Skip to main content
Top
Published in: BMC Complementary Medicine and Therapies 1/2016

Open Access 01-12-2016 | Research article

Herbal remedies and functional foods used by cancer patients attending specialty oncology clinics in Trinidad

Authors: Yuri N. Clement, Varune Mahase, Annelise Jagroop, Kelly Kissoon, Aarti Maharaj, Prashant Mathura, Chrys Mc Quan, Divya Ramadhin, Cherrista Mohammed

Published in: BMC Complementary Medicine and Therapies | Issue 1/2016

Login to get access

Abstract

Background

Cancer is a major disease worldwide, and many patients use complementary and alternative treatments. The purpose of this study was to identify the herbal remedies and functional foods used as complementary medicine by prostate, breast and colorectal cancer patients at speciality care facilities in Trinidad. We also sought to determine how patients rated the efficacy of these modalities compared with conventional treatment.

Methods

A descriptive, cross-sectional survey was conducted using an interviewer-administered pilot-tested de novo questionnaire during the period June to August 2012 at two speciality treatment centres on the island. Data was analysed using χ2 analyses.

Results

Among the 150 patients who reported use of herbal remedies/functional foods, soursop (Annona muricata L.) was the most popular; with 80.7 % using the leaves, bark, fruit and seeds on a regular basis. Other common herbal remedies/functional foods included wheatgrass (Triticum aestivum L.), saffron (Crocus sativus L.) and Aloe vera (L.) Burm. f. The most commonly used functional foods were beetroot (Beta vulgaris L.), carrots (Daucus carata L.) and papaya (Carica papaya L.) used by 43.3 % of patients; and these were mostly blended as a mixture. Herbal remedies and functional foods were used on a daily basis and patients believed that this modality was equally (32.0 %) or more efficacious (14.7 %) than conventional treatment.

