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��������������4����h���/�n����_L�$�*�,�,�,�,�,�,�$1���>P����__��P��������f�f�f�JD����*��f�*��f�f�}(^��������<H�������-b��~���0/��~�!��d!�4^�!��^�����f�����P�P��f���/�������������������������������������������������������������������������!����������� �:	9Anticancer Potential of Plants and Natural Products: A Review
Rahul Dev Lawania1*, Anurag Mishra2
1College of Pharmacy, Gwalior Road, Jakhoda, Agra- 282001 (India)
2Department of Pharmacognosy, School of Pharmacy, Babu Banarasi Das University, Faizabad Road, Lucknow- 227105 (India)

*For Correspondence:
Department of Pharmacognosy, College of Pharmacy, Rohata Ki Nahar, Gwalior Road, Agra- 282 001 U.P. (India)
E. Mail:  HYPERLINK "mailto:lawaniar@gmail.com" lawaniar@gmail.com 
Mob.- +91 9411084924Abstract:
Cancer is one of the leading causes of death and globally the numbers of cases of cancer are increasing gradually. There are several medicines available in the market to treat the various types of cancer but no drug is found to be fully effective and safe. The major problem in the cancer chemotherapy is the toxicity of the established drugs. However plants and plant derived products have proved effective and safe in the treatment and management of cancers. These days most of the research work on cancer drugs is targeted on plants and plants derived natural products. Many natural products and their analogues have been identified as potent anti-cancer agents and day by day the anti-cancer property of various plants is being identified. Here an attempt is being made through this review to highlights the natural products and their analogues established as anti-cancer agents and the new plant species identified with anti-cancer properties either in vivo or in vitro.
Key words: Cancer, Cells, Natural Products, Plants, Carcinoma 


















Introduction:
Cancer is a major public health burden in both developed and developing countries. It is an abnormal growth of cells in body that can lead to death. Cancer cells usually invade and destroy normal cells. These cells are born due to imbalance in the body and by correcting this imbalance, the cancer may be treated. Billions of dollars have been spent on cancer research and yet we do not understand exactly what cancer is. Every year, millions of people are diagnosed with cancer, leading to death. According to the American Cancer Society, deaths arising from cancer constitute 2�3% of the annual deaths recorded worldwide. Thus cancer kills about 3500 million people annually all over the world. Several chemo preventive agents are used to treat cancer, but they cause toxicity that restricts their usage.
What causes cancer?
Cancer begins with damage (mutations) in DNA. DNA instructs the cells, about how to grow and divide. Normal cells often undergo mutations in their DNA, but they have the ability to repair most of these mutations. Or, if they are unable to repair the damage, the cells often die. However, certain mutations aren�t repaired, causing the cells to grow and become cancerous. Mutations also cause cancer cells to live beyond a normal cell life span, this causes the cancerous cells to accumulate [1].
Environmental Factors:
Environmental factors which, from a scientist�s standpoint, include smoking, diet, and infectious diseases as well as chemicals and radiation in our homes and workplace. Among these environmental factors, tobacco use, unhealthy diet, and not enough physical activity are more likely to affect personal cancer risk than trace levels of pollutants in food, drinking water, and the air. However, the degree of risk from those pollutants depends on the concentration, intensity, and exposure. Substantial increase in cancer risk have been shown in settings where workers have been exposed to high levels of ionizing radiation, certain chemicals, metals, and other substances. Even exposures at low doses, which pose only small risk to individuals, can still cause substantial ill health across the whole population. For example, passive tobacco smoke increases risk in the large numbers of people who do not smoke but are exposed to the exhaled smoke of others [1].
Ayurvedic concept of cancer
Charaka and Sushruta Samhita [2-3] both described the equivalent of cancer as �granthi� (benign or minor neoplasm) and �arbuda� (malignant or major neoplasm) [4]. Both can be inflammatory or non-inflammatory, based on the doshas involved [5]. The term dosha describes the three principles that govern the psychophysiological response and pathological changes in the body. The balanced coordination of these three systems (Vata, Pitta and Kapha) in body, mind and consciousness is the Ayurvedic definition of health [6]. The fundamental theory of Ayurvedic treatment is based on restoration of the balance between these three major bodily systems. Tridoshic tumours are usually malignant because all three major body humors lose mutual coordination, resulting in a morbid condition [7]. Ayurvedic classification of neoplasms depends upon various clinical symptoms in relation to tridoshas.
Group I: Diseases that can be named as clear malignancies, including arbuda and granthi, such as mamsarbuda (sarcomas) and raktarbuda (leukaemia), mukharbuda (oral cancer), and asadhya vrana (incurable or malignant ulcers).
Group II: Diseases that can be considered as cancer or probable malignancies, such as ulcers and growths. Examples of these are mamsaja oshtharoga (growth of lips), asadhya galganda (incurable thyroid tumour), tridosaja gulmas, and asadhya udara roga, (abdominal tumours like carcinomas of the stomach and liver or lymphomas).
 Group III: Diseases with the possibility of malignancy, such as visarpa, asadhya kamala (incurable jaundice), asadhya pradara (intreatable sinusitis).
Plants as anti-cancer agents:
Medicinal plants, since time immemorial, have been used in virtually all cultures as a source of medicine. It has been estimated that about 80-85% of population both in developed and developing countries rely on traditional medicine for their primarily health care needs and it is assumed that a major part of traditional therapy involves the use of plant extracts or their active principles [8-10]. Although great advancements have been made in the treatment and control of cancer progression, significant deficiencies and room for improvement remain. A number of undesired side effects occur during chemotherapy. Natural therapies, such as the use of the plant derived products are being used to treat cancer. The search for anti-cancer agents from plant sources started in earnest in the 1950s with the discovery and development of the vinca alkaloids, vinblastin and vincristin and the isolation of the cytotoxic podophyllotoxins [11]. 
