Written by Katja Boehm and the CAM-Cancer Consortium.
Updated February 8, 2017

Essiac

What is it?

Scientific name / brand name / common name

Essiac tea has been used for over 70 years as a remedy for the adverse effects caused by conventional cancer treatments and supposedly for curing cancer itself. The name ‘Essiac’ was created by the Canadian nurse Renée M. Caisse (‘Essiac’ is ‘Caisse’ spelled backwards)1-3. Other Essiac products are known as Flor-Essence®.

Ingredients

The four herbs contained in Essiac® are:
• Burdock root (Arctium lappa L.),
• Indian rhubarb root (Rheum officinale L.),
• Sorrel (Rumex acetosa L.)
• Slippery elm bark (Ulmus rubra/fulva Muhl.)

A modified Essiac product (Flor-Essence®) also includes the following four additional herbs:
• Watercress (Nasturtium officinale L.),
• Blessed thistle (Centaurea = Cnicus benedictus L.),
• Red clover (Trifolium pratense L.) and
• Kelp (Laminaria digitata).

History / providers

According to Renée Caisse, an English miner’s wife had received the recipe for Essiac from a Native Ojibwa Indian medicine man, and had cured her breast cancer with this treatment. Renée Caisse, who worked at the Bracebridge Cancer Clinic in Ontario, Canada from 1935 to 1941, treated cancer patients with Essiac herbal tea for 50 years.

In 1938, concerns about the use of Essiac were raised, after evidence of one reported death and one report of toxicity after Essiac tea injections emerged4,5. In 1941, the Bracebridge Cancer Clinic was closed following a request by the Canadian authorities. Between 1959 and 1978 Caisse worked with Dr Charles Armao Brusch, director of the Brusch Medical Clinic in Cambridge, Massachusetts, in the US, to modify the original recipe and promote the use of Essiac. After carrying out some laboratory studies on mice, four further herbs were added to the recipe (see above) to improve the healing action and taste of Essiac. In 1977 Mrs Caisse sold the original Essiac recipe to Resperin Corporation Ltd of Toronto, Canada.

In 1982 the Resperin Corporation Ltd carried out some poorly designed trials in which physicians using the product were asked to submit case reports. The Canadian Department of National Health and Welfare terminated the tests, claiming that Resperin had conducted a poorly conceived and executed investigation. Health Canada concluded that the evidence was unconvincing and that there was no scientific evidence to support claims that Essiac could cure cancer6. However, under the Canadian Emergency Drug Release Programme, Essiac could be obtained on physician’s request. In 1995 the Essiac formula and its trademark were purchased from Resperin Corporation Ltd by David Dobbie. Thus, Essiac® Products Inc of New Brunswick became the manufacturer of Essiac®. Another Canadian product, Flor-Essence®, is manufactured in British Columbia, where Charles Armao Brusch is involved in using the eight herbs of the modified Essiac formula. Nowadays, more than 40 different formulas of Essiac are available globally.

Claims of efficacy / mechanisms of action / alleged indication

Renée Caisse documents her view of how Essiac affects the cancer process as follows: after enlarging and hardening of the tumour following the first few treatments, tumour softens and, if the tumour was located near an exterior route, the patient discharges large amounts of pus and fleshy material. She believed that somehow Essiac would cause cancerous cells to retreat to the site of the original tumour where they would then shrink and vanish.

Charles A Brusch claimed that Essiac works by identifying toxins, gathering them, breaking them down and discharging them. He also suggested that in an unpublished double-blinded study carried out by his institute, positive results were observed including pain cessation, increased appetite, improved sleep, well-being and energy, decreased depression, anxiety and fear and a decrease in nodular masses.

The explanations put forward for a mechanism of the therapy are not supported by good evidence, nor are they deemed a possible and sufficient explanation by current scientific standards.

Application and dosage

The tea is usually taken 1-3 times before meals to minimise possible adverse effects such as nausea, vomiting and diarrhoea. Initially, Caisse administered one of the herbs by injection and gave the others as tea. Nowadays, most products are in tea form but other products also exist in the form of drops, capsules, liquids and dry versions. The patient is supposed to boil the mixture and then drink the tea. The patient information also advises that no other treatment, including chemotherapy and radiotherapy, should be used while taking Essiac.

