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Controversy around Chinese Herbal Medicine Wormwood (Artemisinin)


October 24, 2008 - 3:19 pm     Print This Post Print This Post     view / write comments

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Dr West

Last week one of the major Seattle newspapers ran an article about a Chinese herbal medicine called artemisinin, or wormwood. The impetus was that some local chemists at the University of Washington conclude based on theory and some lab work with cancer cells that this agent, which is used as a treatment for malaria, can also kill cancer cells. Excited about the prospects of developing a new treatment for cancer, they started a private company.

The first part of the article describes the miracle that artimisin represents against cancer, but the quotes are from lab folks who aren’t treating patients. None of the people praising this approach is an oncologist at the University of Washington/Seattle Cancer Care Alliance, which I think is rather telling.

The counterpoint is provided by Dan Labriola, a naturopath who has helped out here in the past. I was pleased that he provided the same kind of caution that I would, although I feel like I must sound like a broken record. He reminds readers that while this drug has been used for malaria, and some people are trying to obtain it as a treatment for cancer, there’s a big difference between cells or animals in the lab and actual patients, and that there isn’t any evidence that it’s helpful in people at this point. Moreover, there is a real risk that it could be harmful.

Finally, others have come to the same conclusion: the web pages about artemisinin from Memorial Sloan Kettering (here) and the American Cancer Society (here) also note that there is no evidence supporting using this against cancer, and that it can have potentially dangerous side effects. Fine for malaria, but it’s not a cancer treatment at this point.

I bring this up primarily to point to another example of the disservice done by sensationalist media highlighting a treatment quite prematurely, and I fear raising false hopes for patients and their caregivers. While it’s true that they provided a counterpoint, so it isn’t only me trying to provide a cautionary word, the fact that I’ve received calls and e-mails about this is proof enough that some readers are coming away with a mistakenly favorable impression of an approach that isn’t being advocated by people who actually work with cancer patients (at least not to my knowledge).

I’m all for keeping the hope alive — we should chase down every lead we can find to see what pans out — but we always need to be cautious about the difference between the real kind and false hope.

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Posted in: Alternative Cancer Treatments, Naturopathic Medicine/CAM Print This Post Print This Post


  1. October 26, 2008 - 3:37 pm

    All of this biz, buzz, and excitement about artemesinim wormwood as a cancer treatment is just fine as long as we all just keep it in perspective. Remember shark cartilage and laetrile?, not to minimize the efforts of any hard working researcher. However, it would have been great if every claimed cancer treatment or cure since 1949 had proven true but that has not been the case. It would be great if they could just get there! It makes me think of someone trying to get through a snail-paced Seattle cross-town traffic because the seller is waiting for them to buy. It would be great if they could just get there!

    Artemisinin has been around in some form just about forever, mostly in China and Vietnam. Artemisinin is the primary active constituent found in Artemisia annua, which has a long history as an anti-malarial remedy. Artemisia annua is revealed “sweet wormwood” in the Recipes For 52 Kinds Of Diseases which was found in the Mawangdui Han Dynasty tomb (circa 168 B.C.) It is brought up again in the Zhou Hou Bei Ji Fang (Handbook of Prescriptions for Emergency Treatments) written in 340 A. D. The main constituent of wormwood was first isolated in l972 and then exploration at the Walter Reed Army Institute of Research crystallized the active component in l984.

    Artemisinin contains inherent peroxide therefore a reactive oxygen species is present within the molecule. This is what is thought to give artemisinin anti-malaria activity. Derivatives of artemisinin devoid of the peroxide moiety lack anti-malaria ability. It is this peroxide activity that is thought to be effective in creating oxidative stress to malaria components and possibly to cancer cells. The dosage and toxicity of artemisinin have been well studied for short-term use in the treatment of malaria.

    Yet, cancer is not malaria. And the complexities of cancer are way beyond the complexities of malaria. With the common knowledge of a high accumulation of iron in cancer cells it is eminently important to know the specifics of artemisinin and iron. We really need a full understanding of how this plant-derived compound operates in manipulation of iron activity, iron concentration, and iron metabolic by-product production. The long-term use of artemisinin and/or its derivatives has had limited study. We must have a great deal more knowledge prior to getting excited about any efficacy in humans. The real risk is the lack of solid evidence for safety or effectiveness. History in the form of case studies and scientific studies have shown that seemingly harmless substances have indeed created drug-nutrient interactions as well as amplification of various drug side effects. Vitamin C is a classic example of this type of occurrence.

    Since artemisinin have both water-soluble and lipid soluble derivatives (artesunate and artemether respectively), it is possible that it may in some way prove to be useful for cancer treatments and help to provide a real positive difference. Nonetheless, we must keep in mind that, as with any treatment approach, side effects and complications can still occur and the use of wormwood my be limited and only effective for certain types of cancers.

