According to preliminary data, administration of curcumin diminishes the severity of radiation dermatitis, a common adverse event in cancer patients who are receiving radiation therapy.
Rochester, N.Y. - The administration of a component of turmeric may assist in treating the dermatitis that results from radiation therapy, according to pilot research presented at the 2009 annual meeting of the Society for Investigative Dermatology.
Radiation dermatitis is highly common in cancer patients, occurring in nearly 95 percent of those who receive radiation therapy, notes Julie Ryan, Ph.D., M.P.H., the study's lead investigator and assistant professor, departments of dermatology and radiation oncology, University of Rochester, Rochester, N.Y. Patients receiving radiation for breast cancer, head and neck cancer, and lung cancer typically get severe radiation dermatitis, she says.
Moreover, two-thirds of patients who develop radiation dermatitis have higher than grade 2 severity, indicating that they are experiencing pain, according to Dr. Ryan.
"This is an ongoing clinical trial," Dr. Ryan says. "Breast cancer patients are randomized to either placebo or curcumin."
Patients take six grams of curcumin or placebo, in the form of 12 500 mg capsules daily. Patients take the capsules in split doses, either twice per day (six capsules each time) or three times per day (four capsules each time). Patients need to take large doses because curcumin is not readily bioavailable, Dr. Ryan says.
"They need to ingest at least four grams to get it in the bloodstream," she explains. "We give more just to make sure it is getting into the bloodstream. Based on research, patients can take up to 10 or 12 grams daily before they start experiencing gastrointestinal side effects."
It is suggested that patients take curcumin with food to assist with absorption, according to Dr. Ryan, whose pilot study is still recruiting participants.
Scoring study results
Investigators use a radiation dermatitis scoring scale that measures redness or erythema as well as whether there is dry or moist desquamation. Patients also complete the McGill Pain Questionnaire to provide a description of the pain at the treatment site where there is radiation dermatitis.
"We gain a better understanding of what the patient is experiencing, whether it is burning or tender, using this questionnaire," she says.
Dr. Ryan notes that radiation for breast cancer is delivered in several forms, including chest wall irradiation, whole breast irradiation and partial breast irradiation (a newer type of irradiation therapy) for early-stage breast cancer patients. There were no patients who received partial breast irradiation in this study.
An interim analysis of nine study patients who completed the clinical trial showed that curcumin markedly decreased the severity of dermatitis (p=0.018) but did not decrease redness (p=0.084) in the six patients who were receiving whole breast irradiation, compared to those who received placebo. Further analyses indicate curcumin may also relieve pain at the treatment site (p=0.055).
Curcumin did not significantly reduce the severity of radiation dermatitis in the three patients who received chest wall irradiation, compared to patients who received placebo.
"There is a certain radiation dose to the skin where curcumin will no longer be effective," Dr. Ryan says.
Redness that did occur was not a result of curcumin therapy, she adds. "The curcumin appears to keep the skin intact. You are not getting moist desquamation, but you are getting redness from radiation."
Patients complain chiefly about burning, itching and tenderness due to radiation dermatitis. "It is uncomfortable if clothes rub against the area," Dr. Ryan explains.
In patients of color, desquamation can lead to hypopigmentation, so white patches occur on the skin. Some of the visual changes that can occur down the road include scarring and fibrosis, Dr. Ryan notes.
Once the pilot study is completed, Dr. Ryan and colleagues intend to conduct a larger study, as well as test the efficacy of topical administration.
Diclosure: Dr. Ryan reports no relevant financial disclosures.