Treating cancer-related fatigue with American ginseng

Cancer-related fatigue is occurs in 50% to 90% of all patients with cancer and severely affects quality of life, in addition to decreasing the daily functional capacity.

During the American Society of Clinical Oncology meeting, researchers from several US universities reported that American ginseng reduces general and physical cancer-related fatigue.

First, the details.

• 342 patients with cancer participated.
• They were undergoing or completed curative intent treatment and experienced fatigue, rated at least 4 on a numeric analogue fatigue scale (1-10) for at least 1 month.
• Other causes of fatigue, such as pain and sleep, were excluded.
• Patients were randomly assigned to a treatment group for 8 weeks.
• 2,000 mg/d of American ginseng twice daily
• Placebo
• Changes in the Multidimensional Fatigue Symptom Inventory (MFSI) at 4 and 8 weeks were recorded.
• In addition other MFSI subscales and the fatigue-inertia subscale of the Profile of Mood States (POMS) were analyzed.
• MFSI is an 83-item self-report designed to assess the principal manifestations of fatigue using a 5-point scale.
• Neither the patients nor researchers knew the treatment given — double blind.

And, the results.

• 4 weeks
• Mental, emotional, and vigor subscales of the MFSI were not significantly different between treatments.
• 8 weeks
• Scores improved by 20 points over baseline with ginseng vs 10.3 points with placebo.
• Benefits were related to physical aspects of fatigue.
• Mental, emotional, and vigor components weren’t significantly changed between groups.
• There were no significant differences in toxicity or self-reported side effects (mostly nausea and loose stools) between ginseng and placebo.

The bottom line?

The authors concluded, “This trial provides data to support that American ginseng reduces general and physical cancer-related fatigue over 8 weeks without side effects.”

A PubMed search revealed that this is the first placebo-controlled study of American ginseng to treat fatigue related to cancer.

Although ginseng is commonly mentioned as a treatment for fatigue, only 1 other placebo-controlled study of ginseng in patients with chronic fatigue (not due to cancer) has been published. In 2004, researchers at the University of Iowa, in Iowa City reported that after 8 weeks of follow-up, “Fatigue among subjects assigned to either placebo or Siberian ginseng was substantially reduced during the study, but differences between treatment groups were not statistically significant.”

Are the results clinically significant? Probably, when one considers they are based on patient reports and the difficulty in finding convenient, effective and safe treatment for this condition. It would more reassuring to have at least 1 confirmatory study.

As a rule of thumb, the difficulty in treating a condition is reflected in the number of treatment options available. Cancer-related fatigue is a good example. A recently published review by researchers in Miami, Florida and Santo André, Brazil, discusses more than 10 CAM and allopathic treatment options available today.

A summary of an interview with Dr. Brent Bauer at the Mayo Clinic on CAM options for cancer patients is here

6/6/12 10:49 JR