Definition
A combination of vegetables and herbs, Sun's soup is a complementary therapy and dietary supplement used for its apparent anticancer properties and as a stimulant for the immune system.
Selected Vegetables and Sun's Soup are names of various mixtures of vegetables and herbs. These mixtures were developed by Alexander Sun, a Taiwanese biochemist. As of 2005, two formulations of these products are marketed in the United States as dietary supplements.
Purpose
As a complementary therapy, these products are believed to lengthened the survival of patients with advanced non-small cell lung cancer or other types of malignant tumors. In general, Sun's soup is used in conjunction with traditional cancer-fighting therapies, such as surgery, radiation, and chemotherapy.
Description
Also known as Selected vegetables, Sun's soup was developed by Alexander Sun, a biochemist, in the mid-1980s. Initially, the mixture contained shitake mushroom, mung bean, Hedyotis diffusa, and Scutellaria barbata, all of which are thought to fight cancer and stimulate the immune system. A 1999 study published in Hepatogastroenterology by Nakano and colleagues, lentinan, a beta-glucan found in shitake mushrooms, was used as adjunctive therapy with positive results. The authors reported that not only was the survival of the patients with gastric cancer prolonged, but their quality of life was improved. However, the National Cancer Institute asserted that lentinan may not be active when consumed as an ingredient in the soup. But the National Cancer Institute did other substances in shitake mushrooms may offer health benefits.
Sun began to treat other patients with a variant of the original mixture that excluded Hedyotis diffusa and Scutellaria barbata. This second formulation, a freeze-dried powder, was named Selected Vegetables (SV) or Dried Selected Vegetables (DSV). In 1992, Sun began a phase I/II clinical trial to evaluate DSV as a treatment for patients diagnosed with non-small cell lung cancer. By 1999, Sun and colleagues reported their results in an article published in Nutrition and Cancer. Knowing that DSV contained anti-tumor components, Sun and colleagues designed their study to measure how well patients tolerated using it on a long-term basis and its influence on the survival of patients with advanced non-small cell lung cancer. Therefore, there were two parts to the study: the toxicity arm and the survival arm. The toxicity arm was comprised of five patients with stage I non-small cell lung cancer, all of whom were asked to add DSV to their daily diet. Sun and colleagues refer to this group as the "toxicity study group (TG)." The survival arm was comprised of 19 patients with stage III or IV non-small cell lung cancer. Six of the 19 patients added DSV to their daily diet; Sun and colleagues referred to these patients as the "treatment group (SVG)." The remaining 13 patients who did not add DSV to their daily diet served as the "control group (CG)."
It is important to note that all the patients were treated with conventional therapies as deemed appropriate for them. TG patients had surgery plus radiation therapy or radiation therapy alone. SVG patients had radiation therapy alone or chemotherapy alone. CG patients had radiation therapy alone, chemotherapy alone, surgery plus radiation therapy, or chemotherapy plus radiation therapy with the exception of one patient who received palliative care, which is care that focuses on symptom management and quality of life issues.
With regard to the toxicity arm of the study, Sun and colleagues reported that "no clinical signs of toxicity were found in the TG patients in the 24-month study period." In fact, all five patients had either gained weight or maintained their weight. Another way the researchers measured how well the patients were tolerating the use of DSV was by recording changes in Karnofsky Performance Status (KPS), which is a common way of assessing a cancer patient's ability to perform routine tasks. A scoring system of 0 to 100 is used with a greater ability to handle everyday tasks associated with higher scores. Four out of the five TG patients had improved scores, which were measured at the time they entered the study and three months later. One TG patient's score remained the same. Two years after diagnosis, all five TG patients had survived and no recurrent tumors were found during follow-up. Furthermore, Sun and colleagues reported that the TG patients used DSV from 17 months to longer than 24 months. This led Sun and his team to conclude that DSV was "safe, nontoxic, and well tolerated."
With regard to the survival arm of the study, Sun and his team stated that "age, KPS, and body mass index of the SVG and CG patients were comparable" when the study began. Almost five months later a second weight measurement was taken that included 9 of the 13 CG patients and all six of the SVG patients. The average weight loss for the SVG group was 2.1%, whereas the average weight loss for the CG group was 11.6%. Reported as statistically significant, the group that added DSV to their daily diet clearly retained more body weight than the group that did not. A statistically significant difference was also noted with regard to the KPS scores between the CG group and the SVG group. One to three months after entering the trial, the KPS scores were improved for the SVG group, whereas the scores for the CG group declined. In other words, adding DSV to the daily diet of the patients in the SVG group not only appeared to help them avoid a decline in condition, but it was also associated with an actual improvement in condition. Furthermore, the median survival time of the CG patients was four months, whereas the median survival time of the SVG patients was 15.5 months. This statistically significant difference reported by Sun and his team supports the notion that adding DSV to the daily diet of a stage III or IV non-small cell lung cancer patient helps to prolong his or her life.
