Turmeric and its Possible Effects on Cancer

By Xotchil Medina 5/17/2013

Abstract Turmeric has been a very popular spice that has been used in India and Pakistan, and is known as curry powder because it is a main ingredient in making curry. It comes from the root of Curcuma longa which is a plant related to the ginger family. There are three main active compounds collectively known as curcuminoids. Curcumin in the main curcuminoid that is focused on because of its proposed health benefits. These health benefits include enhanced wound healing, anti-cancer, anti-inflammatory, anti-oxidant, anti-bacterial, and helping with digestive distress and high cholesterol levels. Curcumin can have all of the proposed benefits because it is a molecule that can interact with many different target compounds. This becomes important when looking at the anti-cancer properties, which is the focus of this paper. It is found to be useful when paired with other natural compounds or previous cancer treatments because the bioavailability of curcumin is very low. It has been found that curcumin has high promises when looking at the treatment of cancer and other diseases, but that research is mainly in vitro studies. When curcumin is attempted to be used in humans through or administration, it is not bioavailable due to the properties of the compound. Despite the lack of bioavailability, it is a very safe substance that does not appear to have any adverse side effects or risk of toxicity when administered at high concentrations to humans. Research is fairly new so it is difficult to get conclusive answers to whether or not curcumin is effective in treating or preventing cancer. Introduction and Background Turmeric is a bright yellow powdery substance that has been used for its medicinal properties and food coloring agent. It comes from the root of Curcuma longa, which is related to the ginger family. The plant grows naturally throughout India and in other tropical climates. It can grow up to 100cm in height and has long oblong leaves with white flowers and cylindrical rhizomes (Basnet, 2011). Turmeric is sometimes referred to as the curry powder because it is one of the main ingredients used to make curry in Indian dishes. Curcuminoids are the main active ingredients in turmeric and these are curcumin (diferuloyl methane), demethoxycurcumin, and bisdemethoxycurcumin. Curcumin makes up 90% of this ratio and is the main ingredient of study because of its activity in the body.

In traditional medicinal practices in India, turmeric has been used for many different illnesses and conditions through topical or oral administration. Topically, it was used to treat blistering, parasitic skin infection, or acne. Orally, it was used to treat the common cold, liver diseases, urinary tract diseases, and a blood purifier (Chainani-Wu, 2003). Today, people consume curcumin by cooking with the turmeric spice or buying a supplement that is composed of the curcuminoid complex and simple ingredients that make the capsule. These supplements are consumed because there have been some studies that suggest benefits that are essential to achieving maximum health. Almost everyone would benefit from this supplement because of the benefits that are associated with consuming it. As always, patients should consult their physician to make sure that there are not possible interactions with medication that is being taken (Maheshwari, 2006). Key benefits of curcumin include anti-inflammatory, anti-oxidant, wound healing, antimicrobial and anti-cancer effects (Maheshwari, 2006). Inflammation is a precursor to some diseases such as asthma, arthritis, and Crohns disease. Inflammation is the natural response to our body trying to protect itself, and when it does this, our body experiences adverse side effects that can cause harm. A compound that has anti-inflammatory properties can be beneficial because they can help the body regulate our inflammation response so that we are not experiencing unnecessary inflammation. Anti-oxidants are important because free radicals are present in our bodies and they can cause diseases by damaging cells or tissues, but anti-oxidants neutralize these free radicals and keep them from causing unwanted damage. Wound healing and anti-microbial effects go hand-in-hand because when trying to heal a wound, you are mainly trying to keep it from getting infected. Curcumin helps keep the inflammation down around the wound by not letting bacteria grow so that new tissue can grow. Now onto the most controversial benefit of curcumin; this is the anti-cancer effect. The anti-cancer effect of curcumin is the most controversial because some studies show that it has anti-cancer activity in the body, and others say that it is more useful to treat inflammation throughout the body, which in turn may help prevent cancer. The purpose of this paper is to examine the possible benefits of curcumin associated with cancer prevention and growth.