Plant-Derived Anti-Cancer Agents in Clinical Use: 
Vinca Alkaloids:
The first agents to advance into clinical use were the so-called vinca alkaloids, vinblastine (VLB) and vincristine (VCR), isolated from the Madagascar periwinkle, Catharanthus roseus G. Don. (Apocynaceae). These drugs were first discovered during an investigation of the plant as a source of potential oral hypoglycemic agents. While research investigators could not confirm this activity, it was noted that extracts reduced white blood cell counts and caused bone marrow depression in rats, and subsequently it was found that the treatment of mice bearing a transplantable lymphocytic leukemia caused significant life extension. This led to the isolation of VLB and VCR as the active agents, so their discovery may be indirectly attributed to the observation of an unrelated medicinal use of the source plant. It is interesting to note that though the plant was originally endemic to Madagascar, the samples used in the discovery of VLB and VCR were collected in Jamaica and the Philippines. More recent semi-synthetic analogues of these agents are vinorelbine (VRLB) and vindesine (VDS). These agents are primarily used in combination with other cancer chemotherapeutic drugs for the treatment of a variety of cancers. VLB is used for the treatment of leukemias, lymphomas, advanced testicular cancer, breast and lung cancers, and Kaposi�s sarcoma, and VCR, in addition to the treatment of lymphomas, also shows efficacy against leukemia, particularly acute lymphocytic leukemia in childhood. VRLB has shown activity against non-small-cell lung cancer and advanced breast cancer. Of over 2069 anti-cancer clinical trials recorded by the NCI (National Cancer Institute) as being in progress as of July 2004, over 160 are drug combinations including these agents against a range of cancers [12].
Podophyllotoxin Derivatives:
The two clinically-active agents, etoposide and teniposide, which are semi-synthetic derivatives of the natural product, epipodophyllotoxin (an isomer of podophyllotoxin), may be considered as being more closely linked to a plant originally used for the treatment of �cancer�. The Podophyllum species (Podophyllaceae), P. peltatum Linn. (Commonly known as the American mandrake or Mayapple), and P. emodii Wallich from the Indian subcontinent, have a long history of medicinal use, including the treatment of skin cancers and warts. P. peltatum was used by the Penobscot Native Americans of Maine for the treatment of �cancer�, and interest was promoted by the observation in the 1940s that venereal warts could be cured by topical application of an alcohol extract of the dried roots (called podophyllin). The major active constituent, podophyllotoxin, was first isolated in 1880, but its correct structure was only reported in the 1950s. Many closely related podophyllotoxin-like lignans were isolated during this period, and several of them were introduced into clinical trials, only to be dropped due to lack of efficacy and unacceptable toxicity. Extensive research at Sandoz Laboratories in Switzerland in the 1960s and 1970s led to the development of etoposide and teniposide as clinically effective agents which are used in the treatment of lymphomas and bronchial and testicular cancers. Of 2069 anti-cancer clinical trials recorded by the NCI as being in progress as of July 2004, over 150 are drug combinations including etoposide against a range of cancers [13].
Taxanes:
A more recent addition to the armamentarium of plant-derived chemotherapeutic agents is the class of molecules called taxanes. Paclitaxel (taxol) initially was isolated from the bark of Taxus brevifolia Nutt. (Taxaceae), collected in Washington State as part of a random collection program by the U.S. Department of Agriculture (USDA) for the National Cancer Institute (NCI) of America. The use of various parts of T. brevifolia and other Taxus species (e.g. T. canadensis Marshall, T. baccata L.) by several Native American tribes for the treatment of some non-cancerous conditions has been reported, while the leaves of T. baccata are used in the traditional Indian (Ayurvedic) medicine system, with one reported use in the treatment of �cancer�. Paclitaxel, along with several key precursors (the baccatins), occurs in the leaves of various Taxus species, and the ready semi-synthetic conversion of the relatively abundant baccatins to paclitaxel, as well as active paclitaxel analogs, such as docetaxel (Taxotere), has provided a major, renewable natural source of this important class of drugs. Paclitaxel is used in the treatment of breast, ovarian and non-small-cell lung cancer (NSCLC), and has also shown efficacy against Kaposi sarcoma. Paclitaxel has also attracted attention in the potential treatment of multiple sclerosis, psoriasis and rheumatoid arthritis. Docetaxel is primarily used in the treatment of breast cancer. The importance of this class of anti-cancer agents may be judged from the fact that 12 and 23 taxane analogs are in clinical and preclinical development, respectively. In addition, of 2069 cancer clinical trials recorded by the NCI as being in progress as of July 2004, 248 or close to 12% are listed as involving taxane-derived drugs, including 134 with paclitaxel (Taxol), 105 with docetaxel (Taxotere), and 10 with miscellaneous taxanes, either as single agents or in combination with other anti-cancer agents. In addition, 23 taxanes are in preclinical development [14].
Campothecin Derivatives:
Another important addition to the anti-cancer drug armamentarium is the class of clinically-active agents derived from camptothecin, which is isolated from the Chinese ornamental tree, Camptotheca acuminata Decne (Nyssaceae), and known in China as the tree of joy. Camptothecin was discovered from extracts of plants originally collected by U. S. Department of Agriculture, as a possible source of steroidal precursors for the production of cortisone. The extract of C. acuminata was the only one of 1000 of these plant extracts tested for anti-tumor activity which showed efficacy, and camptothecin was isolated as the active constituent. Camptothecin (as its sodium salt) was advanced to clinical trials by the NCI in the 1970s, but was dropped because of severe bladder toxicity. However, extensive research was performed by several pharmaceutical companies in a search for more effective camptothecin derivatives, and Topotecan (Hycamtin), developed by SmithKline Beecham (now Glaxo SmithKline), and Irinotecan (CPT-11; Camptosar), originally developed by the Japanese company, Yakult Honsha, are now in clinical use. Topotecan is used for the treatment of ovarian and small-cell lung cancers, while Irinotecan is used for the treatment of colorectal cancers. Of the 2069 cancer clinical trials recorded by the NCI as being in progress, as of July 2004, 94 or approximately 4.5% are listed as involving camptothecin-derived drugs, including 64 with irinotecan (CPT-11), 26 with topotecan, and 4 with other miscellaneous analogues, either as single agents or in combination with other anti-cancer agents. In addition, 15 other camptothecin derivatives are in preclinical development [15].
Homoharringtonine:
Other plant-derived agents in clinical use are homoharringtonine, isolated from the Chinese tree, Cephalotaxus harringtonia var. drupacea (Sieb and Zucc.) (Cephalotaxaceae), and elliptinium, a derivative of ellipticine, isolated from species of several genera of the Apocynaceae family, including Bleekeria vitensis, a Fijian medicinal plant with reputed anti-cancer properties. A racemic mixture of harringtonine and homoharringtonine (HHT) has been used successfully in China for the treatment of acute myelogenous leukemia and chronic myelogenous leukemia. Purified HHT has shown efficacy against various leukemias, including some resistant to standard treatment, and has been reported to produce complete hematologic remission (CHR) in patients with late chronic phase chronic myelogenous leukemia (CML). Elliptinium is marketed in France for the treatment of breast cancer [16].