Prevalence of use

In 1982 when Canadian health officials conducted a retrospective review of Canadian patients treated with Essiac they found that about 150 physicians in Canada had at that stage reportedly requested supplies of Essiac on behalf of their cancer patients7. In a Canadian survey from 2000 among women with breast cancer 15% reported using Essiac (ResperinTM, Canada Limited)8. Two further surveys were carried out in the USA and targeted specifically at Flor-Essence® users in order to quantify its use, it was found that among the 5051 respondents 22% were diagnosed with breast cancer9,10. Finally, in a survey at the Royal Marsden Hospital in London, UK 318 cancer patients were asked about their use of Essiac and 6% reported using Essiac11.

Legal issues

Essiac cannot be marketed as a drug because it has no licence. It is therefore usually sold as a nutritional supplement. In Canada, Essiac is currently unapproved for marketing and cannot be used in clinical trials without a valid preclinical new drug submission. However, the Canadian government allows Essiac to be manufactured and sold. Manufacturers are not allowed to make any medical claims, instead Essiac is promoted as a health-enhancing herbal tea. Patients who wish to obtain Essiac must ask their physician to make a request to the Canadian Bureau of Human Prescription Drugs, which relays the order to the company and the company then ships it directly to the patient.

Costs

Essiac products vary in price from €4.15 to hundreds of Euros per month for pre-made bottled blends. A pre-fabricated Essiac tea can range from €15.00 to €24.00 per ounce bottle. A higher price does not necessarily indicate higher quality of the product.

Citation

Katja Boehm, CAM-Cancer Consortium. Essiac [online document]. http://cam-cancer.org/The-Summaries/Herbal-products/Essiac. February 8, 2017.

Document history

Assessed as up to date in February 2017 by Barbara Wider.
Assessed as up to date in April 2016 by Barbara Wider.
Assessed as up to date in January 2015 by Barbara Wider.
Assessed as up to date in February 2013 by Katja Boehm.
Fully revised and updated in December 2011 by Katja Boehm.
Fully revised and updated in August 2009 by Katja Boehm.
Summary first published in May 2005, authored by Katja Boehm and Edzard Ernst.

