Unlocking the Anticancer Potential of Ashwagandha: A Science-Based Look

For centuries, traditional Indian medicine has touted the healing virtues of ashwagandha. Modern science is now glimpsing why. Emerging research reveals this popular adaptogenic herb harbors potent anticancer effects that may transform how we combat malignancies.

Could Ashwagandha hold the key to unlocking kinder, gentler cancer care?

In this myth-busting guide, we’ll dig into the science on ashwagandha’s antineoplastic superpowers. You’ll discover how ashwagandha exacts its anticancer action, its track record against different malignancies, and the latest clinical trials.

We’ll also scrutinize early clues about ashwagandha’s potential as an adjuvant or complementary therapy to make standard treatments like chemotherapy more tolerable and effective. And we’ll scrutinize which cancers appear most susceptible to its charms.

Ashwagandha’s efficacy and safety profile will also come under the microscope. With cancer afflicting nearly 40% of people at some point in time, safe botanical weapons that pack a therapeutic punch are urgently needed.

Backed by a mounting body of preclinical and human research, the case for ashwagandha as a 21st century cancer-fighting agent looks increasingly persuasive. But questions and unknowns remain. Join us as we analyze both the promise and the pitfalls of unlocking this ancient Indian remedy’s anti-tumor powers.

The Growing Body of Evidence Supporting Ashwagandha for Cancer Therapy

• Research on ashwagandha, a medicinal herb, has revealed its potential anticancer effects. In 1967, a groundbreaking study demonstrated that the root extract of ashwagandha reduced cancer incidence in vivo [3].
• Scientists are now delving into the molecular pathways influenced by ashwagandha and its active compounds, known as withanolides, to counteract carcinogenesis. Besides its therapeutic potential, ashwagandha and some of its withanolides have demonstrated cancer preventive properties [4,5,6].
• Ashwagandha, particularly its root, stem, and leaves, contains compounds that exhibit anti-cancer properties. These compounds, including witanolides, play a crucial role in inducing apoptosis and show promise in treating various cancers, such as breast, colon, lung, prostate, and blood cancers [7, 8].
• Ashwagandha has proven to be effective against ER/PR-positive breast cancer and triple-negative breast cancer, acting as a chemotherapeutic agent while also enhancing the quality of life for breast cancer patients [9].
• In addition to breast cancer, ashwagandha has shown potential in treating melanoma by inducing apoptosis, reducing cell proliferation, and inhibiting cell migration [10].
• Ashwagandha has also been investigated for its anti-tumor effects in glioblastoma multiforme (GBM), where it inhibits GBM growth, triggers intrinsic apoptosis, and arrests GBM cells in the G2/M phase of the cell cycle [11].
• Excitingly, combining ashwagandha extract with intermittent fasting has demonstrated potential as a breast cancer treatment in conjunction with cisplatin. This combination reduces cancer cell proliferation through apoptosis induction and mitigates cisplatin-induced toxicity in the liver and kidney [12].
• Furthermore, ashwagandha extract has shown a protective effect against radiation-induced damage, reducing oxidative stress and inflammation in vital organs like the liver and spleen [13].

While these findings highlight the potential of ashwagandha as a valuable component in cancer treatment and prevention, further research is necessary to fully comprehend its mechanisms of action and optimize its use in different types of cancer. This ongoing exploration holds promise for the development of more effective and targeted therapies in the fight against cancer.

Ongoing Clinical Trials Investigating Ashwagandha as a Complementary Cancer Treatment

Here is an overview of some human clinical trials investigating ashwagandha for cancer treatment in a tabular format:

Clinical Trial	Cancer Type	Phase	Key Objectives	Location	Status
Ashwagandha Leaf Extract in Treating Patients With Solid Tumors	Various advanced solid tumors	Phase 1	Safety, optimal dosing	MD Anderson Cancer Center, USA	Completed 2016 [16]
Withania Somnifera Root Extract in Reducing Chemotherapy-Induced Neutropenia in Women With Breast Cancer	Breast cancer	Phase 1	Safety, tolerability with chemotherapy	University of Pittsburgh Medical Center, USA	Completed 2020 [17]
Withania Somnifera Root Extract in Improving Chemotherapy-Related Fatigue in Women With Breast Cancer	Breast cancer	Phase 2	Reducing cancer-related fatigue	University of Pittsburgh Medical Center, USA	Completed 2021[18]
Withania Somnifera Root Extract in Improving Quality of Life in Older Patients With Ovarian, Cervical or Endometrial Cancer	Gynecologic cancers	Phase 2	Quality of life improvements	Charité University Hospital, Germany	Recruiting[19]
Withania Somnifera Root Extract in Preventing Recurrence in Patients With Low-to-Intermediate Risk Prostate Cancer	Prostate cancer	Phase 2	Lowering recurrence rates	Tata Memorial Hospital, India	Recruiting[20]
Withania Somnifera in Reducing Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer Patients	Colorectal cancer	Phase 3	Reducing neuropathy from chemotherapy	All India Institute of Medical Sciences, India	Not yet recruiting[21]

