Curcumin and Tumours

Very few would disagree that cancer is the most feared disease in the world.

Caused by genetic mutations, cancer causes normal cells to continuously grow and divide. Usually, the process of cell division is such that new cells can be produced to replace old cells to help us grow and develop. However, cells can only divide up to a certain limit. After their limit is exhausted, they die. Genetic mutations disrupt this process, meaning the cells continue to divide without dying. The result can be a mass or tumour (either benign or malignant), and the latter can spread and destroy tissue and organs.

These genetic mutations that cause cancer can be inherited or occur after birth. Interestingly, most genetic mutations are caused by external factors (non-inherited) such as smoking, stress, viruses, infection, poor sleep, obesity, ingested chemicals, alcohol, sedentary lifestyle, and exposure to environmental pollutants or ionizing radiation.

These factors cause oxidative damage to cells, which leads to chronic inflammation. Inflammation is the main culprit causing age-related degenerative health conditions that plague so many today.

Anti-cancer drugs (of which there are around 150) may be effective, but they are marred by often debilitating side effects. Common and aggressive cancer treatments such as radiation and chemotherapy can damage the bone marrow, gastrointestinal tract, liver, and kidneys. Furthermore, these treatments (especially chemotherapy) cause weight loss, weaken our immunity, cause hair loss, loss of energy, and poor appetite. What is very concerning is that long-term use of many cancer treatment drugs can cause cancer cells to become resistant to the treatment. Such drugs can also cause secondary tumours in otherwise healthy cells.

If you consider such life-altering side-effects, it comes as no surprise that patients and health practitioners are searching for safer cancer treatments that don’t impact the lives of patients so aggressively. Thus, natural chemical compounds have been the subject of studies aiming to understand their role in reducing inflammation, toxicity against cancer cells, and their safety profile.

This leads us to the subject of curcumin and cancer, specifically, curcumin for cancer prevention. A polyphenol derived from turmeric, curcumin is fast-emerging as a natural agent with strong antioxidant, anti-inflammatory, and anti-cancer properties.

Curcumin as an alternative cancer treatment


While more research is needed, small clinical studies suggest that curcumin can be an effective cancer-fighting tool. Plus, it has been found to enhance the effectiveness of conventional cancer treatments such as chemotherapy and radiation therapy. Curcumin benefits for cancer treatment also include a reduction in commonly associated side effects.

So, what makes curcumin “anti-cancer”? It comes down to its ability to reduce inflammation and improve the body’s antioxidant capacity. These properties make curcumin a powerful natural weapon against other chronic conditions such as arthritis, heart disease, depression, diabetes, metabolic syndrome, dementia, and Alzheimer’s.

This review notes that “to date, over 100 different clinical trials have been completed with curcumin, which clearly show its safety, tolerability and its effectiveness against various chronic diseases in humans.” [1]

Anti-cancer mechanisms


The growth of cancer cells is initiated by several processes. These processes involve expressions of various genes and the activation of signaling pathways and inflammatory molecules. Therefore, a substance that can target these processes can be effectively used to prevent or even treat cancer.
Research tells us that curcumin may work via many mechanisms to fight cancer and stop cancer cells from growing and dividing. The most important factor is that curcumin can reduce inflammation in the body.

Curcumin benefits cancer treatment processes by:

  • Inhibiting the initiation, progression, invasion, and spreading of cancer cells.
  • Activating apoptotic signaling pathways that induce programmed death in cancer cells, so these cells die naturally.
  • Reducing inflammation by downregulating a wide range of transcription factors (NF-?B), growth factors, inflammatory cytokines, and enzymes.One of the most important mechanisms through which it controls inflammation is by blocking the nuclear factor-kappa B, a group of proteins that control genes responsible for regulating inflammation, immune responses, and cell growth. Abnormal activation of the NF-?B signalling pathway has been implicated in many inflammatory diseases including cancer.
  • Reducing the side effects of chemotherapy and radiation therapy. 
  • Supporting your immune system in seeking and killing cancer cells on its own.
  • Improving the body’s antioxidant status. Curcumin increases the levels of antioxidant enzyme systems such as superoxide dismutase (SOD), glutathione peroxidase (GSH), glutathione, and catalase.

