Cervical Dysplasia
• None
• Black Cohosh , Blessed Thistle , Dehydroepiandrosterone (DHEA) , Diindolylmethane , "Emmenagogue" Herb, False Unicorn , Folate , Indole-3-Carbinol , Motherwort , Multivitamin and Mineral Supplement , Selenium , Squaw Vine, True Unicorn
Very few cancers can be identified so far ahead of the danger point as cancer of the cervix. A decade or more before invasive cancer develops, the cells lining the surface of the cervix begin to show changes visible under a microscope—in plenty of time for definitive treatment. For this reason, a regular, properly performed and interpreted Pap smear is one of medicine's most effective preventive methods.
The stages of progression from a healthy cervix to cancer begin with what is called mild dysplasia: precancerous alterations in structure and activity. Prolonged infection with human papilloma virus (HPV) is thought to be the primary cause of these changes. Subsequently, altered cells spread from the surface of the cervix down toward the underlying tissue. In the early stages, cancerous changes may disappear on their own, but once these cells fully penetrate the lining, progression to true cancer usually occurs within 5 to 10 years.
Medical treatment consists of watchful waiting for spontaneous regression during the early stages of dysplasia and, if no regression occurs, more aggressive removal of the cervical lining by laser, freezing, or other techniques. These options are usually successful; however, they are invasive and frequently uncomfortable.
The vaccine for preventing HPV infection is expected to markedly reduce cervical cancer risk.
Proposed Natural Treatments
It has been claimed that various natural herbs and supplements can improve the odds of early stages of dysplasia changing back to normal cells. If your physician suggests watchful waiting and a repeat examination, it should be safe to try some of these methods during the waiting period. However, there is no reliable scientific evidence that these treatments are effective, and in all circumstances close medical supervision is necessary to verify good results or identify failure. Alternative treatment is definitely not advisable for advanced cervical dysplasia.
Folate deficiency is thought to increase the ease with which cervical cancer can develop. However, taking extra folate does not appear to reverse cervical dysplasia once it has occurred. 1,2
Indole-3-carbinol (I3C) is a substance found in broccoli-family vegetables. One small double-blind, placebo-controlled trial found evidence that I3C at a dose of 200 or 400 mg per day can improve the chances of cervical dysplasia returning to normal by itself. 3 The related substance, diindolylmethane , might also offer benefit. 12
Observational studies have found that women with cervical dysplasia tend to show a high frequency of general nutritional deficiencies, as high as 67% in one survey. 4 Particular vitamin deficiencies most closely associated with cervical dysplasia include beta-carotene , vitamin C , vitamin B 6 , selenium , and, as previously mentioned, folate . 5,6 However, observational studies are notoriously unreliable; it is quite possible, for example, that people who do not eat healthily also have other risk factors for cervical dysplasia. Only double-blind, placebo-controlled studies can actually show a treatment effective, and these have so far not been promising. For example, a double-blind placebo-controlled study of 141 women found that neither vitamin C nor beta-carotene supplements taken daily in doses of 500 mg and 30 mg, respectively, could reverse cervical dysplasia. 7 Negative results were also seen in studies that investigated beta-carotene by itself. 8,9,10
Some practitioners of herbal medicine feel that a class of herbs known as emmenagogues can be helpful in cervical dysplasia. These include squaw vine, motherwort , true unicorn, false unicorn , black cohosh , and blessed thistle . However, there is no meaningful scientific evidence to indicate that any of there herbs are effective for cervical dysplasia.
Vaginal use of the hormone dehydroepiandrosterone (DHEA) has also been suggested for the treatment early cervical dysplasia, 11 but as yet no controlled studies have been reported.
References
1. Butterworth CE Jr, Hatch KD, Gore H, et al. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr . 1982;35:73-82.
2. Butterworth CE Jr, Hatch KD, Soong SJ, et al. Oral folic acid supplementation for cervical dysplasia: a clinical intervention trial. Am J Obstet Gynecol . 1992;166:803-809.
3. Bell MC, Crowley-Nowick P, Bradlow HL, et al. Placebo-controlled trial of indole-3-carbinol in the treatment of CIN. Gynecol Oncol 2000;78:123-129.
4. Orr JW, Wilson K, Bodiford C, et al. Nutritional status of patients with untreated cervical cancer. I. Biochemical and immunologic assessment. Am J Obstet Gynecol . 1985;151:625-631.
5. Romney SL, Palan PR, Basu J, et al. Nutrient antioxidants in the pathogenesis and prevention of cervical dysplasias and cancer. J Cell Biochem Suppl . 1995;23:96-103.
6. Butterworth CE Jr. Effect of folate on cervical cancer. Synergism among risk factors. Ann N Y Acad Sci . 1992;669:293-299.
7. Mackerras D, Irwig L, Simpson JM, et al. Randomized double-blind trial of beta-carotene and vitamin C in women with minor cervical abnormalities. Br J Cancer. 1999;79:1448-1453.
8. Keefe KA, Schell MJ, Brewer C, et al. A randomized, double blind, phase III trial using oral beta-carotene supplementation for women with high-grade cervical intraepithelial neoplasia. Cancer Epidemiol Biomarkers Prev. 2001;10:1029-1035.
9. Romney SL, Ho GY, Palan PR, et al. Effects of beta-carotene and other factors on outcome of cervical dysplasia and human papillomavirus infection. Gynecol Oncol . 1997;65:483-492.
10. Fairley CK, Tabrizi SN, Chen S, et al. A randomized clinical trial of beta carotene vs placebo for the treatment of cervical HPV infection. Int J Gynecol Cancer . 1996;6:225-230.
11. Suh-Burgmann E, Sivret J, Duska LR, et al. Long-term administration of intravaginal dehydroepiandrosterone on regression of low-grade cervical dysplasia—a pilot study. Gynecol Obstet Invest . 2003:55:25-31.
12. Chen DZ, Qi M, Auborn KJ, Carter TH. Indole-3-carbinol and diindolylmethane induce apoptosis of human cervical cancer cells and in murine HPV16-transgenic preneoplastic cervical epithelium. J Nutr. 2001;131:3294-302.
Last reviewed April 2009 by EBSCO Medical Review Board
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