Medicinal plants in cancer treatment: a brief literature review
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Lorena Gomes de Moraes
Lorena Gomes de Moraes
Araci Molnar Alonso
Araci Molnar Alonso
Eduardo Cyrino Oliveira-Filho of the Brazilian Society of Agricultural Research (EMBRAPA)
First Name
27.19Brazilian Agricultural Research Corporation (EMBRAPA)
Abstract
The c ?? in its various forms, ?? a disease to which touching the O c ?? in its various forms, ?? a disease to that touching in the whole world and, in Brazil, ?? a second major cause of death in adults. Its appearance and development are linked to the lifestyle of the people and the environmental factors to which they are exposed. Among the various therapeutic uses, the medicines, Phytotherapy ?? The treatment of patients as the use of fresh or dried plants and their natural extracts. We are what is necessary for conventional medicine as a more accessible and alternative form of treatment and has been growing considerably, including for the c ?? of the child. Per ?? m ?? Big worries ???? how much ?? Used, its use unfit and uncritical can serious bass recorder? the Why this research in this ?? area and ways of controlling and guiding O ?? population? the overall must be developed. So, the purpose of this work ?? perform a brief review of how much? use of medicinal plants in the treatment of c ?? of the child.
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join for freeDOI: 10.5102 / ucs.v9i1.1308Medicinal drugs in the treatment of cancer: a brief review of the literatureLorena Gomes de Moraes1Araci Molnar Alonso2Eduardo Cyrino Oliveira-Filho3Resumo Cancer, in its various forms, is a disease that affects the whole world and, in Brazil, is the second leading cause of death in adults. Its appearance and development are linked to people's lifestyle and the environmental factors to which they expose themselves. Among the various therapeutic uses attributed to medicinal plants, totherapy is the treatment of diseases by the use of fresh or dried plants and their natural extracts. In recent years, it has been retaken by conventional medicine as a more accessible and alternative form of treatment, and its importance has been growing considerably, including in the fight against cancer. However, there is great concern about the home use of medicinal plants, since their inadequate use and without criteria can have serious consequences. Therefore, research in this area and ways of controlling and orienting the population in general should be developed. Thus, the objective of this work is to perform a brief review regarding the use of medicinal plants in the treatment of cancer.Keywords: Cancer. Medicinal plants. Non-conventional medicine. Phytotherapy. Anticancerigen.1 Introduction Every year, about 1.2 million new cases of invasive cancers are diagnosed in the United States, with about 500,000 people dying in the Biomedicine Program at the Centro Universitário de Brasília - UniCEUB. Email: logmoraes@hotmail.com2 Researcher at Embrapa Cerrados. Email: araci.alonso@cpac.embrapa.br3 Professor at the University Center of Brasília - UniCEUB and researcher at Embrapa Cerrados. Email: eduardo.cyrino@uniceub.br
78 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-Filhoanuales (SIMONE, 2001). In Brazil, the disease represents the second cause of death in adults (CANCER ..., 2004). One of the medical areas that most evolves and mobilizes society is oncology. With the control of acute diseases, the challenge is to control the chronic-degenerative diseases, in which cancers and heart disease predominate (KLIGERMAN, 1999) .1.1 General aspects about cancerThe human body has a precise mechanism that controls growth of different organs, so that they reach a specific size. In most organs, we can find a repair and support mechanism whose function is to repair and recover organ tissue if it is damaged due to injury. The surviving cells proliferate, replacing the damaged ones, and the process ceases as soon as the damage is repaired. This same mechanism also works for the constant replacement of cells that are aging and dying naturally (FRANKS, 1990). According to Otto (2002), cancer can be defined as a logical process in which normal cells, because they undergo modiçcations, have special abilities. These modified cells are known as carcinogens and divide successively, thus forming a grouping of malignant cells that are identical, causing mutations that will determine their new behavior as a faster growth (ABC®CER, 2008). These cells have the ability to create new blood vessels that will nourish them while maintaining their growth activity. They can also spread through blood vessels or lymphatic vessels, reaching distant organs from the site of its origin, a phenomenon known as metastasis. Thus, as the tissues are being invaded, they are losing their functions, and therefore, a person who develops a cancer has strong symptoms that are characteristic according to the place reached (INSTITUTO NACIONAL CANCER, 2008a). Cell accumulation is the formation of tumors, which may be benign or malignant. A benign tumor is one whose cells are similar to their original tissue and show slow growth. This type of tumor rarely represents a risk of death for the individual,| 79Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of literatureser completely removed by surgery. A malignant tumor tends to be more aggressive and has particular characteristics, such as cellular abnormality and metastasis, which makes its diagnosis easier. Changes such as variation in cell size and shape, increase in nuclear size and staining density, and loss of regular cell distribution are