This small randomized, double-blind, placebo-controlled clinical trial was conducted in 30 breast cancer patients to assess curcumin’s ability to reduce the severity of radiation dermatitis. Women with non-inflammatory breast cancer or carcinoma in situ and were receiving radiotherapy, were randomized to receive either 2.0 grams three times per day of curcumin or placebo during their course of radiation treatments. The Radiation Dermatitis Severity (RDS) score was assessed weekly along with the presence of moist desquamation, redness, the McGill Pain Questionnaire-Short Form and Symptom Inventory questionnaires. The average age of the women was 58.1 and 90% were Caucasian.
Curcumin reduced RDS at the end of radiation therapy compared to placebo. The mean RDS scores for curcumin patients were 0.8 lower than the placebo-treated patients, i.e. 2.6 vs. 3.4. There were also fewer curcumin treated patients with moist desquamation (28.6% vs. 87.5%). There were no significant differences in pain scores in total sensory pain or intensity of pain at the treatment site and oral curcumin did not reduce erythema. Curcumin was not effective at reducing the severity of radiation dermatitis in those women who had a total mastectomy prior to radiotherapy.
Commentary: Radiation dermatitis is one of the most common side effects patients acquire from radiotherapy. It occurs in approximately 95% of women receiving radiotherapy for breast cancer and 10% of those are severe cases. Current conventional treatments include washing with lukewarm water and mild soap; applying unscented lanolin-free, water-based moisturizers, hyaluronate cream and possibly topical corticosteroids. Practitioners of natural medicine have been using many options including topical aloe preparations, topical vitamin E, and topical calendula lotion. Calendula lotion in particular has one French study demonstrating efficacy.
Oral curcumin has low bioavailability and according to at least one publication, an oral dose less than 4.0 grams is not detectable in the blood. In the current study, patients had to take 12 capsules per day to achieve the 6.0 grams per day. There are at least 3 technologies that enhance the bioavailability and thus would then require much less number of capsules. These 3 technologies include lecithin bound to curcumin- a “phytosome” process, (ex/ Meriva), curcuminoids/ turmeric essential oil/ lecithin (ex/BCM-95), and a curcumin nanoparticular colloidal dispersion (ex/ Theracurmin).
Reference
Ryan J, Heckler C, Ling M, et al. Curcumin for radiation dermatitis: A randomized, double-blind, placebo-controlled clinical trial of thirty breast cancer patients. Radiation Research 2013;180:34-43.
