Active Phytochemicals from Chinese Herbal Medicines: Anti-Cancer Activities and Mechanisms by Wing Shing Ho. Boca Raton, FL: CRC Press; 2016. Hardcover, 178 pages. ISBN: 978-1-4822-1986-9. $139.95.

Exploration of the anticancer actions of herbal medicines and phytochemicals is an active field of pharmacology, particularly in China where modern investigation of traditional Chinese medicine (TCM) is proceeding rapidly. Many phytochemicals from TCM herbs have anticancer activities, including the promotion of apoptosis (i.e., normal, programmed cell death — a kind of cell “suicide”). Apoptosis is a focus of this volume by Wing Shing Ho, PhD, a professor at the Chinese University of Hong Kong who has been writing in this field for more than a decade.

This book is aimed at an academic pharmacology audience. It presupposes detailed understanding of the biochemical bases for anticancer mechanisms, and provides a good deal of scholarly information in this area. However, due to a number of limitations in the text, chiefly poor editing and organization, the book achieves only moderately well, at best, its purpose of providing an in-depth look at the anticancer pharmacology of TCM herbal constituents.

The book has nine chapters on topics such as “Combination of Cancer Drugs,” “Therapeutic Benefits of Phytochemicals,” “Mechanism of Cancer Drug Action,” “Inhibition of Cancer Growth by Herbal Medicines,” and “Exploration of Herbal Medicine.” It contains two color plates on the mechanism of apoptosis, and an appendix listing the 26 phytochemicals discussed in depth in the book, with their structures, chemical formulas, physical properties, plant sources, and therapeutic classes. Altogether, about 70 phytochemicals are mentioned in the text, some only in passing.

The book does not pretend to offer a full listing of TCM phytochemicals with anticancer activities. It features detailed discussions of apoptosis-promoting compounds, and other compounds with preclinical anticancer actions, including gambogic acid, berberine, tetrandrine, and others (mostly ones studied by Ho and colleagues). The chapter on mechanisms of cancer drug actions features a thorough discussion of apoptosis. However, other important anticancer mechanisms of phytochemicals, such as anti-angiogenic and anti-inflammatory activities, receive short shrift, and immunomodulatory activity is treated only sporadically. The final chapter on future exploration of herbal medicine points to some interesting emerging research directions.

A number of problems mar the usefulness of the book. The English language style is generally good, but awkward sentence structures appear regularly. There are problems in technical proofreading, including referring to the plant family Fabaceae as a “species” and a major error related to the combination index, or CI, of the Chou-Talalay formula for detecting synergism and antagonism in drug combinations. (If a CI is less than 1, synergism is indicated. If a CI equals 1, an additive effect is shown, and if a CI is greater than 1, antagonism is detected. The text indicates both synergism and antagonism as “CI value > 1.”)

In addition, the organization of the text appears haphazard in many places. Chapters are divided into titled sections, but the section titles often bear little resemblance to their contents. The section “Application of Chinese Medicine in Pediatric Populations” makes one reference to a pediatric study in a section that focuses on herbs with multiple therapeutic targets and physician communication about herbal medicines. This pattern occurs throughout the book and is quite disconcerting to the reader.

General issues surrounding the use of TCM phytochemicals in cancer treatment are discussed in several spots, but a consistent viewpoint is not manifested. Although the author frequently discusses combining TCM herbs with conventional treatments, one section curiously dismisses integrative medicine as “futile.” There are substantial sections on herbs used for cardiovascular disease and dementia. While cardiovascular herbs might be helpful in overcoming cardiac toxicity from cancer drugs, this possibility is not really addressed in the data presented. If the author wanted to suggest that anti-dementia herbs might manage treatment-related cognitive deficits, no effort is made to elucidate this link.

The editors of this volume have done few favors to the author by allowing such disorganization to go uncorrected. It detracts substantially from the usefulness of the book, leaving only the few sections with in-depth discussions of apoptotic mechanisms of various phytochemicals as the interesting nuggets of this publication.

—Charlotte Gyllenhaal, PhD
Research Manager
Block Center for Integrative Cancer Treatment
Valparaiso, Indiana