Encouraged by these results, Sun and his team reformulated the mixture and embarked on a pilot study to investigate its anticancer components, which was published in 2001 in Nutrition and Cancer. This third formulation was referred to as frozen selected vegetables (FSV). Through the use of a lung tumor model, tumor growth was assessed in mice. According to Sun and his team, a daily portion of FSV was "found to contain 63 mg of inositol hexaphosphate [found in legumes], 4.4 mg of daidzein [found in soy products], 2.6 mg of genistein [found in soy products], and 16 mg of coumestrol [estrogen-like substance found in plants]." Sun et al reported that mouse food containing 5% of FSV "was associated with a 53% to 74% inhibition of tumor growth rate." Fourteen patients with stage IIIB and stage IV non-small cell lung cancer who added FSV to their daily diet for 2 to 46 months were also evaluated. According to Sun et al, "the lead case remained tumor free for more than 133 months; the second case showed complete regression of multiple brain lesions after using FSV and radiotherapy. The median survival time of the remaining 12 patients was 33.5 months and one-year survival was greater than 70%." Ultimately, Sun et al concluded that not only was ingesting FSV nontoxic, but its ingestion was also "associated with objective responses, prolonged survival, and attenuation of the normal pattern of the progression of stage IIIB and stage IV of non-small cell lung cancer."
Though these results appear promising (as do the results of the previous 1999 clinical trial by Sun et al), the results should be viewed with some degree of caution, because more research is needed. For example, in order to confirm the results of the 2001 study, a large randomized controlled clinical trial should be conducted. Furthermore, as the National Cancer Institute points out, "all of the patients [in the 2001 study] were aware of the reported benefits of Sun's soup and had actively sought treatment." Therefore, the National Cancer Institute states cautions that "the results obtained with such highly motivated, self-selected patients might not be typical of those obtained with most patients diagnosed with advanced non-small cell lung cancer." In addition, both the 1999 and 2001 Sun et al studies share a weakness: the small number of patients involved. Another problem is that the formulations in both studies differ, making a comparison between the two difficult. Therefore, more studies testing both formulations on larger samples sizes are needed to confirm the results.
Recommended Dosage
Patients should consult their physicians for dosage clarification, including how much and how often any dietary supplement should be taken, as well as the best formulation to use. For example, in the study conducted by Sun et al that was published in Nutrition and Cancer in 1999, the mixture tested was in the freeze-dried powder form and the participants orally consumed 30 grams of it a day, which they mixed with water or soup. In the subsequent study conducted by Sun et al that was published in Nutrition and Cancer in 2001, the participants orally consumed 10 ounces a day, which is approximately 283 grams, of the reformulated, frozen mixture. Both forms are available in the United States, but consumers should be aware that dietary supplements are not regulated by the United States Food and Drug Administration. Therefore, Sun's soup should be purchased only from a reputable supplier, preferably one who is recommended by a physician.
Precautions
Patients should consult with their physician regarding all food or over-the-counter medications before they are consumed.
The National Cancer Institute indicates that there is no information on the safety or the efficacy of this treatment.
Side Effects
No toxic side effects are known to be associated with the use of Sun's soup. A bloated sensation was reported by participants in the 1999 study conducted by Sun and colleagues. Participants in the 2001 study did not experience any negative side effects. However, an important distinction between the two studies should be noted. In the 1999 study, the mixture of Sun's soup was in a freeze-dried powder form and was mixed with water or soup. In the 2001 study, a reformulated, frozen mixture of Sun's soup was used. This difference could explain why the participants reported different responses.
Questions to Ask the Doctor
- What is the most likely cause of my SVC syndrome?
- What tests will be done to determine the cause of my SVC syndrome?
- What are my treatment options for SVC syndrome?
- Am I a candidate for a stent?
- If I am a candidate for thrombolytic therapy, will ongoing anticoagulation be used? Will it interfere with my cancer therapy?
- If I choose to do nothing (opt for no therapy), what may be the consequence?
- Is my SVC syndrome presenting an oncologic medical emergency?
Interactions
Although Sun's soup is not known to interact with other medications, it is best for patients to consult a pharmacist and/or physician regarding the safety of its use.
Resources
Periodicals
Borchers, A. T., et al. "Mushrooms, tumors, and immunity." Proceedings of the Society for Experimental Biology and Medicine 221 (1999): 281–293.
Nakano, H., K. Namatame, H. Nemoto, et al. "A multi-institutional prospective study of lentinan in advanced gastric cancer patients with unresectable and recurrent diseases: effect on prolongation of survival and improvement of quality of life. Kanagawa Lentinan Research Group." Hepatogastroenterology 46 (1999): 2662–2668.
Sun, A. S., O. Ostadal, V. Ryznar, et al. "Phase I/II of stage III and IV non-small cell lung cancer patients taking a specific dietary supplement." Nutrition and Cancer 34 (1999): 62–69.
Sun, A. S., H. C. Yeh, L. H. Wang, et al. "Pilot study of a specific dietary supplement in tumor-bearing mice and in stage IIIB and IV non-small cell lung cancer patients." Nutrition and Cancer 39 (2001): 85–95.
Other
"Selected Vegetables/Sun's Soup (PDQR) Health Professional Version." National Cancer Institute. June 2004. [cited February 17, 2005].
—Lee Ann Paradise
