Phytochemicals in African Plant Extracts Stop Chemotherapy Induced Nail Damage

Men and women receiving chemotherapy endure a host of troublesome side effects that affect their ability to perform simple activities of daily living. One, rather distressing, toxicity is nail damage (Onycholysis), which can affect up to half especially those receiving a commonly used category of drug called taxanes^1,2,3. Initially the nails feel hot, sensitive and painful, then ridges appear followed by splitting and separation of the nail from the nail bed. This breakdown of the normal anatomy leads to secondary fungal and bacterial infection that causes further misery and damage.

Current practices:

Supervising oncologists often reduce the dose of chemotherapy when nail damage gets too distressing but this may reduce the beneficial effects of chemotherapy. Oncology nurses advise anecdotal strategies including nail hygiene, wearing nail varnish and avoiding trauma with little or no evidence of success. Cooling the nails bed with iced water helps to reduce its severity⁴. Commercially available cooling gloves are available but they are not particularly popular among UK chemotherapy nurses as they cover the veins of the hands and prevent assessment of the patient's extremities^4,5,6.

Rationale for the UK Polybalm study:

A trial development committee was formed with phytochemists, herbalists, patients, oncologists and oncology nurses from Bedford and Addenbrooke’s Cambridge University Hospitals which worked in liaison with the National Cancer Research Institute’s lifestyle and behavioral change work stream. The bioactive pathways of a host of plant extracts were scrutinized from published laboratory and clinic data.  With an understanding of how chemotherapy damaged nails it soon became clear that a number of natural plant phytochemicals, particularly the polyphenolic acids and polyphenols have biological properties which could protect the nail bed from chemotherapy if applied locally ^{7,8,9,10,11,12}. The full evidence review for the specific essential oils and waxes chosen for this study and entire protocol itself can be found on the trials website (cancernet.co.uk/polybalm.com).  In summary these include:

• Anti-inflammatory

• Analgesic

• Anti-oxidant

• Enhance DNA repair

• Anti-bacterial and anti-fungal

• Moisturising and hydrating

 What is polybalm?

In contrast to the ingredients of conventional cosmetics, the UK manufacturers of polybalm only used unrefined oils, which were cold pressed or gradually warmed avoiding damage to their phytochemical content. The bases of extra virgin olive oil, organic beeswax, unrefined organic cocoa and shea butters. The essential oils included Gaultheria procumbens, lavandula officinalis, eucalyptus globulus, tarchonanthus camphoratus. They wanted to avoid any potential iritants so excluded any man made chemical such, preservatives, colours, parabens, sulphates or petroleum.

The UK Polybalm trial:

60 men and women receiving chemotherapy for breast or prostate cancer were randomised to apply either a simple petroleum moisturising balm to their nail bed 2-3 three times a day or the investigational balm now known as polybalm. None of the patients, doctors, research team or statistician knew which balm was assigned to which participant. The health of the nails was measured by 4 independent tools. Two completed by the patient concerning severity of symptoms and how they affected QOL and two by physicians assessing the physical disfigurement. 

Results:

There was a 180 fold difference in patient recorded QOL and an 11 fold difference in physician recorded disfigurement but both differences were highly statistically significant in all scores (unpaired T-test p<0.00001). There were no reported allergies or adverse events related to either creams. Only patients in the polybalm group had some nail changes also suffered from other severe chemotherapy complications including neutropenic sepsis, diarrhea and peripheral neuropathy¹³.

Conclusion:

The polyphenol rich essential oils and plant-based waxes in this nail bed balm profoundly reduced chemotherapy related nail damage and improved nail related quality of life compared to a plain petroleum based balm. The significant improvement in nail related quality of life will be welcomed by patients suffering this unwelcome toxicity which would otherwise significantly effect up to half of people receiving chemotherapy.

Footnote:

This study was audited to comply with good clinical practice guidelines and Cambridge University Central Research Ethics Committee approval. It was registered with the Health Research Authority. The balms were made specifically for this study by a UK registered manufacturer and European product cosmetic test were performed to fully comply with European Union Cosmetics Standards (ref: 76/768/EEC). No member of the research team received payments to recruit patients into the study. Although this was a scientific evaluation, the FDA and MHRA classed them as a cosmetic, so cannot be recommended for any medical condition or claim health benefits. The investigation balm should not be considered as an alternative medical treatment and should not be used against medical advice. The protocol was in the public domain and the balm, named after the clinical trial, is now distributed by an independent organization (polybalm.com) that has no connection to the trials unit.

