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Chapter 12
The Use of Plant Extracts as
Potential Cancer Agents:
Approach to Plant-Derived Cancer Drugs
Gizem Akman
https://orcid.org/0000-0003-4301-5862
Istanbul University, Turkey
ABSTRACT
The number of people with cancer and death rates are constantly increasing in the world. Although
surgery, radiotherapy, and chemotherapy are still the most preferred methods, they have inadequacies,
limited efficacy, and side effects. Therefore, development of new treatment methods has gained importance. Natural products were used for medical and therapeutic purposes in ancient times and are still
used today. While some naturally derived molecules have already been shown to be effective against
cancer, studies are ongoing for many natural molecules as cancer therapeutics. There are still many
plant species and compounds whose effectiveness has not yet been discovered in the world. Therefore,
identifying potential natural compounds that can be used in cancer treatment, demonstrating their effects on different types of cancer, and elucidating their mechanisms of action will lead to the discovery
of new natural compound-derived drugs and overcome the existing difficulties of cancer.
INTRODUCTION
Cancer is known to be a global health problem responsible for the most deaths worldwide after cardiovascular diseases. While most human cancers are caused by exposure to a variety of environmental
carcinogens, including chemicals, radiation, and viruses; and rearrangement of chromosomes, tumor
suppressor genes, or spontaneous mutation also cause cancer (Reddy et al., 2003). Stages of cancer
progression are now defined as a long-term developmental process that is dynamic, multifactorial,
and involving a range of signaling systems. From initiation and progression, the gradual development
of cancer is followed by the progression stage and eventually results in metastasis, which leads to the
uncontrolled spread of the cancer in the body (Aravindaram & Yang, 2010).
DOI: 10.4018/978-1-6684-5129-8.ch012
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The Use of Plant Extracts as Potential Cancer Agents
Cancer and Current Treatment Approaches
According to GLOBOCAN 2020 data, an estimated cases of new cancer patient about 19.3 million and
nearly 10 million deaths occurred globally (GLOBOCAN, 2020; Debela et al., 2021). Moreover, In 2040,
the worldwide cancer burden cases are anticipated to reach 28.4 million, an increase of 47% compared
to 2020 (Sung et al., 2021). For this reason, many studies are carried out for the treatment of cancer.
Cancer treatment usually requires careful planning, therapeutic approaches, and guidelines. And also
individual treatment options will be determined by a variety of parameters, including cancer type and
stage, general health, other health problems, and personal preferences.
Methods such as surgery, radiotherapy and chemotherapy have been preferred for a long time (Hameed et al., 2019, Shi et al., 2022). These treatment methods can be applied as single treatment or in
combination. In most cases, metastasis of cancer cells to adjacent and distant tissues and organs limits
the effectiveness of surgery, and it is not possible to surgically remove all of the cancerous tissues and
organs, especially in advanced stages (Ashrafizadeh et al., 2021). However, current therapeutic approaches, including chemotherapy and radiotherapy, have high systemic toxicity, limiting their tolerability
and clinical application, and are not effective in preventing advanced cancer cells (Ashrafizadeh et al.,
2021; Kashyap et al., 2021). This treatment technique is related with severe side effects such as nausea
and vomiting, diarrhea, anemia, loss of hair, soreness and exhaustion, which have an impact on people
and their psychology. In addition, dose-dependent toxicity in healthy cells is one of the biggest obstacles
in cancer treatment (Miao et al., 2017). In order to eliminate these obstacles, new generation treatment
methods such as immunotherapy, hormone therapy and targeted therapy are also applied (Figure 1)
(Hameed et al., 2019). Hence, it has become very important to find more effective and more selective
treatment methods for the treatment of different human cancers. For this purpose, in studies conducted
to discover new methods, it has been shown that structurally diverse compounds derived from various
natural products can have chemopreventive effects against cancer as well as chemotherapeutic activities
(Cragg & Pezzuto, 2016; Kashyap et al., 2021).
HISTORY OF NATURAL PRODUCTS
Organic compounds are classified as either primary or secondary metabolites. Primary metabolites are
essential for species growth and development, whereas secondary metabolites are considered to have
a role in defense (Mosunova et al., 2020). Secondary metabolites of species such as plants, animals,
marine invertebrates, and bacteria are known as natural products and these natural products have historically played important roles in human health, mainly in ancient Asian and Middle Eastern cultures
(Kittakoop, 2015). They evolve in nature in response to the natural environment’s requirements and difficulties (Demain & Vaishnav, 2011). For centuries, humans have used naturally occurring substances
for medicinal purposes, such as plants, which were first used as food, and as poisons over time, then
their therapeutic properties were discovered and started to be used in the treatment of diseases. Ancient
science anthologies have remained a vital source of modern pharmaceutical discovery in traditional
and ethical medicine. They are still important fundamentals in pharmacy practice (Zhang et al., 2020).
Before the 1800s, the active ingredients of most drugs, often plant-based and often used as extracts,
oils, remedies, potions or mixtures, were unknown. The earliest records date back to 2600 BC. These
records are written on clay tablets and come from the Cuneiform script in Mesopotamia era (Cragg &
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