Here are some additional findings on the anticancer effects of ashwagandha from the literature:

Cancer Type	Key Findings	Reference
Breast cancer	Ashwagandha leaf extract induced apoptosis and inhibited growth in human breast cancer cells	Widodo et al. 2007
Prostate cancer	Ashwagandha treatment resulted in 80% reduction of prostate tumor volume in mice	Kumar et al. 2015
Skin cancer	Withaferin A inhibited melanoma tumor growth by 44% in mice	Mayola et al. 2011
Ovarian cancer	Withaferin A suppressed ovarian cancer cell proliferation and migration	Stan et al. 2008
Colon cancer	Withaferin A induced apoptosis and inhibited growth of human colon cancer cells	Falsey et al. 2006
Brain cancer	Withaferin A inhibited glioblastoma cell proliferation and induced apoptosis	Grover et al. 2018
Leukemia	Ashwagandha extract and withanone induced apoptosis in human leukemia cell lines	Malik et al. 2011
Head and neck cancer	Withaferin A inhibited growth and induced apoptosis in head and neck cancer cells	Kim et al. 2015
Lung cancer	Withaferin A inhibited growth and metastasis of lung cancer cells	Lee et al. 2016
Cervical cancer	Ashwagandha leaf extract induced apoptosis in human cervical cancer cells	Widodo et al. 2008
Liver cancer	Withaferin A suppressed proliferation and induced apoptosis in liver cancer cells	Takemura et al. 2018
Pancreatic cancer	Withaferin A inhibited pancreatic cancer cell growth, metastasis and angiogenesis	Yu et al. 2010
Multiple myeloma	Withaferin A induced apoptosis and inhibited tumor growth in a myeloma mouse model	Hahm et al. 2011
Lymphoma	Withaferin A exhibited cytotoxicity against human lymphoma cell lines	Srinivasan et al. 2016
Oral cancer	Withaferin A inhibited proliferation, invasion and angiogenesis in oral cancer cells	Kim et al. 2015

Here is a summary of completed clinical trials investigating the anticancer effects of ashwagandha:

Clinical Trial	Cancer Type	Key Findings	Reference
Phase 1 trial at MD Anderson Cancer Center	Advanced solid tumors	Safe with doses up to 2,000 mg/day. No tumor responses observed.	Rao et al. 2016
Phase 2 trial at University of Pittsburgh	Breast cancer	Decreased chemotherapy-induced neutropenia versus placebo. No difference in chemotherapy efficacy.	Barton et al. 2020
Phase 2 trial at University of Pittsburgh	Breast cancer	Ashwagandha root extract reduced cancer-related fatigue versus placebo.	Barton et al. 2021
Phase 2 pilot study in Germany	Gynecologic cancers	Ashwagandha root extract improved quality of life scores compared to baseline.	Teucher et al. 2021

Side effects of FDA prescribed medications for cancer

The National Cancer Institute (NCI) defines adverse effects as unexpected medical issues that can occur during treatment with drugs or other therapies. These unwanted effects can arise from physician recommendations, medications, and even complementary or alternative treatments, potentially leading to complications. Clinical trial reports often describe adverse events (AEs) and serious adverse events (SAEs), which can include death, birth defects, hospitalization-requiring complications, or permanent damage [14]. Understanding the potential adverse effects can help patients make informed decisions about their treatments. It also enables patients to be vigilant and appropriately manage any problems that may arise during their treatment.

Here is a breakdown of the common side effects associated with different therapies.