References:

1. Minisini AM et al: Taxane-induced nail changes. Ann Oncol 14:333-337, 2003
2. Battegay EJ: Angiogenesis: Mechanistic insights. J Mol Med 73:333-346, 1995
3. Wasner G et al: Docetaxel-induced nail changes: J Neurooncol 58:167-174, 2002
4. Ding & Thomas: Cooling for chemo onycholysis. Clin Foc Can Med 2(1):18, 2010
5. Scottie: Frozen glove to prevent docetaxel onycholysis. JCO 23(19) 4424, 2005
6. Ishiguro: Freezing for docetaxel nail toxicity. Sup Care Can 20:2017-2024, 2012
7. Delaquis: Antimicrobial activity of plant oils. Int J Food Microbiol 74(1):101 2002
8. Smith-Palmer: Antimicrobial plant oils. Applied Microbiol 26(2):118-22, 2002
9. Baratta: Antimicrobial & antioxidant essential oils. Flav & Frag J 13(4):235, 2001
10. Radava. Herbs protect cells from UV radiation Pharmacogn Rev. 2011 5(10): 164
11. Mao-Qiang: Topical plant extracts & inflammation. Evid Based Com Alte Med. 2012
12. Baliga: Chemoprevention of botanicals. Phytochem Photobiol Sci. 2006, 5(2):243.
13. Thomas R et al. A double blind RCT of a polyphenolic rich plant balm for onycholysis – the UK Polybalm Trial. 2017 ASCO Proceedings Abstract:101003

A Personal Journey with Cancer - A Talk by Natascha Laing

We wanted to share this vlog with you by the amazing Natascha Laing discussing her personal journey with cancer.

Some words by Natascha about this talk...

"This talk was made to happen by Michael Kern, he has been gently encouraging me to share my story in the hope that I will write a book at some point. 

Though for me I am still very much in the journey of my life, and moment to moment is still very much how I live. This talk was the first time I had ever spoken publicly about myself, and though people are always telling me I have a great message to share, I myself don't know what that message is.

I am not on any social media and not used to putting myself out in that way. Life is such a great mystery for us all, and more so for me as time goes on.

For me being able to embrace my life as it is moment to moment is where I find the most peace, cancer or no cancer."

An invitation to share your life changing stories

Today's post is from Delyth, co-founder of an app we love called 'This Changed Me' - a space for people to share anything that has inspired change in their lives. Delyth got in touch with Yes to Life following her own experience with cancer in her family and would like to share the story of how this changed her life too.

It was nearly two years ago that my mum was diagnosed with Multiple Myeloma, to say that we were shocked is an understatement. I felt my world dissolve under my feet, I allowed the terror to come in and had a couple of complete melt downs. I remember seeing mum for the first time after we received the diagnosis and weeping on her shoulder, she stroked my hair.  I was very much her child and feeling like a child in that moment, not the 40 year old I was at that time.

Mum was amazing and still is.

The way she dealt with the diagnosis and the treatment was head on; her positivity and belief throughout was inspirational. Mum is a glass half full woman. She is incredibly positive and her mindset was strong and infallible even in dark moments.

The way I dealt with this was immediately to search for information – WHAT CAN WE DO to encourage the best outcome. I discovered that there was a lot that we could do – an incredible amount – this was empowering and gave us hope. What I uncovered was life changing in terms of how we managed mum’s treatment and how we are now.

I am a trained Nutritional Therapist but hadn’t had a practice in years, instead I had created, developed and launched an app called This Changed Me which was in part related to my experiences as a therapist. But the diagnosis connected me back to the power of food, mum’s diet had a complete overhaul, we saw a therapist working with people with cancer (that I found via Yes to Life’s website), therefore a lot of supplements, keeping mum positive, keeping her moving and exercising… giving her LOVE and support which is vital.  All of these elements are correlated with recovery.

Mum had a stem cell transplant 2 years ago and has bounced back incredibly quickly and she feels in great health. She has little ups and downs but on the whole is happy, feels vital, she is in the world pursuing all her passions.

I know that the food, supplements, her mind set and positivity, love and support got her through this and contributes greatly to her vitality today. All of this she continues with.

Personally I learnt so much: to pursue my passions, to be true to myself, to try and be much more present, to see life as a gift even in challenging times, to be compassionate and loving, I am far more resilient than I thought I was, I did all I could to be there for my mum, my connection to wellness reinvigorated, I want to help people….

I wanted to share my story with Yes to Life in part because the organisation helped us in time of huge vulnerability. And also because I want to invite the community of Yes to Life to share your life changing stories – big or small – with my community on This Changed Me. I truly believe that your learnings would be inspirational, hopeful and a source of inspiration to other people.

This Changed Me is for people who enjoy sharing life-changing stories – big or small, trivial to life-changing and for those looking for inspiration, support, motivation. 

This Changed Me received a commendation from the renowned Webby Awards last year.

Please take a look here:

This Changed Me

Download on iTunes

If you want to talk with Delyth personally about This Changed Me, please email – hello@thischanged.me