Carctol | Cam-Cancer

Carctol

Abstract and key points

Carctol® is an Ayurvedic herbal mixture consisting of eight herbal extracts, which was developed by Dr Nandlal Tiwari in India.

Its promoters claim that it cures cancer and alleviates adverse effects caused by chemo- and radiotherapy. These claims are, however, not supported by evidence, as not a single clinical trial has so far been carried out.

The safety of Carctol® is uncertain. Although there are no safety issues on record for the combination product, adverse events and interactions have been reported for the individual plants it contains.

Read about the regulation, supervision and reimbursement of herbal medicine at NAFKAMs website CAM Regulation.

Document history

Revised and updated in June 2019 by Barbara Wider.
Assessed as up to date in January 2016 by Barbara Wider.
Assessed as up to date in January 2015 by Barbara Wider.
Assessed as up to date in August 2013 by Barbara Wider.
Last updated in March 2012 by Katja Boehm.
Updated and revised in January 2011 by Katja Boehm.
Fully updated and revised in October 2009 by Katja Boehm.
Summary first published in September 2005, authored by Katja Boehm.

Citation

Katja Boehm, CAM-Cancer Consortium. Carctol® [online document], http://cam-cancer.org/en/carctol. June 4th, 2019.

What is it?

Scientific name / brand name / common name

Carctol® is a mixture of eight powdered herbal extracts developed by the Indian doctor Nandlal Tiwari1.

Ingredients

A 560mg capsule of Carctol® contains the following ingredients2:

1. Blephapharis edulis 200mg

2. Piper cubeba Linn 120mg 

3. Smilax China Linn 80mg 

4. Hemidesmus indicus 20mg 

5. Tribulus terrestris 20mg 

6. Ammannia baccifera Linn 20mg 

7. Lepidium sativum Linn 20mg 

8. Rheum emodi wall 20mg 

No independent analyses of the product are available.

Application and dosage

According to the Carctol® Dr Nandlal Tiwari Pharmaceuticals website, the recommended daily dosage of Carctol® for adults is between 4 and 8 capsules. It is supposed to be taken in parallel with an acid-free, vegetarian diet and needs to be accompanied by digestion-assisting enzymes. Additionally, patients are advised to drink “pre-boiled and then cooled water” as much as possible. Carctol® must be administered strictly, as per dosage schedule, for at least 60 days for an initial response. They are then to be continued as per physician’s advice3.

History / providers

Carctol® was developed by the Indian doctor Nandlal Tiwari (Rajasthan, India). Tiwari is an Ayurvedic medicine doctor who first started promoting Carctol® in 1968 alongside dietary changes. He investigated the effect of indigenous herbs in the forest of Assam by gathering information provided by the tribes there, developed the herbal mixture and allegedly tested it on cancer patients for over 20 years. Tiwari describes Carctol® as "a gift of timeless knowledge of Ayurveda, the complete science of perfection in life specially to Cancer4".

Previously, the official Carctol® website published a list of UK doctors who prescribed Carctol® as an Ayurvedic cancer remedy and in Europe Carctol® was only available through these specific UK doctors5.

However, “Ayurvedic medicine” implies it has a track record of traditional use, which this is not the case for Carctol®. The current Carctol® website no longer contains this information. Carctol® is still available over the internet in India6.

Claims of efficacy / alleged indication

Carctol® is advocated by its promoters to strengthen the immune system, regain physical strength and normal body function over a period of time4. It is specially indicated in cancer; the manufacturers claim that “Carctol® is a general healer of all kinds of tumors. It also treats and removes all the symptoms and side effects caused by chemotherapy and radiotherapy”. […] “30 to 40% patients who come under Carctol®'s control are generally cured and the rest do not [sic]. In other cases, where there might not be a complete healing of cancer, there are strong chances of a significant improvement3".

The official Carctol® website claims that 1,900 terminal-stage cancer patients were treated with Carctol® by Dr Tiwari between 1985 and 1989. The treatment outcomes are reported in a graph plotting the total number of cases against the percentage of response rate in terms of improvements of symptoms (not specified) categorised by each type of cancer7.  The presented data are inconclusive at best and do not support Tiwari’s claim that 30-40% of patients are cured, particularly as all patients left follow up after 2 years.

In 2004, Dr Rosy Daniel in the UK claimed to have prescribed the herbal remedy to 860 cancer patients before and after chemotherapy8,9. At the time Dr Daniel continued to be in touch with about a quarter of these patients and claimed their cancers had not progressed or in some cases have shrunk or disappeared, although she had not audited the patients. Again, none of these claims have been published in the scientific literature.