Discussion of Purported Benefit and Efficacy As previously discussed, there are numerous benefits that curcumin has proposed for a healthy life, but the one that I am going to focus on is the effect it has on cancer prevention and growth. Cancer is something that has been a problem for decades and even centuries because it is hard to kill without killing off tissues and organs around it that are vital to life. It is thought to be caused by the dysregulation of the cell cycle pathway. Curcumin is thought to be beneficial in regulating these pathways because it is a molecule that can interact with many different targets. This ability makes it possible to interact with transcription factors, receptors, kinases, cytokines, enzymes, and growth factors. The wide range of interactive properties of curcumin gives it a broader range of cancers to possibly work against (Anand, 2008). The potential to protect against cancer is exceptional because of the ability to interact with many different stages in the cell cycle as well as enzymes that aide in cell growth and death. People that suffer from some inflammatory diseases or people that have cancer and are looking for possible alternative treatments might be interested in the benefits and activity of curcumin. In animal and in vitro experiments, all of the proposed benefits take place, but it is difficult to get the compound to act the same way in the body. Research and curiosity about anti-cancer effects are relatively new so concrete evidence has not yet been found, but there are a few clinical trials that show some future progressions. In a phase I clinical trial twenty five people were taken that have a malignant or high-risk premalignant conditions. In this trial, the patients were given 1,000 to 8,000 mg a day for three months. The results to this trial were that seven premalignant cases had improvement in the lesions, but two patients developed malignancy despite the treatment. In a phase II trial, twenty five people were treated orally with 8,000 mg per day of curcumin for two months and then continued to eighteen months to measure plasma volumes of the compound. One patient had a stable disease, unaffected by treatment, and another patient had a brief, but apparent tumor regression. From this trial it was found that curcumin has apparent biological activity, but we arent completely sure how to utilize it with positive outcomes in the treatment of cancer. Also, a phase III trial is ongoing, but it is looking to determine the effectiveness of curcumin against cervical, oral, pancreatic, and colon cancers in India (Basnet, 2011). It is very difficult to determine if curcumin is as effective as it sounds because there are not numerous studies or 4

literature that supports the benefits that are claimed. In conjunction with the limited number of studies, there are very few people in the groups that are being studied. This affects our ability to generalize it for the public because the population may not be a good representation of the population. There are very few studies done on the efficacy of curcumin against cancer, but it definitely has activity that people are not sure how to explain yet. Due to the lack in research, there were not many conflicting research articles that prove that it doesnt work. Other professionals agree that there is activity, but we cannot make claims before we have the scientific evidence to back it up. They suggest that before we get this evidence, we should believe that the results could go either way because it honestly may or may not help with cancer. Curcumin is not considered to be as effective as it could be because of the limited bioavailability outside of the gastrointestinal tract. The compound has poor water solubility and short half life which make it so that it isnt available in tissue and blood plasma. There have been some attempts to make curcumin more bioavailable throughout the body, but the research is in vitro based (Teiten, 2010). One of the attempts includes the use of delivery vehicles that include nanoparticles, liposomes, and phospholipids that make it easier for curcumin to travel through blood plasma and increase circulation time. These vehicles help because they create a miscelle that decreases the hydrophobic properties of curcumin and let it travel through the plasma. This makes it so that it can flow through the plasma, but it increases the size of the compound, which can cause a problem when it needs to be absorbed because it is too big to pass through the membrane of the tissue (Basnet, 2011). One of the other attempts is pairing curcumin with compounds that can counteract enzymes that cause metabolism of curcumin. The compounds include piperine from black pepper, quercetin from soy beans, and genistein. This makes it so that curcumin is not metabolized before it can enter plasma and ultimately enter cells and tissue that are infected with cancer or inflammatory diseases (Teiten, 2010). As previously discussed, there is bioactivity of curcumin in the body and possible treatment of cancer. An idea is that curcumin helps with the treatment of cancer by reducing inflammation, cell proliferation, and invasion of cells, but it is not entirely understood. Reducing inflammation is done by inhibiting enzymes and kinases that express certain genes in cells that can lead to 5

