• Does this mean eating more ginger or taking ginger supplements will reduce colon cancer risk?  We don’t know, and this study doesn’t ask or answer that question?
• Does ginger actually reduce inflammation in the colon? Or just cut back  some inflammatory markers that it might be temporarily present?  We don’t know.
• Will ginger have similar side effects as other agents that we know do reduce inflammation like aspirin? We don’t know. For the short time volunteers were taking ginger there didn’t seem to be any difference in side effects, but what may happen long-term . . . We Just Don’t Know!

There is a lot we don’t know. Yet, ginger is being touted by the media as preventing or fighting colon cancer. True, many headlines are hedging bets with words like “may” but the implication is still there.

TV, newspapers, and the Internet have been full of ginger stories this week.  Some actual headlines were:

• Daily dose of ginger may cut cancer risk
• Eat ginger daily to ward off cancer
• Ginger May Help Prevent Colon Cancer
• Ginger May Have Cancer-Fighting Qualities
• Reduction in risk of colorectal cancer by ginger
• Ginger Root Consumption A Way of Preventing Colon Cancer, says Study

Come on! It’s important to do science right and tell people what it really says.

What the Study Did

Thirty healthy volunteers were randomly assigned to get a placebo (dummy pill) or a capsule with 2 grams of ground ginger. That’s about 2 teaspoons full or the equivalent of 20 grams of raw ginger, considerably more than is part of most diets.

They had a flexible sigmoidoscopy before they started taking the ginger to obtain a biopsy of colon tissue and another one 28 days later.

What the Study Showed

At the end of 4 weeks, two markers of COX inhibition associated with inflammation were statistically reduced in volunteers who were taking the ground ginger.  There was a trend, but not a statistical reduction, in two other markers.

COX (cyclooxygenase) is an enzyme that converts fatty acids in the body to chemicals that cause inflammation and pain.  Blocking COX action makes drugs like aspirin, ibuprofen, and Celebrex® work.

Ginger appeared to be tolerable and safe with no more side effects in the people taking the supplements than in those who got placebos.

What the Study Means for Individuals

Does this mean that you should start eating more ginger or taking ginger supplements?  Not unless you want a little ginger to spice up something you are cooking.

There is not enough information yet to connect the dots between potential markers of inflammation, inflammation itself, and colon or rectal cancer, especially in healthy people.

Twenty-eight days was too short a time to find out if ginger as a COX inhibitor might have some of the same adverse events as other COX inhibitors including bleeding and increased cardiovascular events.  While it appears safe in this short trial, daily use of ginger root supplements needs further study.

Bottom line — we don’t know how safe daily ginger supplements are or if they are truly effective in preventing colon or rectal cancer.  But more study is justified, perhaps in people with higher risk of colorectal cancer.  This is a first step.

Lead study author Suzanna Vick emphasized,

If you want to add ginger to part of a healthy diet, that’s great. But you can’t make any conclusions about definite health benefits based on the study findings.

We need to apply the same rigor to the sorts of questions about the effect of ginger root that we apply to other clinical trial research. Interest in this is only going to increase as people look for ways to prevent cancer that are nontoxic, and improve their quality of life in a cost-effective way.

SOURCE: Zick et al., Cancer Prevention Research, Published Online First October 11, 2011.

Studies report that ginger can reduce blood pressure and reduce cholesterol which all help to decrease risk of coronary artery disease. One study showed that ginger is as effective as prescription drugs such as Reglan to treat nausea and vomiting associated with cancer chemotherapy.

Last week there was a big write-up in the Los Angeles Times, so most of my patients cut out the article and asked me if it is okay to take ginger.

We have known for quite a while that ginger ale can help some patients with nausea and vomiting.  A study in the British journal Lancet in 1982 showed it was actually more effective than Dramamine® in preventing motion sickness in seasick Danish sailors.  In another test conducted at Brigham Young University, 36 students were asked to take either 100 mg. of Dramamine (dimenhydrinate), two capsules of Ginger or a placebo. They had to sit in a special rotating chair. None of the students who took Dramamine or the placebo could do the whole six minutes, but half of the students with ginger could finish.  We usually recommend two capsules before your travel and every four hours.

Ginger has also some other interesting effects such as an anti-inflammatory and can help to fight a flu, bronchitis and sore throat because it contains antiviral compounds such as gingerols, shogaolsm and sesquiterpenes which can reduce fevers, pains and cough. Ginger also contains a proteolytic enzyme called zingipain which can help in patients with bunions and arthritis pains. Ginger can be also applied  externally as a compress and can reduce pain particular for  fibromyalgia, joint stiffness, abdominal cramps and skin inflammations.

We usually recommend preparing a warm ginger tea to help break a high fever and rid mucus buildup in the sinuses by drinking a cup every 2-3 hours.

There is one issue you need to check with your physician:  if you have a history of  blood-clotting problems, you need to discuss whether you can take ginger. We know that ginger can prevents blood clots, therefore discuss with your oncologists that you are taking ginger because it can influence blood clotting.

Patients who got ginger (Zingiber Officinale) in capsules twice a day for three days before chemo and three days after reported significantly less nausea that those who were treated with placebo.  All patients in the study also received standard anti-nausea therapy on the day of chemo.

Almost 650 patients, mostly women, were randomly assigned to ginger supplements or a placebo in a blinded trial that will be reported at the 2009 ASCO annual meeting.

Julie Ryan, PhD, MPH, who headed the study at the University of Rochester, told reporters at an ASCO press briefing,

As many as 70 percent of patients who undergo chemotherapy experience nausea and vomiting. We found that patients who received traditional anti-nausea drugs along with ginger supplements prior to chemotherapy experienced significantly less nausea associated with their chemotherapy. However, as with all supplements, patients should speak with their doctors first before taking ginger.

SOURCE: Ryan et al., Ginger for Chemotherapy-related Nausea in Cancer Patients, ASCO 2009 Abstract #9511.

Ginger root

Although ginger is often recommended as a simple remedy for chemotherapy nausea, ginger capsules don’t seem to work any better than a sugar pill to improve the effects of standard nausea drugs.

In a randomized study, 162 patients received either ginger capsules or a placebo for chemotherapy-induced nausea and vomiting. Neither the patients or their doctors knew which they were getting.  All patients were already receiving an 5-HT₃ inhibitor such as Zofran® or Kytril®.  Some were also being treated with Emend® (aprepitant).

All patients in the trial had already had at least one episode of nausea or vomiting during chemotherapy.  They were given either 1 gram or 2 grams of ginger within a capsule or a identical looking placebo in addition to their regular anti-nausea medicine for three days after chemotherapy.

Researchers found no different in either acute nausea and vomiting on the day of chemo or delayed nausea over the next few days.  Combining ginger with Emend actually increased acute nausea and vomiting.

Despite blinding, patients were able to guess accurately whether or not they were actually getting ginger or a sugar pill.

There were no significant differences in side effects between the two groups, although the patients who got ginger capsules had less fatigue.

Dr. Suzanna M. Zick and her colleagues at the University of Michigan in Ann Arbor concluded,

Ginger provides no additional benefit for reduction of the prevalence or severity of acute or delayed CINV when given with 5-HT₃ receptor antagonists and/or aprepitant.

SOURCE: Zick et al., Supportive Care in Cancer, Online First, November 13, 2008.