A Periwinkle and the Fight Against Cancer
The Madagascar Periwinkle is the source of a powerful molecule used to treat certain cancers.
This has been a hard couple of weeks. A loved one has been diagnosed with an aggressive cancer, a type of non-Hodgkin lymphoma (NHL). Following rapid weight loss, exhaustion, unbalanced blood chemistry levels, and fluid accumulation in the lungs—the doctors’ decision to pursue another biopsy finally paid off, and we have a culprit to fight. And what a fight it will be.
The choice of medication will involve a cocktail of steroids, immunotherapy, and chemotherapy drugs. One of the medications to be used popped out to me: vincristine (brand name: Oncovin).
The plant source of Vincristine (scientific name: Catharanthus roseus in the Apocynaceae family; formerly named Vinca roseus) has a rich history in traditional medicine and folklore. This plant was once regarded as magical among Europeans, capable of warding off evil spirits. The French regarded it as the “sorcerers’ violet.”
This once “witchy” plant is now available in the landscaping section of your local hardware stores and plant nurseries. Its common English name is the Madagascar periwinkle or rosy periwinkle. I would hazard that few shoppers realize what a critical plant it is for medicine, as today, it is most appreciated for the beautiful splash of color it adds to yards and container gardens.
In this post, I provide a deeper dive into the history and medicinal utility of the Madagascar periwinkle.
Botanical Origins
As its name implies, the Madagascar periwinkle originates in Madagascar, where an additional six species in the genus Catharanthus are also found. Two other related species are found in Sri Lanka and China. Due to its popularity in ornamental applications and in diverse systems of traditional medicine, Catharanthus roseus is now found across the globe.
Use in Traditional Medicine
The traditional uses of the Madagascar periwinkle are extensive. A 2022 review paper on this plant provides a detailed accounting. Here, I summarize some of the primary applications based on plant part. But first, some terminology:
Aerial parts: all parts of a plant found above ground. This excludes the roots, but can include stems, flowers, fruit, leaves.
Decoction: the plant is actively boiled in water.
Infusion: the plant is steeped in hot water (not simmered/boiled in the water).
Whole Plant
Decoction: wasp stings, muscle pains, nose bleeds, bleeding gums, cancer, diabetes, kidney problems, sedative, arthritis
Juice: hypertension
Aerial Parts
Decoction: regulation of menstruation
Infusion: diabetes
Stem
Decoction: diabetes, dysmenorrhea
Leaves
Decoction: toothache, insect stings, wound healing, diabetes, rheumatism
Infusion: toothache, blood circulation
Juice: indigestion
Root
Decoction: tonic, stomachache, purgative, vermifuge
Infusion: diabetes
One of the most common applications globally has been for treating diabetes. However, details on the safe use of the plant (including dosing and precise preparation) have not been thoroughly vetted in the clinic. For your safety, I advise against preparing homemade remedies from this species. There are well-known toxicity concerns for extracts and isolated molecules from this plant.
Discovery of the Vinca alkaloids
The Vinca alkaloids (so named after the previous scientific name for this species, Vinca roseus) are the earliest microtubule-targeting agents developed and FDA approved for treating cancer. Abnormal cell growth is a hallmark of cancer, and by interfering with how cancer cells grow and divide, the Vinca alkaloids can slow the spread of disease. The approved Vinca alkaloid drugs include Vincristine, Vinblastine, Vinorelbine, and Vinflunine.
The Vinca alkaloids were first isolated in the 1950s from the Madagascar periwinkle plant by Canadian scientists, Robert Noble and Charles Thomas Beer. Initially believed to be hypoglycemic (blood sugar-lowering) agents, they were soon found to have no effect on blood sugar but caused leukopenia (a reduction in the number of white cells in the blood), leading to further study on their impact on cancer. The prototype of Vinca alkaloids, Vinblastine, demonstrated the ability to cause bone marrow suppression in leukemia mouse models, pioneering a new anti-cancer therapy. The FDA has approved various forms of Vinca alkaloids, including Vinblastine and Vincristine, for treating multiple types of cancer such as leukemia and Hodgkin's lymphoma.
Clinical Applications of the Vinca Alkaloids
Vinblastine
Vinblastine is the most heavily studied of the Vinca alkaloids and is a component of the therapeutic cocktails for treating testicular cancer, breast cancers, melanoma, Hodgkin’s lymphoma, non-small cell lung cancer, and brain cancer. According to a review paper on this topic, common side effects can include “toxicity to white blood cells, nausea, vomiting, constipation, dyspnea, chest or tumor pain, wheezing, fever, antidiuretic hormone secretion, weight loss.”
Vincristine
The clinical use of vincristine is somewhat limited by the risks for severe neurotoxicity, however it has proven very useful in the clinical management of numerous cancers. According to a review on this subject, vincristine is used to treat “Philadelphia chromosome-negative acute lymphoblastic leukemia, B-cell lymphoma, metastatic melanoma, estrogen-receptor negative breast cancer, glioma, colorectal cancer, non-Hodgkin’s lymphoma Hodgkin’s lymphoma, neuroblastoma, rhabdomyosarcoma, multiple myeloma, and Wilms’ tumor.” Common side effects include “peripheral neuropathy, nausea, vomiting, diarrhea, bloating, stomach/abdominal pain or cramps, mouth sores, dizziness, headache, hair loss, constipation, loss of appetite, changes in sense of taste, and weight loss.”
Tackling Treatment Resistance
Cancer cells can become resistant to certain treatments, and to overcome the risk of resistance to Vinca alkaloid therapy, cocktail approaches have emerged in which drugs with different mechanisms of action are combined to take a multidirectional attack on the cancer. In the case of my loved one, they will receive vincristine as part of a cocktail of both chemotherapy and immunotherapy drugs to treat their cancer.
The Takeaway
Cancer is a difficult diagnosis to deal with both for patients and their families. The National Cancer Institute offers excellent resources to patients, such as this site dedicated to non-Hodgkin lymphoma.
I’m encouraged by the great leaps that biomedical scientists have made in pushing state-of-the-art therapies forward. Importantly, cancer is not something to be treated with plants alone. Still, plant-derived molecules can play an essential role in the treatment process, as we’ve seen in combination therapies involving the Vinca alkaloids. I remain hopeful for the full recovery of my loved one undergoing this treatment process for their cancer.
Yours in health, Dr. Quave
Cassandra L. Quave, Ph.D. is a scientist, author, speaker, podcast host, wife, mother, explorer, and professor at Emory University School of Medicine. She teaches college courses and leads a group of research scientists studying medicinal plants to find new life-saving drugs from nature. She hosts the Foodie Pharmacology podcast and writes the Nature’s Pharmacy newsletter to share the science behind natural medicines. To support her effort, consider a paid or founding subscription, with founding members receiving an autographed 1st edition hardcover copy of her book, The Plant Hunter.
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Having lost a loved one to cancer, after they had tried every therapy under the sun (surgical removal, chemotherapy, immunotherapy, experimental treatments, radiation, and more I've forgotten), the role plants have played in modern medicine deserves to be expounded. If more people knew about where their treatments come from, the inevitable question becomes, "well, what about more plants?". Well done.