A 2018 report concludes “The anticancer-promoting effects of CUR have largely been attributed to its ability to suppress cell growth, angiogenesis, and metastasis as well as to induce apoptosis in a variety of cancer types. Furthermore, the positive effects of the combined treatment of CUR with conventional chemotherapy drugs or radiotherapy should be considered as a subject of subsequent research, opening up new opportunities for effective intervention in cancer treatment.” [2]


Curcumin improves the effects of chemotherapy


Curcumin and cancer treatments such as chemotherapy can work in tandem, thanks to curcumin’s anti-inflammatory properties. Curcumin can modulate various signalling pathways and enzymes that are involved in cancer cell initiation and development.

Studies suggest that curcumin can also make cancer cells sensitive to anti-cancer drugs such as chemotherapy while reducing their side effects.
Curcumin has been used in clinical trials, alongside cancer drugs such as cisplatin, carboplatin, 5-fluorouracil (5-FU), and gemcitabine. The result of such combinations has been studied in various types of cancer including lung, breast, colon, pancreas, gastric, liver, and prostate. [3]

The “curcumin cancer prevention” relationship works because curcumin is a chemosensitizer. This means that curcumin targets pathways, enzymes, and inflammatory molecules, but also inhibits transcription factor NF-?B (the most significant mechanism).

A small study used a combination of docetaxel (a chemotherapy drug) and curcumin as a treatment for metastatic breast cancer patients. Most patients showed improvements and the researchers were able to determine the recommended dose of curcumin to be “6000 mg/d for 7 consecutive days every 3 weeks in combination with a standard dose of docetaxel. “[4]

It is also suggested that this combination of docetaxel and curcumin could be effective against castration-resistant prostate cancer. [5]

It has been found that curcumin improves the effectiveness of Mitomycin C, a strong drug used to fight different types of cancers. It does so by making cancer cells more sensitive to Mitomycin C, as well as reducing the side effects of this drug. Prolonged use of Mitomycin C can cause permanent damage to kidneys and bone marrow, as well as causing secondary tumours in normal cells. [6]

A 2010 study found that, “The treatment of curcumin with MMC results in a significant dose-dependent increase in cell viability and decrease in lipid peroxidation and DNA damage, suggesting a protective role of curcumin against the anti-cancerous drug mitomycin C.” [7]

It has been found that curcumin can improve the results of conventional cancer treatment when used in patients with myeloid leukemia (CML). [8]

Radio sensitizing and radioprotective properties of curcumin


Curcumin can offer protection against radiation therapy side effects while improving the effect of radiation on cancer cells. One of the most common side effects of radiation therapy is radiation dermatitis, which affects approximately 95% of breast cancer patients.

In a randomized, double-blind, placebo-controlled clinical trial, researchers found that curcumin reduces the skin damage caused by radiation therapy. The study concluded that, “oral curcumin, 6.0 g daily during radiotherapy, reduced the severity of radiation dermatitis in breast cancer patients.” [9]

Another pilot study discovered that curcumin could help to reduce such side effects caused by radiation therapy in prostate cancer patients. Such therapy causes inflammation and loss of mucosa at the neck of the bladder, within the prostate, and other structures. This leads to acute urinary dysfunction, a main side effect of radiation therapy.

In the study, curcumin was given as a supplement at 3 grams per day, resulting in the reduction of urinary symptoms caused by radiation therapy. This improved the quality of life in patients with prostate cancer. [10] This is due to the powerful anti-inflammatory and antioxidant abilities of curcumin.

However, curcumin did not reduce other side-effects of radiation such as bowel complications.

Curcumin’s anti-cancer potential impaired by low bioavailability


From the results of small-scale and pilot studies, we know that curcumin can prevent cancer cell growth, and improve the efficacy of conventional cancer treatments such as chemotherapy and radiotherapy. However, researchers have been unable to replicate the expected results in most human studies. This is because curcumin’s anti-cancer effects are impaired by poor bioavailability and solubility.