indicative of this type of tumor (Franks, 1990). a cancer can be caused by an irreversible alteration of the DNA, a material that is present in all the cells of our body and that controls its normal activities, and also by a cellular replication and proliferation, xando the initial mutation. In order to protect against this modification, mechanisms of detoxification of carcinogens, elimination of affected cells and repair of DNA, which prevent the formation of cancer cells, are necessary. However, our body does not always have the ability to activate such mechanisms, which allows the cells to begin to proliferate. Carcinogens are harmful elements that can lead to a greater probability of DNA damage, increasing the chances of a neoplasia (SASSE, 2004). As examples of such carcinogens, there may be mentioned agents which are linked to the processes and to the environment, such as soot to which chimney sweepers are exposed; viruses, which can cause cancer in mammals; drugs and irradiation agents, and genetic and immunological factors (BERTINO, 1980). Epidemiological studies indicate that of all cancer cases, approximately 80% are associated with environmental factors (BODMER, 1990). Cancer can also be associated with age, gender and family history, making it difficult to be controlled. When talking about environmental factors and lifestyle, they refer to facts that can be changed, such as a person who smokes and is therefore more likely to develop lung cancer than a person who has never smoked ( AME-RICAN CANCER SOCIETY, 2008). Areas of the human body that can be affected by cancer are: head and neck, lung and pleura, skin, breast, digestive system, gynecological and urological system, bones, soft tissues, blood (leukemia), very common in children, and others (CANCER NATIONAL INSTITUTE, 2008c). Table 1 shows the
80 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-Filhotimativa of new cancer cases, in 2008, in regions of Brazil. It can be observed that the Southeast Region presents the largest number of cases in all primary locations, probably because it concentrates the majority of the country's population. In all regions, non-melanoma skin cancer occurs more frequently. In the South, breast and prostate cancers are in second place; in the North, Northeast and Center-West, prostate cancer occupies this position and in the Southeast we observe breast cancer.1.2 General aspects about the use of medicinal plantsWhen the topic of medicinal plants is discussed, it is initially fundamental to present some important concepts in totherapy such as medicinal plants, active principle, the own totherapy and product terapic, terms obtained in Oli-veira and Akisue (1997), in the literature entitled Fundamentals of Pharmacobotany, and presented below.Tab she 1 - Estimates for the year 2008 of new cases of cancer, by region of Brazil, with numbers rounded to 10 or multiple of 10.Localization Primary North Northeast Midwest South Southeast Female Mama 1,210 7,630 2,630 9,500 28,430Traqueia, Bronchus and Lung1,020 3,630 1,690 7,210 13,720 Stomach 1,200 3,840 1,250 4,360 11,150Prostate 1,750 9,820 3,200 9,500 25,260Covietus 1,700 4,720 1,350 3,470 7,440Colon and Challenge 550 2,680 1,430 5.95 0 16.380 Esophagus 230 1.360 560 3.110 5.290 Leukemias 530 1,900 650 1,820 4,640 Oral cavity 400 2,500 750 2,500 8,010 Melanoma 150 450 250 1,950 3,120 Other Locations 4,550 14,190 7,290 27,270 64,610Subtotal 13,290 52,720 21,020 76,640 188,050Pele No Melanoma 4,330 26,240 7,490 22,940 54,010Total 17.620 78.960 28.510 99.580 242.060Source: National Cancer Institute (2008b). (A) medicinal plant: it is any plant which contains in one or more of its organs substances which may be used for therapeutic or precursors of substances used for such ns;| 81Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of the literature b) active principles: they are chemically defined substances, present in the raw materials and in the teraphic responsible for the pharmacodynamic activity, that is, by the therapeutic effects of these materials; c) totherapy: it is the method of treatment of diseases that uses fresh vegetables, plant drugs or even vegetable extracts prepared with these two types of raw materials. The vegetable drug is the plant or its parts which, after collection, preparation and conservation (drying, stabilization) justify its use in the preparation of medicinal products, of which one of the characteristics is the presence of active principles d) is all medicine obtained and elaborated using exclusively active vegetal raw materials with a curative or pro-plastic environment with benefit to the user. According to Mota et al. (2004), the first known way to use medicines is the use of medicinal plants. There are records that report the use of plants by man since antiquity. It is also believed that they were used for the cure of diseases, then considered as castigos or fury of the gods (NEVES, 2007). A few remote primitive civilizations realized that among the edible plants, there were those with more or less toxicity, and that many showed a certain curative power in the fight against diseases. Thus, everything that was discovered was passed down, orally, from generation to generation until the appearance of writing. The World Health Organization (WHO) estimates that the use of some sort of traditional, popular medicine for basic health care is carried out in approximately 80% of the world population, with 85% of the treatments involving medicinal plants (NEVES, 2007). According to Yunes, Pedrosa and Filho (2001), totherapy has been growing notably in the last years, reaching in the world market terapacity a value around 22 billion dollars.
