Chemicals in curry and onions may help prevent colon
cancer...Hopkins
study shows combination of curcumin and quercetin greatly reduces
size and number of colorectal polyps
A small but informative clinical trial by Johns Hopkins
investigators shows that a pill combining chemicals found in
turmeric, a spice used in curries, and onions reduces both the size
and number of precancerous lesions in the human intestinal tract.
In the study, published in the August issue of Clinical
Gastroenterology and Hepatology, five patients with an inherited
form of precancerous polyps in the lower bowel known as familial
adenomatous polyposis (FAP) were treated with regular doses of
curcumin (the chemical found in turmeric) and quercetin, an
antioxidant in onions, over an average of six months. The average
number of polyps dropped 60.4 percent, and the average size dropped
by 50.9 percent, according to a team led by Francis M. Giardiello,
M.D., at the Division of Gastroenterology, The Johns Hopkins
University School of Medicine, and Marcia Cruz-Correa, M.D., Ph.D.,
at Johns Hopkins and the University of Puerto Rico School of
Medicine.
"We believe this is the first proof of principle that these
substances have significant effects in patients with FAP," says
Giardiello.
Familial adenomatous polyposis is a disorder that runs in
families and is characterized by the development of hundreds of
colorectal adenomas (polyps) and eventual colon cancer. Recently,
nonsteroidal anti-inflammatory drugs (NSAIDs) have been used to
treat some patients with this condition, but these compounds often
produce significant side effects, including gastrointestinal
ulcerations and bleeding, according to Giardiello.
Previous observational studies in populations that consume
large amounts of curry, as well as laboratory research on rodents
have strongly suggested that curcumin -- a relatively innocuous
yellow pigment extracted from turmeric, the powdered root of the
herb curcuma longa and one of the main ingredients in Asian curries
-- might be effective in preventing and/or treating cancer in the
lower intestine, according to Cruz-Correa. She said curcumin has
been given to cancer patients, and previous studies have
demonstrated that is well tolerated at high doses.
Similarly, quercetin -- a member of a group of plant-derived
polyphenolic anti-oxidant substances known as flavanoids (found in a
variety of foods including onions, green tea and red wine) -- has
been shown to inhibit growth of colon cancer cell lines in humans
and abnormal colorectal cells in rodents.
Although these substances were administered together, due to
relative dose levels it is Giardiello's belief that curcumin is the
key agent.
"The amount of quercetin we administered was similar to what
many people consume daily; however, the amount of curcumin is many
times what a person might ingest in a typical diet, since turmeric
only contains on average 3 percent to 5 percent curcumin by weight,"
says Giardiello. Because of this, he cautions that simply consuming
curry and onions may not have the same effect as was produced in
this study.
In the trial, five patients were selected from the Cleveland
Clinic in Weston Fla. All patients had previously had their colons
surgically removed. Four of the five patients retained the rectums,
whereas the remaining patient had both colon and rectum removed and
part of the small intestine adapted to serve as colon and rectum.
All patients had five or more adenomas in their lower intestinal
tract. None of the patients had taken NSAIDS for more than one week
during the three months leading up to the study.
Participants were examined using a flexible sigmoidoscope
before treatment was initiated and at three month intervals (range
three to nine months) during treatment. Number and size of polyps
were examined at each visit.
Each patient received 480 milligrams of curcumin and 20
milligrams of quercetin orally three times a day for six months and
was told not to use NSAIDs for the duration of the study. Three
patients followed treatment as prescribed. One patient did not
follow the scheduled treatment doses between months three and six
and was continued on therapy until the ninth month. A second patient
dropped out of the study after the third month.
A decrease in polyp number was observed in four of the five
patients at three months and four of the four patients at six
months.
Side effects were minimal. One patient reported slight nausea
and sour taste within a couple of hours of taking the pill, which
went away within three days, and a second patient had mild diarrhea
for five days.
"This study showed for the first time that curcumin treatment
was efficacious in decreasing the number of polyps in patients with
FAP, similarly to what has been seen with the use of synthetic NSAID
agents, but with minimal side effects. Furthermore, we saw that
adenomas found in the small intestine of our patients also responded
to curcumin," says Cruz-Correa. She says a randomized clinical trial
will be conducted between Johns Hopkins and University of Puerto
Rico Comprehensive Cancer Center involving more patients. No date
has been set for this trial.
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This study was supported by a grant from the National
Institutes of Health. Additional researchers who contributed to this
study include Daniel A. Shoskes, M.D.; Patricia Sanchez, M.D.;
Rhongua Zhao, M.D., Ph.D., and Steven D. Wexner, M. D., of the
Cleveland Clinic, Weston, Fla.; and Linda M. Hylind of The Johns
Hopkins University School of Medicine.