One of the latest 'miracle' cancer cures hails from China, and it is Kanglaite, a preparation made from a traditional staple food. It highlights the nature of Chinese remedies and the Chinese approach to health. Dr. Mae-Wan Ho reports.
Pharmacologist Li Dapeng began extracting the anticancer compounds out of the seeds of Job's tears (Coix lachryma-jobi) (Box 1) and experimenting with the compounds since 1975. Twenty years later, he won his government's approval to market an extract he calls Kanglaite, to help fight cancer and to reduce the side effects of conventional treatments. Li Dapeng has set up his own company in Hanzhou, the Zhejian Kanglaite Pharmaceutical Company Ltd, in order to market the drug.
Box 1
Chinese pearl barley the latest cancer cure
It has long been suspected that the low cancer rates in southeast China could be due to a dietary staple in the region, Coix lachryma-jobi, or Jobs's tears, a relative of maize.
The species appears to be widely distributed throughout the world. The seeds, shaped like tear drops and coloured greyish white to dark brown, are often used as beads in necklaces because they come with a perforating hole from one end to the other. When shelled, the kernel is white and looks like barley; and indeed, is referred to as such. Its Chinese name, yi-yi-jen, or yi-mi (in southeast China) is the same as that used for barley, or yang-yi-mi, 'yang' meaning 'foreign', or 'across the ocean'.
Yi-mi is used in soups and porridges and is a common ingredient in many herbal medicines for treating a variety of ailments including cancer. It has also been widely used as a diuretic, analgesic and antispasmodic agent.
Kanglaite has gone through a four-month clinical trial on 15 to 18 volunteers in a hospital in Salt Lake City, Utah, making it the first drug derived from a traditional Chinese herbal remedy to go into clinical trials in the United States. The drug is patented in China, United States, Canada, Japan and the European Union.
No one knows exactly how Kanglaite works, but the drug has been taken by more than 270 000 patients in some 2000 hospitals in China, and has proven effective against malignant tumours such as carcinomas in the lung, liver, stomach and breast.
It appears to fight cancer on many fronts. Apart from inhibiting the growth of cancer cells and killing them directly, it also stimulates immune functions that get rid of cancer cells, and improves the quality of life for cancer patients by decreasing cancer pain and prevents the loss of body weight. It has no harmful side effects on vital functions of the heart, liver, kidney and blood. It reduces toxic side effects of radio- and chemotherapy, and increases the effectiveness of these conventional treatments. When used in combination with surgical intervention, it helps kill tumour cells. It is, to all intent and purposes, the perfect cancer cure, so it is claimed (see Box 2).
Box 2
How Kanglaite works
Studies published in a collection from Zhejiang University Press and elsewhere claim that Kanglaite has the following effects.
At the beginning of 2003, FDA approved a phase II trial on non small-cell lung cancer, a hitherto untreatable cancer once it has gone past the very early stages when surgical intervention is feasible.
But what exactly is Kanglaite?
Kanglaite is a "neutral lipid fraction" extracted using organic solvents in a several purification steps (see Box 3) and formulated as an injection for patients. It is a mixture of rather ordinary lipids, the precise role of each of which in the large spectrum of effects remains unknown.
Box 3
What is Kanglaite?
Kanglaite is the "neutral lipid" of the endosperm of Job's tears, extracted with an organic solvent, such as acetone, and further refined and washed in several simple steps, then combined with glycerol and lecithin from soy or egg to make an emulsion in water that can be injected intravenously into patients.
The anti-tumour action of lipids extracted from the endosperm of Job's tears was known much earlier: it was reported for the first time by Japanese scientists Tyunosin Ukita and Ako Tanumura in 1961, and again in the 1980s by Chinese scientist, Si Pei-hai. But the earlier extracts were not economical enough for the market, and the formulations were not pure enough for clinical use.
The "neutral lipid" turns out to be a rather unremarkable mixture of triglycerides (over 90%) with smaller amounts of diglycerides (about 1.5%), monoglycerides (about 6 %) and alkylacylacetin (about 1%). These lipids have a rather ordinary profile of saturated and unsaturated long-chain fatty acids (16 and 18 carbons).
Despite the wide spectrum of benefits claimed for the "neutral lipid", based both on in vitro studies in cell cultures and in vivo studies in mice, and later in human subjects, it is unclear whether different components of the mixture are responsible for specific effects, or it is the mixture per se that has all those effects.
There is a strong underlying assumption, nevertheless, that the different effects are due to different components in the grain, and indeed, a number of pharmacologically and physiologically active substances have been isolated from different parts of the Coix plant that show specific anti-inflammatory, anti-tumour, anti-microbial, hypoglycaemic, and ovulatory effects.
A team of researchers at the National Taiwan University has recently identified 6 phenolic compounds in the hull (shell) of Job's tears that have strong anti-oxidant activities. The researchers showed that different parts of the grain vary in their content of anti-oxidants, with the greatest amounts in the hull, followed by the testa (seed membrane) and the bran, and the smallest amounts in the polished grain. And the six phenolic compounds also had different degrees of anti-oxidant effects.
Antioxidants inhibit the oxidation of lipids in cell membranes, leading to impairment of cell function. Antioxidants neutralise reactive oxygen species (ROS) and oxygen free radicals. Excess ROS is implicated in diseases such as inflammation, aging, atherosclerosis (hardening of the arteries), cancer, rheumatoid arthritis, and liver toxicity. (See Organic agriculture helps fight cancer, I-SIS report.)
Despite these clear successes, however, there are critics who claim, justifiably, that the present penchant for extracting and purifying herbal medicine is anathema to the very tradition of Chinese medicine. Chinese herbal medicines frequently involve not just the single unprocessed herb, but especially mixtures of many herbs in different proportions, according to the needs of individual patients (see Globalising Chinese medicine, this series). The aim is to restore the patient to physiological balance that's synonymous with the state of health.
The experience of conventional Western medicine has amply demonstrated that knowing the molecular mechanisms of a compound is no guarantee that it will have the desired benefit for the organism, for the simple reason that all parts of the organism are interconnected and intercommunicating. Nevertheless, knowledge of molecular mechanisms can contribute to understanding the whole, once we stop seeing the organism as a collection of separate molecular nuts and bolts. Besides, identifying the different components in a mixture could contribute to quality assurance and standardisation, discouraging forgeries and malpractice in medications that are going to be increasingly important for global healthcare.
In view of the numerous health benefits of this widely distributed staple food, why not incorporate the Coix grain into everyone's diet? It serves to bring home the most distinctive aspect of traditional Chinese medicine: good nutrition is indistinguishable from health promotion, and food shades insensibly into medicine that's widely available and affordable.
I believe that the tension between the analytical reductionist and the synthetic holistic approaches will be resolved in the spirit of the organic materialism and eclectic pragmatism characteristic of the Chinese culture through the ages (see Traditional Chinese medicine & contemporary western science, this series).
The more important tension is between corporations that want to extract maximum profit from patented medicines and the health needs of ordinary people as well as the danger of over-harvesting of wild plant species.
Article first published 09/04/03
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