82 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. Despite having a large number of research groups and the largest biodiversity reserve in the world, Brazil does not have a strong presence in the global market of terapica, losing even to countries technologically less developed. According to the Resolution of the Collegiate Board of Directors (DRC) n ° 48/2004 of the National Agency of Sanitary Surveillance (ANVISA), otherapies are medicines obtained from vegetal active raw materials removed from specific parts (Leaf, root, bark, fruits, or seeds), and are known for the efficacy and risks they may present, and the safety of their use is established through ethnopharmacological utilization surveys , and technical-scientific documentation contained in publications. The therapeutical characteristics of plants are often described in several studies, and this is due to the fact that there are users of medicines throughout the world. Moreover, popular observations on the use and effectiveness of plants contribute to this type of research, where several multidisciplinary areas can be involved, such as botany, pharmacology and tochemistry (MACIEL et al., 2002). It is common in many countries to cultivate plants in backyards, gardens, or even in small containers (LUZ, 2001), which shows that the use and access to these plants culture from remote times to the present. In this context, the objective of this work is to present a brief review on the use of medicinal plants for the treatment of cancer.2 The use of medicinal plants as a complementary method In the last 20 years, diagnosis and treatment of various types of cancer have made great strides, through the use of molecular biology methods, biochemical analyzes and modern imaging methods, which allow an adequate diagno- of treatments involving radio-therapy, chemotherapy, surgery and bone marrow transplantation (CANCER, 2004).| 83Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Medicine plans in cancer treatment: a brief review of literature Nowadays, a large number of people with cancer resort to various possibilities to try to seek their cure, thus considering the possibility of using non-conventional medicine. Although this type of medicine has a growing use every day, its functioning is not adequately known by most of the people who use it, mainly because they do not receive clarification on the subject (ELIAS; ALVES; TUBINO, 2006). Complementary or alternative therapeutic methods are of concern to health professionals working with oncology patients, since they fear the risk of the patient abandoning traditional medicine and treating only the non-conventional medicine, which may impair their treatment, especially in the initial phase (FLETCHER , 1992). In this context, Araújo et al. (2007) conducted a survey in hospitals of the public health network of João Pessoa, where cancer patients were interviewed by means of questionnaires. This interview aimed to evaluate the use of medicinal plants by patients and to verify their knowledge. In total, 40 cancer patients were interviewed. Of these, 47.5% agreed to make use of some medicinal plant. Among the participants, 58% reported not using the plant alone, three revealed using the plant together with radiotherapy, five used more than one plant at a time and three confirmed the use associated with the prescribed drugs. Most patients reported having started using the plants as a referral to friends or relatives, 79% did not tell doctors about their use, and all said they had experienced a relative improvement in symptoms. The ratio of the 13 plants cited by patients is shown in Table 2. Many of them were used to decrease the side effects of chemotherapy or to combat complications of the disease itself.