References

  1. Kaegi E. Unconventional therapies for cancer: 1. Essiac. The Task Force on Alternative Therapies of the Canadian Breast Cancer Research Initiative. CMAJ 1998;158:897-902.
  2. Boon H, Wong J. Botanical medicine and cancer: a review of the safety and efficacy. Expert Opin Pharmacother 2004;5:2485-501.
  3. Tai J, Cheung S, Wong S, Lowe C. In vitro comparison of Essiac and Flor-Essence on human tumor cell lines. Oncol Rep 2004;11:471-6.
  4. Thomas R. The Essiac report: The True Story of a Canadian Herbal Cancer Remedy and of the Thousands of Lives it Continues to Save, 3rd ed. Los Angeles: Alternative Treatment Information Networks, 1993.
  5. Meehan D, Agar J. Doctor’s license suspended; some patients still support him. The Grand Rapids Press, April 18th, 1997:12.
  6. NIH National Cancer Institute. Essiac/Flor Essence PDQ. [Online documents]. Available at: https://www.cancer.gov/about-cancer/treatment/cam/hp/essiac-pdq#cit/section_3.4, accessed 8 February 2017. 
  7. Henderson IWD. Director, Bureau of Human Prescription Drugs, Health Protection Branch, Health and Welfare Canada, Vanier, Ontario. Letter to J.W. Meakin. Executive Director, Ontario Cancer Treatment and Research Foundation, Toronto, Ontario, November 19th 1982.
  8. Boon H. Use of complementary / alternative medicine by breast cancer survivors in Ontario: Prevalence and perceptions. J Clin Oncol 2000;18:2515 – 2521.
  9. Low Dog T. Traditional and alternative therapies for breast cancer. Altern Ther Health Med 2001; 7:36-47.
  10. Tamayo C, Richardson M. Presentation at 36th Annual Drug Information Association Meeting. Baltimore, MD, June 17-21, 1999.
  11. Morita H, et al. Cytotoxic and mutagenic effects of emodin on cultured mouse carcinoma FM3A cells. Mutat Res 1988;204:329-32.
  12. Ulbricht C, Weissner W, Hashmi S, Rae Abrams T, Dacey C, Giese N, Hammerness P, Hackman DA, Kim J, Nealon A, Voloshin R. Essiac: systematic review by the natural standard research collaboration. J Soc Integr Oncol 2009;7(2):73-80.
  13. Zick SM, Sen A, Feng Y, Green J, Olatunde S, Boon H. Trial of Essiac to ascertain its effect in women with breast cancer (TEA-BC). Journal of Alternative and Complementary Medicine 2006;12(10):971-80.
  14. Hutchinson DJ. Experimental Chemotherapy, Memorial Sloan-Kettering Cancer Center, Rye, N, personal communication, September 26, 1988 and March 1989.
  15. Glun GL. Essiac. Nature’s cure for cancer. Wildfire 1991:6:48-55.
  16. Foldeak S, Dombradi GA. Tumor-Growth Inhibiting Substances of Plant Origin. I. Isolation of the Active Principle of Arctium lappa. Acta Phys Chem 1964;10:91- 93.
  17. Dombradi CA, Foldeak S. Screening Report on the Antitumor Activity of Purified Arctium Lappa Extracts. Tumori 1966;52:173.
  18. Itokawa H, Watanabe K, Mihara K. Screening Test for Antitumor Activity of Crude Drugs (2). Shoyakugaku Zasshi 1982;36:145-9.
  19. Woo WS, Lee EB, Chang I. Biological Evaluation of Korean Medicinal Plants. II. Yakhak Hoe Chi 1977;21:177-183.
  20. Morita K, Kada T, Namiki M. A desmutagenic factor isolated from burdock (Arctium lappa Linne). Mutat Res 1984;129:25-31.
  21. US Congress, Office of Technology Assessment: Unconventional Cancer Treatments. Washington, DC: U.S. Government Printing Office, 1990. OTA-H-405, pp 71-5.
  22. Belkin M, Fitzgerald DB. Tumor-Damaging Capacity of Plant Materials. 1. Plants Used as Cathartics. J Natl Cancer Inst 1952;13:139-155.
  23. Kupchan SM, Karim A. Tumor inhibitors. 114. Aloe emodin: antileukemic principle isolated from Rhamnus frangula L. Lloydia 1976;39:223-4.
  24. Pettit GR, Blazer RM, Reierson DA. Antineoplastic agents. 51. The yellow jacket Vespula pensylvanica Lloydia 1977;40(3):247-52.
  25. Leonard BJ, Kennedy DA, Cheng FC, Chang KK, Seely D, Mills E: An in vivo analysis of the herbal compound essiac. Anticancer Res 2006; 26(4B):3057-3063.
  26. Kulp KS, Montgomery JL, Nelson DO, Cutter B, Latham ER, Shattuck DL, Klotz DM, Bennett LM. Essiac and Flor-Essence herbal tonics stimulate the in vitro growth of human breast cancer cells. Breast Cancer Res Treat 2006; 98(3):249-59.
  27. Seely D, Kennedy DA, Myers SP, Cheras PA, Lin D, Li R, Cattley T, Brent PA, Mills E, Leonard BJ: In vitro analysis of the herbal compound Essiac. Anticancer Res 2007; 27(6B):3875-3882.
  28. Eberding A, Madera C, Xie S, Wood CA, Brown PN, Guns ES: Evaluation of the antiproliferative effects of Essiac on in vitro and in vivo models of prostate cancer compared to paclitaxel. Nutr Cancer 2007; 58(2):188-196.
  29. Rodriguez P, Blanco J, Juste S, et al. Allergic contact dermatitis due to burdock (Arctium lappa). Contact Dermatitis 1995;33:134-5.
  30. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.
  31. Natural Medicines Comprehensive Database. Essiac. https://naturalmedicines.therapeuticresearch.com/ (accessed 8 February 2017).
  32. Sasaki Y, Kimura Y, Tsunoda T, Tagami H. Anaphylaxis due to burdock. Int J Dermatol 2003;42:472-3.
  33. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  34. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  35. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  36. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  37. Bolton-Smith C, Price RJ, Fenton ST, et al. Compilation of a provisional UK database for the phylloquinone (vitamin K1) content of foods. Br J Nutr 2000;83:389-99.
  38. Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther Health Med 2001;7:S33.
  39. Nelsen J, Barrette E, Tsouronix C, et al. Red clover (Trifolium pratense) monograph: A clinical decision support tool. J Herbal Pharmacotherapy 2002;2:49-72.
  40. This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34.
  41. Baker DH. Iodine toxicity and its amelioration. Exp Biol Med (Maywood) 2004;229:473-8.
  42. Phaneuf D, Cote I, Dumas P, et al. Evaluation of the contamination of marine algae (Seaweed) from the St. Lawrence River and likely to be consumed by humans. Environ Res 1999;80:S175-S182.