Curcumin Part I: Skin Cancer
Curcumin, is the most active component of the well known natural spice tumeric. It is the most studied natural substance in the world - and for good reason. With over 4000 publications to date, including thousands of in vitro lab studies, animal studies and a number of human clinical trials, its proven therapeutic benefits are vast. These documented benefits include improvements in diabetes, heart disease, neurodegenerative disease such as Alzheimer’s, many cancers, arthritis, skin and oral diseases.1,2
THE PROBLEM IS GETTING ENOUGH OF IT
However the challenge with curcumin is getting it to each organ in high enough concentrations to exert the amazing effects observed in these studies. Firstly both tumeric and and its most active component, curcumin are VERY poorly absorbed. To compound matters, a large percentage of the curcumin absorbed from the bowel is lost by liver transformation to weaker or inactive metabolites, and rapid excretion. So while epidemiological studies indicate that ingesting small amounts of tumeric regularly, is beneficial, you literally would have to eat several pounds of tumeric a day to derive the benefits of curcumin established in the scientific studies.
EXCITING NEW DEVELOPMENTS AT LUMINNOVA HEALTH
The good news is that newer and greatly improved curcumin formulations have recently become available. Luminnova Health has partnered with Advanced Orthomolecular Research which is known as one of the most advanced supplement formulators in the world to offer its premium oral curcumin supplement - Curcumin Ultra. Curcumin Ultra incorporates curcumin with the highest bio-availability (absorption) but also, crucially, higher bio- accessibility (uptake into target tissues).3,4 Animal studies confirm uptake into the brain, heart, liver, kidneys and spleen.5 It also includes tumeric polysaccharides which have demonstrated benefits of their own, including inflammation and arthritis.6 Curcumin Ultra is now available through Luminnova Health and Family Medicine Centre on Blake Road.
Another solution to the bioavailability problem is to absorb topical curcumin directly into the skin. Luminnova Health offers an ultra-high penetration formulation of topical curcumin for this purpose and is available through The Skin Centre.
CURCUMIN AND SKIN CANCER
There is a substantial body of scientific evidence supporting the role of curcumin in cancer prevention and treatment. In vitro and animal studies have demonstrated significant activity against multiple types of cancer including breast, colon, prostate, lung, liver and many other cancers.7-14 Clinical studies have shown that curcumin can be used as a means of preventing cancer15-17, to improve the response to standard cancer treatments and significantly improve symptoms and quality of life of cancer patients.2,18
Oral and topical curcumin has also shown promise in targeting skin cancer including basal cell cancer, squamous cell cancer and even melanoma.19,20 The majority of the studies showing positive effects are studies on cancer cell lines and animal studies but the results are impressive. Multiple mechanisms21-32 have been described by which curcumin has its anti- neoplastic effects.
Reduced angiogenesis (reduced blood supply to cancer cells)
Cell cycle arrest (less cancer cell multiplication)
Apoptosis (selective death of cancer cells)
Reduced metastasis (spread of cancer cells to distant organs)
Reduced inflammation (inflammation drives the cancer process)
Suppression of oncogenes (genes which drive cancer formation)
Potentiation of tumour suppressors (factors that inhibit tumor growth)
However at present there are not enough human studies available to recommend curcumin as standalone treatment for skin cancer, particularly melanoma. However, based on the copious evidence available, I do recommend it for prevention of skin cancer and treatment of clinically obvious pre-cancers (actinic keratoses) along with optimal sun protection. In fact, I recommend Curcumin Ultra for anyone who has a personal or family history of skin cancer or any other type of cancer for that matter.
Treatment of actinic keratoses (pre-cancers) with topical curcumin has proven to be very effective and well tolerated. We have also administered topical curcumin in exceptional cases where patients with certain types of biopsy-proven basal cell and squamous cell carcinoma opted not to undergo standard treatment options for varying reasons. The results have been nothing short of impressive!
