Cancer is a life threatening condition. This condition has only two types of treatments which are most commonly given to the people who have this disease. The patients are either given radiation therapy or chemotherapy.
Chemotherapy is the process of using chemical agents to inhibit the growth and kill the cancerous cells. These chemical agents cannot differentiate between cancerous cell and normal cells since these are chemicals with no specificity.
Chemo-toxicity is the toxicity or side-effects induced by the chemotherapeutic drugs, i.e. the drugs or chemicals used for cancer treatment.
The toxicity of the chemotherapeutic drugs affects a number of parts of the body. The organs like heart, kidney and lungs are most commonly affected. The bodily functions such as those of muscles, nerves or stomach are also impeded.
These side-effects of chemo-toxicity lead to pain, nausea, vomiting, fatigue, loss in coordination, anaemia, problems in clotting of blood, hair loss, fatigue, breathlessness, infections etc.
Among all the toxicities induced by chemotherapy, hematotoxicity and neurotoxicity are the most frequent. Hematotoxicity results in bleeding disorder and compromised immunity.
Neurotoxicity causes neuropathy (nerve damage), most importantly peripheral neuropathy. This result in weakness, numbness, pain, tingling sensations, sensitivity to stimuli like touch or light, impaired organ functions or even paralysis.
The chemo-toxicity arises from the damage caused by cancer drugs to the healthy cells of the body. The chemotherapeutic drugs target the rapidly dividing cells, i.e. the cancer cells.
During this process, the healthy fast dividing cells of the body such as blood cells also become a target of these drugs. The damage to the healthy cells triggers various inflammatory responses and produce reactive oxygen species (ROS) leading to the side-effects.
To overcome the chemo-toxicity, other drugs to treat the respective side-effects are generally used. However, these drugs may prolong the complications or may not prove to be as effective.
In keeping with the above problem, the demand for natural remedies to conquer the chemo-toxicity is ever increasing.
A number of herbs and plant products are proving to be an effective measure against the side-effects of the chemotherapeutic drugs. One such plant product is turmeric, a common spice.
What is Chemotherapy Induced Toxicity
Each drug has a different mode of action which it uses to kill the cells. A system was proposed by Suter and Ewer which classify chemotherapeutic drugs according to the damage they cause.
Type I drugs are the ones which cause irreversible damage while Type II drugs are the ones that cause reversible damage . In order for all the cancerous cells to be eliminated, these chemotherapeutic drugs are given in the maximum dose.
The adverse side-effects of these drugs tend to harm other normal organs and tissue of the body resulting in neurotoxicity (brain toxicity) and kidney toxicity. The chemotherapy agents induce the production of reactive oxygen species (ROS) which are harmful for the cells .
Another complication associated with chemotherapy is oral complications. It results in damage of the oral tissues (stoma toxicity) which include changes in saliva, infection, bleeding, taste alternation and mucositis (damage of the alimentary tract). The late toxicity includes mucosal atrophy and xerostomia (dry mouth) .
One such drug is Cisplatin (cis-diamminedichloroplatinum II) which is recommended for treatment of lung cancer, bladder cancer, prostate cancer, ovarian cancer, esophagus cancer and breast cancer. This drug has an anti-tumor action and hinders nucleic acid synthesis .
It also degrades enzymes which play a significant role in protecting tissues from oxidative damage. Other drawbacks include lipid peroxidation and disruption of redox balance.
Another example of chemotherapeutic drug with adverse side-effects is Doxorubicin (Adriamycin). This drug is used for treating leukemia, soft tissue sarcoma, thyroid cancer, breast cancer and other. The drug mostly results in cardio toxicity which includes loss of myofibrils and swelling of sarcoplasmic reticulum.
This drug binds to iron and forms a complex which increases the radical reactions which lead to formation of oxygen free radicals. These radicals are extremely harmful for the tissues .
What is turmeric?
Turmeric, scientifically known as Curcuma longa, is the rhizome of the plant which is used fresh or dried powdered form as a spice in cooking.
Besides its culinary use, it is also an important ingredient of the traditional medicines like Ayurveda. It is used as a dye, in cosmetics and as a preservative.
Turmeric is long known as an antiseptic and pain relieving substance. Scientific studies have thrown a light on its various other properties, most notably its anti-inflammatory, antioxidant and immune-modulating activities.
Turmeric is loaded with certain bioactive compounds that enable it to have these properties. The most bioactive compound of turmeric is the curcuminoids, particularly curcumin.
It has many other constituents as well, such as Vitamins (B&C), volatile oils, omega 3 fatty acids, α-linolenic acid, minerals like Sodium, Potassium, Iron, proteins , carbohydrates, dietary fibres and many more.
Mechanism: How does turmeric protect from chemo-toxicity?