Structures of Plant-Derived Anti-Cancer Agents in Clinical Use


Figure 1: Podophyllotoxin





Figure 2: Taxol






Figure 3: Campothecin



           
Figure 4: Vinblastin                                                           Figure 5:  Vincristin

Plants proved effective as anti-cancer agent in vivo or in vitro:
Achyranthes aspera 
Achyranthes aspera Linn. (Apamarg), belonging to family Amaranthaceae, is commonly found as a weed on way side and at waste places throughout India.  The methanolic extract, alkaloid, non-alkaloid and saponin fractions exhibited significant inhibitory effects at a concentration of 100�g on the Epstein-Barr virus early antigen activation induced by the tumor promoter 12-O-tetradecanoylphorbol-13-acetate in Raji cells. In in vitro assay the non-alkaloid fraction containing mainly nonpolar compounds showed the most significant inhibitory activity [17]. In in vivo two-stage mouse skin carcinogenesis test the total methanolic extract possessed a pronounced anticarcinogenic effect [18]. 
Allium sativum (Allicin)
Allium sativum (garlic, lasun) is used to treat a wide variety of diseases in India. Allicin is a major component of raw garlic and ajoene is a product of the rearrangement of allicin. Its cytotoxic effect has been tested using human primary fibroblasts, a permanent, nontumorgenic cell line derived from baby hamster kidney cells and a tumorgenic lymphoid cell line derived from a Burkitt lymphoma. The cytotoxic action was in the range 2-50 �g/ml [19]. In addition, some organosulfur compounds derived from garlic, including S-allylcysteine, have been found to retard the growth of chemically induced and transplantable tumors in several animal models [20]. Administration of garlic (250 mg/kg, p.o., thrice a week) in male wistar rats, effectively suppressed 4-nitroquinoline-1-oxide induced tongue carcinogenesis as revealed by the absence by the carcinomas in the initiation phase and their reduced incidence in the post initiation phase [21]. Therefore, the consumption of garlic may provide some kind of protection from cancer.
Andrographis paniculata
Phytochemical investigation of the ethanol extract of the aerial parts of this herb resulted in the isolation of 14 compounds including flavonoids and labdane diterpenoids. The cytotoxic activities of these isolates was evaluated against various cell lines and found that these isolates have a potent tumour inhibitory activity against all investigated cell lines [22].  The dichloromethane fraction of methanol extract of Andrographis paniculata gave three active constituents which exhibited cytotoxic activity and also potent immunostimulating activity [23]. However, there were also reports of its adverse side effects. Its side effects may include gastric upset, headache, bitter taste and fatigue. Since it have effects on liver, high doses of Andrographis paniculata extracts may affect liver functions [24].
Annona muricata
Graviola is known by its scientific name, Annona muricata. The important class of medicinal components found in graviola is acetogenins. Acetogenins was found in the fruit, seeds, leaves, and bark of the graviola plant. Preliminary research showed that acetogenins block production of adenosine triphosphate, which inhibits the pump that removes cancer drugs from the cell, allowing chemotherapy to be more effective. Furthermore, research suggested that acetogenin may have chemotherapeutic potential, especially against cancer that resistant to multiple drugs [25]. Parkinson disease-like movements may result from oral ingestion of graviola [26]. Specific acetogenins have been reported to be selectively toxic for various types of cancer cells like lung carcinoma, solid human-breast cancer tumor, prostatic adenocarcinoma, pancreatic carcinoma, colonic adenocarcinoma, liver cancer, human lymphoma, and multiple-drug resistant human-breast adenocarcinoma [27].
Apis mellifera
Apis mellifera is the scientific name of honey bee, from which honey is produced. Honey is used to hasten healing of skin wounds, ulcerations, and burns in Indian system of medicine. A protein of the honeybee Apis mellifera enhances proliferation of primary-cultured rat hepatocytes and suppresses apoptosis in the absence of serum [28].  It has also showed cytotoxicity in normal human lymphocytes and HL-60 cells [29]. Hamzaoglu et al. (2000) implanated cancer cell into neck wounds of mice, then divided mice into two groups. A marked decrease in wound cancer tumors were found in the group of mice that had surgical wounds coated with honey pre- and postoperatively. This finding may have some application in human surgery [30]. 
Astralagus hedysarum 
A polysaccharide from Astralagus hedysarum has shown anti tumor activity. An intraperitoneal injection of 500 mg/kg resulted in increase in the deposition of the third component of complement (C3) of macrophages in ICR mouse after two hours. The injection of Astralagus hedysarum, when given five times, the proportion of C3 positive macrophages was more than that of one time injection. The results suggest that Astralagus hedysarum has immuno-potentiating action and can be useful in cancer chemotherapy [31].  Other species of Astragals like A. membranaceus has also been investigated for its cytotoxic activity. Astragalus membranaceus, has been shown to be capable of restoring the impaired T cell functions in cancer patients [32]. The macrophage-like tumors and the myeloid tumors were found to be more sensitive to the cytostatic activity of AM, whereas the fibroblast-like tumors and the mouse Ehrlich ascites tumor appeared to be relatively resistant. A. membranaceus was able to induce monocytic differentiation of both human and murine cells in vitro. Collectively, the results showed that A. membranaceus could exhibit both in vitro and in vivo anti-tumor effects, which might be achieved through activating the anti-tumor immune mechanism of the host [33].
Bidens pilosa
Bidens pilosa is used in folk medicine for various applications due to the presence of polyacetylenes, flavonoids, terpenoids, phenylpropanoids and others. Bioactivity-guided fractionation of different extracts of B. pilosa leaf showed potential in vitro anticancer activity and led to the identification of a potential marker compound, phenyl-1,3,5-heptatriyne. Erythrocyte osmotic fragility experiments revealed the various extracts as well as the marker component's toxicity profiles on normal blood cells [34]. The extract from whole plant was extracted with n-hexane; chloroform and methanol extract (E1-E3). The extracts were fractioned by column chromatography method and fractioned with ethyl acetate, acetone and water (F1-F3). All the extracts and fractions were tested for anticancer and antipyretic activity. Among extracts E1 shows remarkable anticancer activity [35].
Bolbostemma paniculatum
Tubeimoside-V is a triterpenoid saponin extracted from Bolbostemma paniculatum (Cucurbitaceae), a Chinese herb with anticancer potential. Scientific studies proved that Tubeimoside-V is an efficient apoptotic killing agent of glioblastoma cells and suggest that it may play a critical role in anti-tumor chemotherapy [36]. Along with, tubeimoside-I, tubeimoside-II and tubeimoside-V have promised cytotoxic activity by inhibiting DNA synthesis and induced phenotypic reverse transformation of tumor cells [37].
