Nelli-rasakinda herbal regime can boost im­mu­nity of oral cancer pa­tients, study shows

Sunday Times (Sri Lanka) - - NEWS - By Ku­mu­dini Het­tiarachchi

Their good­ness has been oft- men­tioned but now the im­mu­nity-boost­ing ca­pa­bil­ity of this herbal duo has been tried, tested and con­firmed in a unique ‘western-east­ern’ medicine part­ner­ship.

Nelli ( Em­blica of­fic­i­nalis) and rasakinda (Ti­nospora cordi­fo­lia) have been placed un­der scru­tiny and per­formed their roles ef­fec­tively in boost­ing the im­mu­nity (the abil­ity to re­sist and fight dis­ease) of peo­ple who have un­der­gone surgery for oral cancer.

The nelli- rasakinda herbal regime has been used in a ran­dom­ized dou­ble blind prospec­tive clin­i­cal trial and re­search study on oral car­ci­noma of the buc­cal (cheek) mu­cosa and the tongue at the Oral and Max­illo­fa­cial Unit of the Kara­pi­tiya Teach­ing Hos­pi­tal, with sup­port from the In­sti­tute of Indige­nous Med­i­cal Sci­ence, Univer­sity of Colombo.

“Na­ture gave us an an­swer on how indige­nous ayurvedic medicine could im­prove the im­mu­nity of oral cancer pa­tients,” says Con­sul­tant Oral & Max­illo­fa­cial Sur­geon, Dr. D.K. Dias who con­ducted the re­search with the sup­port of Se­nior Lec­ture r, Depart­ment of Surgery, In­sti­tute of Indige­nous Med­i­cal Sci­ence, Univer­sity of Colombo, Dr. L.P.A. Karunathi­lake.

The study fo­cused on ‘chemo­pre­ven­tion’ by us­ing the dried pow­der form of the nelli (amla) fruit and the stem of rasakinda (guduchi) af­ter com­ple­tion of the con­ven­tional cancer treat­ment of these pa­tients. It ex­plored al­ter­na­tive or ex­per­i­men­tal meth­ods of chemo­pre­ven­tion to pre­vent or re­duce the re­cur­rence of the ma­lig­nancy in once-treated pa­tients.

An­i­mal stud­ies on the nelli-rasakinda pow­der mix have been con­ducted in other coun­tries in­clud­ing China and there is ev­i­dence to in­di­cate that it helps to mod­u­late the im­mune sys­tem, cre­at­ing an anti- cancer, anti- tu­mour and anti-ox­i­dant ef­fect, says Dr. Dias, ex­plain­ing that he had got the pow­der- mix tested at the Industrial Tech­nol­ogy In­sti­tute (ITI) to en­sure that there were no other in­gre­di­ents, be­fore ad­min­is­ter­ing it to the pa­tients. The tests had found that it was “very high” in anti-ox­i­dants.

Pro­vid­ing dis­turb­ing in­for­ma­tion on the oral cancer sit­u­a­tion in the coun­try, Dr. Dias who has per­formed more than 2,000 op­er­a­tions linked to this ma­lig­nancy in the past 25 years, says that it is the “com­mon­est” cancer among men, on par with breast cancer among women. Oral cancer kills 3 to 4 peo­ple each day in Sri Lanka Oral cancer af­fects around 2,500 pa­tients each year in Sri Lanka The ‘pro­file’ of those who are hit by oral cancer is: Mainly men in so­ci­ety’s un­der­priv­i­leged strata who in­clude many farm­ers and estate work­ers. Lament­ing that even with tech­no­log­i­cal ad­vances in the treat­ment of oral cancer, the long-term prog­no­sis has not changed, he says it re­volves around three vi­tal fac­tors: How ag­gres­sive the cancer is which would hinge on en­vi­ron­men­tal re­sponses such as drugs, food, wa­ter and pol­lu­tants; how ag­gres­sive the treat­ment is; and the pa­tient’s im­mu­nity to act against the cancer.

“We have no con­trol over how ag­gres­sive the cancer is,” he says, adding that there is also no con­trol over how the treat­ment would work in in­di­vid­ual pa­tients. “As such, we picked up the fac­tor of how the pa­tient’s im­mu­nity would act against the cancer.”