The turmeric component, curcumin is considered a very efficacious substance against various complications related to inflammatory responses and oxidative stress such as those caused by chemo-toxicity.
Since chemo-toxicity is mediated by the production of ROS and inflammatory responses, the antioxidant and anti-inflammatory action of curcumin can be very useful in combating it.
The anti-inflammatory activity of curcumin is mainly associated with the enhanced expression of PPAR-γ gene. PPAR-γ is known to suppress the pro-inflammatory molecules, such as TNF-α.
Curcumin’s anti-inflammatory action is also linked to its ability to inhibit a number of enzymes and other molecules involved in inflammation, such as cyclooxygenase (COX), lipooxygenase, nitric oxide, interleukins etc.
The antioxidant activity of curcumin is related to its free radical scavenging mechanism. Curcumin lowers the energy of the ROS, which are highly active such as superoxides and peroxides.
This prevents their combination with proteins or other components of a cell that leads to their damage. The ability of curcumin to chelate highly reactive metallic ions also adds to its antioxidant activity.
Turmeric (curcumin) has been studied to be a potent protective agent against the chemo-toxicity. It has been found to protect against neurotoxicity, haematological toxicity, cardiotoxicity and other side-effects of a number of chemotherapeutic drugs.
7 Chemotherapeutic drugs from whose toxicity Turmeric protects from
There are a wide range of chemotherapeutic drugs whose toxicity turmeric is known to protect from. Some of the popular and extensively used such drugs are as following:
1. Curcumin counteracts side effects of Cisplatin and Oxaliplatin
Cisplatin and oxaliplatin are the chemotherapeutic drugs that are metallic salts and are alkylating agents, i.e. they damage the DNA of cancer cells.
Cisplatin is a Platinum based compound, it binds with the purine bases in DNA and thus, blocks cell division leading to death of the cell.
It is being used alone or in combination with other cancer-drugs to achieve maximum effectiveness. It is used to treat various cancers such as those of bladder, testicle, ovary, lungs, brain, breast etc.
Cisplatin is known to induce toxicities such as nausea, neurotoxicity, liver toxicity, poor functioning of kidney or damage to retina and ear.
Oxaliplatin is also a Platinum based drug that damages the DNA of the cancer cells. It forms cross-links in the DNA to inhibit DNA synthesis.
It is used in combination with other drugs to effectively treat breast cancer, colorectal cancer, ovarian cancer etc.
The toxicities induced by oxaliplatin include neurotoxicity, gastrointestinal toxicity and haematological toxicity.
Turmeric has proven its protective effects against various side-effects induced by these drugs.
Curcumin, the predominant component of turmeric has been found protect against many side-effects induced by cisplatin. It guards against nephrotoxicity, neurotoxicity and ototoxicity (ear damage).
Peripheral neuropathy is a prevalent side-effect induced by both cisplatin and oxaliplatin. In a study, the anti-inflammatory and antioxidant activity of curcumin was able to decrease the nerve damage caused by Platinum from these drugs.
Curcumin has also been found to protect the kidneys from cisplatin-induced kidney damage. It reduces inflammation, oxidative stress and prevents death of kidney cells.
It is found to guard against the ear damage caused by cisplatin by scavenging free radicals and increasing the expression of hemeoxygenase enzyme.
Curcumin’s gastroprotective action is useful against the oxiplatin induced gastrointestinal side-effects as well.
What does it mean?
It means consumption of turmeric can protect from the side-effects of cisplatin and oxaliplatin, which are used to treat various types of cancers. Turmeric can be effective in reducing the damages to kidneys, nerves (especially in peripheral neuropathy), ear and gastrointestinal region.
2. Turmeric protects from Doxorubicin (Adriamycin) toxicity
Doxorubicin, commonly available under the name of Adriamycin, is an anthracycline antibiotic drug. It is extracted from the bacterium Streptomyces peucetius var.caesius.
This chemotherapeutic drug targets the DNA of cancer cells by generating reactive oxygen species that damage the DNA. It is also thought to disrupt the repair mechanism of the DNA by intercalation.
It is used to treat a variety of cancers including breast, lung, gastric, thyroid, non-Hodgkin’s and Hodgkin’s lymphoma etc.
The major drawback of the use of doxorubicin is that it causes cardiotoxicity, i.e. toxicity of heart due to oxidative stress and cell death induced by disruption of DNA repair in the heart cells.
It induces cardiomyopathy or damage to the muscles of heart which results in chest pain, abnormalities in blood pressure or even heart failure.
Turmeric has been found to attenuate the toxicities induced by doxorubicin. Curcumin’s antioxidant activity reduces the oxidative stress thereby protecting heart, kidney and liver against the side-effects.
