Cancer Approach: Aloe Vera

 

For a half-century, aloe vera “[g]el processors and distributors armed with biblical quotes and anecdotal testimonials” have sought “recognition for their products”—too often “accompanied” however, by “misinformation,” none of which were more elaborate than promoting aloe vera for the treatment of cancer. But, check out this recent case report. A 64-year-old Hispanic woman with a tumor on her eyeball, which looked like a classic case of ocular surface squamous neoplasia, a type of eye cancer. And, therefore, surgery was recommended to remove it. “[B]ut the patient declined [the surgery], and instead initiated the use of concentrated [aloe] vera eye drops 3 times [a day] based on a friend’s suggestion.” Just some off-the-shelf aloe vera gel product, and to the doctor’s surprise, the lesion showed significant improvement after just one month. And, two months later, it went from this to gone completely. At the time of writing, it was six years later, and it appeared the cancer was gone, and had stayed gone.

Now, normally, you’d go in and cut out the cancer “with wide margins” to make sure you get it all, because “[d]espite the best efforts of the ocular surgeon, recurrence rates as high as [worse-than-a-flip-of-a-coin] have been reported,” because there’s little bits of cancer you miss on surgery. And, here, there’s this tumor that disappeared without surgery.

Are we sure it was cancerous, though? Well, she “refused [a] biopsy.” So, we don’t know for certain. However, it did have all the defining characteristics. And so, to see it disappear without any side effects, and stay gone, is pretty extraordinary. “Surgical resection” still remains the recommended treatment, but at least there’s an option for patients to try if they don’t want to go down that route.

Of course, this was just a single case report, no control group. It’s not like she had tumors in both eyes, and just tried the aloe on one. There was a controlled study suggesting aloe could prolong survival in those with advanced untreatable cancer, but it wasn’t a randomized controlled study, but a decade later, there was.

Hundreds of patients with metastatic cancer “randomized to receive chemotherapy with or without Aloe,” and the aloe group had three times the number of complete responses, significantly greater objective tumor responses, and two-thirds had some level of disease control, compared to only half in the non-aloe group. But, does that translate out into improved survival? Yes. For example, at one year, 70% of the aloe group was still alive, whereas most in the non-aloe group were dead.

And, as a bonus, the chemo was “better tolerated” in the aloe group, with less fatigue, for example, and better maintenance of their immune system. So, given the better disease control, given the better survival, “This study seems to suggest that aloe may be” a successful add-on therapy in terms of both tumor regression rate and survival time.

Now, this was a randomized controlled study, but not a randomized placebo-controlled study. It’s not like the control group was getting like some fake aloe drink. So, some of the tumor response may have been like a mind-over-matter placebo effect.

Now, there are potential downsides. As I explained in a previous video, swallowing aloe can, in rare cases, trigger liver inflammation, and cause electrolyte imbalances, due to diarrhea or vomiting. For example, there was a case reported of “aloe-induced [low potassium] in a patient with breast cancer,” which rapidly resolved once she stopped the aloe—thought to be due to the laxative effect aloe can have.

If you want to talk to your doctor about giving it a try, note this was not aloe vera, but aloe arborescens, a tree-like aloe that can grow to be like 10 feet tall. The concoction they made was a mixture of about two-thirds of a pound of fresh aloe leaves to a pound of honey, plus about three tablespoons of 40% alcohol, given orally at a dose of two teaspoons, three times a day, “starting 6 days prior to the onset of chemo[therapy].”

 

 

 

 

“Worldwide attention was drawn to the possible value of [aloe] after the Second World War, when skin burns of victims of the atomic bombs on Japan were [evidently] successfully treated with [aloe vera] gel.” But you don’t really know for sure, until you put it to the test.

Today, most radiation burns are caused by doctors giving radiation treatments for cancer. These can cause severe, painful, scarring skin reactions that can interfere with the therapy. Yet, sadly, we have yet to come up with good “prophylactic skin treatment measures to prevent [this] radiation[-induced] skin toxicity.” Enter aloe vera gel, used on skin burns “for centuries.” So, a randomized double-blind placebo-controlled trial was performed: aloe vera gel versus a placebo gel, and no benefit was found.

“After the completion of [the study, though,] many clinicians involved felt that the patients participating in [the] trial had less” skin inflammation than normal across the board, suggesting that maybe the placebo gel was helping too. So, to their credit, they actually ran a second experiment to see if aloe was better than nothing. And, once again, aloe appeared to have no effect at all. “[I]n both trials the…severity scores were virtually identical”—meaning aloe vera gel simply didn’t work.

What about an even larger trial? Hundreds of patients randomized to aloe vera gel or just like plain skin lotion, not only during the radiation treatments, but extending for two weeks afterwards. And, the skin lotion placebo worked even better, in terms of reducing skin peeling and pain. And so, yet again, aloe failed. And, indeed, if you do a systematic review of all such studies, there is simply “no evidence” suggesting aloe is helpful.

Head and neck cancer patients suffer the additional burden of radiation damage to the lining of their mouth and throat, and aloe didn’t seem to help with that either.

Okay. So, aloe may not help with cancer treatment, but how about helping with the cancer itself? In a petri dish, aloe inhibits the proliferation of human breast cancer cells, cervical cancer cells, and lung cancer cells. So, is aloe vera a natural cancer soother? Unfortunately, “in vitro potency [meaning like petri dish studies] often fails to translate to the clinic,” because the compounds aren’t bioavailable enough to build up to test-tube-levels within the tumor in the body. So, while “[s]ome studies suggest an anti-proliferative effect on cancer cells in vitro…evidence from clinical trials [was] lacking.” Until…1998.

Fifty patients with advanced untreatable cancer treated with melatonin, which they thought might boost anticancer immunity, or melatonin with about 20 drops of an aloe extract twice a day, which they made by soaking one part aloe leaves to nine parts 40 proof alcohol. And, the aloe group appeared to do better—nearly twice as likely to either have “a partial response,” or at least some stabilization. And, the most important outcome: improved survival.

Here are the survival curves. So, for example, six months out, 80% of the aloe group were still alive, whereas more than half of the non-aloe group were dead. The researchers conclude that melatonin and aloe “may be recommended…[to] patients with very advanced untreatable [cancers] since it didn’t seem to cause any bad side effects, and seemed to help.

We don’t know if the aloe helps on its own, though, and a subsequent study by the same group muddied the waters further by adding a third component, a tincture of myrrh. But, the main problem with these studies is that they weren’t randomized. So, if sicker patients were intentionally—or unintentionally—placed in the non-aloe control group, that could explain the apparent aloe benefit. The problem is that there had never been any randomized studies of aloe for advanced cancers, until…now (or at least 2009), which we’ll cover, next.

 

 

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