By MSD in the Philippines
Herbal medicine, also known as botanical medicine or phytotherapy, uses plants, their parts, or mixtures of plant extracts to treat illnesses1. It is widely used in the Philippines as an alternative to standard medical treatment for cancer.
A cross-sectional survey conducted in 2018 surveyed 380 patients with cancer on follow-up at the Philippine General Hospital (PGH) Medical Oncology outpatient clinic about their condition and herbal and dietary supplements (HDS) intake patterns. The cross-sectional survey revealed that 88.95% of the respondents used HDS in the course of their illness, and 62.72% reported an almost-daily usage2.
Modern medicine is often costly and stigmatized because of possible side effects to patients. In the hopes of improving their condition, some patients try to look for alternatives that are less expensive and have milder effects on their bodies. However, completely replacing standard medical treatment with only herbal medicine entails numerous health risks. Without the guidance of a medical professional, patients can endanger themselves and worsen their condition.
Below are some information that cancer patients should know about herbal medicine:
1. The efficacy of herbal medicine in cancer treatment is still under-researched.
In their study titled “Applying an Ethical Framework to Herbal Medicine,” Chatfield et al. (2018) expressed that the effectiveness of herbal medicines is still under-researched. Scientists are still yet to prove the healing properties of herbs against cancer1.
Without sufficient scientific support, the clinical efficacy of herbal pharmaceuticals is unable to be demonstrated. Most doctors rely on clinically tested medicine to accurately treat their patients and fully inform them of the possible risks and benefits.
Moreover, marketing claims referenced on unfounded user testimonials and personal anecdotes on unproven HDS may entail significant health risks3.
2. False assumptions on the effects of herbal medicine may entail health risks.
Chatfield et al. (2018) also stated that many people falsely assume that herbal medicine is safer because of their natural origin. Still, these herbal products have pharmacological effects like standard medicine1.
Some individuals may be allergic to certain herbs, and intaking them without proper medical consultation puts them at risk.
3. Relying on herbal medicine alone may delay proper assessment and treatment.
Using only herbal pharmaceuticals may deprive patients of the proper medical attention they need. It can result in the worsening of their condition and may even expedite the risk of mortality.
The same study from the Philippine General Hospital (PGH) Medical Oncology Clinic showed that about 25% (85 patients) of the survey respondents relied initially on herbal and dietary supplements alone. This sole reliance on alternative supplements delayed them in getting conventional cancer treatment2.
The study also revealed that among 380 respondents, 76.29% of patients who take HDS were largely unmonitored2. Patients who are not guided by medical professionals may be endangering themselves more. Delays in diagnosis and treatment may increase mortality among patients, becoming more detrimental when prolonged4.
4. Some herbs interfere with standard cancer treatment.
Certain herbs contain properties that can interfere with standard cancer treatment. These herbal attributes may impede the conventional pharmaceuticals’ medicinal effects or influence them to become toxic to the patient3.
For instance, some dietary and natural products can interfere with surgery, chemotherapy and radiation therapy5.
Meanwhile, other herbal supplements may have adverse effects on a patient undergoing surgery, such as decreased efficacy of anesthetics or detrimental complications like bleeding or high blood pressure. Hence, when patients are under conventional cancer treatments, they should consult first with their health care team about using dietary or natural products6.
5. There is a lack of regulation surrounding HDS.
In the Philippines, legislative controls on herbal medicine were established through the passage of Republic Act 8423 in 1997. The Act brought forward the creation of the Philippine Institute of Traditional and Alternative Health Care (PITAHC), leading the research, promotion, advocacy, and development of standards on traditional and alternative health care and its integration into the national health care delivery system. Thus, further improving the quality and accessibility of healthcare services to Filipinos7, 8.
Nevertheless, even with the current policies placed for herbal medicines, patients should consult their treating healthcare professional about whether the use of HDS is appropriate. Like conventional drugs, herbal medicines have adverse effects, such as growing antibiotic resistance, that should be considered, particularly when these are used for a specific disease8.
Moreover, current regulatory policies still lack provisions regarding HDS’s implications of long-term effects, efficacy and safety for public use, and potential interactions with other food and drugs. Also, the operating regulatory guidelines of the PITAHC currently does not have environmental provisions to ensure the reliable supply of herbal medicinal plants8.
As of 2018, there only are ten (10) Philippine medicinal plants approved for therapeutic utility by the Food and Drug Administration (FDA) 7. However, none of these plants have been approved in the country for cancer treatment.
6. There is no standard dosage for HDS.
There is currently insufficient evidence to support the proper dosage prescription of herbs. Although supplements may come with dosage recommendations from the manufacturer, these remain just recommendations. Currently, RA 8423 lacks the means for testing the developmental toxicity and carcinogenicity of herbal medicines with known or unknown traditional use8.
Subsequently, underdosing and overdosing on herbal medicine can lead to potential health risks that ma worsen a patient’s condition9.
Herbal medicine is only one of many alternative medical treatments in the country. With standard medical treatment expenses, many people are willing to try cheaper alternatives.
With the prevalence of cancer in the country, the health sector is prompted to conduct further research and scientific studies to provide cancer patients with more treatment options. If patients want to try an alternative treatment or complementary medicine, they should always seek the advice of professional doctors.