Conclusions

This survey identified the most common herbal remedies and functional foods used among prostate, breast and colorectal cancer patients in Trinidad. Although functional foods rarely pose a problem, herbs may interact with conventional chemotherapy and physicians need to inform patients regarding probable herb-drug interactions.
Appendix
Available only for authorised users
Literature
2.
go back to reference Warner WA, Morrison RL, Lee TY, Williams TM, Ramnarine S, Roach V, et al. Associations among ancestry, geography and breast cancer incidence, mortality, and survival in Trinidad and Tobago. Cancer Med. 2015;4(11):1742–53.CrossRefPubMedPubMedCentral Warner WA, Morrison RL, Lee TY, Williams TM, Ramnarine S, Roach V, et al. Associations among ancestry, geography and breast cancer incidence, mortality, and survival in Trinidad and Tobago. Cancer Med. 2015;4(11):1742–53.CrossRefPubMedPubMedCentral
3.
go back to reference Bunker CH, Patrick AL, Maharaj G, Keenan HA, Ramnarine S, Belle A, et al. Prostate cancer risk is three-fold higher among men, aged 50–64, of African descent compared with men of Asian-Indian descent in Trinidad and Tobago. Ethn Dis. 2002;12(4):S3-30-3.PubMed Bunker CH, Patrick AL, Maharaj G, Keenan HA, Ramnarine S, Belle A, et al. Prostate cancer risk is three-fold higher among men, aged 50–64, of African descent compared with men of Asian-Indian descent in Trinidad and Tobago. Ethn Dis. 2002;12(4):S3-30-3.PubMed
4.
go back to reference Mungrue K, Moonan S, Mohammed M, Hyatali S. Prostate cancer survival in Trinidad: Is PSA a prognostic factor? Can Urol Assoc J. 2012;6(6):E249–55.CrossRefPubMed Mungrue K, Moonan S, Mohammed M, Hyatali S. Prostate cancer survival in Trinidad: Is PSA a prognostic factor? Can Urol Assoc J. 2012;6(6):E249–55.CrossRefPubMed
5.
go back to reference Ragin C, Mutetwa B, Attong-Rogers A, Roach V, Taioli E. Geographic and outcome variation among black men diagnosed with prostate cancer. Infect Agent Cancer. 2011;6 Suppl 2:S2.CrossRefPubMedPubMedCentral Ragin C, Mutetwa B, Attong-Rogers A, Roach V, Taioli E. Geographic and outcome variation among black men diagnosed with prostate cancer. Infect Agent Cancer. 2011;6 Suppl 2:S2.CrossRefPubMedPubMedCentral
6.
go back to reference Taioli E, Attong-Rogers A, Layne P, Roach V, Ragin C. Breast cancer survival in women of African descent living in the US and in the Caribbean: effect of place of birth. Breast Cancer Res Treat. 2010;122(2):515–20.CrossRefPubMed Taioli E, Attong-Rogers A, Layne P, Roach V, Ragin C. Breast cancer survival in women of African descent living in the US and in the Caribbean: effect of place of birth. Breast Cancer Res Treat. 2010;122(2):515–20.CrossRefPubMed
7.
go back to reference Camacho-Rivera M, Ragin C, Roach V, Kalwar T, Taioli E. Breast cancer clinical characteristics and outcomes in Trinidad and Tobago. J Immigr Minor Health. 2015;17(3):765–72.CrossRefPubMed Camacho-Rivera M, Ragin C, Roach V, Kalwar T, Taioli E. Breast cancer clinical characteristics and outcomes in Trinidad and Tobago. J Immigr Minor Health. 2015;17(3):765–72.CrossRefPubMed
8.
go back to reference Mutetwa B, Taioli E, Attong-Rogers A, Layne P, Roach V, Ragin C. Prostate cancer characteristics and survival in males of African Ancestry according to place of birth: data from Brooklyn-New York, Guyana. Tobago and Trinidad Prostate. 2010;70(10):1102–9.CrossRefPubMed Mutetwa B, Taioli E, Attong-Rogers A, Layne P, Roach V, Ragin C. Prostate cancer characteristics and survival in males of African Ancestry according to place of birth: data from Brooklyn-New York, Guyana. Tobago and Trinidad Prostate. 2010;70(10):1102–9.CrossRefPubMed
9.
go back to reference Pihlak R, Liivand R, Trelin O, Neissar H, Peterson I, Kivistik S, et al. Complementary medicine use among cancer patients receiving radiotherapy and chemotherapy: methods, sources of information and the need for counselling. Eur J Cancer Care (Engl). 2014;23(2):249–54.CrossRef Pihlak R, Liivand R, Trelin O, Neissar H, Peterson I, Kivistik S, et al. Complementary medicine use among cancer patients receiving radiotherapy and chemotherapy: methods, sources of information and the need for counselling. Eur J Cancer Care (Engl). 2014;23(2):249–54.CrossRef
10.