    Most researchers acknowledge that wormwood should only be used in a professional setting together with a complementary approach applying immune support and dietary modifications. Some studies/research even utilize detoxification as part of the protocol, which I professionally would not introduce until at least six months after all treatments are completed.

    In a preponderance of research, artemisinin is almost always used in concert with other supplements or herbals, rarely alone by itself. So there is obviously more to all of this. Based on the approach of these studies we are not really sure what is creating the positive results in these mice (not people). With more than one variable involved we have to ask ourselves which came first?…the artemisinin or the supplements, the artemisinin or the lifestyle, the chicken or the egg, the declared winner or the election (sorry, I could not help that last one.)

    So as this artemesinim wormwood controversy makes an effort to billboard, right now this reporter feels there are just too many worms in the wood.

    Be good to yourself,

    Dr. Bufi

    Dr Bufi
  2. January 13, 2009 - 8:05 pm

    Both of you Dr. West and Dr. Bufi, you both have to remember that sure the Artemisinin has been tested on rats and that rats and humans are no comparison true there but also Dr. Bufi you say what came first the chicken or the egg…. I comment to you both, the medicine Industry is a TRILLION dollars industry, and all of the DRUGS that both of you doctors West and Bufi that both of you prescribe are governed by the FDA the Government makes Money of of Drugs, those drugs that are given to patients are Tested on Rats as the Artemisinin was tested so Dr. Bufi what came first the Drug (Pill) or Science?? What makes me really mad is that people will get on the internet and post their expereince with Artmesinin TRUE LIFE EXPERIENCES that it worked for them without the use of Chemotherapy and You Doctors and Governemt Will shut them down saying either you were misdiagnosed or you didn’t have cancer in the first place, when they advertise Drugs or prescribed pills for patients the show all of the Toxic Side effects of the Drug but That is ok for everyone to take because the Government can regulate Making Money off of it, the government cannot regulate a herb because it is accessable to everyone, example Sovereign Silver a colloidal silver tested with an electron miscroscope shows Numerous lab results compared to High Potent Doctor Prescribed Drugs against a bacteria and concludes that the Sovereign Siler killed the bacteria within 6 minutes and the High Potent Doctor Prescribed Drug didn’t, you go into CVS and find Bandaids on the Shelf that Contain Silver on the Bandaid to put on a cut hm let me think now since Colloidal silver a clean colloidal silver Sovereign Silver cannot be administered for cuts by a doctor MD Doctor but they can give you a bandaid that has silver on it from CVS???? it all comes down to Money Money and GREED GREED. There are cures out there but if the Government cannot Govern that cure through Medicine and Make MONEY off of it then it is considered not a cure. Don’t get me wrong one must use others stuff in conjunction like Immune Boosters that work together to keep the Internal Human System working together bo become Strong not only one drug or Herb and do the trick but Lets give credit to some Herbs like lets give Credit to some Drugs not all Herbs work and NOT ALL DRUGS WORK.

    JGROH
  3. May 3, 2009 - 8:41 pm

    sloan kettering and cancer care alliance - on no evidence - not to be mean but I say Poppy Cock to them once again,

    Those two organizations told me three years ago my wife would never make it past 6 months. They also told me no one has ever lived past a year with her diagnoses - they also told me - a Dr from eatons team there was no proof that the immune system treatements like stimuvax or anything like it helped fight cancer. When they say anything I beleive the opposite - the opposite has happened on every single thing they told us including what her response would be on tarceva and what my dead friends results would be on their treatments for stage iv pancreatic cancer.

    If they say it I do the opposite so I am going to buy some of this stuff today! ;-)

    of course is a sad tale but I can prove every word on paper - three years later at Cancer treatment center and swedish medical centers infusions and scans, etc and my wife is Alive, playing keyboards and my friend is 8 feet under after just 8 months of their treatments.

    I saw a lady given six months to live with stage 4 pancreatic cancer and instead of dead she was in remission after six months! I was blown away but she was a real person not some story. artemisinin here I come ! ;-0

    God Bless
    Joe

    oracle
  4. October 7, 2009 - 11:20 am

    Artemisinin is a well researched compound. The University of Washington, College of Engineering posts more than 150 cites for scientific studies on artemisinin and cancer: http://depts.washington.edu/bioe/about/news/artemisinin/artemisinin.html.

