Urinary tract cancers
related to use of adulterated Chinese formula
Cytoscopic examinations revealed a high
incidence of urinary tract cancer in Belgians exposed to Aristolochia
fangchi through consumption of Chinese weight-loss pills.
The 39 people studied all had end-stage renal nephropathy caused
by consumption of the adulterated Chinese formula and agreed to
the cancer screening as a preventive measure. Among the patients,
the researchers detected 18 cases of urothelial carcinoma; 17
cases of cancer of the ureter, renal pelvis, or both; and one
papillary bladder tumor. Nineteen of the remaining participants
displayed mild-to-moderate urothelial dysplasia, and two were
normal. Total consumption of more than 200 g Aristolochia
over time was associated with significantly higher cancer risk.
The presence of Aristolochia fangchi in the Chinese formula
is believed to be due to a manufacturing error in which the toxic
herb was accidentally substituted for Stephania tetrandi.
In an editorial published in the same issue of New England
Journal of Medicine as the study, former FDA chief David Kessler
admonished, "Examples like that described by Nortier et al.
should persuade Congress to change the law to ensure the safety
and efficacy of dietary supplements before more people are harmed."
Nortier JL, Martinez M-C, Schmeiser HH, et al. Urothelial carcinoma
associated with the use of a Chinese herb (Aristolochia fangchi).
New England Journal of Medicine 2000; 342: 1686-1743.
© 2003 by Herb Research Foundation,
Boulder, CO, USA.