Cannabis sativa
In vitro studies of components of marijuana (Cannabis sativa) indicate a potential to inhibit human breast cancer cells and to produce tumor eradications. In experiments introducing marijuana to malignant brain tumors, it was found that survival of animals was increased significantly [38]. Cannabinoids, the active components of Cannabis sativa and their derivatives exert palliative effects in cancer patients by preventing nausea, vomiting and pain and by stimulating appetite. In addition, these compounds have been shown to inhibit the growth of tumour cells in culture and animal models by modulating key cell-signalling pathways [39].
Centaurea ainetensis
The anti-cancer activity of extracts of Centaurea ainetensis has been investigated in human colon carcinoma cells. The crude extract inhibited the proliferation of a host of colon-derived cancer cells. In vivo, the crude extract injected intraperitoneally before the subcutaneous injection of the carcinogen 1, 2-dimethylhydrazine, drastically reduced the number of tumors and decreased the mean size of aberrant crypt foci. Further bioassay-guided fractionation of the crude extract resulted in the identification of the bioactive molecule Salograviolide A, a sesquiterpene Lactone, to which the growth inhibition in colon was linked. Salgraviolide A, at non-cytotoxic concentrations to normal human intestinal cells, reduced the growth of colon cancer cell lines. Salograviolide A also revealed potent cytotoxic action against epidermal squamous cell carcinogenesis [40-41].
Camellia sinensis (Green Tea)
Some results in animal and epidemiological studies suggest that Epigallocatechin-3-gallate (EGCG) the most abundant polyphenol in green tea, could inhibit the invasion and migration of human oral and colon cancer cells and that the effects may partially because of the decreased productions of MMP-2, MMP-9 and uPA [42]. It is demonstrated that EGCG can inhibit the growth of some cancer cell lines, including hepatocellular carcinomas cell lines HLE, HepG2, HuH-7 and PLC/PRF/5 through the induction of cell-cycle arrest [43], in ovarian carcinoma cell lines HEY and OVCA 433 [44-45], in human colorectal cancer cell lines HT-29 and HCA-7 [46-47]. Not only EGCG but other flavonoids such as quercetin and rutin have anticarcinogenicity and antitoxicity properties through inhibition of oxidative activation [48].
Daphne mezereum
An alcohol-water extract of Daphne mezereum, a plant widely used in folk medicine for treating cancers showed antileukemic activity against the P-388 lymphocytic leukemia in mice. Systematic fractionation of the extract has led to isolation and characterization of mezerein as the principal antileukemic component [49]. 
Gossypium hirsutum
Gossypol, also known as cottonseed oil, has a scientific name of Gossypium hirustum or Gossypium herbaceum. It is used as male contraceptive; gossypol is also used for metastatic carcinoma of the endometrium or ovary and HIV. Preliminary in vivo and in vitro studies have suggested that glossypol has cytotoxic and antitumor properties on many cytosolic and mitochondrial enzyme systems, the very system that is fundamental for tumor cell growth, including melanoma, endometrial, colon, lung, prostate, breast, brain, and adrenocortical cancer [50-52]. However no typical dose is available for the treatment of cancer and self-medication with gossypol is considered unsafe because of its potential toxicity [53]. 
Hydrocotyle asiatica
Hydrocotyle asiatica is the scientific name of Gotu kola, brahmi, synonyms with Centella asiatica. In early studies on animal tissue, brahmi exhibited cytotoxic and antitumor properties. It has been found that brahmi increased the life-span of tumor-bearing mice. Brahmi usually is tolerated well when used in typical doses of 600 mg of dried leaves three times a day [54]. A side effect is photosensitivity; therefore, individuals using brahmi are advised to wear sunscreen and clothing to prevent sunburn [55]. An aqueous extract of leaves of brahmi has shown prominent cytotoxic activity against mouse melanoma, human breast cancer, rat glioma cell lines [56]. Oral administration of crude extract of C. asiatica and its partially purified fractions retarded the development of solid and ascites tumours and increased the life span of these tumours bearing mice. Cytotoxic and antitumour effect involves direct action on DNA synthesis [57]. C. asiatica modulate nitric oxide and tumour necrosis factor-alpha in mouse macrophages [58]. Asiaticoside possess good wound healing activities because of its stimulating effect on collagen synthesis. It might be useful in cancer chemotherapy as it induce apoptosis and enhance antitumour activity of vincristin in cancer cells [59]. Asiatic acid was also found having anticancer effect on skin cancer [60].
Hypericum perforatum
Hypericin is a substance isolated from Hypericum perforatum commonly known as St.John�s Wort. Hypericin belong to group of compound known as napthodianthrones. Hypericin inhibited the growth of glioma cell lines in vitro and induced glioma cell death due to inhibition of Protein Kinase-C, as measured by thymidine uptake. The glioma-inhibitory activity of hypericin was comparable to or greater than tamoxifen which was used as standard [61-62]. Hypericum perforatum components act as serotonin-reuptake inhibitors and thus exert cytotoxic effects on several human cancer cell lines, in vitro and in vivo [63].
Mangifera indica
Mangifera indica is a nutritional supplement obtained from stem bark of Mangifera indica L. (mango). This aqueous extract is used in Cuba in presumably healthy people with environmental, nutritional risk factors, or population with chronic diseases to increment the quality of life through the increase of antioxidant mechanisms [64]. Ethnomedical studies lead to a great improvement of quality of life in patients with cancer [65]. Preclinical studies have demonstrated anti-angiogenic effects of mango in different cell lines. The active ingredient of mango formulations consists on a defined mixture of polyphenols, terpenoids, steroids, fatty acids and microelements that imparts unique properties to these formulations like antioxidant supplement [66].
Nervilia fordii
Nervelia fordii is used widely in China as a folklore medicine. The effective petroleum ether extract and ethyl acetate extract parts of Nervilia fordii were selected and then anticancer experiments in vivo were done by using S180-mice and H-22 mice models. Petroleum ether and ethyl acetate extract parts both had obvious anticancer effect to S180-mice and H-22 mice, and could prolong H-22 mice life. This study revealed the anticancer potential of petroleum ether and ethyl acetate extracts of Nervilia fordii in vivo [67]. 