go back to reference Liu TG, Xiong SQ, Yan Y, Zhu H, Yi C. Use of chinese herb medicine in cancer patients: a survey in southwestern china. Evid Based Complement Alternat Med. 2012;2012:769042.PubMedPubMedCentral Liu TG, Xiong SQ, Yan Y, Zhu H, Yi C. Use of chinese herb medicine in cancer patients: a survey in southwestern china. Evid Based Complement Alternat Med. 2012;2012:769042.PubMedPubMedCentral
11.
go back to reference Clement YN, Williams AF, Aranda D, Chase R, Watson N, Mohammed R, et al. Medicinal herb use among asthmatic patients attending a specialty care facility in Trinidad. BMC Complement Altern Med. 2005;5:3.CrossRefPubMedPubMedCentral Clement YN, Williams AF, Aranda D, Chase R, Watson N, Mohammed R, et al. Medicinal herb use among asthmatic patients attending a specialty care facility in Trinidad. BMC Complement Altern Med. 2005;5:3.CrossRefPubMedPubMedCentral
12.
go back to reference Clement YN. Herbal self-medication at primary health care facilities in Trinidad. J Altern Complement Med. 2009;15(1):6–7.CrossRefPubMed Clement YN. Herbal self-medication at primary health care facilities in Trinidad. J Altern Complement Med. 2009;15(1):6–7.CrossRefPubMed
13.
go back to reference Clement YN, Morton-Gittens J, Basdeo L, Blades A, Francis MJ, Gomes N, et al. Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad. BMC Complement Altern Med. 2007;7:4.CrossRefPubMedPubMedCentral Clement YN, Morton-Gittens J, Basdeo L, Blades A, Francis MJ, Gomes N, et al. Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad. BMC Complement Altern Med. 2007;7:4.CrossRefPubMedPubMedCentral
15.
go back to reference Poonthananiwatkul B, Lim RH, Howard RL, Pibanpaknitee P, Williamson EM. Traditional medicine use by cancer patients in Thailand. J Ethnopharmacol. 2015;20(168):100–7.CrossRef Poonthananiwatkul B, Lim RH, Howard RL, Pibanpaknitee P, Williamson EM. Traditional medicine use by cancer patients in Thailand. J Ethnopharmacol. 2015;20(168):100–7.CrossRef
17.
go back to reference Chang FR, Wu YC. Novel cytotoxic annonaceous acetogenins from Annona muricata. J Nat Prod. 2001;64(7):925–31.CrossRefPubMed Chang FR, Wu YC. Novel cytotoxic annonaceous acetogenins from Annona muricata. J Nat Prod. 2001;64(7):925–31.CrossRefPubMed
18.
go back to reference Liaw CC, Chang FR, Lin CY, Chou CJ, Chiu HF, Wu MJ, et al. New cytotoxic monotetrahydrofuran annonaceceous acetogenins from Annona muricata. J Nat Prod. 2002;65(4):470–5.CrossRefPubMed Liaw CC, Chang FR, Lin CY, Chou CJ, Chiu HF, Wu MJ, et al. New cytotoxic monotetrahydrofuran annonaceceous acetogenins from Annona muricata. J Nat Prod. 2002;65(4):470–5.CrossRefPubMed
19.
go back to reference Sun S, Liu J, Kadouh H, Sun X, Zhou K. Three new anti-proliferative Annonaceous acetogenins with mono-tetrahydrofuran ring from graviola fruit (Annona muricata). Bioorg Med Chem Lett. 2014;24(12):2773–6.CrossRefPubMed Sun S, Liu J, Kadouh H, Sun X, Zhou K. Three new anti-proliferative Annonaceous acetogenins with mono-tetrahydrofuran ring from graviola fruit (Annona muricata). Bioorg Med Chem Lett. 2014;24(12):2773–6.CrossRefPubMed
20.
go back to reference George VC, Kumar DR, Rajkumar V, Suresh PK, Kumar RA. Quantitative assessment of the relative antineoplastic potential of the n-butanolic leaf extract of Annona muricata Linn. in normal and immortalized human cell lines. Asian Pac J Cancer Prev. 2012;13(2):699–704.CrossRefPubMed George VC, Kumar DR, Rajkumar V, Suresh PK, Kumar RA. Quantitative assessment of the relative antineoplastic potential of the n-butanolic leaf extract of Annona muricata Linn. in normal and immortalized human cell lines. Asian Pac J Cancer Prev. 2012;13(2):699–704.CrossRefPubMed
21.
go back to reference Yang C, Gundala SR, Mukkavilli R, Vangala S, Reid MD, Aneja R. Synergistic interactions among flavonoids and acetogenins in Graviola (Annona muricata) leaves confer protection against prostate cancer. Carcinogenesis. 2015;36(6):656–65.CrossRefPubMedPubMedCentral Yang C, Gundala SR, Mukkavilli R, Vangala S, Reid MD, Aneja R. Synergistic interactions among flavonoids and acetogenins in Graviola (Annona muricata) leaves confer protection against prostate cancer. Carcinogenesis. 2015;36(6):656–65.CrossRefPubMedPubMedCentral
22.
