Revisiting Sutherlandia (cancer bush)

Some years ago, there was much speculation and interest in a South African indigenous medicinal plant which was thought to hold the key to the treatment of millions of poor people living with HIV and Aids, helping them relieve the symptoms of Aids. Sutherlandia frutescens (commonly referred to as cancer bush) is an indigenous Southern African shrub that has a traditional African and settler folklore history.

It has previously been hyped as a treatment for a ridiculously long list of mostly improbable conditions and as a treatment, even cure, for cancer and AIDS, which action is specifically forbidden by law, for the good reason that it may raise false hopes and even lead to substitution for effective treatment of life-threatening illnesses. Sutherlandia moreover, contains significant concentrations of canavanine, an analogue of a conditionally essential amino acid, which in ill and or protein deficient individuals, erroneously enfolds into their proteins, only to have these tissues, even entire organs and or systems, eventually rejected and attacked by their own immune system. Canavanine moreover, is distinctively immunosuppressive of critical cellular immune responses against cancer cells and infectious organisms, including viruses, bacteria, protozoa, helminths and fungi. Sutherlandia is therefore potentially an extremely dangerous substance and ought not to be fraudulently sold as a safe and efficacious panacea.

However, many reports remain contradictory and it is clear that further research and clinical trials are needed to refine the safety reports and concerns of scientists. The traditional use of this medicinal herb has been long established and a balanced view is required in the absence of clinical efficacy and safety reports.

Traditional Uses of Sutherlandia in Folk Medicine
This South African herb has been used traditionally by the natives to treat a number of ailments including:

• cancer, which is the reason for its local nickname as the 'cancer bush'
• to help improve the overall health of patients suffering from HIV/Aids
• diabetes
• arthritis
• as a pain reliever
• to fight viral infections
• to reduce inflammation

What Are the Health Benefits of Sutherlandia?
There have been a number of studies into the health benefits of Sutherlandia. Scientists have been especially interested in determining whether this plant can actually fight aids, diabetes, cancer and a host of other dreaded diseases. Here is a summary of research into Sutherlandia's health benefits as published in various peer reviewed journals:

A paper entitled "In vitro culture studies of Sutherlandia frutescens on human tumor cell lines", published in the Journal of of Ethnopharmacology, 2004 Jul;93(1):9-19 found that sutherlandia inhibited the proliferation of specific cancer cells by as much as fifty percent. This study only tested sutherlandia in vitro, which is to say in a test tube, and did not use animals or humans.

A study published in Methods Find Exp Clin Pharmacol. 2004 Jul-Aug;26(6):409-16. found that Sutherlandia frutescens had anti-inflammatory (reduces inflammation), analgesic (is a pain killer) and lowered blood sugar levels. The researches concluded that the experimental testing lent credence to the traditional medical uses of this plant as a treatment for arthritis and type 2 diabetes.\

In "The antioxidant potential of Sutherlandia frutescens" published in J Ethnopharmacol. 2004 Nov;95(1):1-5., researchers at the University of South Africa concluded that the plant has strong anti-oxidant activities which may explain its reported effectiveness in treating inflammation.

In "Anti-HIV activities of organic and aqueous extracts of Sutherlandia frutescens and Lobostemon trigonus" J Ethnopharmacol. 2005 Jan 4;96(1-2):113-9. researchers published the results of testing to determine if sutherlandia as well as another local plant called Lobostemon had any effect on the HIV/AIDS virus, as claimed by the natives and traditional folk medicine. The researchers concluded that "The study shows that Sutherlandia extracts contain inhibitory compounds active against HIV target enzymes, while aqueous Lobostemon leaf extracts contain a potent HIV-1 RT inhibitor, thus showing a potential mechanistic action of these plants in aiding HIV-positive patients."

A study conducted by the Department of Clinical Epidemiology and Biostatistics, McMaster University in Ontario, Canada conducted research relevant to determining Sutherlandia's usefulness in fighting AIDS. Their research was published in an article entitled "Impact of African herbal medicines on antiretroviral metabolism" in the journal AIDS. 2005 Jan 3;19(1):95-7. concluded that: "Sutherlandia showed significant effects on cytochrome P450 3A4 metabolism and activated the pregnane X receptor approximately twofold. P-glycoprotein expression was inhibited, with Hypoxis showing 42-51% and Sutherlandia showing 19-31% of activity compared with verapamil. Initiating policies to provide herbal medicines with antiretroviral agents may put patients at risk of treatment failure, viral resistance or drug toxicity."