tumor proliferation. The fact that curcumin can limit these pathways makes it possible to provide treatment to previously existing tumors or change the gene expression of the cell so that it no longer creates a tumor to grow. It can help with proliferation and invasion by stopping the cell cycle from progressing by killing the cells through apoptosis. This is achieved by curcumin regulating the up regulation of pro-apoptotic proteins and down regulation of anti-apoptotic proteins which leads to the opening of mitochondrial permeability. There are several theories as to how curcumin interferes with the cell cycle, but a majority of them include the killing of tumor cells through apoptosis (Teiten, 2010). Curcumin may not have significant effects on cancer when administered by itself, but it has been found to be beneficial with other conventional treatments. These other treatments may be failing by themselves as well and could use an enhancement that helps treatment become more successful. When you combine curcumin with radiation, it becomes a radiosensitizer that can cause the cancer cells to be susceptible to radiation again. Cancer cells that have been previously treated with radiation may have mutated to where they are no longer being affected by radiation and curcumin can help with that (Teiten, 2010). Overall curcumin is a safe compound that should only be given caution by a certain population. The US FDA has determined that turmeric/curcumin is Generically Recognized As Safe (GRAS) with an acceptable daily intake level of 0.1-.3mg/kg-BW. In the research studies, the dosages that the participants were receiving were greatly larger than someone would consume in the diet so any level lower than that is considered safe for the healthy, normal person (Basnet, 2011). Large amounts appear to be tolerated by humans without significant side effects or a worry of toxicity (Chainani-Wu, 2003). Although it is recognized as something safe for almost everyone, there are some exceptions. People that have issues with their gall bladder or bile duct should not take it because it can cause some irritation. Also children should not take it as a supplement because there are not enough studies on them to make sure they are safe. If medications are taken that are similar to aspirin, curcumin can mix with them to cause unknown adverse side effects, and the primary care physician should be contacted. Lastly, people who think they may be allergic to the ginger family of plants and pregnant women should not take curcumin supplements because it can cause unwanted uterine contractions (Wiegman).

Curcumin can be ingested in a number of ways. The first way is by taking the capsule supplement, which is 250-500 mg 2-3 times a day. Next, you can buy the powder and cook with it, which in turn gives your food some good flavor, and you add 1/8 teaspoon or more to taste. A tincture, also known as an extract, can be bought and 1/8 to 1/2 teaspoon added to warm water taken 2-3 times a day. The last one is a tea that is composed of 1/4 teaspoon turmeric powder and 1/4 teaspoon ginger in 1 cup of boiling water. You let the powder steep for ten minutes and then add honey or lemon juice if desired. The tea is meant to be drunken 2-3 cups a day (Sidhe, 2012). Conclusion Curcumin is a compound that has many possible benefits that have been used for a long period of time. People have used it to fight acne, wounds, inflammation, and much more. There have been suggestions that it can also have an anti-cancer effect to people with cancer. In vitro studies have shown that curcumin can help stop the growth of cancer or even prevent it, but this is not relating closely to human studies where the results are mixed. It was found that curcumin in fact does have biological activity in humans when administered orally at high amounts. There was a patient from the clinical trial that had a period in time where the tumor stopped growing. This is something small, but it does confirm that curcumin can help if we can figure out a way to increase bioavailability and figure out how it works in our bodies. When paired with other conventional treatments against cancer, such as radiation, it aided in cancer cell apoptosis and decreasing the rate of growth. Research has just begun on this topic and the more research that is done, the more we can conclude about the actions of curcumin against cancer. I believe that curcumin as a supplement can help a wide range of people because it is safe and has an extensive array of benefits. Curcumin is a natural ingredient in a spice that we can use to cook and it doesnt have any serious side effects, so people that need help with inflammation or need a new treatment against cancer should definitely try using it as a supplement. It may not help significantly, but any help against pain and suffering from cancerous cells may be the relief that some patients are looking for. We may not know the mode of action specifically, but this doesnt mean that research has stopped; it is just once again showing us how complex cancer is.

References Anand, P., Sundaram, C., Jhurani, S., Kunnumakkara, A. B., & Aggarwal, B. B. (2008). Curcumin and cancer: An old-age disease with an age-old solution. Cancer Letters, 267(1), 133-164. Basnet, P., & Skalko-Basnet, N. (2011). Curcumin: An anti-inflammatory molecule from a curry spice on the path to cancer treatment. Molecules. 16(6), 4567-4598. Chainani-Wu, N. (2003). Safety and anti-inflammatory activity of curcumin: A component of turmeric (curcuma longa). The Journal of Alternative and Complimentary Medicine, 9(1), 161-168. Evans, A. (2012, January 27). The amazing health benefits of turmeric. Retrieved from http://www.mnn.com/food/healthy-eating/stories/the-amazing-health-benefits-of-turmeric Maheshwari, R. K., Singh, A. K., Gaddipati, J., & Srimal, R. C. (2006). Multiple biological activities of curcumin: A short review. Life Sciences, 78(18), 2081-2087 Sidhe, W. (2012). How to take turmeric curcumin. Retrieved from http://www.ehow.com/how_5003542_turmeric-curcumin.html Teiten, M-H., Eifes, S., Dicato, M., & Diederich, M. (2010). CurcuminThe paradigm of a multi-target natural compound with applications in cancer prevention and treatment. Toxins. 2(1), 128-162. Wiegman, S. (n.d.). Who should not use curcumin. Retrieved from http://www.sharecare.com/question/who-should-not-use-curcumin