go back to reference Zorofchian Moghadamtousi S, Karimian H, Rouhollahi E, Paydar M, Fadaeinasab M, et al. Annona muricata leaves induce G1 cell cycle arrest and apoptosis through mitochondria-mediated pathway in human HCT-116 and HT-29 colon cancer cells. J Ethnopharmacol. 2014;156:277–89.CrossRefPubMed Zorofchian Moghadamtousi S, Karimian H, Rouhollahi E, Paydar M, Fadaeinasab M, et al. Annona muricata leaves induce G1 cell cycle arrest and apoptosis through mitochondria-mediated pathway in human HCT-116 and HT-29 colon cancer cells. J Ethnopharmacol. 2014;156:277–89.CrossRefPubMed
23.
go back to reference Kapadia GJ, Azuine MA, Rao GS, Aria T, Iida A, Tokuda H. Cytotoxic effect of the red beetroot (Beta vulgaris L.) extract compared to doxorubicin (Adriamycin) in the human prostate (PC-3) and breast (MCF-7) cancer cell lines. Anticancer Agents Med Chem. 2011;11(3):280–4.CrossRefPubMed Kapadia GJ, Azuine MA, Rao GS, Aria T, Iida A, Tokuda H. Cytotoxic effect of the red beetroot (Beta vulgaris L.) extract compared to doxorubicin (Adriamycin) in the human prostate (PC-3) and breast (MCF-7) cancer cell lines. Anticancer Agents Med Chem. 2011;11(3):280–4.CrossRefPubMed
24.
go back to reference Kapadia GJ, Rao GS, Ramachandran C, Iida A, Suzuki N, Tokuda H. Synergistic cytotoxicity of red beetroot (Beta vulgaris L.) extract with doxorubicin in human pancreatic, breast and prostate cancer cell lines. J Complement Integr Med. 2013 Jun 26;10. pii: /j/jcim.2013.10.issue-1/jcim-2013-0007/jcim-2013-0007.xml. doi: 10.1515/jcim-2013-0007 Kapadia GJ, Rao GS, Ramachandran C, Iida A, Suzuki N, Tokuda H. Synergistic cytotoxicity of red beetroot (Beta vulgaris L.) extract with doxorubicin in human pancreatic, breast and prostate cancer cell lines. J Complement Integr Med. 2013 Jun 26;10. pii: /j/jcim.2013.10.issue-1/jcim-2013-0007/jcim-2013-0007.xml. doi: 10.​1515/​jcim-2013-0007
25.
go back to reference Longnecker MP, Newcomb PA, Mittendorf R, Greenberg ER, Willett WC. Intake of carrots, spinach, and supplements containing vitamin A in relation to risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 1997;6(11):887–92.PubMed Longnecker MP, Newcomb PA, Mittendorf R, Greenberg ER, Willett WC. Intake of carrots, spinach, and supplements containing vitamin A in relation to risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 1997;6(11):887–92.PubMed
26.
go back to reference Xu X, Cheng Y, Li S, Zhu Y, Xu X, Zheng X, et al. Dietary carrot consumption and the risk of prostate cancer. Eur J Nutr. 2014;53(8):1615–23.CrossRefPubMed Xu X, Cheng Y, Li S, Zhu Y, Xu X, Zheng X, et al. Dietary carrot consumption and the risk of prostate cancer. Eur J Nutr. 2014;53(8):1615–23.CrossRefPubMed
27.
go back to reference Butalla B, Wertheim BC, Thompson P, Thomson CA. Effects of a carrot juice intervention on plasma carotenoids, oxidative stress, and inflammation in overweight breast cancer survivors. Nutr Cancer. 2012;64(2):331–41.CrossRefPubMed Butalla B, Wertheim BC, Thompson P, Thomson CA. Effects of a carrot juice intervention on plasma carotenoids, oxidative stress, and inflammation in overweight breast cancer survivors. Nutr Cancer. 2012;64(2):331–41.CrossRefPubMed
28.
go back to reference Shebaby WN, Bodman-Smith KB, Mansour A, Mroueh M, Taleb RI, El-Sibai M, et al. Daucus carota Pentane-Based Fractions Suppress Proliferation and Induce Apoptosis in Human Colon Adenocarcinoma HT-29 Cells by Inhibiting the MAPK and PI3K Pathways. J Med Food. 2015;18(7):745–52.CrossRefPubMed Shebaby WN, Bodman-Smith KB, Mansour A, Mroueh M, Taleb RI, El-Sibai M, et al. Daucus carota Pentane-Based Fractions Suppress Proliferation and Induce Apoptosis in Human Colon Adenocarcinoma HT-29 Cells by Inhibiting the MAPK and PI3K Pathways. J Med Food. 2015;18(7):745–52.CrossRefPubMed
29.
go back to reference Shebaby WN, Mroueh M, Bodman-Smith K, Mansour A, Taleb RI, Daher CF, et al. Daucus carota pentane-based fractions arrest the cell cycle and increase apoptosis in MDA-MB-231 breast cancer cells. BMC Complement Altern Med. 2014;14:387.CrossRefPubMedPubMedCentral Shebaby WN, Mroueh M, Bodman-Smith K, Mansour A, Taleb RI, Daher CF, et al. Daucus carota pentane-based fractions arrest the cell cycle and increase apoptosis in MDA-MB-231 breast cancer cells. BMC Complement Altern Med. 2014;14:387.CrossRefPubMedPubMedCentral
30.