One of the major advantages of using topical curcumin over chemotherapeutic agents such as 5-Fluouracil (Effudex) or Imiquimod (Aldara) is the absence of redness and soreness seen with these standard treatments. The prominent redness and discomfort experienced with these treatments are major reasons patients delay dealing with pre-cancerous areas despite the risk of doing so. A few examples of skin cancers treated are illustrated below. Note that the the signs of photodamage (skin aging) have improved and pre-cancers on the surrounding skin have also significantly cleared.
Topical Curcumin arrests the growth of Basal Cell Cancer and Clears Surrounding Pre-Cancers
Topical Curcumin Treats Squamous Cell Carcinoma and Rejuvenates the surrounding skin!
References
Aggarwal B and Harikumar K. Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. The International Journal of Biochemistry and Cell Biology. Volume 41, Issue 1. January 2009. Pages 40-59.
Kunnumakkara AB et al. Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases. Br J Pharmacol. 2017 Jun;174(11):1325-1348. doi: 10.1111/bph.13621. Epub 2016 Oct 21.
Krishnakumar IM et al. An enhanced bioavailable formulation of curcumin using fenugreek-derived soluble dietary fibre. Journal of Functional Foods. Volume 4, Issue 1. January 2012, Pages 348-357.
Kumar D et al. Enhanced bioavailability and relative distribution of free (unconjugated) curcuminoids following the oral administration of a food-grade formulation with fenugreek dietary fibre: A randomised double-blind crossover study. Volume 22, April 2016, Pages 578-587.
Krishnakumar IM et al. Improved blood‒brain-barrier permeability and tissue distribution following the oral administration of a food-grade formulation of curcumin with fenugreek fibre. Volume 14, April 2015, Pages 215-225.
Anand P, Sundaram C, Jhurani S, Kunnumakkara AB, Aggarwal BB. Curcumin and cancer: an “oldage” disease with an “age-old” solution. Cancer Lett. 2008 Aug 18;267(1):133-64.
Park W, Amin AR, Chen ZG, et al. New perspectives of curcumin in cancer prevention. Cancer Prev Res (Phila). 2013;6(5):387-400.
Bachmeier BE, Killian P, Pfeffer U, Nerlich AG. Novel aspects for the application of Curcumin in chemoprevention of various cancers. Front Biosci (Schol Ed). 2010 Jan 1;2:697-717.
Anand P, Sundaram C, Jhurani S, Kunnumakkara AB, Aggarwal BB. Curcumin and cancer: an “oldage” disease with an “age-old” solution. Cancer Lett. 2008 Aug 18;267(1):133-64.
Sonavane K1, Phillips J, Ekshyyan O, Moore-Medlin T, Roberts Gill J, Rong X, Lakshmaiah RR, Abreo F, Boudreaux D, Clifford JL, Nathan CA.Topical curcumin-based cream is equivalent to dietary curcumin in a skin cancer model. J Skin Cancer. 2012;2012:147863.
Beatrice E. Bachmeier, Peter H. Killian, and Dieter Melchart. The Role of Curcumin in Prevention and Management of Metastatic Disease.
Ajay Goel and Bharat B. Aggarwal. Curcumin, the Golden Spice From Indian Saffron, Is a Chemosensitizer and Radiosensitizer for Tumors and Chemoprotector and Radioprotector for Normal Organs. Nutrition and Cancer. Volume, 62, 2010.
Kunnumakkara AB, Diagaradjane P, Anand P, et al. Curcumin sensitizes human colorectal cancer to capecitabine by modulation of cyclin D1, COX-2, MMP-9, VEGF and CXCR4 expression in an orthotopic mouse model. Int J Cancer. 2009;125(9):2187-2197
Cruz-Correa M, Shoskes DA, Sanchez P, et al. Combination treatment with curcumin and quercetin of adenomas in familial adenomatous polyposis. Clin Gastroenterol Hepatol. 2006;4(8):1035-8.
Carroll RE, Benya RV, Turgeon DK, et al. Phase IIa clinical trial of curcumin for the prevention of colorectal neoplasia. Cancer Prev Res (Phila). 2011;4(3):354-64.
