Medicinal plants used in treatment and management of cancer in Kakamega County, Kenya
Graphical abstract
Introduction
Cancer is a broad group of various diseases typified by unregulated cell growth. In cancerous state cells division and growth is uncontrollable resulting in tumours that, if malignant, may metastasise to other parts of the body. These neoplastic cells originate from highly specialized cells through a process of regression to a simpler; more primitive stage and which unlike the normal parent cells; divide continuously (Anand and Kunnumakara, 2008). The main properties of neoplastic tissue include; sustained proliferative signalling, evasion of growth suppressors, resistance to cell death, replication, angiogenesis, invasion and metastasis, reprogramming energy metabolism and escaping immune destruction (Anand and Kunnumakara, 2008). The causes of rise in cases of cancer are not known. However, increased cancer risk is known to correlate with tobacco use, certain infections, radiation, lack of physical activity, age, poor diet, obesity, and environmental pollutants. These factors may damage genes directly or combine with existing genetic faults within cells to cause the disease (Anand and Kunnumakara, 2008).
Globally cancer account for approximately 13% of all deaths each year with the most common being lung cancer (1.4 million deaths), stomach cancer (740,000 deaths), liver cancer (700,000 deaths), colorectal cancer (610,000 deaths), and breast cancer (460,000 deaths) (WHO, 2010). Although cancer may be evident at any age, invasive cancer commonly occurs over the age of 65 (Coleman et al., 2009). In Kenya, mortality from various forms of cancer is approximated at 50 per day with about 80,000 cases diagnosed each year (Pact Kenya Cancer Assessment in Africa and Asia, 2010).
Current treatment regimens include chemotherapy, radiotherapy and surgery (Vickers, 2004). Patient survival varies greatly depending on the type, location and stage of the disease at the onset of treatment. Chemotherapy in addition to surgery has proved useful in a number of different cancer types including breast, colorectal, pancreatic, osteogenic sarcoma, testicular, ovarian and certain lung cancers. However, the effectiveness of chemotherapy is often limited by toxic effects on other non-target tissues. Consequently, complementary and alternative therapies such as herbal therapies are increasingly used. Such interventions have however not been rigorously studied or tested (Vickers, 2004). Use of plants for therapy is not new, indeed plants have been considered a valuable source of bioactive compounds for treatment of many conditions, including cancer, in almost all cultures and communities for thousands of years (Syam et al., 2011). Industrialised societies are increasingly relying on medicinal plants as evidenced by the extraction and development of several drugs and chemotherapeutics from traditionally used rural herbal remedies (UNESCO, 1998). Like most chemotherapeutic anticancer drugs, plant extracts work by either targeting fast dividing cell by impairing mitosis or causing target cells to undergo apoptosis (Chong et al., 2009). Although many herbal remedies lay claim to anticancer effects, only a few are substantially used as alternative cancer therapies (Cassileth and Chapman, 1966).
Africa has diverse medicinal plants that are increasingly becoming an integral part of ethnomedical approached to cancer treatment. Most notable is Catharanthus roseus (L.) G.Don which yields anti-tumour agents vinblastine and vincristine (Lucy and Edgar, 1999). In Kenya, anecdotal evidence indicates that most communities have some form of herbal anticancer remedies (Kareru et al., 2007). Although information on indigenous medicinal plants used for many diseases has been recorded by several authors (Glover, 1996, Kokwaro, 1993, Kaendi, 1997, Lindsay and Hepper, 1978), little work has been done on anticancer plants in Kenya. The present study documented medicinal plants traditionally used by communities in treatment and management of cancer. The study was carried out in Kakamega County, Kenya, a populous region adjacent to a tropical forest, the Kakamega forest.
Section snippets
Study area
Kakamega County located in the Western part of Kenya is the second most populous county in Kenya with a population of 1,660,651 and an area of 3224.9 km2 (Kenya Open Data, 2011) (Fig. 1). The area is tropical with high rainfall (1250–1750 mm per annum) and temperature range of 10.3–30.8 °C with an average of 20.5 °C. Kakamega Forest National Reserve, with the only tropical rainforest in Kenya, is found in Kakamega County. The County has a total of 55 health facilities; 12 hospitals, 15 health
Results
The survey focused on medicinal plants used in treatment of cancer. The respondents comprised thirty two THMPs (22 males and 10 females). Majority of the respondents were mature adults aged between 35 and 74 years with 57% having practiced ethnomedicine for more than 10 years. Literacy level was however considerably low. In the study area, the most commonly treated cancers included skin cancer, stomach cancer and breast cancer. Others include cervical cancer, uterine cancer, prostate cancer and
Discussion
This study identified 65 plants belonging to 59 genera and 34 families used in the treatment of cancer in Kakamega County. Some of these candidate plants have been documented in treatment of cancer; notably Catharanthus roseus (L.) G. Don (Aslam et al., 2010). Although these plants have other therapeutic uses (Table 2), most have been reported to possess cytotoxic and antitumor properties (Table 2). Additionally isolation of anticancer and cytotoxic bioactive phytoconstituents has been
Conclusion
This present study showed that the inhabitants of Kakamega County use a variety of medicinal plants for cancer intervention. Twenty five plants were reported for the first time as being important in the management of cancer. In addition many of the plants identified have been reported to possess antitumor and cytotoxic properties. The herbal remedies were made from a combination of different plants and plant components indicating a synergistic advantage. It is not surprising that the
Acknowledgements
The present study received financial support from Carnegie Corporation of New York through Regional Initiative in Science and Education (RISE AFNNET). The THMPs of Kakamega County are the owners of the traditional knowledge presented in this paper, and any benefits accrued from it must be shared with them appropriately. I appreciate the support of my university supervisors; Dr. Charles Kimwele, Dr. Jemimah Oduma, Prof. Peter Gathumbi and Prof. Stephen Kiama. I wish to thank Mrs. Gaudencia
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