This PDQ cancer information summary has current information about the use of Essiac/Flor Essence in the treatment of people with cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board.

Overview

• Essiac and Flor Essence are herbal tea mixtures that are sold worldwide as health tonics or herbal dietary supplements (see Question 1).
• Laboratory, animal, and clinical (human) studies with Essiac and Flor Essence have not reported clear evidence of an anticancer effect (see Question 3 and Question 4).
• The U.S. Food and Drug Administration (FDA) has not approved Essiac or Flor Essence as a cancer treatment (see Question 6).

Questions and Answers About Essiac and Flor Essence

1. What are Essiac and Flor Essence?
   Essiac and Flor Essence are herbal tea mixtures that have been used as anticancer treatments. They have been used to treat other health conditions, including diabetes, AIDS, and gastrointestinal diseases.
   Essiac is reported to contain 4 herbs:

   • Burdock root.
   • Indian rhubarb root.
   • Sheep sorrel.
   • Slippery elm (the inner bark).
   Flor Essence is reported to contain the same 4 herbs found in Essiac plus these 4 other herbs:

   • Watercress.
   • Blessed thistle.
   • Red clover.
   • Kelp.
   Different batches of these mixtures may contain different ingredients or amounts and the effects may not always be the same.
   Essiac and Flor Essence are sold worldwide as health tonics or herbal dietary supplements. One company sells Flor Essence and several companies make and sell mixtures called Essiac. This summary refers to the trademarked (brand name) mixtures only.
2. How is Essiac or Flor Essence given or taken?
   Essiac and Flor Essence are taken orally as herbal teas.
3. What laboratory or animal studies have been done using Essiac or Flor Essence?
   In laboratory studies, tumor cells are used to test a substance to find out if it is likely to have any anticancer effects. In animal studies, tests are done to see if a drug, procedure, or treatment is safe and effective in animals. Laboratory and animal studies are done before a substance is tested in people.
   Laboratory and animal studies have tested the effects of Essiac and Flor Essence. For more information on laboratory and animal studies done using Essiac or Flor Essence, see the Laboratory/Animal/Preclinical Studies of the health professional version of Essiac/Flor Essence.
4. Have any studies of Essiac or Flor Essence been done in people?
   No results of clinical studies with people of Flor Essence have been reported. In addition, no reports of clinical trials of Essiac have been reported in peer-reviewed scientific journals.
   A case study was reported on a patient with prostate cancer who began drinking Essiac tea after having a rising prostate-specific antigen (PSA) level while on hormone therapy. The patient reported a drop in PSA level soon after starting Essiac that lasted for several months. The authors of the study reported that the PSA response could not be linked to Essiac.
5. Have any side effects or risks been reported from Essiac or Flor Essence?
   The only reported side effects caused by Essiac are nausea and vomiting. According to the company making Flor Essence, side effects may include increased bowel movements, frequent urination, swollen glands, skin blemishes, flu-like symptoms, and slight headaches.
6. Is Essiac or Flor Essence approved by the FDA for use as a cancer treatment in the United States?
   The FDA has not approved Essiac or Flor Essence to treat cancer or any other medical condition.
   Essiac and Flor Essence are available in the United States as dietary supplements. The FDA regulates dietary supplements separately from foods, cosmetics, and drugs. The FDA's Good Manufacturing Practices require that every finished batch of supplements is safe and that the claims on the label are true and do not mislead the consumer. However, the FDA does not regularly review the way that supplements are made, so all batches and brands of Essiac and Flor Essence supplements may not be the same.

About This PDQ Summary

General CAM Information

Complementary and alternative medicine (CAM)—also called integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.

Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.

Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any type of treatment. Some complementary and alternative therapies may affect their standard treatment or may be harmful when used with conventional treatment.

Evaluation of CAM Therapies

It is important that the same scientific methods used to test conventional therapies are used to test CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to test CAM therapies for use in cancer.

Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have been tested using demanding scientific methods. A small number of CAM therapies that were thought to be purely alternative approaches are now being used in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) meeting in November 1997, acupuncture has been found to help control nausea and vomiting caused by chemotherapy and pain related to surgery. However, some approaches, such as the use of laetrile, have been studied and found not to work and to possibly cause harm.

The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being studied. The program is overseen by the NCI’s Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients’ medical records and related materials to OCCAM. OCCAM carefully reviews these materials to see if any seem worth further research.

Questions to Ask Your Health Care Provider About CAM

When considering complementary and alternative therapies, patients should ask their health care provider the following questions:

• What side effects can be expected?
• What are the risks related to this therapy?
• What benefits can be expected from this therapy?
• Do the known benefits outweigh the risks?
• Will the therapy affect conventional treatment?
• Is this therapy part of a clinical trial?
• If so, who is the sponsor of the trial?
• Will the therapy be covered by health insurance?

To Learn More About CAM

National Center for Complementary and Integrative Health (NCCIH)

The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.

• NCCIH Clearinghouse
• Post Office Box 7923 Gaithersburg, MD 20898–7923
• Telephone: 1-888-644-6226 (toll free)
• TTY (for deaf and hard of hearing callers): 1-866-464-3615
• E-mail: info@nccih.nih.gov
• Website: https://nccih.nih.gov

CAM on PubMed

NCCIH and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the websites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.)

Office of Cancer Complementary and Alternative Medicine

The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI website.

National Cancer Institute (NCI) Cancer Information Service

U.S. residents may call the Cancer Information Service (CIS), NCI's contact center, toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 am to 9:00 pm. A trained Cancer Information Specialist is available to answer your questions.

Food and Drug Administration

The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.

• Food and Drug Administration
• 10903 New Hampshire Avenue
• Silver Spring, MD 20993
• Telephone: 1-888-463-6332 (toll free)
• Website: http://www.fda.gov

Federal Trade Commission

The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:

• Who Cares: Sources of Information About Health Care Products and Services
• Fraudulent Health Claims: Don’t Be Fooled

• Consumer Response Center
• Federal Trade Commission
• 600 Pennsylvania Avenue, NW
• Washington, DC 20580
• Telephone: 1-877-FTC-HELP (1-877-382-4357) (toll free)
• TTY (for deaf and hard of hearing callers): 202-326-2502
• Website: http://www.ftc.gov