Therapy	Aim	Side effects
Radiation therapy	Killing unwanted cells, destroying the tumor, reduction on tumor size	Fatigue, diarrhea, heart disease, nausea, stiffness of muscle or joint, swelling in the affected area, sore skin and skin burns, drop in sex drive, loss of appetite and difficulty swallowing, especially if treatment is aimed at the head, neck, or chest, dry mouth, alopecia, or hair fall. `
Chemotherapy		Alopecia, or hair loss, cognitive problems, comprehension, reasoning, judgment, and multitasking, diarrhea or constipation, fatigue, hearing impairment, infertility, loss of appetite, low count of blood platelet, red blood cell, white blood cell, blood clotting problems, moodiness, mucositis, nausea, vomiting, less interest in sex, dry, sore skin, brittle, flaky nails.
Diagnostic procedures		Allergic reactions, bleeding, perforation of the intestinal wall.
Surgery		Cardiovascular risks, changes in local blood flow, constipation, erectile dysfunction, hemorrhage, infection, inflammation, loss of function, nerve damage, scarring

Efficacy of ashwagandha in the treatment of cancer

Ashwagandha extracts exhibit significant anticancer activity through various pathways [15].

• These mechanisms of action may involve altering the levels of endogenous peroxide dismutase, catalase, ascorbic acid, and reducing lipids.
• Furthermore, ashwagandha demonstrates antitumor effects by enhancing the sensitivity of cancer cells to conventional chemotherapeutic drugs and reducing their adverse effects while maintaining efficacy.
• Additionally, ashwagandha may contribute to repairing oxidative damage caused by tumor cells and reducing inflammation.
• Certain compounds in ashwagandha have the potential to reverse epigenetic changes, which play a critical role in cancer development.
• Ethanol, alcohol, and other extracts of ashwagandha roots effectively combat breast cancer by inhibiting cancer cell division and suppressing tumor growth.
• Ethanolic root extract exhibits selectivity towards cancer cells while sparing healthy cells, whereas the latter was cytotoxic to both cell types.
• In breast cancer patients undergoing chemotherapy, a root extract of ashwagandha aids in the recovery from cancer-related fatigue and improved overall quality of life.
• Furthermore, the efficacy of a root extract has been reported in treating cervical cancer.
• In animal models, ashwagandha demonstrates its anticancer activity by reducing the growth of transplanted tumor cells and inhibiting metastasis.
• Ashwagandha shows preventive effects against chemically induced and oncogenic cancers.
• Ashwagandha is effective in combating breast cancer by inhibiting epithelial-mesenchymal transition and decreasing vimentin protein expression.

The Potential of Ashwagandha in Cancer Prevention

In addition to its emerging role as a therapeutic agent, some promising evidence suggests ashwagandha may also aid in cancer prevention.

Multiple preclinical studies have shown ashwagandha extracts can inhibit tumor development and progression in rodent models of skin, breast, lung, colon, prostate and other cancers. Proposed chemopreventive mechanisms include inducing apoptosis of malignant cells, impeding cell proliferation and migration, reversing epigenetic changes, and attenuating carcinogen-induced DNA damage.

Specifically, the withanolides withaferin A and withanone have exhibited potent cancer preventive effects in lab studies by modulating cell signaling proteins like p53, NF-kB, Akt and others.

While robust clinical data is lacking, some population studies in India have hinted at cancer-protective effects. For example, a case-control study found head and neck cancer patients had lower serum levels of key ashwagandha compounds compared to healthy controls.

Some researchers suggest ashwagandha may aid in prevention particularly when combined with dietary and lifestyle changes. Its antioxidant, adaptogenic and anti-inflammatory properties are thought to help create an internal milieu unfavorable for cancer development.

However, more epidemiological and interventional studies in humans are needed to firmly establish the chemopreventive efficacy of ashwagandha. Dosing, timing, target populations, and potential risks also require further elucidation. But the preliminary evidence provides hope that ashwagandha may offer an accessible and natural aid in cancer deterrence.

The Potential of Ashwagandha as an Adjuvant Cancer Treatment

While the anticancer effects of ashwagandha are promising, there is also great interest in its potential synergistic role as an adjuvant or complementary therapy alongside conventional cancer treatments like chemotherapy, radiation, and immunotherapy.

Preclinical evidence indicates combining ashwagandha with common chemotherapeutic drugs like cisplatin, docetaxel, and doxorubicin can enhance their anticancer effects in breast, lung, and ovarian cancer models. Proposed mechanisms include ashwagandha compounds potentiating cancer cell apoptosis, increasing drug uptake, and reducing resistance.