Oroxylum indicum:
Oroxylum indicum (Sonapatha) is used in various polyherbal formulations in Indian system of medicine. Studies have proved anticancer potential of Oroxylum indicum using various models. A 95% ethanol extract exhibited cytotoxic activity against Hep2 cell lines at a concentration of 0.05% [68]. Flavonoid baicalein present in Oroxylum indicum has anti-tumour effect on human cancer cell lines and inhibited the 50% proliferation of HL-60 cell lines at a concentration of 25-30 microM [69]. Methanolic extract of O. indicum strongly inhibited the mutagenicity of Trp-P-1 in ames test [70]. Administration of nitrosated O. indicum fractions at a dose of 0.25-2 g/kg body weight has genotoxic and cell proliferative activity in the pyloric mucosa of rat stomach in vivo [71]. Extract of Oroxylum indicum showed the toxicity on tumor cell lines tested, with an IC50 value 19.6��g/ml for CEM, 14.2��g/ml for HL-60, 17.2��g/ml for B-16 and 32.5��g/ml for HCT-8 [72]. The methanolic and aqueous extracts of Oroxylum indicum have been demonstrated extensive cytotoxicity in selected tested cell lines, with the methanolic extract showing greater cytotoxic potential. Both extracts exhibited moderate levels of DNA protection against oxidative stress [73].
Picrorrhiza kurroa
Picrorrhiza kurroa (Kutki) has also shown to reduce formation of liver cancer due to chemical exposures in animal studies. Kutkin is a combination of active herbal constituents, picrosides I, II and III and kutkoside, found in the herb Picrorrhiza kurroa, which has been used in Ayurveda. Kutkin's antioxidant activity has been shown to decrease levels of lipid peroxidases and hydroperoxidases, free radical producing agents, and help facilitate the recovery of SOD, a powerful antioxidant in the liver needed to prevent oxidative damage [74]. 
Rubia cordifolia
The cyclic hexapeptides and quinones of Rubia cordifolia exhibited a significant anticancer activity against various proliferating cells. The hexapeptides showed potent antitumour activity by binding to eukaryotic 80S ribosomes resulting in inhibition of aminoacyl -tRNA binding and peptidyl �tRNA translocation, thus leading to the stoppage of protein synthesis [75-77]. From the chloroform fraction of Rubia cordifolia roots three constituents were isolated namely mollugin, furomollugin and dehydro-a-lapchone. Mollugin has shown inhibition of passive cutaneous anaphylaxis and protection of mast cell degranulation in rats. It also exhibited considerable activity against lymphoid leukemia (P338) in mice [78]. The Rubia cordifolia extract had shown a mitodepressive effect on the rate of cell division in bone marrow cells of Swiss male mice. This exposure-time-dependent reduction was attributed to the effect of inhibiting protein synthesis, suggesting probable effect of Rubia extract on the biosynthesis of certain amino acids as well as RNA synthesis [79]. The cytotoxic action of Rubia cordifolia had been evaluated with DNA Topoisomerases I and II inhibition and cytotoxicity of constituents isolated from the roots was tested. Topoisomerases I and II inhibitory activities were measured by assessing the relaxation of supercoiled pBR 322 plasmid DNA. The tetrazolium-based colorimetric assay (MTT assay) was used for the cytotoxicity towards human colon carcinoma, human breast carcinoma and human livercarcinoma (HepG2) cell lines. Seven compounds were isolated possessing cytotoxic activity [80]. 
Salvia miltiorrhiza:
Tanshinone-I derived from the traditional herbal medicine, Salvia miltiorrhizae, was investigated on the expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 in tumor necrosis factor-alpha (TNF-alpha) stimulated endothelial cells. Furthermore, study investigated the effect of tanshinone I on cancer growth, invasion and angiogenesis on human breast cancer cells MDA-MB-231, both in vitro and in vivo. Tanshinone-I dose dependently inhibited ICAM-1 and VCAM-1 expressions in human umbilical vein endothelial cells (HUVECs) that were stimulated with TNF-alpha for 6 h. Pretreatment with tanshinone I significantly reduced adhesion of either monocyte U937 or MDA-MB-231 cells to HUVECs. Interestingly, the inhibitory effect of tanshinone-I on monocyte and cancer cell adhesion to HUVECs was mimicked by transfection with ICAM-1 and VCAM-1 small interfering RNA. In addition, tanshinone I effectively inhibited TNF-alpha-induced production of vascular endothelial growth factor (VEGF) and VEGF-mediated tube formation in HUVECs. Tanshinone-I also inhibited TNF-alpha-induced VEGF production in MDA-MB-231 cells and migration of MDA-MB-231 cells through extracellular matrix. Additionally, reduction of tumor mass volume and decrease of metastasis incidents by tanshinone were observed in vivo. In conclusion, this study provides a potential mechanism for the anticancer effect of tanshinone I on breast cancer cells, suggesting that tanshinone-I may serve as an effective drug for the treatment of breast cancer [81]. Tanshinone IIA was isolated from Salvia miltiorrhiza, induced apoptosis by proteolytic cleavage of a major component in apoptotic cell death mechanism [82].
Scutellaria:
Scutellaria is a traditional herbal remedy with potential anti-cancer activity. A study was performed to evaluate anticancer mechanisms of thirteen Scutellaria species and analyze their leaf, stem and root extracts for levels of common biologically active flavonoids: apigenin, baicalein, baicalin, chrysin, scutellarein, and wogonin. Malignant glioma, breast carcinoma and prostate cancer cells were used to determine tumor-specific effects of Scutellaria on cell proliferation, apoptosis and cell cycle progression, via the MTT assay and flow cytometry-based apoptosis and cell cycle analysis. The extracts and individual flavonoids inhibited the proliferation of malignant glioma and breast carcinoma cells without affecting primary or non-malignant cells. The flavonoids exhibited different mechanisms of anti-tumor activity as well as positive interactions. The antitumor mechanisms involved induction of apoptosis and cell cycle arrest at G1/G2. Of the extracts tested, leaf extracts of S. angulosa, S. integrifolia, S. ocmulgee and S. scandens were found to have strong anticancer activity. This study provides basis for further mechanistic and translational studies into adjuvant therapy of malignant tumors using Scutellaria leaf tissues [83]. Yin et al., (2004) reported the growth inhibitory effect of S. barbata and determined its mechanism of antitumor activity using human lung cancer cell line A549. Ethanol extracts of S. barbata greatly inhibited A549 cell growth, with IC50 of 0.21 mg/ml [84]. Tanshinone IIA isolated from herb might have potential anticancer activity on both ER-positive and -negative breast cancers, cell proliferation, apoptosis, signal transduction, transcriptional regulation, angiogenesis, invasive potential and metastatic potential of cancer cells [85]. Microarray and pathway analysis of tumor related genes identified the differentially expressed genes responding to tanshinone I and suggest that tanshinone I exhibits anticancer effects both in vitro and in vivo [86]. Other species of Scutellaria like S. baicalensis, Scutellaria litwinowii etc. have proved recently as a potent anticancer agent in various in vitro as well as in vivo models [87-89].