84 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-FilhoTab she 2 - Medicinal plants reported by cancer patients interviewed in hospitals of the public health network in João Pessoa (PB). Popular and scientific name of the medicinal plant Indication Used part of use Preparation Place of production Garlic (Allium sativum L.) Hypertension, high cholesterol and cancerBulbo Mixed with alcohol; (Schinus terebinthifo-lius Raddi) Incantation and cancer Bark Seating bath Decoct In the fairsBabosa (Aloe vera (L) Burm. f.) Cancer Whole plant Mixed bottled with cachaça On the fairs and at the residence itselfBabatenon (Stryphnodendron adstringens (Mart.) Coville) Wounds Bark Tea Decoct At the fairsBrand (Peumus boldus Mol) Difficult digestion -Chá InfusoIn the fairs and super marketsCamomila (Matricaria chamo-milla L.) Nervousness Leaf Tea DecoctoNovember and Fairs (Pimpinella anisum L.) Insomnia, thawing of the leaves of the leaves of the tree, and of the leaves of the tree. appetite and children's ca Chili; spices Infusion In the super markets Ginseng (Panax ginseng CA Meyer) Stimulant-Capsules Oral In the pharmacies Purple pea or dick (Tabebuia avellanedae Lor. ex Griseb) Incanation and cancer Peel Ingestion with water Dye Obtained readyJatobá (Hymenaea courbaril L.) Inamation Scrape Tea Decoct With the vicinityRomã (Punica granatum L.) Inamation Fruit bark Garlic Decoct In the fairs Source: (ARAÚJO et al., 2007).| 85Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of literature Garlic (Allium sativum L.) is among the first spices cultivated in the world, being easily identified by its characteristic odor. Its knowledge in folk medicine has been through centuries, and is used to treat various problems such as flu, burns, wounds, headaches, respiratory diseases, diabetes, cardiovascular disorders and cancer (BLOCK et al., 1993) . Many researchers have reported pharmacological evidence supporting its use as an anticancer agent. A number of sulfur compounds, extracted from and identified from garlic, have been shown to possess these properties. Through many studies, it has been reported that mechanisms of suppression of cancer initiation and development are related to these isolated components, and are actually powerful antineoplastic agents (THOMSON; ALI, 2003). Garlic also has activity (Schinus therenbithifolius Raddi) is a small tree with foliate racemes and has large, reddish and red fruits. It is indicated to combat fevers, rheumatism and sílis. It is also advised in cases of muscle atony, tendon distension, arthritis, rheumatism, weakness of the digestive organs and lymphatic tumors (BALBACH, 1995) .The aloe vera (L) Burm. which can also be found in the dry parts of Africa and in the mountains of tropical Africa. The juice of its leaves is emollient and resolutive, and can be used for inflammation and burns, and bare leaves are indicated for contusions and rheumatic pains (BARRACA, 2008). It is currently used in modern medicine in many parts of the world, in addition to being present in the cosmetic, pharmaceutical and food industry (VEGA et al., 2005). The barbatimão (Stryphnodendron adstringens (Mart.) Coville) is a red-re and harsh bark. He has two little girls and bipinnate leaves. It is used in cases of hemorrhage, leukorrhea and gonorrhea. Externally it can be applied in ulcers and wounds (BALBACH, 1995). The boldo (Peumus boldus Mol), originally from Chile, is widely used to combat bad digestion, strengthening the
86 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-Filhoestômago and the nerves. It is also indicated for hepatitis, liver congestion, gastric disorders, dizziness, insomnia, intestinal colic and several other diseases (BOLDO-CHILE, 2008). Chamomile (Matricaria chamomilla L) is used in folk medicine in the form of (Spore et al., 1991). The grassgrass (Cymbopogon citratus (DC), Stapf) is one of the most abundant species in the world. an herbaceous plant from the family of grasses, from Asia, which is easy to grow and has a wide distribution in Rio Grande do Sul. Tea from its fresh leaves is widely used in folk medicine, and it is also possible to extract the essential oil , which has activity against the leukemic cells (DUBEY et al., 1997). The purple cashew (Anacardium occidentale L.) has several medicinal properties and is stimulant of the organism. It is mentioned as forticant, digestive, antigripal, analgesic, antitermic, diuretic, soothing and others (GOMES; NEGRELLE, 2003). It fights diabetes, is anti-hemorrhagic, and can even be used in gargling to heal throat and other infections (ERVAS MEDICINAIS, 2008). Fennel (Pimpinella anisum L.) is an annual herb that has been widely cultivated worldwide. Its fresh leaves are used to season or garnish food and through the seeds can be made an oil, which can be used as medicine, perfume, soap and others (STEPHENS, 2009). This herb has a considerable reputation as a medium for coughs and chest diseases, and is widely used as pastilles. The oil has a beneficial effect on the bronchi, combating asthma and bronchitis. It is also widely used to combat childhood colic (BOTANICAL, 2008). Ginseng (Panax ginseng C.A Meyer) is one of the most important genera in the East, wherehas been used as a source of medicine. Several species are found in the northern hemisphere. The root of ginseng has been used for thousands of years in Asian countries, where it is traditionally used as a strength restoration tonic. Studies suggest that ginseng also has activity against the development of cancer, being used in tablets (SHIN et al., 2000).
