Mortality

Several studies evaluated the association between ginseng-use and mortality among patients with cancer.

In the Shanghai Breast Cancer Study, 1455 women with newly diagnosed breast cancer completed a questionnaire about ginseng-use at recruitment and were followed using surveys to identify any cancer diagnoses and cancer-related outcomes.8 Women who used ginseng had a significantly lower risk of mortality (hazard ratio [HR], 0.71; 95% CI, 0.52-0.98) and breast cancer-specific mortality and recurrence (HR, 0.70; 95% CI, 0.53-0.93) compared with never-users.

A prospective cohort study of 6282 subjects age 55 or older with follow-up over 18 years found a significant decrease in all-cause mortality among male ginseng users compared with nonusers (HR, 0.90; 95% CI, 0.81-0.99), but not among female users9. Cancer-specific mortality was, however, numerically lower among female ginseng users compared with nonusers (HR, 0.80; 95% CI, 0.60-1.08). There was no association between cancer-specific mortality and ginseng-use among men.

Quality of Life and Cancer-related Fatigue

Several studies demonstrated improved quality of life with ginseng-use among patients with cancer. The Shangai Breast Cancer Study demonstrated an improved quality of life score, particularly in the psychologic and social well-being domains, with ginseng-use compared with nonuse.8 A double-blind study that randomly assigned 53 patients with cancer to receive sun ginseng or placebo daily for 12 weeks demonstrated improvement in several quality of life scores.10

A large study of 4149 women with breast cancer from the Shanghai Breast Cancer Survival Study, however, found no improvement in quality of life with ginseng-use at 6, 18, or 36 months post-diagnosis.11

Related Articles

Ginseng has been more extensively studied for the treatment of cancer-related fatigue. A double-blind trial randomly assigned 290 patients with cancer to receive increasing doses of American ginseng (750 to 2000 mg daily) or placebo for 8 weeks.12 Patients receiving ginseng demonstrated improved fatigue scores compared with placebo, particularly at doses of 1000 to 2000 mg per day. More patients in the ginseng arm vs the placebo arm self-reported a benefit and treatment satisfaction.

To further evaluate its anti-fatigue effect, another multicenter, double-blind trial randomly assigned 364 patients with cancer to receive 2000 mg of American ginseng or placebo for 8 weeks.13 Ginseng-use resulted in a significantly better fatigue score compared with placebo at 8 weeks (P = .003), particularly among patients receiving active anticancer treatment. There was no difference in adverse events between the arms.

An open-label, single-arm study of 30 patients with cancer-related fatigue who received 800 mg daily of Asian ginseng for 29 days found that 87% of patients had an improvement in fatigue within 15 days.14 Improvements also occurred in well-being and appetite scores.

Conclusions

Several case-control and prospective cohort studies conducted in a Korean population suggest that ginseng intake can reduce the risk of cancer, though this was not supported by other cohort studies in different populations. Similarly, studies suggest that ginseng consumption may reduce the risk of mortality in an Asian population, but not in a primarily Caucasian population. But according to a recent study, a Western diet may alter the gut microbiota metabolism of ginseng, resulting in lower levels of active metabolites compared with an Asian diet.15

There is a paucity of data of ginseng-use for the treatment of cancer. Ginseng appears, however, to be effective in preventing or treating cancer-related fatigue and may improve quality of life.

References

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  9. Yi SW, Sull JW, Hong JS, Linton JA, Ohrr H. Association between ginseng intake and mortality: Kangwha cohort study. J Altern Complement Med. 2009;15:921-8. doi: 10.1089/acm.2008.0296
  10. Kim JH, Park CY, Lee SJ. Effects of sun ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot trial. J Clin Pharm Ther. 2006;31:331-4.
  11. Bao PP, Lu W, Cui Y, et al. Ginseng and Ganoderma lucidum use after breast cancer diagnosis and quality of life: a report from the shanghai Breast Cancer Survival Study. PLoS ONE. 2012;7:e39343. doi: 10.1371/journal.pone.0039343
  12. Barton DL, Soori GS, Bauer BA, et al. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care Cancer. 2010;18:179-87. doi: 10.1007/s00520-009-0642-2
  13. Barton DL, Liu H, Dakhil SR, et al. Wisconsin ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst. 2013;015:1230-8. doi: 10.1093/jnci/djt181
  14. Yennurajalingam S, Reddy A, Tannir NM, et al. High-dose Asian ginseng (Panax ginseng) for cancer-related fatigue: a preliminary report. Integ Cancer Ther. 2015;14:419-29. doi: 10.1177/1534735415580676
  15. Wan JY, Wang CZ, Zhang QH, et al. Significant difference in active metabolite levels of ginseng in humans consuming Asian or Western diet: the link with enteric microbiota. Biomed Chromatogr. 2017;31(4). doi: 10.1002/bmc.3851