In a study at the University of South Korea published as "Inhibitory effects of the extracts of Sutherlandia frutescens (L.) R. Br. and Harpagophytum procumbens DC. on phorbol ester-induced COX-2 expression in mouse skin: AP-1 and CREB as potential upstream targets." in Cancer Lett. 2005 Jan 31;218(1):21-31 concluded that compounds made from Sutherlandia as well as another plant commonly known as Devil's Claw inhibited certain cell activities associated with cancer spread.

A study has confirmed that Sutherlandia frutescens extracts can kill carcinoma cells. It concluded that "These findings warrant further research with a view to develop Sutherlandia frutescens extracts for use in anti-cancer therapy." -- See: J Ethnopharmacol. 2005 Apr 8;98(1-2):163-70. It should be noted that this study only looked at the effect of Sutherlandia on cancer cells growing in a lab, and not its effect on cancer growing in a human being.

A  published study conducted by the University of Johannesburg (J Ethnopharmacol. 2011 Aug 2.) concludes that "Sutherlandia frutescens and S. tomentosa extracts show promise as apoptosis-inducing anti-cancer agents." In plain English, Sutherlandia was found to cause Oesophageal cancer cells to die. This study did not use human subjects, however.

Another study published in the Journal of Ethnopharmacology showed that Sutherlandia extract "revealed a decrease in malignant [breast] cell numbers when compared to their controls." See: J Ethnopharmacol. 2009 Jul 6;124(1):45-60. Epub 2009 Apr 14.

Dennis Lubahn, Ph.D., professor of biochemistry and child health, National Institutes of Health (NIH) Botanical Center, University of Missouri-Columbia and a team of researchers noted that Sutherlandia  can help to cut down on the risk of prostate cancer. This was based on the evidence that in mice results were very promising. Sutherlandia is an adaptogen that has been known to improve the immune system, manage stress, reduce symptoms of HIV infection, reduce cancer risk and treat diabetes symptoms. However, he noted no modern clinical evidence shows Suterlandia’s benefits to human. A 2007 study did show it was safe for healthy adults at a 400-mg/d dose for three months (PLoS Clin Trials. 2007 Apr 27;2(4):e16).

A 2012 study investigating the potential apoptosis-inducing effects of two S. frutescens extracts and one Sutherlandia tomentosa extract on the SNO oesophageal cancer cell line showed promise as anti-cancer agents via the mechanism of apoptosis (death of cancer cells): Skerman NB, Joubert AM, Cronjé MJ (2012) The apoptosis inducing effects of Sutherlandia spp. extracts on an oesophageal cancer cell line. Journal of Ethnopharmacology. 137(3): 1250-60

Conclusion
Preliminary scientific testing seems to be confirming what the indigenous people of South Africa have known for centuries. It appears that this multi-purpose plant is indeed a sort of miracle pharmacy with positive effects on cancer, diabetes, inflammatory diseases, and arthritis.

Frustratingly, none of these preliminary studies on Sutherlandia have been followed up with double blind clinical trials involving humans. Most of the testing has been done on cancer cells and the HIV virus growing in a test tube, so it is not known for sure whether Sutherlandia would have any effect on humans. However, the fact that the preliminary research tends to confirm the traditional uses of this plant, which of course were discovered by local medicine men who did not have the benefit of laboratories but rather derived their knowledge from the practical use of the "Cancer Bush" on their patients, is very intriguing and warrants further study.

A word of caution: there are many websites that are promoting Sutherlandia as a wonder drug for the treatment of cancer and HIV/Aids and I suspect that many people are self-medicating. Though the early research is encouraging, there is no evidence that Sutherlandia actually cures cancer or AIDs. In addition, the lack of human or animal testing means that we do not know whether Sutherlandia is safe, or how it might interact with other medications.

Useful Links:

1. Sutherlandia frutescens at AfricanBotanicals.com. Sutherlandia frutescens capsules powerfully assists the body to mobilise its own immunological and physiological resources to combat disease and physical and mental stress.
2. Sutherlandia frutescens and Cancer. More information about the possible uses of Sutherlandia
3. Sutherlandia Frutescens - Cancer Bush. Information about Sutherlandia as well as many other medicinal herbs.

References:

1. http://www.drboxalls.co.za/news/the-health-benefits-of-sutherlandia-the-amazing-cancer-bush-from-south-africa/56
2. http://quotations.hubpages.com/hub/The-Health-Benefits-of-Sutherlandia-the-So-Called-Cancer-Bush-from-South-Africa