Regression of follicular lymphoma with Devil’s Claw; coincidence or causation?

Abstract

Background: Alternative therapies are frequently used by cancer patients. Two follicular lymphoma patients who had objective tumor regression after taking Devil’s Claw without cytotoxic therapy are reported here. Methods and Results:  Patient #1 presented with co-existent IgG plasma cell dyscrasia and stage 3A lymphoma (5 cm. diameter nodes). CT scan 10 months later showed partial regression. On enquiry, he was taking Devil’s Claw and Essiac. He later developed overt myeloma, when he stopped herbal supplements and received high dose therapy and stem cell transplant, following which there has been no lymphoma progression. Patient #2 presented with stage 3A lymphoma (2.5 cm. diameter nodes). He learned of patient #1 through our Lymphoma Patient Support Group and started Devil’s Claw. CT scan 11 months later showed decreased adenopathy and splenomegaly which has been sustained for four years. Discussion and conclusions: Devil’s Claw tuberous root has anti-inflammatory properties probably by suppressing COX-2 and iNOS expression. There are no prior reports of its anticancer activity. COX-2 inhibition has a role in colon cancer prevention, has been implicated in lymphomagenesis, and associated with both stage of lymphoma and response to treatment. However, spontaneous regression in lymphoma has been reported in 16% of patients in one series, of whom none were on herbal medications or COX-2 inhibitors. The key issue in both these patients is whether or not disease regression was “spontaneous” or causally related to Devil’s Claw therapy. The timing of response suggests a positive effect. Further investigation is warranted, preferably with a COX-2 inhibitor of known purity.