Written by Greg Arnold, DC, CSCS. Of the 114 patients recovering from breast cancer surgery, those who applied 2% Boswellia cream to the radiated area for 5 weeks had significantly less skin inflammation and toxicity compared to the placebo group.
According to the American Cancer Society, about 246,660 new cases of invasive breast cancer in women will be diagnosed which will result in about 40,450 deaths in 2016 1. For those who undergo radiation treatment for breast cancer, 85-95% will experience “radiation dermatitis” which is a skin reaction that is “a sharp increase of free radicals, resulting in DNA damage and alteration of protein, lipids and carbohydrates” 2. As a result, finding ways to help offset the harms of radiation dermatitis are needed.
A 2015 study 3 involved 114 women aged 47 to 69 who underwent breast cancer surgery and were scheduled to undergo five radiation treatments. They received either a 2% Boswellia cream (55 women) or a placebo cream (59 women) for five weeks. The creams were applied twice daily: immediately after radiation therapy and before bedtime on radiation therapy days, in the morning and at night in days with no radiotherapy administration. Subjects also had the option of using cortisone cream in addition to Boswellia cream or the placebo cream.
Before and after the study, skin reactions were evaluated by the researchers as in previous studies 4 as well as with computer-assisted skin color analysis. Skin toxicity from the radiation treatments was assessed by the Radiation Therapy Oncology Group rating scale 5.
After five weeks, researchers noted the following between the two groups:
- 22% of Boswellia patients had an “intense” skin reaction to radiation therapy compared to 49% in the placebo group (p < 0.05).
- For skin redness (“erythema”), 62.5% of Boswellia patients had “intense” redness compared to 70.7% in the placebo group (p < 0.05).
- For skin toxicity after radiation treatment, 71.19% of placebo subjects had second degree skin toxicity compared to 54.55% in the Boswelia group (p < 0.05).
- Regarding the self-use of cortisone cream, 25.45% of Boswellia patients reported using it compared to 62.71% of placebo patients (p < 0.05).
- 21 subjects in the Boswellia group recorded having an adverse reaction to the cream (itching/burning sensations) compared to 29 subjects in the placebo group (p < 0.05).
While citing the anti-inflammatory properties of Boswellia 6,7 and research suggesting Boswellia may benefit sun-damaged skin 8, the researchers concluded that “boswellia-based cream is effective in reducing the use of topical corticosteroids and is able to reduce the grade of erythema and the skin superficial symptoms. However, they admit that “Further studies comparing boswellia cream with other topical agents will be appropriate to confirm the effectiveness of this treatment for breast cancer patients under radiation therapy.”
Source: Togni et al. Clinical evaluation of safety and efficacy of Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in mammary carcinoma: a randomized placebo controlled trial. European Review for Medical and Pharmacological Sciences. 2015; 19: 1338-1344
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Posted January 2, 2017.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.
References:
- Breast Cancer What is Breast Cancer? American Cancer Society; 20169. Accessed December 30, 2016.
- Hymes SR, Strom EA, Fife C. Radiation dermatitis: clinical presentation, pathophysiology, and treatment 2006. Journal of the American Academy of Dermatology. 2006;54(1):28-46.
- Togni S, Maramaldi G, Bonetta A, Giacomelli L, Di Pierro F. Clinical evaluation of safety and efficacy of Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in mammary carcinoma: a randomized placebo controlled trial. Eur. Rev. Med. Pharmacol. Sci. 2015;19:1338-1344.
- Viyoch J, Tengamnuay I, Phetdee K, Tuntijarukorn P, Waranuch N. Effects of trans-4-(aminomethyl) cyclohexanecarboxylic acid/potassium azeloyl diglycinate/niacinamide topical emulsion in Thai adults with melasma: a single-center, randomized, double-blind, controlled study. Current Therapeutic Research. 2010;71(6):345-359.
- Cox JD, Stetz J, Pajak TF. Toxicity criteria of the radiation therapy oncology group (RTOG) and the European organization for research and treatment of cancer (EORTC). International Journal of Radiation Oncology* Biology* Physics. 1995;31(5):1341-1346.
- Sferra R, Vetuschi A, Catitti V, et al. Boswellia serrata and Salvia miltiorrhiza extracts reduce DMN-induced hepatic fibrosis in mice by TGF-beta1 downregulation. European review for medical and pharmacological sciences. 2012;16(11):1484-1498.
- Hamidpour R, Hamidpour S, Hamidpour M, Shahlari M. Frankincense (乳香 Rǔ Xiāng; Boswellia Species): From the selection of traditional applications to the novel phytotherapy for the prevention and treatment of serious diseases. Journal of traditional and complementary medicine. 2013;3(4):221.
- Calzavara‐Pinton P, Zane C, Facchinetti E, Capezzera R, Pedretti A. Topical Boswellic acids for treatment of photoaged skin. Dermatologic therapy. 2010;23(s1):S28-S32.