go back to reference Glei M, Hofmann T, Küster K, Hollmann J, Lindhauer MG, Pool-Zobel BL. Both wheat (Triticum aestivum) bran arabinoxylans and gut flora-mediated fermentation products protect human colon cells from genotoxic activities of 4-hydroxynonenal and hydrogen peroxide. J Agric Food Chem. 2006;54(6):2088–95.CrossRefPubMed Glei M, Hofmann T, Küster K, Hollmann J, Lindhauer MG, Pool-Zobel BL. Both wheat (Triticum aestivum) bran arabinoxylans and gut flora-mediated fermentation products protect human colon cells from genotoxic activities of 4-hydroxynonenal and hydrogen peroxide. J Agric Food Chem. 2006;54(6):2088–95.CrossRefPubMed
31.
go back to reference Borowicki A, Stein K, Scharlau D, Glei M. Fermentation supernatants of wheat (Triticum aestivum L.) aleurone beneficially modulate cancer progression in human colon cells. J Agric Food Chem. 2010;58(3):2001–7.CrossRefPubMed Borowicki A, Stein K, Scharlau D, Glei M. Fermentation supernatants of wheat (Triticum aestivum L.) aleurone beneficially modulate cancer progression in human colon cells. J Agric Food Chem. 2010;58(3):2001–7.CrossRefPubMed
32.
go back to reference Hussain A, Gheewala TM, Vas AJ, Shah K, Goala P, Khan S, et al. Growth inhibitory and adjuvant therapeutic potential of aqueous extract of Triticum aestivum on MCF-7 and HeLa cells. Exp Oncol. 2014;36(1):9–16.PubMed Hussain A, Gheewala TM, Vas AJ, Shah K, Goala P, Khan S, et al. Growth inhibitory and adjuvant therapeutic potential of aqueous extract of Triticum aestivum on MCF-7 and HeLa cells. Exp Oncol. 2014;36(1):9–16.PubMed
33.
go back to reference Otsuki N, Dang NH, Kumagai E, Kondo A, Iwata S, Morimoto C. Aqueous extract of Carica papaya leaves exhibit anti-tumor activity and immunomodulatory effects. J Ethnopharmacol. 2010;127(3):760–7.CrossRefPubMed Otsuki N, Dang NH, Kumagai E, Kondo A, Iwata S, Morimoto C. Aqueous extract of Carica papaya leaves exhibit anti-tumor activity and immunomodulatory effects. J Ethnopharmacol. 2010;127(3):760–7.CrossRefPubMed
34.
go back to reference Aung HH, Wang CZ, Ni M, Fishbein A, Mehendale SR, Xie JT, et al. Crocin from Crocus sativus possesses significant anti-proliferative effects on human colorectal cancer cells. Exp Oncol. 2007;29(3):175–80.PubMedPubMedCentral Aung HH, Wang CZ, Ni M, Fishbein A, Mehendale SR, Xie JT, et al. Crocin from Crocus sativus possesses significant anti-proliferative effects on human colorectal cancer cells. Exp Oncol. 2007;29(3):175–80.PubMedPubMedCentral
35.
go back to reference Chryssanthi DG, Dedes PG, Karamanos NK, Cordopatis P, Lamari FN. Crocetin inhibits invasiveness of MDA-MB-231 breast cancer cells via downregulation of matrix metalloproteinases. Planta Med. 2011;77(2):146–51.CrossRefPubMed Chryssanthi DG, Dedes PG, Karamanos NK, Cordopatis P, Lamari FN. Crocetin inhibits invasiveness of MDA-MB-231 breast cancer cells via downregulation of matrix metalloproteinases. Planta Med. 2011;77(2):146–51.CrossRefPubMed
36.
go back to reference Samarghandian S, Shabestari MM. DNA fragmentation and apoptosis induced by safranal in human prostate cancer cell line. Indian J Urol. 2013;29(3):177–83.CrossRefPubMedPubMedCentral Samarghandian S, Shabestari MM. DNA fragmentation and apoptosis induced by safranal in human prostate cancer cell line. Indian J Urol. 2013;29(3):177–83.CrossRefPubMedPubMedCentral
37.
go back to reference Festuccia C, Mancini A, Gravina GL, Scarsella L, Llorens S, Alonso GL, et al. Antitumor effects of saffron-derived carotenoids in prostate cancer cell models. Biomed Res Int. 2014;2014:135048.CrossRefPubMedPubMedCentral Festuccia C, Mancini A, Gravina GL, Scarsella L, Llorens S, Alonso GL, et al. Antitumor effects of saffron-derived carotenoids in prostate cancer cell models. Biomed Res Int. 2014;2014:135048.CrossRefPubMedPubMedCentral
Metadata
Title
Herbal remedies and functional foods used by cancer patients attending specialty oncology clinics in Trinidad
Authors
Yuri N. Clement
Varune Mahase
Annelise Jagroop
Kelly Kissoon
Aarti Maharaj
Prashant Mathura
Chrys Mc Quan
Divya Ramadhin
Cherrista Mohammed
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2016
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-016-1380-x

Other articles of this Issue 1/2016

BMC Complementary Medicine and Therapies 1/2016 Go to the issue