| 87Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of the literature The purple ipê (Tabebuia avellanedae Lor. Ex. Griseb) is a very popular tree in popular medicine; (Hymenaea courbaril L.) is a large, canopy tree, with the largest number of small trees and wood dark red. The bark and the resin are vermifuge and stomachic. Your tea is indicated for acute or chronic cystitis. It can also be used in cases of blenorrhea, bronchitis, cough, various pain and inflammation (BALBACH, 1995). Pomegranate (Punica granatum L.) has been widely cited in several scientific studies. It is widely used popularly and has anti-in -a-matya, antimicrobial, hypoglycemic and antioxidant activity. Research has investigated its use as a chemoprotective agent and adjuvant in the treatment of cancer, in which it has been very promising (KIM, MEHTA; YU, 2002). Another similar research was done by Elias and Alves (2002) , in which oncological patients, who were treated at the University Hospital of the University of Brasília (HUB), were interviewed to verify the use of unconventional therapies. In this study, 105 patients participated and the most frequent neoplasms were breast cancer, lymphomas and lung cancer. Of the total, 67 patients (63.81%) reported using or having used non-conventional medicine. Of all the patients interviewed, 95 confirmed that they had never received any guidance on the use of this type of medicine, and 82 expressed a desire to receive clarification on the subject. Of the patients who reported use, 71.4% received referrals from friends, family, or neighbors.3 Medicinal products for plant-based cancer The use of natural products as anticancer agents began with folk medicine and, over the years, incorporating into traditional and allopathic medicine. Many drugs that are currently used in chemotherapy have been isolated from certain plant species or derived from a natural prototype.
88 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. We can cite as an example the vinblastine, vincristine, tenoposide etoposide, irinotecan, topotecan and taxanes (CRAGG et al., 1993). Vimblastine and vincristine are alkaloids isolated from the plant Catharanthus roseus (L.) G. Don, which has several popular names such as Periwinkle from Madagascar, Rosea vinca and others. Initially these drugs were screened as oral hypoglycemic agents, since the plant was popularly used for treatment for diabetes. Although the researchers' studies did not confirm their effectiveness in this area, they eventually found that these agents were able to reduce white blood cells and cause bone marrow depression in mice, and could then be used in treatment of leukemias with (CRAGG; NEWMAN, 2005). In addition, these alkaloids are of the specific phase of the cell cycle, where they bind to microtubule proteins during metaphase, thus interrupting mycosis. Thus, the cell loses the ability to divide and die (OTTO, 2002). Vincristine is more potent in cases of acute lymphoblastic leukemia, producing complete remissions in about 70% of patients (DEVITA JUNIOR, 1980). Vimblastine, used in combination with other medicinal products, is indicated for leukemias, lymphomas, advanced testicular cancer, breast and lung cancer (CRAGG; NEWMAN, 2005). Another active principle is etoposide, which is a semisynthetic glycoside produced by from podophyllum (Podophyllum peltatum) extracts. Studies have shown that podo-lotoxins act as inhibitors of nuclear topoisomerase II, causing breaks in DNA binding. They also have the ability to inhibit the transport of nucleosides and the mitochondrial transport of electrons. The drug based on this active principle is indicated, in combination with others, mainly for the treatment of testicular cancer. It can also beused the against lung cancer, lymphomas and monocytic leukemia (BERTINO; SAL-MON, 2001) .The irinotecan is a water-soluble semi-synthetic, derived from Campto-thecina, which is an alkaloid isolated from the bark of a Chinese tree ( Camptotheca acuminata Decne). Camptothecin progressed in clinical studies in the 1970s and, even with some antitumor activity, it was insoluble in water and post-
