The use of herbal medicine for cancer therapy in Indonesia: a prospective cohort study

Introduction: Herbal medicine is widely used in Indonesia, including for cancer treatment, but data on its effectiveness is limited. This study aimed to assess the effectiveness of herbal medicine in cancer patients by evaluating their wellness index (WI), compliance, and herb usage patterns. Methods: Data were obtained from the Jamu Registry for the period from 2014 to 2018. The improvement in patients' health status was assessed by quantifying the WI score, a modification of the World Health Organization's (WHO's) quality of life (QoL) measure. Additionally, drug compliance and patterns of commonly used herbs were also evaluated. Results: This study involved 130 participants, 82.3% of whom were female, with 33% diagnosed with breast cancer. Preference for herbal medicine alone was associated with older age, lower education, and rural residence. The six most commonly prescribed herbs were Andrographis paniculata, Catharanthus roseus, Curcuma zanthorrhiza, Gynura divaricata, Physalis angulata, and Centella asiatica. Overall, 75.4% of patients improved their WI score, with greater improvement in those using only herbal medicine (81.9%) compared to complementary therapies (48%) (P = 0.001). Drug compliance was good, with 72.3% adhering to their regimen. In silico analysis highlighted anti-cancer properties in these herbs, with α-tocopherol from P. angulata and kaempferol-3-O-β-D-glucopyranoside from G. divaricata showing potent effects, modulated by ERα and MDM2, both linked to breast cancer. Conclusion: Herbal medicine is widely regarded as a complementary and alternative treatment option for cancer patients in Indonesia. Our study further demonstrates that the use of herbal medicine contributes to an improvement in the overall well-being of these patients.