The issue is that the human body is not able to absorb much curcumin from food or supplements as it is broken down and eliminated from the body very quickly. To improve curcumin absorption, you can take oral piperine supplements. However, prolonged piperine use can have adverse effects.

What does this leave? Thankfully, liposomal technology has been developed to provide an effective way to deliver nutrients.


Why Liposomal Curcumin?


Researchers have explored many kinds of drug delivery systems including solid dispersion, micelles, microemulsion, and liposomes.

A 2017 review explores liposomal curcumin and its use in cancer treatment, noting that liposomal curcumin is an effective mode of delivery and provides superior anti-cancer effects. In other words, liposomal delivery enhances the antitumor effects of curcumin and reduces the dose required to kill cancer cells. Therefore, patients don’t need to take very high doses of curcumin to reap the desired health benefits, including reduced pain and swelling, and a reduced risk of heart disease and diabetes.

The review noted that “Liposomal CUR formulation has greater growth-inhibitory and pro-apoptotic effects on cancer cells.” and concluded the “combination of CUR and liposomes should enhance the stability, bioavailability, targeting property and anticancer efficacy of CUR.” [11]

So, what are liposomes? They are double-layered spherical structures that can be used to carry both fat-soluble and water-soluble drugs and nutrients directly to the target cells. Liposomes not only improve the bioavailability and absorption of nutrients but protect the stability of encapsulated agents.

As of now, early studies in this area show that curcumin can be an effective natural compound to fight cancer. With strong antioxidant and anti-inflammatory properties, curcumin is known to offer help in the treatment of many other health conditions, for example:

  • Reduces inflammation, a key risk factor in heart disease and other serious diseases ¦    Improves endothelial function
  • Reduces pain and joint function in arthritis and may work better than anti-inflammatory drugs to bring relief in this condition.
  • Improves insulin resistance and may cut down the risk of diabetes in people who are already at a high risk
  • Reduces cellular and DNA damage caused by radiation exposure
  • Reduces the risk of dementia and depression in the elderly
  • Reduces damage caused by smoking and protects lung health
  • May be helpful against Alzheimer’s as it lowers inflammation in the brain; prevents the build-up of amyloid-ß plaques (hallmark Alzheimer’s disease). 

Clearly, curcumin is a great supporter of overall health. It is a great idea to take curcumin as a dietary supplement to help reduce the risk of chronic conditions that are largely caused by oxidative stress and inflammation.

References:
  1. Kunnumakkara et al. Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases. Br J Pharmacol. 20172.  
  2. Wojcik et al. Molecular Mechanisms Underlying Curcumin-Mediated Therapeutic Effects in Type 2 Diabetes and Cancer. Oxidative Medicine and Cellular Longevity. 2018.
  3. Kumar et al. Molecular mechanisms underlying chemopreventive potential of curcumin: current challenges and future perspectives. Life Sciences. 2016.
  4. Bayet-Robert et al. Phase I dose escalation trial of docetaxel plus curcumin in patients with advanced and metastatic breast cancer. Cancer Biology & Therapy. 2010.
  5. Mahammedi et al. The new combination docetaxel, prednisone and curcumin in patients with castration-resistant prostate cancer: a pilot phase II study. Oncology. 2016.
  6. Zhou et al. Curcumin improves MMC-based chemotherapy by simultaneously sensitising cancer cells to MMC and reducing MMC-associated side-effects. Eur J Cancer. 2011
  7. Siddique YH et al. Assessment of cell viability, lipid peroxidation and quantification of DNA fragmentation after the treatment of anticancerous drug mitomycin C and curcumin in cultured human blood lymphocytes. Exp Toxicol Pathol. 2010
  8. Ghalaut et al. Effect of imatinib therapy with and without turmeric powder on nitric oxide levels in chronic myeloid leukemia. J Oncol Pharm Pract. 2012
  9. Ryan et al. Curcumin for radiation dermatitis: a randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patients. Radiation Research. 2013.
  10. Hejazi et al.  A pilot clinical trial of radioprotective effects of curcumin supplementation in patients with prostate cancer.  Journal of Cancer Science & Therapy. 2013
  11. Feng et al. Liposomal curcumin and its application in cancer. Int J Nanomedicine. 2017