Black cohosh, an herb widely used by breast cancer patients to alleviate hot flashes and other menopausal symptoms, may alter the way that cells respond to drugs commonly used to treat breast cancer, according to a School of Medicine study in the journal Breast Cancer Research and Treatment.
Recent studies have shown that many patients receiving cancer therapy are also self-medicating with complementary and alternative medicines, often without telling their physicians, says the lead researcher, Sara Rockwell, professor of therapeutic radiology and pharmacology.
"Over 30 insurers now cover at least one alternative therapy," she says. "Out-of-pocket spending for complementary and alternative medicines was recently estimated to be $27 billion per year, similar to the out-of-pocket costs for all physician services."
She says the herb is being widely used by and recommended to breast cancer patients who are experiencing menopausal symptoms due to removal from hormone replacement therapy or to the effects of their therapy.
In this research, Rockwell and her team used a widely studied mouse breast cancer cell line to see whether commercially available extracts of black cohosh altered the response of cancer cells to radiation and to four drugs commonly used in cancer therapy.
The black cohosh increased cell killing by two of the drugs, decreased the effectiveness of one drug and did not alter the effects of radiation or a fourth drug, notes Rockwell. Why each agent responded differently needs to be studied further, she says, but enough is known about the herb's effects on cancer cells to caution patients about using it and other over the counter agents without consulting their physicians.
"Our studies caution that black cohosh should not be considered to be a harmless herb that is inconsequential to the health of cancer patients or to the outcome of conventional cancer therapy," Rockwell says.
Co-authors included Yanfeng Liu and Susan Higgins, both from the Department of Therapeutic Radiology at Yale. The research was supported by a grant from the Donaghue Women's Health Investigator Program at Yale. Further studies are in progress with support from the National Cancer Institute.
-- By Jacqueline Weaver
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