Ginseng for breast cancer treatment related fatigue ,"fuzzy head"

[Lani]

Ginseng may relieve cancer patients' fatigue [from USA Today]
Nelle Moriarty says she's grateful for new breast cancer drugs like Herceptin.
But like most patients in cancer therapy, Moriarty, 55, says the medication often leaves her exhausted and struggling to concentrate. That's why Moriarty, a marriage-and-family therapist from Rochester, Minn., says she volunteered for a clinical trial about treating cancer-related fatigue in a new way: ginseng capsules.
Ginseng has been used in Chinese medicine to promote health for 2,000 years. A National Cancer Institute survey in 2004 found that 36% of adults use ginseng or some other form of complementary or alternative medicine. But scientists have never before studied ginseng's potential to ease cancer fatigue in such a carefully controlled way, says lead author Debra Barton of the Mayo Clinic in Minnesota.
Barton's research is one of a trio of studies, all financed by the cancer institute, on complementary and alternative cancer medicines presented Sunday at the American Society of Clinical Oncology meeting in Chicago. The studies are part of a growing effort to bring scientific scrutiny to popular folk remedies and natural products.
In Barton's pilot study of 282 patients, researchers randomly assigned patients to take either a placebo or one of three daily doses of ginseng: 750 milligrams, 1,000 milligrams or 2,000 milligrams.
After eight weeks, roughly 27% of those who took the two highest ginseng doses rated their fatigue as "moderately" or "very much" better, she says. Only 10% of those who took placebos or the lowest ginseng dose improved that much. One-third of those on the highest two doses were satisfied with treatment, compared with 24% of those on low-dose ginseng and 13% of those on placebos. Ginseng didn't appear to cause any side effects, Barton says. The study didn't address whether ginseng controlled patients' cancer.
Moriarty, who later learned that she had been given the lowest ginseng dose, says the capsules helped keep her focused in the afternoon. She has opted to continue using the plant. "I've never experienced anything quite like this," Moriarty says. "It clears your head."
The design of Barton's study — considered the gold standard of medical evidence — makes its results reliable, says Andrea Barsevick, director of nursing research at Fox Chase Cancer Center in Philadelphia. Although researchers have produced at least 20 previous studies of ginseng and cancer, Barsevick says, all were small, lacked comparison groups or had other problems that made them less reliable.
Barsevick notes that cancer patients and survivors desperately need a better way to treat fatigue, which affects most of those getting chemo and up to 35% of patients who finish treatment. The only proven way to relieve cancer-related fatigue, she says, is exercise.

ABSTRACT from ASCO 2007: #9001: A pilot, multi-dose, placebo-controlled evaluation of american ginseng (panax quinquefolius) to improve cancer-related fatigue: NCCTG trial N03C [American Society of Clinical Oncology]
Background: Fatigue is one of the most common symptoms in people diagnosed with cancer. Ginseng is a popular herb for treatment of this. It has been termed an "adaptogen", felt to be able to restore balance to the body; its potential anti-fatigue efficacy is supported by animal data. The purpose of this pilot trial was to evaluate three doses of American Ginseng versus placebo for cancer-related fatigue.
Methods: Patients with a life expectancy = 6 months and a history of cancer-related fatigue who had been experiencing fatigue = 1 month were eligible. Exclusion criteria included prior use of ginseng, chronic systemic steroids and brain malignancies. Other etiologies for fatigue, such as pain, were also excluded. Participants were randomized to receive, in a double blind manner, placebo, 750 mg/d, 1,000 mg/d or 2,000 mg/d of American Ginseng in BID dosing for 8 weeks. Endpoints included The Brief Fatigue Inventory (BFI), the Vitality Subscale of the SF-36 and several numeric analogue questions of perceived benefit; endpoints were measured at baseline, 4 weeks and 8 weeks. Area under the curve (AUC) and change from baseline were calculated.
Results: Two hundred eighty two patients (69-72 per arm) were enrolled from 10/21/2005 to 07/05/2006. Available 8-week data are provided in the table below; higher numbers are better. There were no statistically significant differences in any grade of toxicity between active and placebo arms, and an equivalent number of patients discontinued the study due to adverse events in each arm.
Conclusion: This randomized pilot trial provided data to suggest that American Ginseng doses of 1000-2000 mg/d may be effective for alleviating cancer related fatigue. Therefore, further study of American Ginseng in cancer survivors appears warranted.