In case of cardiotoxicity, curcumin inhibits lipid peroxidation and enhances the endogenous antioxidants in the cardiac cells and thus prevents the oxidative stress induced injury to the cells.
What does it mean?
Turmeric treatment to the cancer patients under doxorubicin treatment can prevent the toxicities induced by the drug. The major side-effect of this drug on heart can be avoided and side-effects on kidney and liver can also be prevented.
3. Turmeric remedies adverse effects caused by 5-Fluorouracil
5-Fluorouracil (5-FU) is an anti-metabolite chemotherapeutic drug, i.e. it interferes with the normal metabolism of cells by blocking enzymes.
In the cancer cells, it prevents cell proliferation by blocking enzyme for thymidine formation, required for DNA synthesis.
This drug is used to treat various cancers such as breast, gastric, colon, oesophageal, colorectal, cervical etc.
The toxicities induced by 5-FU are commonly found to be that of gastrointestinal and skin. It is also known to cause side-effects to liver and heart.
Turmeric has a protective action against the toxicities induced by 5-FU as well. Curcumin has been found to reverse the intestinal dysfunction caused by this drug. It could reverse the weight loss, reduce toxin levels in serum and prevent the death of intestinal epithelial cells.
It also protects against the toxicities induced by 5-FU in the breast cancer cells.
What does it mean?
It means use of turmeric by cancer patients under the treatment of 5-Fluorouracil can help to reduce the toxicities induced by this drug. Turmeric can guard against the intestinal damage and damage to other healthy cells.
4. Turmeric’s antioxidant activity protects from Methotrexate toxicity
Methotrexate is another anti-metabolite chemotherapeutic drug. It inhibits formation of tetrahydrofolate which is required for synthesis is thymidine base of DNA. This prevents cell-proliferation. It also has immune-suppressant properties.
This drug is used to treat the cancers of blood, head, neck, lymph node, breast, lung etc.
The toxicities induced by methotrexate include oral mucositis, myelosuppression, liver and skin toxicities.
Turmeric administration prior to methotrexate treatment is found to be hepatoprotective. The anti-inflammatory action of turmeric protects the liver cells from injury and it also improves antioxidant capacity of the liver cells.
Turmeric’s antioxidant action has also been found to protect the intestines from methotrexate induced damage.
Administration of curcumin has also shown nephroprotective effects on methotrexate induced kidney damage. It could prevent the damage by decreasing pro-inflammatory molecules like TNF-α, nitric oxide etc. And by increasing levels of cellular antioxidants in the kidney.
What does it mean?
It means administration of turmeric prior to the treatment of methotrexate can induce protective effects against the toxicity caused by the drug in liver, intestines etc.
5.Streptozotocin (Zanosar) induced side effects can be alleviated by curcumin
Streptozotocin or streptozocin, popularly available under the name Zanosar, is an antibiotic obtained from the bacteria Streptomyces achromogenes. It is also an alkylating agent.
It works by the inhibition of DNA synthesis in the cells through cross-linking and free radical generation to prevent cell proliferation.
Streptozotocin is specifically used to treat the cancer of islet cell cancer of pancreas and carcinoid tumors.
The oxidative stress generated by this drug can result in several toxicities which include diabetes, damage to kidney and liver. The streptozotocin induced diabetes also leads to other side-effects like cataract etc.
Turmeric (curcumin) has shown its effect on the streptozotocin induced diabetic cataract. The reduction of oxidative stress and osmotic stress was effective in preventing or delaying the condition.
What does it mean?
It means including turmeric in diet by the cancer patients under streptozotocin treatment can benefit in reducing the side-effects of this drug.
6. Turmeric protects from Mitomycin C induced kidney toxicity
Mitomycin C is an antibiotic chemotherapeutic drug obtained from the bacteria Streptomyces caespitosus. It is an alkylating agent that generates free radicals and cross-links DNA to inhibit its synthesis and prevent cell proliferation.
It is used to treat cancers of oral cavity, lip, breasts, larynx, urinary bladder and digestive organs like, stomach and pancreas.
The toxicities induced by this drug are those to lungs, kidney, heart, bone marrow, eyes etc.
Many studies have highlighted the potential of turmeric to prevent the side-effects induced by mitomycin C. The use of curcumin in mitomycin C treatment has shown protection against the severe side-effects on kidney and bone marrow.
The toxic effect of this drug on bone marrow is reduced by curcumin through lowering lipid peroxidation and preventing DNA damage.
What does it mean?
It means inclusion of turmeric along with mitomycin C treatment can guard against the severe side-effects of this chemotherapeutic drug. Turmeric can prevent the damage to bone marrow and kidney significantly.
7. Curcumin protects Paclitaxel (Taxol) toxicity
Paclitaxel or taxol is a natural chemotherapeutic compound which is extracted from the bark of the tree Taxus brevifolia.
