Integrative Ayurvedic Approaches in Cancer Supportive Care: A Review of Mechanistic Evidence, Clinical Outcomes, and Future Directions

Abstract

Background: Despite remarkable advances in surgical techniques, systemic chemotherapy, targeted agents, and immunotherapeutics, cancer continues to impose a devastating global burden - not merely through mortality, but through the profound erosion of patient quality of life that treatment itself often causes. Ayurveda, codified more than two millennia ago in the Charaka Samhita, Sushruta Samhita, and Ashtanga Hridayam, contains within its classical texts sophisticated descriptions of neoplastic disease (Arbuda, Granthi) alongside multimodal management strategies encompassing pharmacology, detoxification, and dietetics. Over the past two decades, laboratory and clinical investigators have begun translating this classical knowledge into contemporary mechanistic terms, yielding a body of evidence that warrants serious scholarly attention. Objective: To conduct a critical narrative synthesis of available mechanistic, preclinical, and clinical literature on Ayurvedic interventions in the supportive management of cancer, with particular attention to immune reconstitution, attenuation of treatment-related toxicity, and patient-reported quality-of-life outcomes. Methods: Peer-reviewed literature published between January 2000 and December 2024 was retrieved from PubMed/MEDLINE, Scopus, Web of Science, and the AYUSH Research Portal. Boolean search strategies combined MeSH and free-text terms including: Ayurveda, integrative oncology, cancer supportive care, Rasayana, Panchakarma, immunomodulation, chemoprevention, Withania somnifera, Tinospora cordifolia, Curcuma longa, Triphala, and oral mucositis. Studies were included if they reported outcomes relevant to cancer symptom burden, treatment toxicity, or quality of life in human subjects or documented anti-cancer mechanisms in validated cell or animal models. Conclusions: The reviewed evidence supports a clinically meaningful role for select Ayurvedic interventions - principally Rasayana herbs (Withania somnifera, Tinospora cordifolia, Emblica officinalis), classical polyherbal formulations (Triphala, Kanchnar Guggulu), and Panchakarma-based detoxification protocols - as adjuncts to conventional oncology. Documented benefits include mitigation of cancer-related fatigue, chemotherapyinduced nausea, radiation-induced oral mucositis, and myelosuppression. Methodological rigour, preparation standardisation, and pharmacokinetic characterisation remain areas requiring urgent attention before definitive clinical recommendations can be made.