The prostate gland is a major source of serious health problems for men. It is susceptible to the most common chronic inflammatory condition, benign prostatic hyperplasia (BPH), and prostate cancer is the most common malignancy. Age is a key risk factor for both BPH and prostate cancer, but diet, physical activity, and exposure to toxins also contribute to risk. BPH is specifically associated with hormonal changes that occur as men age. Family history is a predictor of prostate cancer.

Chronic inflammation is itself a risk factor for cancer and there is evidence that BPH is a forerunner of prostate cancer. At the molecular level, alterations in DNA structure characteristic of all cancers, are detected in the DNA from BPH tissues independently of the more extensive damage seen in the DNA from prostate tumors [1]. At the level of therapy, two plant extracts (Pao pereira and Rauwolfia vomitoria) that react with this damaged DNA and induce apoptosis in cancer cells have demonstrated effectiveness against prostate cancer and advanced prostate cancer [2-5]. Recent research from Dr. Jun Yan’s laboratory at Nanjing University, sponsored by the Beljanski Foundation, shows that both extracts are also remarkably effective for BPH in an animal model: the androgen imbalance seen in older men is corrected, the prostate is reduced to normal size and the inflammatory condition is directly suppressed [6-9]. The effects of the extracts demonstrate that BPH is reversible.

In Benign Prostatic Hyperplasia, a chronic inflammation that causes prostate enlargement, Rauwolfia vomitoria extract triggers persistent autophagy that leads to death of BPH cells by apoptosis. The result is that BPH cells are removed from the body. Normally, cells maintain homeostasis by recycling their proteins and organelles using a process called autophagy—literally “self-digestion”. Autophagy promotes the survival of cells that contain defective proteins or structures: the recovered components can be reused to make healthy proteins and structures. In BPH, Rauwolfia extract induces an extension of the self-digestion process called autophagic apoptosis, which ends in BPH cell death. For the serious inflammation in Benign Prostatic Hyperplasia, induction of autophagic apoptosis is just what the doctor ordered and Rauwolfia extract does it! Rauwolfia extract is likely to trigger this mechanism in precancerous inflammations in other hormonally regulated tissues such as breast.

We investigated Rauwolfia vomitoria extract as a therapeutic option for benign prostatic hyperplasia, a common disease in older men with serious impact on quality of life. The oral administration of the Rauwolfia extract significantly reduced prostate weight in animals with BPH, which is shown by the decreased thickness of the prostate epithelial layer. Similar effects were observed in the BPH animals treated with finasteride. The Rauwolfia extract significantly reduced the level of androgen receptor and 5 alpha reductase as well as testosterone-induced proliferation markers — Proliferating cell nuclear antigen (PCNA) and Cyclin D1. As evidence of its lack of side effects, Rauwolfia did not reduce sperm counts whereas Finasteride did.

The poor treatment outcomes of pancreatic cancer are linked to an enrichment of cancer stem cells (CSCs) in these tumors, which are resistant to chemotherapy and promote metastasis and tumor recurrence. In these experiments, the pancreatic CSC population, identified using cell surface markers or a tumor spheroid formation assay, was significantly reduced by the Rauwolfia vomitoria extract. In vivo the Rauwolfia extract significantly reduced the tumorigenicity of pancreatic cancer cells. Taken together, these data showed that Rauwolfia preferentially inhibited pancreatic cancer stem cells.

Cancer stem cells are a type of stem cell specific to cancer, that is able to reproduce through self-renewal and regeneration into new tumor cells. Cancer stem cells are thought to survive chemotherapy treatments and provide the basis for tumor regrowth. It is critical to find treatments for cancer stem cells to prevent this disease from resurfacing in a person again and again. Research conducted at Kansas University Medical Center concluded that both the Pao pereira (Pau pereira) and Rauwolfia vomitoria extracts inhibited the proliferation of multiple human ovarian cancer cell lines in vitro.

Research conducted at the University of Kansas Medical Center concluded that Rauwolfia vomitoria was effective against ovarian cancer cells both alone and in combination with carboplatin. The combination decreased tumor size in animal experiments by 87 to 90%. The authors conclude that, “Rauwolfia vomitoria has potent antitumor activity and in combination significantly enhances the effect of carboplatin against ovarian cancer.”

In preclinical pancreatic cancer models, Rauwolfia vomitoria extract induced apoptosis in pancreatic cancer cells in a dose-dependent manner. The combination of Rauwolfia extract and gemcitabine had a synergistic effect in inhibiting cell growth. Pancreatic tumor growth was significantly suppressed by Rauwolfia treatment and metastasis was inhibited as well. Adding Rauwolfia extract to gemcitabine treatment further reduced tumor burden and metastatic potential in the gemcitabine resistant tumors. These data suggest that Rau possesses anti–pancreatic cancer activity and could improve the effect of gemcitabine.

The tropical shrub, Rauwolfia vomitoria, is a medicinal plant used traditionally to treat a variety of ailments. A bioactive ß-carboline alkaloid, alstonine, present in this extract was previously shown to have anti-cancer activity against cancer cell lines. This study considers the potential anti-prostate cancer activity of this extract in vitro and in vivo. Rauwolfia vomitoria extract standardized for ß-carboline alkaloids was tested for ability to influence the growth and survival of the human LNCaP prostate cancer cell line. A WST-1 assay was used to measure cell growth, and cell cycle analyses were conducted with flow cytometry. Western blot detection of PARP cleavage and accumulation of cells containing subgenomic DNA indicated induction of apoptosis. Pathway specific microarray analyses were utilized to identify the effect of Rauwolfia extract on the expression of 225 genes. Mice xenografted with LNCaP cells were treated with the extract or placebo control, and tumor growth was measured for 5 weeks.