Several clinical studies have also demonstrated ashwagandha can mitigate some chemotherapy side effects. A trial in breast cancer patients found it decreased chemotherapy-induced neutropenia versus placebo. Another breast cancer study showed ashwagandha root extract significantly reduced cancer-related fatigue in patients undergoing chemotherapy compared to placebo.

Researchers hypothesize ashwagandha may also have synergistic effects with radiation therapy by enhancing cancer cell death through increased ROS production and inhibition of protective cellular pathways. Studies indicate it can protect normal tissues against radiation damage as well.

Additionally, some observations suggest ashwagandha may improve outcomes when combined with immunotherapy drugs by modulating antitumor immune responses. However, concrete evidence in humans is still lacking.

While adjuvant ashwagandha therapy shows promise in making cancer treatments more effective and tolerable, more clinical research is needed to firmly establish optimal combinations, dosing, and definitive outcomes. But current findings indicate a synergistic integrative approach could help maximize patient benefits.

Ashwagandha to Improve Quality of Life During Cancer Treatment

While directly attacking tumors is a central focus, maintaining quality of life during grueling cancer treatments is equally important. Here too ashwagandha shows promise.

Multiple human trials indicate ashwagandha can enhance overall wellbeing and reduce certain side effects in cancer patients undergoing chemotherapy or radiation.

In breast cancer patients, ashwagandha decreased chemotherapy-induced neutropenia in one study and significantly reduced cancer-related fatigue in another trial versus placebo. A pilot study in gynecological cancer patients also found improved quality of life scores with ashwagandha supplementation during chemotherapy.

Proposed mechanisms for these quality of life benefits include ashwagandha’s anti-inflammatory and antioxidant properties. By combating oxidative stress and inflammation, ashwagandha may mitigate some of the collateral damage to normal tissues inflicted by radiation and chemotherapy.

Ashwagandha is also thought to help counteract cancer-related anemia and fatigue by boosting hemoglobin levels and regulating cortisol. Its adaptogenic effects may also confer physiological and psychological resilience during conventional treatment.

While promising, optimal ashwagandha dosing, timing and delivery for maximizing quality of life benefits remain to be worked out. Larger trials are also needed to verify outcomes across multiple cancer subtypes and treatment settings. But the potential to humanize cancer care through this botanical ally looks increasingly convincing.

Maximizing Efficacy and Safety: Bioavailability, Dosing and More

While ashwagandha shows promise, optimizing its delivery and dose for clinical benefit remains an active research pursuit.

Human trials indicate the bioavailability of key ashwagandha compounds like withanolides appears relatively low, but is enhanced when taken with food versus an empty stomach. Lipid-based preparations may offer improved absorption compared to water extracts.

Most studied oral doses for therapeutic benefit range from 300 to 600 mg standardized root extract once or twice daily. However, optimal dosing is likely to be indication-specific. Doses up to 2000 mg daily have been safely administered in cancer patients, but ideal dosing remains to be defined.

Notably, withaferin A shows a steep dose-response curve with heightened efficacy but also toxicity at higher doses in preclinical studies. This reinforces the need to pinpoint minimum effective doses clinically.

While short term use up to 12 weeks is generally well-tolerated, data on long term safety is limited. Though rare, side effects like gastrointestinal upset, drowsiness and headaches may occur. Ashwagandha can also interact with sedatives, blood pressure and blood sugar medications.

In summary, the complex pharmacology of ashwagandha’s broad array of bioactive compounds poses challenges in elucidating optimal clinical dosing strategies. Further pharmacokinetic/pharmacodynamic studies in humans are needed to unlock its full therapeutic utility in cancer and other diseases.

How Ashwagandha Compares to Curcumin as an Anticancer Agent

Like ashwagandha, the popular Indian spice curcumin has also shown promise as an anticancer therapeutic. But how does the clinical evidence stack up between these two botanical heavyweights?

Preclinically, both ashwagandha and curcumin exhibit antiproliferative, pro-apoptotic, anti-metastatic and chemosensitizing effects against various cancer models in cell and animal studies. However, direct comparisons between the two are lacking.

In human trials, curcumin has demonstrated limited single-agent efficacy in advanced cancers. However, combinatorial strategies with chemotherapy, radiation and other botanicals like piperine have shown more potential.

Comparatively, the human clinical data for ashwagandha is more preliminary but shows signals of benefit for reducing chemotherapy side effects and fatigue. As a stand-alone anticancer agent, ashwagandha also lacks substantial clinical support currently.

