The facility—being set up with support from the Centre’s Department of Atomic Energy, Tata Memorial Centre’s (TMC’s) governing authority, the Ayush (traditional medicine) ministry and the Maharashtra government at an estimated cost of Rs 300 crore—is expected to be functional by 2026.
“There are numerous low-quality evidence to suggest that several plant-based extracts and herbs used in indigenous forms of medicines have anti-cancer properties, but there is a lack of high-quality evidence to substantiate these findings,” TMC director Dr C. S. Pramesh told ThePrint.
Through the ICTREC, which is in the process of being built, Pramesh said, the idea is to subject a number of these herbs to rigorous scientific trials to fill the knowledge gaps and understand whether they work in cancer care.
At a press conference last week, clips from which were widely shared on social media, Sidhu had said that a rigorous dietary regime that included ingredients such as turmeric, apple cider vinegar, Tulsi, sour fruits and spiced tea, among others, helped his wife Navjot Kaur (Noni) recover after a diagnosis of stage IV breast cancer.
A day later, in a statement issued in public interest, the TMC underlined that the treatment of cancer involves the use of treatment modalities like surgery, radiotherapy, and systemic therapy such as chemotherapy and other drugs, individually or in combination, depending on the type and stage of cancer.
“We urge the public to report to an appropriate healthcare facility if there are any symptoms of possible cancer, and, if diagnosed with cancer, to take evidence-based treatment as advised by trained physicians,” it said.
The statement also cautioned that there is no good quality evidence to support the use of dietary advice as suggested in the video for cancer treatment.
Many oncologists ThePrint reached said that while there may be anecdotal evidence to suggest that some herbs, nutraceuticals or extreme methods such as starvation help cancer patients, they should not be relied upon till these products are subjected to rigorous clinical trials in actual patients to prove their efficacy.
“People should also keep in mind that there are no one-size-fits-all formulae, nor are nutraceutical products properly regulated in India, leading to gullible and desperate patients falling easily for false claims and misinformation,” said Dr Mandeep Singh Malhotra, a surgical and molecular oncologist with the CK Birla Hospital in Delhi.
Dr Vedant Kabra, surgical oncologist with Fortis Memorial Research Institute in Gurugram also said that while many drugs used in modern medicine have their roots in plants, any nutraceutical for cancer or any other disease should be trusted only when its efficacy is demonstrated through proven principles of drug development.
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Ongoing projects on studying herbs
Proponents of Ayurveda have long been insisting that not only does Guduchi (inospora cordifolia) have anti-neoplastic (neoplasm refers to an abnormal growth of tissue that may be malignant or benign) properties, it can also help limit systemic damage in the body that can lead to cancer and may be able to help with the adverse effects of chemotherapy.
One of the most promising effects of the herb, according to them, is immunomodulatory activity—through which it modifies the response of the immune system—by raising the number of white blood cells in the body.
At ACTREC, a team of researchers led by the head of clinical pharmacology, Dr Vikram Gota, is now doing a phase 3 trial to analyse whether the addition of Guduchi to docetaxel-based chemotherapy will help reduce its adverse effects and improve quality of life for cancer patients.
Docetaxel is a crucial drug used in chemotherapy in case of several types of solid tumours but is also known for its fairly robust toxicity profile with side-effects including unusual bleeding or bruising, nosebleeds and blurred vision, among others.
Another early stage research project by Dr Gota, presented at numerous prestigious cancer conferences internationally has also shown that Withaferin-A, an active compound derived from Ashwagandha and known for its anti-inflammatory and immunomodulatory properties, can reduce mortality by 50 percent among bone marrow transplant patients, who receive the treatment as part of care for blood cancers.
This study, Gota told ThePrint, is now in phase 2.
Researchers at the institute are also evaluating the efficacy of curcumin—the principal active compound in turmeric—in case of oral mucositis, a common and painful side-effect of cancer treatments like chemotherapy, radiation therapy, and stem cell transplants.
While Ayurvedic doctors have been vouching for anti-inflammatory properties of turmeric for ages, new studies show early evidence that it may also have anti-proliferative (that tends to inhibit cell growth) and immunomodulatory qualities.
“Most of our work on plant-based products and alternative medicines, as of now, is focused on evaluating their role in managing side-effects related to standard therapies used for treating cancers as cancer treatment itself can lead to toxicity in patients,” Dr Gota remarked.
The studies at the centre are just not limited to drugs derived from herbs used in indigenous forms of medicines since ancient times, but also extend to traditional remedies such as yoga.
A scientific paper that came out from the TMC in 2022, for instance, showed that yoga can improve disease-free survival in breast cancer patients by 15 percent and overall survival by 14 percent.
The institute called the study the first one where long-term benefits in quality of life have been noted with the addition of yoga for women undergoing treatment for breast cancers—the leading form of malignancy in India.
Marrying indigenous knowledge with science
TMC director Dr Pramesh shared that the institute has tied up with several experts in the indigenous forms of medicine who will be working with it on both identifying the herbal plants as well as researching them.
The idea is to cultivate nearly 500 plants, many of which which require climate control, and research them for cancer management in collaboration with institutes like the Central Ayurveda Research Institute, the Indian Institute of Technology (IIT) Bombay, the Indian Institute of Integrative Medicine, the Council of Scientific and Industrial Research in Jammu, the Agharkar Research Institute in Pune, M. A. Podar Hospital in Mumbai, and Banaras Hindu University, among others.
Dr Pramesh meanwhile emphasised that the project is entirely on research mode and the institute, as of now, is not propagating that any of the herbal medicines are ready for clinical use.
“There is no dearth of low quality evidence (to suggest that several herbs have anti-cancer properties) and the risk of accepting low quality evidence just because we don’t have high quality evidence is a very dangerous one,” Dr Pramesh said.
He also maintained that there are enough examples in modern medicine itself where initially, some interventions have been started with low quality evidence, only to be proven wrong by better conducted scientific research.
“This certainly puts science back many years if not decades, if we adopt low practice, low level evidence as adequate because once a practice becomes established, it becomes extremely difficult to roll it back and we will actually end up potentially harming patients if we change treatment decisions or make any clinical recommendation based on low quality evidence,” Dr Pramesh said.
Another aspect, the TMC director said, is to study the drug interactions between standard therapies used in cancer care and traditional medicines.
Drug interactions occur when a drug’s effect is changed by taking it with another drug or supplement—through changes in its absorption, distribution, metabolism, and excretion. It can lead to changes in a medicine’s efficacy and toxicity.
“Many of the drug interactions between these traditional medicines and the standard form of treatment that we offer as part of modern medicine have interactions which are as of now unknown,” Dr Pramesh stressed.
Dr Gota maintained that the current scientific exercises studying the role of herbs in mitigating side-effects related to cancer treatment could be seen as build-up to the larger ICTREC project.
“When the ICTREC comes into being, if we have clinical evidence to show their safety and efficacy, we should be in a position to offer some of these complementary medicines to patients in an integrative manner,” said the cancer scientist.
(Edited by Gitanjali Das)
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