roem. & Schult.) DC)
Cat’s claw refers to a woody vine belonging to the Uncaria genus that has been used in traditional South American medicine for centuries. The most researched species is Uncaria tomentosa. Over 50 constituents have been identified in cat’s claw, including pentacyclic oxindole alkaloids, quinovic acid glycosides, polyphenols, plant sterols, and carotenoids [208]. Emerging research indicates that based on preliminary cell and animal studies, cat’s claw bark extracts exhibit immunostimulating, anti-inflammatory, antiviral, antioxidant, and possible anticancer effects [209]. Studies reveal promising anticancer effects from various cat claw extracts and isolated compounds against different human cancer cell types. Experiments indicate inhibited proliferation, cell cycle disruption, and cell death induction in breast, lung, and brain cancer cell models [210]. Quinovic acid glycosides enhance the apoptotic effects of chemotherapeutics like paclitaxel across ovarian and pancreatic cancer cells [211]. Though currently limited in number and scope, one animal study reported that oral Uncaria tomentosa doses prevented increased blood vessel growth and spread to the lungs in a murine melanoma model [212, 213]. More pharmacokinetic animal studies optimizing bioactive cat claw preparations and human trials are necessary to verify if it warrants inclusion as a complementary therapy against malignancies. Clinical research examining a cat’s claw’s potential to impact cancer outcomes or development risk beneficially remains exceptionally scarce. Only one small human pilot study has reported data so far where cat’s claw supplementation reduced DNA damage from chemotherapy drugs in leukemia patients [214]. However, rigorously controlled trials with larger sample sizes are still needed to demonstrate therapeutic efficacy or adequate dosing guidelines of standardized cat’s claw formulations against the progression, recurrence, or prevention of particular cancers in humans conclusively.
In preclinical analyses, multiple mechanisms may contribute to the observed anticancer effects of specific cat’s claw extracts. Experiments indicate that certain alkaloid and quinovic acid fractions stimulate anti-tumor immune activity through increased lymphocyte proliferation, phagocytosis, and cytokine modulation, vital for early detection and defense [215]. Antiproliferative, pro-apoptotic, antiangiogenic, and antimetastatic activities have also been reported in various human cancer cell culture experiments [216, 217]. As an antioxidant-rich herb, cat’s claw compounds protect against DNA damage from oxidation, nitrous compounds, and inflammation tied to pathogenesis [218]. Using a cat’s claw as an herbal supplement may also aid the prevention of particular cancers over the long term. Some surveys link cat’s claw usage to perceived improvements in immune markers, DNA repair, antioxidant capacity, and lower infection rates, which could mitigate associated inflammation and cancer risks. However, placebo-controlled studies have been limited in humans so far [214, 219]. As an immunostimulant herb, cat’s claw holds alkaloids and carboxyl alkyl esters that activate white blood cell functioning vital to clearing aberrant cells before malignancy develops. Quinovic acid glycosides prevented oxidative damage and cell death from toxin exposure in several cell assays, though human chemopreventive applications require more substantiation. The cellular and limited animal studies report anticancer mechanisms of specific Uncaria tomentosa extracts related to immunomodulation, antiproliferation, and preliminary metastasis and angiogenesis inhibition.
While Cat’s Claw is considered safe for most people when used in moderate amounts, there are some risks and contraindications associated with its use. Due to its immunostimulant effects, Cat’s Claw should be used cautiously by individuals with autoimmune diseases like lupus, multiple sclerosis, or rheumatoid arthritis, as it might exacerbate these conditions. Cat’s claw may slow blood clotting, posing a risk for individuals with bleeding disorders or those on anticoagulant or antiplatelet medications. Due to its effects on blood clotting, it is advisable to discontinue the use of Cat’s claw at least 2 weeks before scheduled surgery to avoid excessive bleeding. There are no standardized dosing recommendations for cat claw supplements or extracts. The studied dosages vary widely from 20 to 3000 mg daily. If consumed as a tea, 1000 to 4000 mg of the bark is boiled in 250 mL of water. Dosages for other forms, such as tinctures or capsules, should follow the manufacturer’s recommendations or a healthcare provider’s guidance.
3. Challenges and future directions
While preclinical evidence shows promise for plant-based cancer therapeutics, translating these to clinical practice faces hurdles like inconsistent quality/standardization of extracts, limited knowledge of mechanisms, potential interactions with other drugs, negative perceptions among clinicians, and inadequate clinical trial data substantiating safety and efficacy. However, the future holds exciting possibilities for expanding plant medicines’ role in cancer care through innovations enhancing bioavailability via novel delivery systems, scaling production/purification of active compounds, developing synergistic phytochemical formulations, emergent technologies like nano-encapsulations, and increased adoption of traditional ethnopharmacology knowledge into modern research. If challenges around conducting more rigorous human trials, identifying optimal therapeutic combinations/dosages, navigating regulatory systems, and changing clinical attitudes can be overcome, phytochemicals may find expanding niche applications as cheaper, safer adjuvants amplifying chemotherapy/radiation efficacy and mitigating side effects, while boosting prevention through routine nutritional intake among high-risk groups.
4. Conclusion
This comprehensive review highlights the promising anticancer potential of numerous dietary phytochemicals derived from familiar herbs and spices. Extensive preclinical evidence demonstrates that bioactive compounds from plants such as curcumin, ginger, garlic, basil, and black pepper can influence multiple intracellular signaling pathways integral to the hallmarks of cancer, including resisting cell death, sustaining proliferation, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. By modulating key enzymes, transcription factors, cytokines, growth factors, and gene expression, these natural products exhibit cytotoxic, pro-apoptotic, anti-inflammatory, antioxidant, anti-angiogenic, and anti-metastatic effects across diverse cancer cell lines and animal models. While clinical research is still limited, early human trials support the safety, tolerability, and preliminary efficacy of specific herbal preparations against progression markers or chemotherapy side effects for various malignancies. As conventional treatment options become increasingly costly and toxic, botanical medicines may offer safer, affordable complementary approaches, amplifying therapeutic outcomes through multimodal mechanisms. Further pharmacokinetic, formulation, delivery, and clinical research can pave the way for plant-derived anticarcinogens to realize their full preventative and therapeutic potential. Integrating traditional ethnopharmacology wisdom with modern scientific rigor can usher in more holistic, patient-centered cancer care paradigms emphasizing natural products alongside conventional modalities.
Acknowledgments
I would like to express my gratitude to the various AI tools that assisted me in preparing and editing this book chapter. GitHub Copilot, an AI-powered code completion tool, provided valuable suggestions and code snippets that streamlined the writing process. Research Rabbit, an AI-based research assistant, helped me discover relevant literature and organize my references efficiently. Furthermore, Plagiarism Checker, an AI-powered plagiarism detection tool, ensured the originality of the content and helped me maintain academic integrity throughout the writing process. While these AI tools were incredibly helpful, I emphasize that the final content, ideas, and arguments presented in this chapter are my own. The AI tools served as assistants, but the responsibility lies with me for the work’s accuracy, clarity, and coherence.
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