We’re busy updating our review of artemisinin and artesunate and will provide a rating when that’s complete. While we’re working, we share a summary from our predecessor website, Beyond Conventional Cancer Therapies. The information we share here was last updated in August 2021.

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The Artemisia annua plant contains chemical compounds effective against malaria and also considered to have anticancer activity. Artemisinin is a natural derivative of Artemisia annua, and artesunate is a prescription medication derived from Artemisia annua. Since artesunate is a prescription drug approved for use in malaria, its use in cancer is considered off-label.

Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

Artemisinin’s anticancer activity is believed to occur when it comes in contact with iron. Cancer cells concentrate iron for use in cellular division (the malaria parasite also collects high concentrations of iron). Artemisinin’s contact with iron triggers the release of free radicals between cells that destroy cancer cells. Because of this “ferroptosis” effect, iron is often administered several hours before artemisinin to enhance targeting of the cancer cells while sparing normal cells.

Clinical Evidence

Case studies and preliminary clinical trials have shown some anticancer effects in human patients, but the evidence is not strong or compelling at this point:

Artemisinin

  • Reduced PSA and tumor regression for seven months in one prostate cancer patient1

Artesunate

  • A 2018 review of clinical artesunate and artemisinin derivatives did not find efficacy in the treatment of cervix, breast, colorectal and lung cancers.2
  • Colorectal cancer: reduced tumor proliferation (antiproliferative) in a small trial3
  • Advanced non small-cell lung cancer: the standard combination of vinorelbine and cisplatin combined with intravenous (IV) artesunate was effective and well tolerated4
  • Melanoma: response and regressions of splenic and lung metastases in case studies5
Lab and Animal Evidence

Click or tap to open.

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Artesunate reduced disease recurrence when used at the time of surgery in a small trial.34

Artesunate did not prohibit tumor recurrence in a prostate cancer patient who had developed resistance to atemisinin.35

Cautions

At doses used to treat malaria, Artemisia-derived drugs are generally safe and well tolerated, but no phase I clinical trials have tested the safety of higher doses that are likely required for treating cancer. Doses used in animal studies have been much higher than those used in anti-malaria treatment.

Some potentially serious side effects and drug interactions with Artemisia annua and/or its derivatives are noted, as well as contraindications and cautions.

  • Artemisinin during pregnancy may cause harm to the fetus.36
  • Artemisinin, when combined with oxidative chemotherapies or radiation, may cause toxicity, especially liver toxicity.37 Efferth reports two case studies of patients with glioblastoma who received artemisinin-type drugs that resulted in liver toxicity in both cases and bone marrow suppression and death in the second case. The treatment drugs were combined with chemotherapy and Chinese herbs in the first case and dichloroacetic acid in the second case.38 Monitoring liver function routinely is advised.
  • A number of articles report interactions between Artemisia annua or its derivatives with drugs and/or natural products.39
  • Patients with gastrointestinal disorders or ulcers should not take artemisia.40
  • Long-term use (up to 37 months) in metastatic breast cancer patients did not result in any major safety concerns.41
  • For more information on side effects of artesunate (in doses used to treat malaria):Medscape: Drugs and Diseases. artesunate Rx

Consult your pharmacist for interactions, and discuss using Artemisia annua or its derivatives with your doctor. BCCT suggests that patients who use Artemisia derivatives for cancer seek guidance for usage, dose and formulation from an integrative cancer care clinician or traditional Chinese medicine practitioner with experience working with cancer patients.

See Commentary below.

Access

Plant leaves and powdered and liquid extracts are available for purchase in the US. Artemisinin, a natural derivative of Artemisia annua, is available for purchase as a supplement.

Artesunate, the synthetic drug derived from the Artemisia plant, is available by prescription in the US only for patients who have a documented case of severe malaria. It is used widely in European cancer clinics providing complementary therapies.

Dosing

Exact dosage of the herb Artemisia annua in cancer has not been determined in clinical trials. Concentrations of the active ingredients vary among products.42 See Quality and Sources of Herbs, Supplements and Other Natural Products for general information.

Integrative cancer care plans, protocols and references listed below suggest doses. For a lengthy discussion of dosages of the various plant and supplement derivatives of Artemisia annua, artemisinin and artesunate, see these sources:

Integrative Programs, Protocols and Medical Systems

A number of European complementary and alternative medicine cancer clinics use this natural product, and Chinese researchers consider it a very promising anticancer therapy.

  • Programs and protocols
    • Alschuler & Gazella complementary approaches:43
      • Head and neck cancer
      • Prostate cancer
    • Bastyr University Integrative Oncology Research Center protocol for Stage IV Breast Cancer44
    • Chang strategies45
    • MacDonald breast cancer program46
    • McKinney protocols47
      • General cancer
      • Breast cancer
      • Carcinoid/neuroendocrine cancer
      • Cervical cancer
      • Colorectal cancer
      • Esophageal cancer
      • Fibrosarcoma
      • Gallbladder cancer
      • Head and neck cancer
      • Kidney cancer
      • Leukemia
      • Liver cancer
      • Lung cancer
      • Lymphoma
      • Multiple myeloma
      • Myelodysplastic syndrome
      • Ovarian cancer
      • Pancreatic cancer
      • Prostate cancer
      • Stomach cancers
  • Used in the Parmar & Kazcor treatment plans48
  • Traditional systems
    • Traditional Chinese medicine

Commentary

In her 2010 book, naturopathic oncologist and BCCT advisor Lise Alschuler, ND, FABNO, advises avoiding using artemisinin during radiation therapy and for an additional 30 days after therapy ends.49

Integrative oncologist and BCCT advisor Keith Block, MD, advises in his 2009 book: “Until we have more research, I advise not taking this herbal while you are undergoing conventional treatment.”50

Also known by these names

  • Annual wormwood
  • Artemisinin (derivative used in cancer)
  • Qing Hao
  • Qinghaosu
  • Sweet Annie
  • Sweet sagewort
  • Sweet wormwood
  • Semi-synthetic drug derivatives:
    • Artesunate
    • Artemether

More Information

References

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