| 89Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of the unpredictable toxicology literaturesuía, leading to the interruption of its future evaluation. The renewed interest in camptothecin was motivated by the identification of topoisomerase I as the main target in the 1980s. The discovery of this new mechanism of action stimulated efforts directed towards the synthesis of more water-soluble analogs, with a more toxic perl favorable and consistent antitumor activity. Irinotecan signicativa exhibits activity against gastric carcinomas, lung, pancreatic and cervical and even tumors of the central nervous system of high-grade lymphomas and leukemia (GRIVICICH et al., 2001) .The taxane anticancer agents are derived from the bark of Taxus brevi-folia Nutt, and include paclitaxel and docetaxel. They bind to the microtubules of the cells modifying the equilibrium dynamics, resulting in a paralysis of the cell cycle between metaphase and anaphase. Paclitaxel is indicated primarily for the treatment of breast and ovarian cancer, but may also be used in epithelial tumors such as the neck, esophagus, and lung. Docetaxel is a semisynthetic analysis of paclitaxel, and is also approved for use against breast and lung cancer (BERTINO, SALMON, 2001). Table 3 presents a list of plant-derived agents in the laboratory investigation process in the year 2001. At the time, some drugs mentioned were already used in the chemotherapy of cancer patients and others were still in the test phase. The name of the compound, the type of cancer treated, and the phase in the tests for the period were verified.No nal of the 90's, with the entry into force of the law of industrial property in Brazil and based on the Resolution of the Collegiate Directorate - RDC number 17 of 24/02/2000 of ANVISA, various national pharmaceutical zeram partnerships with academia, with nalidade to promote develo-to tomedicamentos of whose records require cientícos studies for proof of quality, efficacy and safety of use (CALIXTO, 2003).
90 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-FilhoTab el 3 - derived anticancer agents plantasComposto cancer type StatusVincristina leukemia, lymphoma, breast, lung, solid childhood cancers and other Phase III / IVVimblastina breast, lymphoma, germ cell and renal cancer Phase III / IVPaclitaxel ovary, breast, lung, bladder, head and neck Phase III / IVDocetaxel breast and lung cancer Phase IIITopotecan ovary, lung and child Phase II / IIIIrinotecan Colorectal and lung cancer Phase II / IIIFlavopiridol Experimental Phase I / IIAcronyciline experimental Phase II / IIIBruceantin Preclinical experimental / experimental Phase Ialicarpin Preclinical / Phase IFonte: Rock, Lopes and Schwartsmann (2001) modicado.Diversos contributed programs have been developed by the National Cancer Institution-to (INCA) in countries such as Brazil, Costa Rica, Mexico and Panama, and involve possibilities of new drugs and chemical plants for the of the child. Tropical forests are well exploited by such programs because of their high diversity in ora species. Similar projects are developed around the world in several institutions, such as the Oswaldo Cruz Foundation (FIOCRUZ), in Rio de Janeiro, the Institute of Biological Diversity of Costa Rica, the Institute of Chemistry of the National University of Mexico, the Kunming Institute of China and the Cancer Research Center of the Russian Academy of Medical Sciences (TAYLOR, 2000) .4 Some positive aspects regarding the use of medicinal plantsThe abundance of different native plant species and the easy access that users can have to them are factors that lead people to show a preference for alternative medicine. It is also possible to mention the low cost of pre-boom infusions, since it provides advantages for low-income populations (NAKAZAWA, 1999). The fact that medicinal plants can be grown in the backyard of the home, or in the homes of relatives and friends, is also a positive point (VIGANÓ, J .; VIGANÓ, J. A .; CRUZ-SILVA, 2007). Segundo Álvarez| 91Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of the literature (2005), totherapy, compared to modern medicine, has shown to be more useful when used in the treatment of certain chronic diseases, presenting fewer side effects and being cheaper and cheaper . Another advantage is that therapeutic drugs can be associated with allopathic drugs, but some caution is needed in relation to such combination, since to-fast drugs may potentiate the effects of some of these drugs. According to Parente and Rosa (2001), another important factor in the growing demand for totherapy is the there is a shortage of resources from public health agencies, resulting in higher prices for industrialized medicines, a fact that is not usually found in