On why some peo­ple fall vic­tim to cancer and oth­ers do not, Dr. Dias says that when a cancer at­tempts to raise its head in a per­son’s body, that per­son’s im­mune sys­tem bat­tles against it and neu­tral­izes it.

How­ever, the ma­lig­nancy will keep try­ing to get a grip in that per­son’s body.

In a per­son’s im­mune sys­tem, mean­while, there are two sets of dis­ease- fight­ing sol­diers – the ‘non-spe­cific’ sol­diers and the ‘spe­cific’ sol­diers, he says, ex­plain­ing sim­ply this com­plex sys­tem. The ‘non-spe­cific’ sol­diers are the first­line of de­fence and will bat­tle every in­fec­tion or dis­ease such as cancer that en­ters the per­son’s body. How­ever, some­times, when these ‘non-spe­cific’ sol­diers are de­feated, un­for­tu­nately, they be­come the al­lies of the per­son’s en­emy, that is cancer, and help the cancer grow and spread.

“This is why we tar­geted the ‘spe­cific’ sol­diers with the nelli-rasakinda pow­der mix in a 10-year study from 2005-2015 cov­er­ing 163 pa­tients ini­tially, who had cheek and tongue cancer,” he says, stress­ing that it was in ad­di­tion to the stan­dard con­ven­tional treat­ment.

In the study, the pa­tients had been di­vided into two groups. One group had been given the slightly brown­ish nelli-rasakinda pow­der to be drunk daily mixed with milk for three months, while the other group had got a placebo (what seemed to be the nelli-rasakinda pow­der-mix but was not). The study had been able to fol­low 114 pa­tients for five years.

The im­por­tant find­ings are:

There was a sta­tis­ti­cally “sig­nif­i­cant” re­duc­tion in the no­dal re­cur­rence of the pa­tients who had been op­er­ated on for tongue cancer. There was a sta­tis­ti­cally “sig­nif­i­cant” re­duc­tion in the lo­cal re­cur­rence of the pa­tients who had been op­er­ated on for buc­cal cancer. The re­cur­rence re­duc­tion in both groups led to bet­ter sur­vival rates – the five-year re­cur­rence-free sur­vival of these trial groups was 62.7% when com­pared with 42.3% in the con­trol group. There­fore, it is jus­ti­fi­able to con­clude that the nelli-rasakinda mix showed sta­tis­ti­cally sig­nif­i­cant ben­e­fits in pre­vent­ing cancer re­cur­rence in the fol­low-up pe­riod, which leads to an over­all im­prove­ment in the sur­vival rate.

The ac­tions of nelli and rasakinda were:

En­hanced pro­duc­tion and se­cre­tion of in­ter­feron and cor­ti­cos­teroids. (In­ter­fer­ons are a group of sig­nalling pro­teins made and re­leased by host cells in re­sponse to the pres­ence of viruses, bac­te­ria, par­a­sites and tu­mour cells, while cor­ti­cos­teroids are hor­mones which pro­vide re­lief for in­flam­ma­tion.) Anti-vi­ral prop­er­ties as well as func­tion­ing as anti-bacterial and anti-fun­gal agents. Im­muno-mod­u­la­tors in a va­ri­ety of im­mune-com­pro­mised con­di­tions. Adapt­abil­ity to in­duce leuko­cy­to­sis (an in­crease in the to­tal num­ber of white blood cells). Im­prove­ment in phago­cy­to­sis and in­tra­cel­lu­lar killing ca­pac­i­ties of neu­trophils (a type of white blood cell) and macrophages (mo­bile white blood cells). Phago­cy­to­sis is the process in which phago­cytes in a white blood cell, in­gest or en­gulf other cells or par­ti­cles. In­duc­ing T-lym­pho­cyte (that plays a cen­tral role in cell-me­di­ated im­mu­nity) pro­lif­er­a­tion and in­creas­ing cy­tokine se­cre­tion. Cy­tokines are a num­ber of sub­stances, such as in­ter­feron, in­ter­leukin and growth fac­tors se­creted by cer­tain cells of the im­mune sys­tem and have an ef­fect on other cells. Cy­to­toxic (toxic to liv­ing cells) ef­fect on cancer cells. In­hibit­ing the pro­lif­er­a­tion of tu­mour cells.

Dried Nelli Rasakinda. Pix by M.A. Pushpa Ku­mara

Dr. D.K. Dias

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