It is used in cancer treatment due to its ability to arrest the division of cell during mitosis by preventing disassembly of microtubule, which results in cell death.
It is used to treat tumours in ovary, breast, lung, prostate, cervix etc. and also to treat leukemia and lymphoma.
Paclitaxel or taxol poses toxicity to heart, nerves, lungs etc and increases the risk of malignant development at other sites in the body.
Turmeric has been found to be useful in preventing the side-effects induced by this drug.
In a study, curcumin was able to suppress drug resistance to placitaxel treatment (in breast cancer) in lungs and subsequent metastasis. This was a consequence of inhibition of NF-kappa B (induced by placitaxel) by curcumin.
What does it mean?
It means turmeric can be used to prevent the side-effects of paclitaxel, such as metastasis (development of malignancy at other sites than the cancer under treatment).
Dosage of Turmeric for Chemotherapy induced toxicity
Turmeric in diet is beneficial in preventing cancer. Dietary turmeric is also known to be effective against chemo-toxicity.
The active component of turmeric, i.e. curcumin is poorly absorbed by the body. Therefore, it should be taken in combination with black pepper and/or healthy fats like coconut oil to improve its bioavailability. (Read How to improve turmeric’s bioavailability?)
Certain chemo-toxicity may require large dosage of turmeric. In this case, use of turmeric supplements is highly recommended. The dose regimen to be followed can be referred from the article Turmeric/ Curcumin Dosage for Cancer: A Scientific Plan.
Golden Paste is another option for the consumption of turmeric. It is a paste made of fresh turmeric or its dried powder form mixed with black pepper and healthy fats.
Turmeric intake should be started with low doses (1/4-1/2 teaspoon a day for a week) and can be increased gradually over weeks to 2-3 teaspoons per day, if no side-effects related to it is observed.
Turmeric supplement or Golden Paste may cause acid reflux if taken in on an empty stomach. (Read Does turmeric cause acid reflux?)
Also, turmeric should not be taken with other medicines as it may interact with certain medicines. A gap of at least 3-4 hours should be maintained between intakes of the two. (Read Black pepper in GP: Does it cause drug interaction?)
If not taking Golden Paste or turmeric supplements, turmeric use is highly advisable in the regular cooking to prevent and fight chemo-toxicity as well as cancer.
Turmeric powder can be added to soups, rice dishes, smoothies, curries or other such preparations. Half-an-inch of fresh turmeric root or its juice form can be consumed.
To identify good brands of organic turmeric, you can check our recommendation on best organic turmeric brands.
Turmeric in dietary use is considered to be very safe in any type of medical condition. In fact, dietary use of turmeric is highly advisable in cancer which automatically makes it advisable in treating chemo-toxicity as well.
Doctor’s advice is indispensable before using turmeric supplements by cancer patients.
Ingestion of turmeric in empty stomach can cause acid reflux in sensitive individuals. Therefore, it is better to avoid its consumption on an empty stomach. (Read Does turmeric cause acid reflux?)
Avoid taking turmeric supplements at the same time as taking any medications. Maintain a 3-4 hour gap.
Turmeric should be taken with caution in case of bleeding problems. Therefore, turmeric supplements should be avoided but dietary amounts are safe. (Read Is turmeric a blood thinner?)
Limit turmeric consumption in case of risk of gout and kidney stones. Turmeric in large quantities can raise the risk of developing kidney stones (in sensitive individuals). (Read Is turmeric safe in gout? Does turmeric cause kidney stones?)
Turmeric is a stimulant of bile flow. If one is suffering from gallstone, this may lead to bile duct obstruction, causing pain and other problems. (Read Is Turmeric Consumption Safe In Gallstones?)
Discontinue taking turmeric supplements if you are scheduled for a surgery. It is suitable to stop using turmeric supplements around 2 weeks prior to a surgery. Being a blood thinner, turmeric can interfere with the process of blood clotting after a surgery.
Avoid using turmeric supplements if you are pregnant or breastfeeding
For cancer patients under chemotherapy, chemo-toxicity is a major concern that needs to be addressed to better their survival and lifestyle.
Turmeric is a highly valuable natural remedy to combat the side-effects induced by the chemotherapeutic drugs.
Several studies assure the immense potential of turmeric in preventing, treating and even reversing chemo-toxicity.
Some of the highly toxic side-effects caused to major body parts and organs, by the widely used chemotherapeutic drugs have been taken care of by turmeric.
Additionally, turmeric enhances the anti-cancer effects of a number of these drugs which add to the unmatched benefits of this spice.
Concisely it can be said that turmeric is a boon for cancer patients under chemotherapy who suffer from various life-threatening side-effects.