Turmeric - A journey of recovery

Turmeric is primarily known as a spice used in Indian cooking, with its vibrant yellow colour and softly pungent flavour. The spice is derived from the roots of the curcuma longa plant. In recent years, the properties of turmeric's active chemical ingredient curcumin have been studied extensively, and people have been increasingly turning to the plant for its related benefits. Several studies have gone into the anti-inflammatory effects of curcumin (the main compound found in turmeric), as well as its potential to reduce the risk of Alzheimers.

In this article we're going to take a close look at how curcumin can aid in fighting the adverse side effects of cancer therapies, and also how using curcumin can actually help to reduce the risk of further cancer cell growth.

Curcumin’s Cancer Fighting Properties.

After cardiovascular diseases, cancer is the second biggest global killer on a global scale. The two main medical treatments for the various forms of cancer are radiotherapy and chemotherapy, and both treatments can lead to inflammation in the patient as a side effect. The treatments can cause acute inflammation leading to severe reactions in the body's tissues, resulting from high sensitivity or from exposure to high doses of ionizing radiation. The inflammation caused by these therapies can lead to adverse conditions and effects such as dermatitis, mucositis, (caused by inflammation in the tongue or gastrointestinal system), pneumonitis and fibrosis (due to inflammatory responses in the lungs and other organs), and bone marrow toxicity. These conditions can have lasting effects on the patient's quality of life, with possibly life threatening implications. Inflammation can also negatively impact the outcome of radiotherapy and chemotherapy, and chronic inflammation can cause a second cancer to develop in the years after treatment.

There is a growing interest in the use of complementary and traditional treatments for inflammatory conditions, particularly as conventional pharmaceutical anti-inflammatory medication can have undesirable side effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of cardiovascular diseases and also problems with calcium absorption. Traditional, more natural alternatives, on the other hand, are proven to be less toxic and cause less side effects.

The Link between Inflammation and Cancer

A tumor typically comprises a number of cells; along with the tumor cells there will be immune cells and other benign cells such as fibroblasts, endothelial and epithelial cells. Together this makes up the tumor's microenvironment, and the response of the tumor to radiotherapy, chemotherapy or immunotherapy is highly dependent on these cells.

Inflammatory cells found in the body such as macrophages, lymphocytes and dendritic cells all play an important role in how well a tumor responds to therapy. However, while these cells can eradicate tumor cells, new evidence shows that the inflammatory response caused can also trigger further tumor growth and angiogenesis (the process by which new blood vessels form, providing nutrients to the tumor cells). This is another principal reason why research is going into ways to regulate inflammation in the treatment of cancer.

When the tumor is exposed to therapy (such as chemo or radiotherapy) cells are killed through different mechanisms, of which apoptosis and necrosis are the most effective in how they combat inflammatory and tolerogenic (producing immunity tolerance) responses.

The Anti-Inflammatory Properties of Curcumin

Curcumin has a long history of being used in traditional medicine in Asia (India particularly) for its anti-inflammatory properties. Some of the traditional applications of turmeric have been tested through modern studies, including trials for using curcumin in the treatment of cancer, respiratory diseases, osteoarthritis, nonalcoholic fatty liver disease, and dyslipidemia.

Here are some of the discoveries about curcumin:

• Studies have shown curcumin can positively impact over 90 inflammatory targets found in cells.
• Curcumin has the ability to reduce the effect of transcription factors like NF‐κB, an instrumental factor in the regulation of inflammation.
• Attenuates the metabolism of prostaglandins and lipoxygenases (both contribute to inflammation and aid in the production of free radicals).
• Inhibits the development of cytokines related to inflammation, such as IL-1 and TNF‐α, which are related to the high toxicity often found in bone marrow cells after cancer therapy.
• Antioxidant properties which prevent oxidative damage and carcinogenesis.
• Minimises tumor induced liver conditions

The ways in which curcumin interact with bone marrow cells is a key factor in how it can aid in preventing chemotherapy induced inflammation:

• An experiment with carcinoma-bearing mice proved curcumin to reverse the reduction of bone marrow cells.
• Targets iNOS, which induces nitrative DNA damage. Curcumin prevents DNA damage response through the nitroacetylation of 8‐oxoguanine‐DNA glycosylase 1, an important modulator of base excision repair (BER) pathways, therefore correcting lesions that distort the DNA helix structure.
• Protects bone marrow cells from the toxic effects of radiation and chemotherapy, by reversing the reduction of hematopoietic parameters (blood cellular components in the red bone marrow of our bones).
• Through the inhibition of glucose regulatory protein (GRP58) - a protein which mediates the mitomycin DNA cross link - curcumin is able to reduce DNA damage and subsequent toxicity in bone marrow cells.

The other adverse conditions which commonly develop in response to chemo or radiotherapy are dermatitis, mucositis, pneumonitis and lung fibrosis. Here are some of the direct ways in which curcumin works to prevent these ailments:

Dermatitis

• Dermatitis is caused by ionizing radiation, which lead to complex-signalling pathways, causing redness, dryness, ulcers and more on the skin.
• Following exposure to radiation, mice that had developed dermatitis were administered 200mg of curcumin which reduced the appearance of the skin condition.
• On a separate experiment with pigs, a curcumin cream was administered twice daily for 35 days, and the results showed a significant improvement in the healing of the wounds (caused by dermatitis).

Mucositis

• One of the most common side effects of radiotherapy, appearing in head, neck and gastrointestinal related cancers. The symptoms include acute inflammation, pain and ulceration.
• Rats that received 200mg of curcumin a day following irradiation showed an inhibition of inflammatory mediators NF‐κB and protein kinase B (Akt).

Pneumonitis and Lung Fibrosis

• Pneumonitis in the lungs is caused by the chronic upregulation of several inflammatory mediators, which leads to an accumulation of inflammatory cells.
• Pneumonitis can appear a few months after radiotherapy, whereas fibrosis can appear several years later.
• Curcumin has proven to have a radio-protective effect on oxidative injury and fibrosis in the lung tissue.
• After administering curcumin on a daily basis to mice exposed to radiation, the results showed the curcumin intake significantly reduced fibrosis, however it could not lessen the effects of pneumonitis.

Curcumin and Cancer

Apart from the ways listed above in which taking curcumin can help to alleviate (or even eradicate) some of the conditions associated with cancer, there is also evidence to suggest curcumin can aid in the reduction of the inflammation of cancer cells themselves.

Curcumin intake can induce apoptosis (cell death) in cancerous cells through the upregulation of proapoptotic genes. In addition to causing cell death, curcumin can attenuate inflammatory cytokines (which promote the growth of cancer stem cells), through suppressing the activating proteins NF‐κB, STAT‐3, and phosphodiesterases, amongst others.

Because of the potent anti-inflammation properties of curcumin, its use has also been proposed for radio-sensitization and radio-protection. As curcumin can target and inhibit a large number of inflammatory mediators, it reduces the risk of angiogenesis and the proliferation of cancer cells, therefore reducing tumor growth and repopulation during radiotherapy.

Curcumin can therefore be taken as a supplement alongside cancer therapy, afterwards to help reduce the possibility of inflammatory conditions, and even as a preventative supplement.

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