this type of medicine.5 Some negative aspects regarding the use of medicinal plantsThe active principles of medicinal plants are responsible both for the therapeutic properties such as into intoxications and adverse reactions, which may occur due to their use in inadequate doses and / or for prolonged periods. The fact that there is a lack of objective and updated information about the possible risks and benefits of the use of medicinal plants can be considered one of the main factors that contribute to the population practicing self-medication. Because they are natural, many people find that the use of medicinal plants is safer and end up using them incorrectly (BASTOS, 2007). The use of medicinal plants, which supposedly have a harmless health action, can be responsible for disastrous results, since the same plant can present both therapeutic and toxic action, which will be determined by the dosage used and the method of preparation (GOMES et al., 2001). According to Turolla and Nascimento (2006), many plants have substances that can trigger adverse reactions. Such substances may be associated with their own constituents or contaminants and adulterants present in therapeutic preparations, which requires strict quality control in the culture, collection, extraction of their constituents and in the preparation of the medicinal product.
92 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-Filho In Brazil, native medicinal plants are consumed with little or no evidence of their pharmacological properties. The toxicity of these plants results in a serious public health problem, since the adverse effects of tomedications and their interaction with other drugs commonly occur. The research carried out to evaluate the safe and correct use of plants and medicines in Brazil is still precarious, as well as the control of commercialization by trade organizations in open markets, markets or stores of natural products (MACIEL et al. The use of medicinal plants as unconventional medicine is very old, and is currently showing a significant increase, mainly in the lower social strata of the population, since it is a form cheaper treatment and easy access. Because it is a natural form of treatment, based on information transmitted from person to person, and, colloquially, by friends, relative or someone considered knowledgeable of the subject, the use of plants transmits a sense of security to users; however, cases of worsening disease or symptoms, or even into intoxication by inappropriate use or in excessive amounts are not uncommon. It is known that cancer is an extremely aggressive disease, and that its carriers, for obvious reasons, tend to to be open to any treatment options to achieve healing or to alleviate their suffering. In this context, the research presented in this review showed that a considerable proportion of cancer patients make parallel use of the plants as a form of treatment, and that almost always do so on their own initiative and without the knowledge of the responsible physicians. It is quite probable that the practice extends to other diseases. It has been possible to verify that the practice of unconventional medicine by the use of medicinal plants, based on empirical knowledge transmitted orally by persons without specific training, is very common, not only in less populated areas, but also in large Brazilian urban centers.| 93Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011There is a lack of integration in Brazil between users, regulators, academics and legislators, in order to resolve the issue, not only because of the potential dangers inherent in the indiscriminate use of medicinal and medicinal plants , but also for what could be discovered as new ways of treating cancer and other diseases. Brazil is immense, its biodiversity is enormous, but the research is at least incipiente.Entrando in the field of education and training of professionals in the area, it is also perceived that little importance is given to totherapy once that conventional medicine prefers to use industrialized drugs considered as quicker, effective and safe. Apparently this is not a specialty, but an auxiliary activity; a matter of scholars and researchers, generally framed within what has been called alternative medicine, in which oriental techniques of massage, use of stones, colors and other devices prevail, and where, for a long time, acupuncture and homeopathy survived , and that today are