Use of Complementary and Alternative Medicine (CAM) in Patients With Colorectal Cancer

Herbal and alternative medicine use: a cross sectional study to evaluate the prevalence and predictors of use in cancer patients

Background

Herbal and alternative medicine is increasingly used among cancer patients to manage disease, symptoms, and improve quality of life. Reported usage rates worldwide vary from 3.5% to 90%. Understanding prevalence and predictors of such use is essential for safety and efficacy, especially considering potential interactions with conventional treatments.

Methods

This cross-sectional study aimed to evaluate the prevalence and predictors of herbal medicine use among cancer patients in Jordan. All cancer patients, including pediatric and adult patients who can give consent or assent, were included in the study.

Results

Out of 602 patients surveyed, 163 (27.1%) reported using herbal medicine. Among users, 68.7% were female, 52.9% had lower education levels, and 60% were unemployed. Of the key predictors: lower income (OR = 3.24, p = 0.021) and self-perceived knowledge of herbal medicine (OR = 18.9, p < 0.001). Knowledge assessment revealed that 54% relied on social media for information, while only 11% consulted healthcare professionals. Between 60% and 80% of patients were unaware of potential interactions between herbal treatments and cancer therapies. Additionally, the 85% reported that their healthcare providers did not inform them about these risks. Reasons for using herbs and alternative included maintaining health (52.4%) and cancer treatment (47.6%). Among non-users, 29% doubted its effectiveness, and 34% felt uninformed.

Conclusion

The study revealed that low income and high self-perceived awareness about herbal medicine are key predictors of herbal usage. However, there is a significant knowledge gap, with many patients relying on social media and being unaware of potential interactions with oncology treatments. Customized educational interventions are needed to address these factors.

Cinnamaldehyde-Rich Cinnamon Extract Induces Cell Death in Colon Cancer Cell Lines HCT 116 and HT-29

Cinnamon is a natural spice with a wide range of pharmacological functions, including anti-microbial, antioxidant, and anti-tumor activities. The aim of this study is to investigate the effects of cinnamaldehyde-rich cinnamon extract (CRCE) on the colorectal cancer cell lines HCT 116 and HT-29. The gas chromatography mass spectrometry analysis of a lipophilic extract of cinnamon revealed the dominance of trans-cinnamaldehyde. Cells treated with CRCE (10-60 µg/mL) showed significantly decreased cell viability in a time- and dose-dependent manner. We also observed that cell proliferation and migration capacity were inhibited in CRCE-treated cells. In addition, a remarkable increase in the number of sub-G₁-phase cells was observed with arrest at the G₂ phase by CRCE treatment. CRCE also induced mitochondrial stress, and finally, CRCE treatment resulted in activation of apoptotic proteins Caspase-3, -9, and PARP and decreased levels of mu-2-related death-inducing gene protein expression with BH3-interacting domain death agonist (BID) activation.