Silybum marianum
Protective effect of Silymarin, a flavonoid compound isolated from the milk thistle plant, has been proved against UVB radiation-induced non-melanoma skin cancer in mice. Forty mice were used in each protocol and were divided into control and treatment groups. Silymarin was applied topically at a dose of 9 mg per application before UVB exposure, and its effects on tumor incidence, tumor multiplicity (number of tumors per mouse), and average tumor volume per mouse were evaluated. Silymarin treatment reduced tumor incidence from 100% to 60%, tumor multiplicity by 78%, and tumor volume per mouse by 90% and thus revealed the strong anticancer property [90]. Silymarin can suppress the proliferation of a variety of tumor cells (e.g., prostate, breast, ovary, colon, lung, bladder); this is accomplished through cell cycle arrest at the G1/S-phase, induction of cyclin-dependent kinase inhibitors, down-regulation of anti-apoptotic gene products, inhibition of cell-survival kinases and inhibition of inflammatory transcription factors. Silymarin can also down-regulate gene products involved in the proliferation of tumor cells, invasion, angiogenesis and metastasis [91]. Silibinin, a major constituent (flavanolignan) of the fruits of Silybum marianum prevents TPA-induced MMP-9 expression and VEGF secretion by inactivation of the Raf/MEK/ERK pathway in MCF-7 human breast cancer cells [92].
Smilax china
Kaempferol-7-O-beta-D-glucoside (KG), a flavonoid glycoside, isolated from Smilax china L. rhizome, displayed marked anticancer activity on a panel of established cancer cells, of which, HeLa human cervix carcinoma cells were the most sensitive. KG displayed a significant anti-tumor effect through cell cycle arrest and apoptotic induction in HeLa cells, which suggested that KG might have therapeutic potential against cervix carcinomas [93-94]. 
Strychnos nuxvomica:
Strychnos nuxvomica, from Loganiaceae family, that is indigeneous to East India and is largely collected from forests of Sri Lanka, Northern Australia and India, has shows cytotoxic activity against multiple myloma cell line- ROMI 8226. Root extract of the drug was screened using the same cell lines and exhibited anti-proliferative activity in a dose and time dependent manner [95]. Major alkaloids present in the seed of Strychnos nux-vomica are effective against HepG2 cells proliferation, among which brucine proceed HepG2 cells death via apoptosis, through the participation of caspase-3 and cyclooxygenase-2 [96].
Taraxacum officinale:
Plants of the genus Taraxacum, commonly known as dandelions, have a history of use in Chinese, Arabian and Native American traditional medicine, to treat a variety of diseases including cancer. Three aqueous extracts were prepared from the mature leaves, flowers and roots of Taraxacum officinale and was investigated for tumour progression related processes such as proliferation and invasion. The crude extract of dandelion leaf decreased the growth of breast cancer cells [97]. Study reveales the effect of T. officinale on the cytotoxicity and production of cytokines in human hepatoma cell line, Hep G2 and results showed that TO decreased the cell viability by and significantly increased the tumor necrosis factor (TNF)-� and interleukin (IL)-1� production [98].
Terminalia chebula:
Antimutagenic activity of hydrolyzable tannins from Terminalia chebula in Salmonella typhimurium has been documented [99]. A group of researchers have reported the inhibitory action on cancer cell growth by the phenolics of Terminalia chebula Retz fruit and found that chebulinic acid, tannic acid and ellagic acid were the most growth inhibitory phenolics of Terminalia chebula [100]. Besides, acetone extract of bark and fruit powder of Terminalia chebula harbors constituents with promising antimutagenic/anticarcinogenic activity [101]. 
Vernonia amygdalina
Vernonia amygdalina (VA), member of the Compositae family, is a small shrub that grows in the tropical Africa. The in vivo studies were conducted using sixty 5-6 week old female athymic nude mice. Mice were injected subcutaneously with 106 MCF-7 breast cancerous cells in the flank area and monitored for tumor growth. Compared to the negative control mice, VA completely reversed or eliminated the tumors of the animal in both treatment groups. Immuno histochemical data revealed that VA increased basal apoptotic but decreased angiogenic activities in both breast cancernoma cells [102]. 
Withania somnifera (Withanolides)
 Withaferin-A is the most important withanolide isolated so far from Withania somnifera. Withaferin-A showed marked tumor-inhibitory activity in carcinoma of nasopharynx, Ehrlich ascites carcinoma, Sarcoma 180, Sarcoma Black and E 0771 mammary adenocarcinoma in animal models. Withania somnifera is part of Ayurvedic formulations for cancer prescriptions and the folk healers usually recommend the chewing of the leaves of the drug [103-105]. 
The chemopreventive effect has also been demonstrated in a study of Withania somnifera root extract on induced skin cancer in mice given WS before and during exposure to the skin cancer causing agent 7, 12-dimethylbenz(a)anthracene. A significant decrease in incidence and average number of skin lesions was demonstrated compared to the control group [106]. An in vitro study showed withanolides from Withania somnifera inhibited growth in human breast, central nervous system, lung, and colon cancer cell lines comparable to doxorubicin. Withaferin A more effectively inhibited growth of breast and colon cancer cell lines than did doxorubicin [107]. Withania somnifera was evaluated for its antitumor effect in urethane induced lung adenomas in adult male albino mice. Simultaneous administration of WS (200 mg/kg daily orally for seven months) and urethane (125 mg/kg biweekly for seven months) reduced tumor incidence significantly. The histological appearance of the lungs of animals protected by WS was similar to those observed in the lungs of control animals. WS treatment also reversed the adverse effects of urethane on total leukocyte count, lymphocyte count, body weight, and mortality [108]. A significant increase in the life span and a decrease in the cancer cell number and tumour weight were noted in the tumour-induced mice after treatment with WS. These observations are suggestive of the protective effect of Withania somnifera in carcinogens [109].