Mechanisms of action

Promoters of Carctol® claim that the combination of herbs causes the anti-carcinogenic activity of Carctol® through a synergistic effect. According to Dr Tiwari, Carctol® works by eliminating acids in the body. In combination with dietary changes it allegedly changes the pH in the body from acid to alkaline by creating an alkaline environment within the body, in which acidic cancer cells cannot survive3.

Prevalence of use

No data exist to estimate the use of Carctol® by cancer patients.

Legal issues

No current information on the regulatory status of Carctol® could be found. Previously, Carctol® had been classified as an unlicensed medicine by the Medicines and Healthcare products Regulatory Agency (MHRA).

Costs and expenditures

The cost of Carctol® are only available upon request6. Previously, a month’s supply of Carctol® has been indicated at around EUR 135 (GBP 90) plus shipping and VAT8. The digestive enzymes patients are recommended to take at the same time cost EUR 14 per month. The time span recommended for using the product initially is two months.

Does it work?

Clinical trials and pre-clinical studies

No published clinical or pre-clinical trials of Carctol® could be found. The only article published in the scientific peer-reviewed literature did not find any studies on Carctol® and concluded that “the claim that Carctol® is of any benefit to cancer patients is not supported by scientific evidence10".

Case reports/series

No case reports published in the peer-reviewed literature could been found.

Is it safe?

The safety of Carctol® has not been systematically assessed. The distributors of the remedy claim that Carctol® is not associated with adverse effects or herb-drug interactions but these claims are based on the misconception that “obtained and made from completely natural resources, it [Carctol] can never cause any harm or side effects"3,11These do not necessarily refer to the dosages used in Carctol®.

Adverse effects

No adverse effects of Carctol® have been reported. The official Carctol® website publishes reports of laboratory-based toxicological testing in mice and rats at the All India Institute of Medical Sciences, which shows no risk of toxicities, as well as a certificate of analysis from the Lyne, Martin and Radford laboratories in London, UK12. However, no pre-clinical study assessing the toxicity of Carctol® has been published in the medical literature.

One of the ingredients of Carctol®, Rheum emodi, has been associated with GI discomfort and uterine contractions. Long-term use can result in muscular weakness, bone loss, potassium loss, and irregular heart rhythm. When consuming Hemidesmus indicus in excessive amounts, gastrointestinal (GI) irritation or temporary kidney impairment may occur due to its saponin constituents. Orally, ingesting large amounts of Lepidium sativum may cause GI irritations. Piper cubeba and Tribulus terrestris can have psychoactive effects11.

Contraindications

None known.

Interactions

Hemidesmus indicus may interact with heart medication as it may increase digitalis glycoside absorption. Theoretically, due to reports that Piper cubeba increases stomach acid, it might decrease the effectiveness of antacids and proton pump inhibitors. Theoretically, Tribulus terrestris might enhance the blood glucose-lowering effect of hypoglycaemic drugs. Concurrent use of Rheum might decrease mineral absorption. Overuse might cause potassium depletion, increasing the risk of cardio toxicity and digoxin toxicity11.

Precautions/warnings

Patients are advised to drink large amounts of water each day. There is no data on the use of Carctol during pregnancy and lactation.

Quality issues

There are no independent assessments of the quality of Carctol®.

References
  1. Carctol Official Website, Dr Nandlal Tiwari Pharmaceuticals. Carctol home, accessed 3rd June 2019.
  2. Carctol Official Website, Dr Nandlal Tiwari Pharmaceuticals. Carctol composition, accessed 3rd June 2019.
  3. Carctol Official Website, Dr Nandlal Tiwari Pharmaceuticals. Carctol – frequently asked questions, accessed 3rd June 2019.
  4. Carctol Official Website, Dr Nandlal Tiwari Pharmaceuticals. About Carctol, accessed 3rd June 2019.
  5. Carctol previous website, last accessed on 08th May 2012)
  6. Indiamart website, accessed 3rd June 2019. 
  7. Carctol Official Website, Dr Nandlal Tiwari Pharmaceuticals. Success stories, accessed 3rd June 2019.
  8. Ebner S. Dr Daniel's 'miracle' cureThe Guardian, 21 September 2004, accessed 3rd June 2019.
  9. Hall C. I’ve seen herbal remedy make tumours disappear, says respected cancer doctor. The Telegraph, 20th September 2004, accessed 3rd June 2019.
  10. Ernst E. Carctol: profit before patients? Breast Care 2009;4:31-3.
  11. Natural Medicines Database,(requires subscription, accessed 8th May 2015)
  12. Carctol Official Website, Dr Nandlal Tiwari Pharmaceuticals. Clinical tests, accessed 3rd June 2019.

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