In the scientific arena, ginseng and the various ginsenosides are used in many forms and administered via various routes. This review will focus primarily on those methods commonly used in clinical practice. CANCER PREVENTION
The various anticancer actions of P. ginseng, as demonstrated in animal and in vitro trials, support its use as an agent to prevent the development and progression of cancer. A 5-year prospective study of 4634 patients over 40 years of age found that ginseng reduced the relative risk of cancer by nearly 50% (Yun 1996).
A retrospective study of 905 case-controlled pairs taking ginseng showed that ginseng intake reduced the risk of cancer by 44% (odds ratio equal to 0.56). The powdered and extract forms of ginseng were more effective than fresh sliced ginseng, juice or tea. The preventative effect was highly significant (P < 0.001). There was a significant decline in cancer occurrence with increasing ginseng intake (P < 0.05) (Yun & Choi 1990).
Epidemiological studies in Korea strongly suggest that cultivated Korean ginseng is a non-organ-specific human cancer preventative agent. In case-control studies, odds ratios of cancer of lip, oral cavity and pharynx, larynx, lung, oesophagus, stomach, liver, pancreas, ovary and colorectum were significantly reduced by ginseng use. The most active compounds are thought to be ginsenosides Rg3, Rg5 and Rh2 (Yun 2003).
Ginseng polysaccharide (18 mg/day) has also been shown to be effective in improving immunological function and quality of life in elderly patients with non-small cell lung cancer (Zhang et al 2004).
Chemotherapy Overexpression of P-glycoprotein or multidrug resistance-associated protein may lead to multidrug resistance of cancer cells. Protopanaxatriol ginsenosides have been shown to sensitise cancer cells to chemotherapeutic agents in vitro by increasing the intracellular accumulation of the drugs through direct interaction with P-glycoprotein (Choi et al 2003b, Kim et al 2003b). The ginsenoside Rh2 possesses strong tumour-inhibiting properties and sensitises multidrug-resistant breast cancer cells to paclitaxel (Jia et al 2004) and animal models demonstrate a © 2007 Elsevier Australia
synergistic antitumour effect for ginseng acidic polysaccharides and paclitaxel (Shin et al 2004a).
Panax ginseng polysaccharide (12 mg IV daily) has also been trial led during treatment for ovarian cancer and the authors suggest that it is 'effective, safe and reliable for reducing the toxic effects of chemotherapy' (Fu et al 2005).
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