Zingiber officinale 
Ethanolic extract of Zingiber officinale (ginger) demonstrated anti-tumor-promoting effects in a mouse skin tumorigenesis model. Preapplication of Zingiber officinale onto the skin of mice resulted in significant inhibition of 12-0-tetradecanoylphorbol- 13-acetate (TPA)-caused induction of epidermal ODC, cyclo oxygenase, and lipoxygenase activities and ODC mRNA expression in a dose-dependent manner. Preapplication of Zingiber officinale to mouse skin also afforded significant inhibition of TPA-caused epidermal edema and hyperplasia. In long-term tumor studies, topical application of Zingiber officinale 30 min prior to that of each TPA application to 7, 12-dimethylbenz(a)anthracene initiated mice resulted in a highly significant protection against skin tumor incidence and its subsequent multiplicity [110]. 
Ginger�s natural bioactives, specifically ginger extract and 6-gigerol, have been investigated for their in vitro inhibition of two key aspects of colon cancer biology-cancer cell proliferation and angiogenic potential of endothelial cell tubule formation. These selected ginger bioactives had a direct effect on YYT rat cancer cell proliferation and an indirect effect on MS1endothelial cell tube formation. Compound 6-gingerol was most effective at lower doses in inhibiting endothelial cell tube formation [111]. Ginger extract exert its antitumor effects on colon cancer cells by suppressing its growth, arresting the G0/G1-phase, reducing DNA synthesis and inducing apoptosis [112]. 
Plants namely Azadirachta indica (Meliaceae), Boesenbergia pandurata (Zingiberaceae), Coscinium fenestratum (Menispermaceae) were extracted with 95% ethanol and tested for cytotoxic effects. The results showed that three plants, A. indica, B. pandurata, and C. fenestratum, exhibited high cytotoxic activity against the Hep2 cell lines at a minimum concentration of 0.05% in ethanol extract. In addition, C. fenestratum demonstrated the most potent cytotoxic extract based on its lowest IC50 (5 mg/mL).
All extracts produced a reduction in cell proliferation of Hep2 cells at 4- and 8 hrs incubations (with B. pandurata and C. fenestratum resulting in the best growth inhibition at lower concentrations. At the highest concentration tested (2,500 �g/mL) with an 8 hrs incubation period, A. indica and B. pandurata resulted in 95% inhibition of cell proliferation, while C. fenestratum provided 80% inhibitions respectively [68, 73].
Calotropine, a glycoside present in Calotropis procera (Aak) has shown anti tumor activity against human epidermoid carcinoma cells of rhinopharynx in vivo studies [113]. Calotropis procera inhibited the growth of cells and mitotic activity in a dose-dependent manner in vitro [114]. Ellipticine, an indole alkaloid isolated from Ochrosia ellipitica, is a potent topoisomerase inhibitor [115]. Curcumin, the active constituent of Curcuma domestica, has potent anticancer activity in animal models [116]. Homoharringtonine, an alkaloid from Cephalotaxus homoharringtonia, when combined with cytarabine, has shown activity in chronic myelogenous leukemia (CML) in a study 105 patients received continuous infusion of homoharringtonine 2.5 mg/kg/m2/day plus subcutaneous cytarabine 15 mg/kg/m2/day for five weeks. L-Canavanine isolated from Medicago sativa and Canavalia esniformis, has shown significant antineoplastic activity in animal models bearing carcinoma and cancer cell lines [116-117]. 




Table 1: Other Anti-cancer Plants [118-120, 136]  
Botanical name of plant with family namePart usedParts used and their main active componentsOrigin / native placeAgave americana
(Agavaceae)LeafSteroidal saponin, alkaloid, coumarin, isoflavonoid, hecogenin
and vitamins (A, B, C)Central AmericaAgropyron repens
(Poaceae)RhizomesRhizome contains essential oil, polysaccharide and mucilageEuropeAgrimonia pilosa
(Rosaceae)HerbAgrimonolide, flavonoid, triterpene, tannin and coumarinChina, Japan,
Korea, IndiaAilanthus altissima
(Simaroubaceae)BarkTriterpene, tannin, saponin and quercetin-3-glucosideChina, KoreaAkebia quinata
(Lardizabalaceae)FruitFlavonoid and saponinChina, Japan, KoreaAlpinia galanga
(Zingiberaceae)RhizomesKaempferide and flavoneEuropeAristolochia contorta (Aristolochiaceae)Root and fruitLysicamine and oxaaporphineChina, KoreaAster tataricus
(Asteraceae)Whole plantTriterpene, monoterpene and epifriedelanolJapan, KoreaBryonia dioicaRootCucurbitacin and glycosideEuropeCannabis sativa (Cannabinaceae)LeafStereo isomers of cannabitriolSouth AfricaChelidonium jajus var. asiaticum
(Papaveraceae)HerbAlkaloids (sanguinarine, chelerythrine, berberine)Asia, EuropeChimaphila umbellate (Ericaceae)Whole plantEricolin, arbutin, urson and tanninAsia, EuropeCoix lachryma jobi
(Poaceae)SeedTrans-ferulyl stigmasterolChinaDryopteris crassirhizoma (Polypodiaceae)RhizomesFilicinic and filicic acids, aspidinol and aspidinChina, Japan, KoreaEchinops setifer
(Asteraceae)Whole plantEchinopsineKoreaErythronium americanum
(Liliaceae)Whole plantAlpha-methylenebutyrolactoneNorth AmericaEuonymus alatus
(Celastraceae)Whole plantTriterpene, euolatin, steroid and sesquiterpene alkaloidChina, Japan, KoreaEupatorium cannabinum (Asteraceae)Whole plantSesquiterpene, lactone, pyrrolizidine alkaloid
and flavonoidEurope, Asia,Fragaria vesca
(Rosaceae)Leaf and fruitFlavonoid, tannin, borneol and ellagic acid Asia, EuropeAsia, EuropeFritillaria thunbergii
(Liliaceae)Whole plantAlkaloid and peimineChina, SiberiaGalium aparine
(Rubiaceae)CleaverIridoid, polyphenolic acid, tannin, anthraquinone
and flavonoidEurope , AfricaHydrastis canadensis (Ranunculaceae)Whole plantIsoquinoline alkaloids (hydrastine, berberine, berberastine, candaline), resin and lactoneCanada, United StatesJunchus effuses
(Juncaceae)Whole planttridecanone, effusol, juncanol, phenylpropanoid and a-tocopherolChina, Japan, KoreaLantana camara
(Verbenaceae)Whole plantAlkaloids (camerine, isocamerine, micranine,
lantanine, lantadene)Tropical AmericaLarrea tridentate
(Zygophyllaceae)Whole plantResinSouthwestern USA,
MexicoLonicera japonica
(Caprifoliaceae)Whole plantTannins, saponins and carotenoidsChinaOlea europrae
(Oleaceae)Leaf and oilOleic acid and polyphenolAmericaPanax quinquefolium
(Araliaceae)RootsGinsenoside, sesquiterpene, limonene vitamins (B1, B2, B12)China, Japan, KoreaPhaleria macrocarpaFruitsGallic acidIndonesiaPolygonatum multiflorum
(Liliaceae)Whole plantSaponin, flavonoid and vitamin A Asia, Europe, North AmericaPotentilla chinensis
(Rolsaaceae)Whole plantGallic acid and tanninChina, Japan, KoreaPygeum africanum
(Boraginaceae)Bark Phytosterol, triterpene and tanninAfricaPyrus malus
(Rosaceae)Bark and fruitQuercetin, catechin, flavonoid, coumaric and gallic acids, phloridzin and procyanidinBritainRhus chinensis
(Anacardiaceae)LeafTannin, apigenin and glycoside; seed contains bruceosides (A, B), brucein D and fatty oilChina, Japan, KoreaRubus idaeus
(Rosaceae)LeafFlavonoid and tannin; fruit contains vitamins (A, B, C)  and ellagic acidAsia, EuropeScilla natalensis
(Hyacinthaceae)BulbBulbSouth AfricaScrophularia nodosa (Scrophulariaceae)Aerial partsIridoid, flavonoid and phenolic acidEuropeSmilax chinensis
(Liliaceae)RhizomesTannin, saponins and flavonoidChina, JapanTabebuia spp.