    I believe cancer patients must look to cancer research instead of depending on drugs patented by drug companies. Many substances are overlooked by drug companies because of the amount of profit they may provide. The research I have on ARS is as follows:

    ARS and a number of its derivatives (artesunate, dihydroartemisinin, artemether, arteether) have been found to be MDR reversal agents and cytotoxic agents. They are mild inhibitors of P-glycoprotein and according to one study may prevent drug resistance by affecting the mitochondria 1.
    What makes artemisinin an MDR reversal agent is not as well understood as its cytotoxic properties, which have been well documented. Artemisinin and its derivatives have been found to induce apoptosis by creating peroxide-induced free radicals; by inhibiting pro-inflammatory cytokins 2 and VEGF. It was found to inhibit breast cancer by reducing levels of estrogen receptor A, making it an anti-estrogen 3. It is also known to inhibit angiogenesis.
    Perhaps its most prominent mode of action is the chemical reaction artemisinin causes when it comes in contact with iron: it creates reactive peroxide chemicals that kill cancer cells. Since cancer cells are known to have a higher rate of iron uptake than healthy cells, cancer cells are selectively destroyed 4.
    Of the semisynthetic derivatives that have been developed, ( artemether, arteether, artesunate (ART) and others) ART was found to be the most potent in vitro 5. It was found to induce apoptosis in Doxorubicin-resistant leukemia cells via reactive oxygen species (ROS) 6. Perhaps artesunate’s superior efficacy over other forms is due to the fact that it metabolizes into dihydroartemisinin (DHA), which has been identified as the most effective form of artemisinin in several studies 7, 8.
    Dr. Narenda Singh, bio of the University of Washington reports that a combination of artemisinin, artesunate and artemether may be the best treatment 9.
    The greatest problem with artemisinin products is that they lose bioavailability very quickly. In a patient study artemisinin plasma concentrations “decreased by the fifth day of administration to about 20% compared with those on the first day 10..” Researchers have attributed this to hepatocellular activity. Studies have found that ARS products cause an induction of CYP 450 enzymes that quickly metabolize the drug. Researchers found this to occur at doses approaching 500 mg, so lower doses of 200 mg/d may work best. The study noted that enzyme levels returned to normal in 6 – 8 days, which suggests that taking ARS on a one week on, one week off schedule may also be helpful 11. An ARS protocol may benefit from the inclusion of grapefruit, which is known to inhibit CYP 450 enzymes. The anti-acid drug Prilosec, which specifically inhibits CYP2C19 may also be helpful in inhibiting its rapid metabolism.
    Artemisinin products are toxic (particular the derivitaves) and will cause neutroprenia and elevated liver enzymes in high doses. A clinical trial in Germany is currently using artesunate at daily doses of up to 200 mg. (Clinical trials Gov. identifier: NCT00764036)

    1. Biological & pharmaceutical bulletin, 2002, vol. 25, no12, pp. 1555-1561
    2. Anti-malarial agent artesunate inhibits TNF-{alpha}-induced production of proinflammatory cytokines via
    inhibition of NF-{kappa}B and PI3 kinase/Akt signal pathway in human rheumatoid arthritis fibroblast-like
    synoviocytes. Rheumatology 46, 920-926 (2007)
    3. Artemisinin selectively decreases functional levels of estrogen receptor-alpha and ablates estrogen-induced proliferation in human breast cancer cells. Carcinogenesis 29, 2252-2258 (2008)
    4. Ancient Chinese remedy shows potential in preventing breast cancer, University of Washington News, Dec. 19, 2005
    5. In vitro test on Philippine isolates of Plasmodium falciparum against four standard antimalarials and four qinhaosu derivatives. Bull World Health Organ. 1994; 72(5): 729–735
    6. ROS-Mediated Apoptosis in Doxorubicin-Resistant T Leukemia Cells, PloS One 2(8): e693,
    doi: 0.1371/journal.pone.0000693
    7. The DHA derivitive was found to be the most effective variation of artemisinin against ovarian cancer cells. Acta Pharmacologica Sinica 2007 July; 28 (7): 1045-1056
    8. Dihydroartemisinin Induces Apoptosis and Sensitizes Human Ovarian Cancer Cells to Carboplatin Therapy, J Cell Mol Med. 2008 May 2.
    9. Artemisinin in Cancer Treatment, Dr. Narendra P. Singh, Department of Bioengineering University of Washington
    Seattle
    10. High In Situ Rat Intestinal Permeability of Artemisinin Unaffected by Multiple Dosing and With No Evidence of P-Glycoprotein, Drug Metabolism And Disposition, Vol 27, Issue 2, 227-232, February 1999
    11. A semiphysiological pharmacokinetic model for artemisinin in healthy subjects incorporating autoinduction of metabolism and saturable first-pass hepatic extraction, Br J Clin Pharmacol. 2005 February; 59(2): 189–198

    mlee_realtor@yahoo.com
  5. April 8, 2010 - 12:56 pm

    I couldn’t help but notice that the ACS article you cited is about Artemisia Absynthium, NOT Artemisia Annua, the source of artemisinin.

    Already got my bottle of artemisinin.

    Draoi
  6. April 9, 2010 - 9:54 am

    I tried it and it didn’t work for me, but I know several cancer patients who claim it did work for them. Like every treatment, there is resistance after some point with it and some people are now trying injectible ART. If you have cancer you try substances that have been found to kill or inhibit cancer cells. It is easy to tell if something is working for most people by tumor markers. If one thing doesn’t provide benefit we keep trying other things. I just wish there were more things available for me to try.

    mlee_realtor@yahoo.com