recognized medical specialties. Thus, it is important to emphasize the need to strengthen the research in the sector for all the disciplines related to totherapy, since it is a modality of therapy that is growing in importance each year in Brazil and in the world, and that also has its space, since it was the forerunner of the current conventional medicine.Herbal medicine in cancer treatment: a brief reviewAbstractCancer in its various forms, is a disease that aects the whole world and in Brazil is the second leading cause of death in adults. eir emergence and develo-pment are linked to the lifestyle of people and environmental factors to which they are exposed. Among the various therapeutic uses attributed to medicinal plants, herbal medicine is the treatment of diseases by the use of fresh or dried plants and their natural extracts. In recent years it has been taken up by conventional medi-
94 | Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011Lorena Gomes de Moraes, Araci Molnar Alonso, Eduardo Cyrino Oliveira-Filhocine the most aordable and alternative treatment and has grown considerably, including cancer. But there is a great concern regarding the use of medicinal plants in home made, its discretion and without misuse can have serious consequences. For this fact, research in this area and ways to control and guidance to the general population should be developed. us, the purpose of this paper is a brief review on the use of medicinal plants in treating cancer.Keywords: Cancer. Medicinal plants. Unconventional medicine. Phytotherapy. Anticancer.ReferenciasABCÂNCER. What is. Available at: <http://www.abcancer.org.br/ sobre.php? C = 8 & s = 18 & lang = 16>. Accessed on: 4 Mar. 2008. VALVAREZ, T. Z. Benefits of therapy. Cuban Journal of Medicinal Plants, Havana, v. 10, n. 2, p. 1-2, may / ago. 2005. AMARAL, F. M. M. et al. Microbiological quality of the stem bark of Tabebuia avellanedae Lor. former Griseb. marketed in São Luís / Maranhão. Academic View, Curitiba, v. 2, n. 2, p. 65-70, jul./dez. 2001. AMERICAN CANCER SOCIETY. What are the risk factors for cancer? Available at: <http://www.cancer.org/docroot/CRI/content/CRI_2_4_2x_ What_are_the_risk_fact ors_for_cancer_72.asp? Sitearea =>. Accessed on: 27 feb. 2008.ANISE. In: GRIEVE, M. Botanical.com: a modern herbal. 2008. Available at: <http://www.botanical.com/botanical/mgmh/a/anise040.html>. Accessed on: 14 May 2008.ARÁUJO, E. C. et al. Use of medicinal plants by cancer patients from public health hospitals in João Pessoa (PB). Space for Health, Londrina, v. 8, n. 2, p. 44-52, jun. 2007.ARNOUS, A. H .; SANTOS, A. S .; BEINNER, R. P. C. Medicinal plants for home use: popular knowledge and interest in community farming. Space for Health, Londrina, v. 6, n. 2, p. 1-6, jun. 2005.| 95Universitas: Health Sciences, Brasília, v. 9, n. 1, p. 77-99, jan./jun. 2011 Medicinal plants in the treatment of cancer: a brief review of the literatureBALBACH, A. Plants heal. São Paulo: Vida Plena, 1995.BARRACA, Sérgio Antonio. Slug In: UNIVERSITY OF SÃO PAULO. Medicinal plants. 2008. Available at: <http://ci-67.ciagri.usp.br/pm/ver_1pl.asp>. Accessed on: 7 May 2008. BASTOS, G. M. Use of home-made preparations of medicinal plants used in the treatment of infectious diseases. 2007. 111 f. Dissertation (Master's Degree in Pharmaceutical Sciences, Clinical Pharmacy) -Faculty of Pharmacy, Ondotology and Nursing, Federal University of Ceará, Fortaleza, 2007.BERTINO, J. R. Principles of neoplasia. In: THORN, G. W. Harrison Internal medicine. 8. ed. Rio de Janeiro: Guanabara Koogan, 1980. p. 1710-1715.BERTINO, J.R .; SALMON, S. E. Principles of cancer therapy. In: BENNETT, G. Internal Medicine. 21. ed. Rio de Janeiro: Guanabara Koogan, 2001. p. 1178-1194.BHUVANESWARI, V. et al. Tomato and garlic by gavage modulate 7,12-dimethylbenz [a] anthracene-induced genotoxicity and oxidative stress in mice. Brazilian Journal of Medical and Biological Research, [S.l.], v. 37, n. 7, p. 1029-1034, Jul. 2004. doi: 10.1590 / S0100-879X2004000700012BLOCK, E. et al. Organosulfur chemistry of garlic and onion: recent results. Pure and Applied Chemistry, North Carolina, v. 65, n. 4, p. 625-632, 1993.BODMER, W. F. Heredity and susceptibility to Cancer. In: FRANKS, L. M .; TEICH, N. Introduction to the cellular and molecular biology of cancer. São Paulo: Roca, 1990. p. 89-105. In: UNIVERSITY OF SÃO PAULO. Medicinal plants. 2008.
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