title: High-Dose Asian Ginseng (Panax Ginseng) for Cancer-Related Fatigue: A Preliminary Report.
abstract: OBJECTIVE
  Cancer-related fatigue (CRF) is the most common and severe symptom in patients with cancer. The number and efficacy of available treatments for CRF are limited. The objective of this preliminary study was to assess the safety of high-dose Panax ginseng (PG) for CRF.
  
  
  METHODS
  In this prospective, open-label study, 30 patients with CRF (≥4/10) received high-dose PG at 800 mg orally daily for 29 days. Frequency and type of side effects were determined by the National Cancer Institute's Common Terminology Criteria for Adverse Events, version 4.0. Scores on the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, day 15, and day 29. Global Symptom Evaluation (GSE) was assessed at day 29.
  
  
  RESULTS
  Of the 30 patients enrolled, 24 (80%) were evaluable. The median age was 58 years; 50% were females, and 84% were white. No severe (≥grade 3) adverse events related to the study drug were reported. Of the 24 evaluable patients, 21 (87%) had an improved (by ≥3 points) FACIT-F score by day 15. The mean ESAS score (standard deviation) for well-being improved from 4.67 (2.04) to 3.50 (2.34) (P = .01374), and mean score for appetite improved from 4.29 (2.79) to 2.96 (2.46) (P = .0097). GSE score of PG for fatigue was ≥3 in 15/24 patients (63%) with median improvement of 5.
  
  
  CONCLUSIONS
  PG is safe and improves CRF fatigue as well as overall quality of life, appetite, and sleep at night. Randomized controlled trials of PG for CRF are justified.
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA syennu@mdanderson.org.
authors: Sriram
authors: S
authors: Yennurajalingam
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Akhila
authors: A
authors: Reddy
authors: Department of GU Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Nizar M
authors: NM
authors: Tannir
authors: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Gary B
authors: GB
authors: Chisholm
authors: Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Richard Tsong
authors: RT
authors: Lee
authors: Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Gabriel
authors: G
authors: Lopez
authors: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Carmen P
authors: CP
authors: Escalante
authors: Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Ellen F
authors: EF
authors: Manzullo
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Susan
authors: S
authors: Frisbee Hume
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Janet L
authors: JL
authors: Williams
authors: Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Lorenzo
authors: L
authors: Cohen
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Eduardo
authors: E
authors: Bruera
mesh_terms: D000368:Aged; D004305:Dose-Response Relationship, Drug; D005221:Fatigue / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D005894:Panax / Q000737:chemistry*; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D010936:Plant Extracts
keywords: Panax ginseng; cancer; fatigue; quality of life