(Bignoniaceae)BarkQuinine, bioflavonoid and co-enzyme QSouth AmericaThuja occidentalis
(Cupressaceae)Whole plantFlavonoid, tannin, volatile oil and mucilage
Northeastern USA, EuropeThymus vulgaris
(Lamiaceae)Whole plantVolatile oil, flavonoid and tanninSouth EuropeTrifolium pratense
(Fabaceae)FlowerGlucosides (trifolin, trifolitin, trifolianol), flavonoid and phenolic acidAsia, Europe, Africa, AustraliaVitex rotundifolia
(Verbenaceae)Whole plantCamphene, pinene and diterpeneChina, Japan, Korea
Some promising plant-derived anticancer �leads� : 
Numerous types of bioactive compounds have been isolated from plant sources. Several of them are currently in clinical trials or preclinical trials or undergoing further investigation. Flavopiridol is a synthetic flavone, derived from the plant alkaloid rohitukine, which was isolated from Dysoxylum binectariferum (Meliaceae) [121]. It is currently in phase I and phase II clinical trials against a broad range of tumors, including leukemia, lymphomas and solid tumors [122]. Synthetic agent roscovitine which is derived from natural product olomucine, originally isolated from Raphanus sativus (Brassicaceae), is in Phase II clinical trials in Europe [123]. Combretastatins were isolated from the bark of the South African tree Combretum caffrum (Combretaceae) [124]. Combretastatin A-4 is active against colon, lung and leukemia cancers and it is expected that this molecule is the most cytotoxic phyto-molecule isolated so far [125-126]. Betulinic acid, a pentacyclic triterpene, is a common secondary metabolite of plants, primarily from Betula species (Betulaceae) [127]. Betulinic acid was isolated from Zizyphus species, e.g. mauritiana, rugosa and oenoplia [128-129] and displayed selective cytotoxicity against human melanoma cell lines [130]. The development of systemic and topical formulations of the agent for potential clinical trials by the NCI is ongoing. Pervilleine A was isolated from the roots of Erythroxylum pervillei (Erythroxylaceae) [131]. Pervilleine A was selectively cytotoxic against a multidrug resistant (MDR) oral epidermoid cancer cell line (KB-V1) in the presence of the anticancer agent vinblastine [132]. Pervilleine A is currently in preclinical development [132]. Silvestrol was first isolated from the fruits of Aglaila sylvestre (Meliaceae) [133]. Silvestrol exhibited cytotoxicity against lung and breast cancer cell lines (Gordon & David, 2005). Biological studies are ongoing to determine the mechanism(s) of action for silvestrol. 
Two novel alkaloids, schischkinnin and montamine have been isolated from the seeds of Centaurea schischkinii and Centaurea montana [134]. Both the alkaloids exhibited significant cytotoxicity against human colon cancer cell lines. The unique structural features of schischkinnin and montamine can be exploited as a template for generating compounds with enhanced anticancer activity. However, further investigations are necessary for their use as anticancer agents. 
Conclusion:
This review paper provides information on herbs and natural products with potential to decrease growth of cancer or be used as adjuvant with cancer treatments for patients who already have or have had cancer. It is documented that medicinal herbs have rich anticancer potential, and on the forefront whenever we talk about anticancer remedies, are significant source of synthetic and/or herbal origin. Natural products discovered from medicinal plants have played an important role in the treatment of cancer. They have exhibited anticancer activity in animal models of leukemia, skin cancer and sarcomas. Through generating awareness regarding usage of herbs and exploring natural product properties, healthcare professionals, can play significant clinical roles as knowledge resources for masses. From information from this review health care professionals can initiate discussion with colleagues to determine whether patient may benefit from from taking a specific herb or natural product. Selected plants have been explored for biological activity and further investigations into anticancer activity of the plants showing promising activity, must be undertaken. Vinca rosea alkaloids, Vinblastine and Vincristine, are one of the most potent anticancer drugs known. Taxol isolated from Taxus brevifolia has figured high in the therapeutic segment of cancer. Cancer being associated with high mortality rates if herbs can be used even in the palliative care or to reduce the side effects associated with cancer would be of great relief for the sufferer.
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h?�\�aJh�u�h�u�\�aJmHsHh?�\�aJmHsHDq=r=�=�=�=>�>�>�>�>?!?"?�?�?�?�?�?�a�q�t�����������	�
���T�Y�[����������*�2�7�9���������������6�7�K�T�\�������������������������������������������������������������Ƶ��������������h�u�h�u�6�\�aJmHsH!h�u�h�u�6�\�]�aJmHsHh�u�h�u�\�aJmHsHUh�u�h�u�6�\�]�aJ
h?�\�aJh�u�h�u�\�aJh�u�h�u�6�\�aJANahar N, Das RN, Shoeb M, Marma MS. Aziz MA, Mosihuzzaman M. Four triterpenoids from the bark of Zizyphus rugosa and Z. oenoplia. Journal of Bangladesh Academy of Science, 21: 151, (1997).
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