Golombick T, Diamond TH, Manoharan A, et al. Monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, and curcumin: a randomized, double-blind placebocontrolled cross-over 4g study and an open-label 8g extension study. Am J Hematol. 2012;87(5): 455-60.
Ryan JL, Heckler CE, Ling M, et al. Curcumin for radiation dermatitis: a randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patients. Radiat Res. 2013;180(1):34-43.
Sonavane K1, Phillips J, Ekshyyan O, Moore-Medlin T, Roberts Gill J, Rong X, Lakshmaiah RR, Abreo F, Boudreaux D, Clifford JL, Nathan CA.Topical curcumin-based cream is equivalent to dietary curcumin in a skin cancer model. J Skin Cancer. 2012;2012:147863.
Beatrice E. Bachmeier, Peter H. Killian, and Dieter Melchart. The Role of Curcumin in Prevention and Management of Metastatic Disease.
Ravindran J, Prasad S, Aggarwal BB. Curcumin and cancer cells: how many ways can curry kill tumor cells selectively? AAPS J. 2009 Sep;11(3):495-510.
Zhang J, Du Y, Wu C, et al. Curcumin promotes apoptosis in human lung adenocarcinoma cells through miR-186* signaling pathway. Oncol Rep. 2010 Nov;24(5):1217-23.
Zhang J, Zhang T, Ti X, et al. Curcumin promotes apoptosis in A549/DDP multidrug-resistant human lung adenocarcinoma cells through an miRNA signaling pathway. Biochem Biophys Res Commun. 2010 Aug 13;399(1):1-6.
Clark CA, McEachern MD, Shah SH, et al. Curcumin inhibits carcinogen and nicotine-induced mammalian target of rapamycin pathway activation in head and neck squamous cell carcinoma. Cancer Prev Res (Phila). 2010 Sep 17.
Cheng CY, Lin YH, Su CC. Curcumin inhibits the proliferation of human hepatocellular carcinoma J5 cells by inducing endoplasmic reticulum stress and mitochondrial dysfunction. Int J Mol Med. 2010 Nov;26(5):673-8.
Wang L, Shen Y, Song R, Sun Y, Xu J, Xu Q. An anticancer effect of curcumin mediated by downregulating phosphatase of regenerating liver-3 expression on highly metastatic melanoma cells. Mol Pharmacol. 2009 Dec;76(6):1238-45.
Rowe DL, Ozbay T, OʼRegan RM, Nahta R. Modulation of the BRCA1 protein and induction of apoptosis in triple negative breast cancer cell lines by the polyphenolic compound curcumin. Breast Cancer. 2009 Sep 2;3:61-75.
Banerjee M, Singh P, Panda D. Curcumin suppresses the dynamic instability of microtubules, activates the mitotic checkpoint and induces apoptosis in MCF-7 cells. FEBS J. 2010 Aug;277(16): 3437-48.
Yoon MJ, Kim EH, Lim JH, Kwon TK, Choi KS. Superoxide anion and proteasomal dysfunction contribute to curcumin-induced paraptosis of malignant breast cancer cells. Free Radic Biol Med. 2010 Mar 1;48(5):713-26.
Hua WF, Fu YS, Liao YJ, et al. Curcumin induces down-regulation of EZH2 expression through the MAPK pathway in MDA-MB-435 human breast cancer cells. Eur J Pharmacol. 2010 Jul 10;637(1-3): 16-21.
Boonrao M, Yodkeeree S, Ampasavate C, Anuchapreeda S, Limtrakul P. The inhibitory effect of turmeric curcuminoids on matrix metalloproteinase-3 secretion in human invasive breast carcinoma cells. Arch Pharm Res. 2010 Jul;33(7):989-98.
Yu Z, Shah DM. Curcumin down-regulates Ets-1 and Bcl-2 expression in human endometrial carcinoma HEC-1-A cells. Gynecol Oncol. 2007 Sep;106(3):541-8.