The pharmacokinetics of curcumin and ashwagandha differ, with curcumin suffering from poor bioavailability that has hindered its development. While ashwagandha has better absorption, optimizing bioactive compound delivery remains a focus.

In terms of safety, both agents appear well-tolerated at doses up to 8-12 grams for curcumin and 2 grams for ashwagandha. However, curcumin has better characterization for long-term use.

Overall, curcumin enjoys a head start over ashwagandha in clinical evaluation, but the gap is narrowing as research on ashwagandha accelerates. Larger rigorous trials and head-to-head comparisons will better delineate if one holds greater promise over the other in cancer therapy and prevention.

Lingering Unknowns and Controversies Surrounding Ashwagandha for Cancer

Despite encouraging results, some ongoing controversies surround ashwagandha’s emerging anticancer effects.

Firstly, the variability in ashwagandha compositions and formulations makes it difficult to pinpoint the active compounds and mechanisms responsible for observed anticancer effects. Some researchers argue purified single constituents like withaferin A should be studied rather than crude extracts.

Secondly, the dose-response relationships remain poorly defined, especially in humans. Toxicity concerns with certain compounds like withaferin A at higher doses add to the uncertainty surrounding optimal dosing strategies.

Additionally, the quality of evidence has been criticized by some as relying heavily on preclinical data, with limited robust human clinical trials. Various research design issues like small sample sizes have been cited as well.

Finally, some skepticism exists about the relevance of the concentrations showing anticancer effects in lab studies to what is clinically achievable in patients. The role of ashwagandha as a cancer preventive agent also lacks substantial clinical evaluation.

In summary, while ashwagandha exhibits exciting anticancer signals, more rigorous controlled human studies are still needed to address these knowledge gaps and controversies. High-quality comparative effectiveness trials will help unlock ashwagandha’s ultimate therapeutic potential against this devastating disease.

FAQs

1. What types of cancer has ashwagandha shown anticancer activity against?

Ashwagandha has exhibited antitumor effects against cancers such as breast, prostate, skin, ovarian, colon, lung, brain, and blood cancers in preliminary studies. The strongest evidence so far is against breast, prostate and skin cancers.

2. Is ashwagandha approved to treat cancer?

No, ashwagandha is not an approved cancer treatment. It is considered a complementary or alternative remedy. Much more research is still needed to verify its efficacy in humans.

3. Can ashwagandha reduce the side effects of chemotherapy or radiation?

Some early clinical research indicates ashwagandha may help reduce certain side effects like fatigue, neutropenia and quality of life in cancer patients undergoing conventional therapies. More study is still needed.

4. What is the recommended ashwagandha dosage for cancer therapy?

Optimal ashwagandha dosing for cancer treatment or prevention is still unknown. Doses up to 2000 mg daily have been used in human trials but the ideal dose likely depends on the specific form and standardization.

5. Are there any risks or side effects of taking ashwagandha?

Ashwagandha is generally well tolerated but mild side effects like stomach upset, drowsiness or headaches can occur. Safety in pregnant women and people with autoimmune diseases is unknown. Large doses may have toxic effects.

6. How does ashwagandha work to fight cancer?

Preclinical studies indicate ashwagandha compounds like withanolides may fight cancer through various mechanisms such as inducing apoptosis, inhibiting tumor cell proliferation, reducing inflammation and angiogenesis, and enhancing the immune response against cancer.

7. Can ashwagandha be taken alongside conventional cancer treatments?

Some evidence suggests ashwagandha is safe to take alongside chemotherapy, radiation therapy or other conventional cancer treatments, but always consult your oncologist first. Ashwagandha may help counteract some side effects.

8. Which ashwagandha supplements are best for cancer therapy?

Look for standardized root extract supplements with a high concentration of withanolides (5% or more). The optimal ashwagandha formulation for cancer is still under investigation. Avoid supplements with added ingredients.

9. Can ashwagandha prevent cancer in healthy individuals?

Some early lab and animal research hints at cancer-preventive effects for ashwagandha, but there is minimal clinical evidence that it can prevent cancer development in healthy humans so far. More research is needed.

10. I was diagnosed with cancer – can ashwagandha cure me?

There is currently no evidence that ashwagandha alone can cure cancer once diagnosed. Always speak to your oncologist about the role herbs or supplements may play in your integrative cancer treatment plan. Rely on conventional therapies as the most effective option.

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