Role of Ganoderma Supplementation in Cancer Management by
Dr. Raymond Chang, M.D., F.A.C.P.
ABSTRACT
Ganoderma has been used as folk medicine since ancient times and it
is a popular healthfood frequently promoted as a cancer cure. It is
now well established from in vitro and animal studies that the
polysaccharide fraction of Ganoderrna is largely responsible for its
antitumor efficacy. Although there is yet no controlled clinical
trials in humans for Ganoderma against cancer to date, the
'indications for its supplemental use can be indirectly supported
with clinical trial data from comparable fungal polysaccharides
because of a common final pathway of action mediated via the beta-glucan
receptor. Based on such indirect data, indications for Ganoderma use
in cancer include supplementation a) to reduce side-effects during
chemotherapy or radiotherapy, b) to prolonging survival and minimize
metastasis, c) to improve quality of life, and d) to prevent
occurrence or recurrence. In sum, although the cure of any cancer
with Ganoderma alone is unlikely, it is probably beneficial under
defined circumstances in most cases of malignancy.
INTRODUCTION
Ganoderma has been recognized traditionally and scientifically as
potentially useful in the treatment of cancer, but there is a
notable discrepancy with the public's frequent impression that
Ganoderma may be a cure for cancer and the lack of clinical trials
demonstrating such efficacy. We intend to summarize the extent of
available theoretical, experimental and clinical data for the use of
Ganoderma supplementation in cancer and outline its indications,
especially in the context of clinical results from bioactively
similar polysaccharide derived biological response modifiers (BRM's)
from other fungi (Mizuno 1996).
EXPERIMENTAL EVIDENCE OF GANODERMA'S POTENTIAL IN CANCER
TREATMENT
Ikekawa et al. (1968) first reported on the efficacy of soluble
extracts from Ganoderma in inhibiting transplanted sarcoma 180 in
mice. This host-dependent antitumor activity has been subsequently
confirmed to be from the polysaccharide fractions of Ganoderma
(Sasaki et al., 1911). Multiple similar studies subsquently confirms
this observation and antitumor efficacy of Ganoderma has been
demonstrated from various species, at different stages of growth and
using different solvents for extraction and different routes of
administration. Antitumor activity has been demonstrated in vitro as
well as in syngeneic tumor systems in animals. However, no human
trials of Ganoderma against cancer in peer reviewed journals nor any
controlled clinical trials in humans have yet been conducted or
published.
From a theoretical point of view, it is important to note that other
fungal polysaccharides of comparable structure and functiona as
those found in Ganoderma have undergone rigorous clinical trials,
including Lentinan, Sizofilan, PSK (Krestin), and PSP. Since it is
now increasingly clear that immunostimulatory bioactivity from most
beta-glucan based compounds function via a similar beta-glucan
receptor (Czop 1985), it has been possible to hypothesize that
Ganoderma polysaccharides should function similarly (Chang, 1996).
Clinical effects of various glucan based BRM's should therefore be
comparable. Results from Lentinan, Sizofilan, PSK and PSP human
trials demonstrated the efficacy of these glucan BRM's in prolonging
survival in recurrent or advanced gastric and colon cancer, lung
cancer and gynecologic cancers. Data from such bioactively
comparable compounds all suggest improved quality of life or
survival for cancer patients may be possible with Ganoderma
supplementation.
INDICATIONS AND EVIDENCE SUPPORTING THE USE OF GANODERMA
SUPPLEMENTATION IN CANCER
Whilst some efficacy of Ganoderma in cancer is undoubted, it remains
important to specify the various indications and cite the evidence
to support its use. This can be discussed under four different
circumstances:
|
A. |
As a supplement during chemotherapy or radiotherapy to reduce
side-effects 4 such as fatigue, loss of appetite, hair loss,
bone marrow suppression and risk of infection. There are studies
demonstrating Ganoderma's efficacy against I fatigue (Yang
1994), hair loss (Miyamoto et al. 1985), and bone marrow
suppression (Jia et al. 1993) and the presence of similar
clinical evidence for other glucan BRM's applied in the setting
of cancer chemotherapy or radiotherapy (Shi 1993) lends further
support to the supplementation of Ganoderma in combination with
cytotoxic cancer therapies. The recommended dose should be in
the range of five to ten grams of fruiting body or equivalent
per day (Chang 1994).
|
|
B. |
As a supplement for cancer patients to enhance survival and
reduce likelihood of metastasis. While only anecdotal data
exists that Ganoderma supplementation may enhance survival of
cancer patients, this survival advantage has been demonstrated
for a number of comparable glucan BRM's. Specifically, Lentinan
use in advanced or recurrent gastric cancer demonstrated a
significant lifespan prologation advantage at 1, 2, 3 and 4
years in a randomizaed control trial (Taguchi 1987). Sizofilan
given together with chemotherapy enhanced survival of cervical
cancers irrespective of stage in a prospective randomized
controlled trial (Inoue et al. 1993), significantly enhanced
survival (P<= .01) in lung cancer patients (Honma 1982) and
improved five year survival of bead and neck cancer from 73.4 to
86.7% was noted in another small study (Kimura et al. 1994).
More appropriate for comparison to Ganoderma is perhaps and PSK
or PSP, which are orally administered. Mitomi et al. (1994)
found significantly improved survival and disease-free survival
(P=0.013) in resected colorectal cancer given PSK
supplementation over three years when compared to control in a
multi-center randomized controlled trial.
In an animal model, Ganoderma has been demonstrated to
effectively prevent metastasis (Lee 1984), and these results are
comparable to those of Lentinan (Suga 1994). Other glucan BRM's
have been demonstrated to effectively prevent or suppress
pulmonary metastasis of methylcholanthrene-induced sarcomas,
human prostate cancer DU145M, and lymphatic metastasis of mouse
leukemia P388 (Kobayashi et al. 1995). The recommended dose
should be five to ten grams or more of fruiting body or
equivalent per day, with a linear enhancement in efficacy
expected up to 30 grams per day (Chang 1994).
|
|
C. |
As a supplement for cancer patients to improve quality of life.
Again, only anecdotal information exists for Ganoderma in this
situation but other oral glucan derivatives such as PSP has been
found to be useful in improving quality of life in cancer
patients (Yao 1993). Significantly, Ganoderma supplementation
was noted to decrease pain in cancer patients (Kupin 1994). The
recommended dose would be five to ten grams of fruiting body or
equivalent per day (Chang 1994).
|
|
D. |
As a supplement for the prevention of occurrence or recurrence
of cancer. Since immune stimulation, especially Natural Killer (NK)
and Cytotoxic Lymphocyte (CTL) activation may be effective in
the immune prevention of cancer by enhanced immune surveillance
(Lotzova 1985), and Ganoderma has been demonstrated to enhance
NK and CTL activity when administered orally (Won et al. 1989),
it is thus a candidate for prevention of the occurrence or
recurrence of cancer. Stavinoha et at. demonstrated the efficacy
of Ganoderma in the preventing the progression of
microadenomatous growths in animals (Stavinoha 1993), and the
efficacy of other glucan BRM's in primary and secondary cancer
prevention have been similarly demonstrated in vitro, in vivo
and in clinical trials.
|
CONCLUSION
Although Ganoderma and its derivatives are not pharmaceuticals and
have not undergone rigorous clinical trials to be tested against
cancer, there is abundant in vitro, animal and indirect clinical
evidence to support its supplemental use in cancer. Standardization
in bioactive polysaccharide content and dosages will be necessary to
assure its rational use, and clinical trials in select cancers with
defined endpoints will confirm its efficacy.
