Madagascar Periwinkle (Changchunhua): Both an Ornamental Flower and a Famous Anti-Cancer Drug
Many people grow Madagascar periwinkle (changchunhua) on their balconies. It blooms almost year-round, hence the name "long-spring flower." It is an ornamental plant well suited to home cultivation, and it is also the raw material for one of the most famous chemotherapy drugs, vinblastine.
Madagascar periwinkle contains more than thirty alkaloids, four of which have anti-tumor effects: vinblastine (VBL), vincristine (VCR), leurosine (epoxyvinblastine), and vindesine (isovelbanamine). Vinblastine and vincristine have been widely used clinically to treat cancer for decades and are important chemotherapy drugs with broad-spectrum anti-cancer activity, effective against many types of cancer.
Cancer patients are no strangers to vinblastine and vincristine, because they are often used during chemotherapy. Their side effects are also strong; injecting vinblastine and vincristine causes a series of adverse effects such as nausea, vomiting, leukopenia, and hair loss.
Besides yielding alkaloids for treating cancer, Madagascar periwinkle can also be decocted and taken internally to treat various cancers. But because it is too toxic, it cannot be used for long periods. If a patient suffers too many side effects when using Madagascar periwinkle alone, it must be combined with other Chinese herbs to reduce its toxicity. I have previously written about my self-formulated Stomach-Healthing and Blood-Generating Decoction (Jianwei Shengxue Tang) for supporting cancer patients through radiotherapy and chemotherapy, a formula I have used for years that has proven effective repeatedly; it can be used to address the side effects of Madagascar periwinkle.
Madagascar periwinkle is one of the few plants that can potentially cure cancer. Vinblastine has a good therapeutic effect on transplanted lymphocytic leukemia in DBA/2 mice, while vincristine not only prolongs the survival of diseased mice but often cures them.
Vinblastine and vincristine also have a marked inhibitory effect on mammary tumors and adenoma 755. Vindoline (changchunhuo'an) is toxic to nasopharyngeal carcinoma KB cells and is also effective against mouse leukemia. Some components of Madagascar periwinkle have a certain inhibition rate on mitosis of ovarian cells and on transplanted Ridgeway osteogenic sarcoma in mice, and also have a marked effect on Ehrlich ascites carcinoma.
The anti-tumor mechanism of Madagascar periwinkle has not yet been fully elucidated. It is known that its anti-tumor action is directly related to the drug's high affinity for tubulin binding; vinblastine can arrest cancer-cell mitosis at metaphase.
Madagascar periwinkle also lowers blood pressure, blood sugar, and blood lipids, and can be used to treat idiopathic thrombocytopenic purpura and epidemic hemorrhagic fever. But because of its great toxicity, although Madagascar periwinkle has these effects, it is rarely used clinically to treat such diseases.
Madagascar periwinkle is not a traditional commonly used Chinese herb; it is not recorded in the classic materia medica works. It appears only in some contemporary regional materia medica, such as the Guangxi Bencao Xuanbian, Qingdao Zhongcaoyao Shouce, Fujian Zhiwuzhi, Kang'ai Bencao, and Changyong Zhongcaoyao Shouce.
Contemporary TCM summarizes its medicinal nature as: "bitter, cold, toxic," with the actions of "resolving toxicity and anti-cancer, clearing heat and pacifying the liver." It treats various cancerous swellings, hypertension, sores and toxins, and burns. When decocted for oral use, the usual dosage is 5-10 g; alternatively, extracts are made into injections for intravenous administration.
Madagascar periwinkle can also be used externally, generally by crushing it and applying it directly to superficial tumors, or inserting it into the body through the anus, vagina, or nasal cavity. But its irritant effect is strong and can easily cause embolic phlebitis, so external use must also be cautious. If there is an ulcer, Madagascar periwinkle should not be used. When taking the decoction orally, one should follow the method used in chemotherapy—take it for a few days and then rest for a few days. After taking Madagascar periwinkle, the patient should drink as much water as possible to promote the excretion of toxins.
Side effects caused by Madagascar periwinkle include leukopenia, poor appetite, nausea and vomiting, abdominal pain, constipation, diarrhea, muscle aches, numbness of the fingers, loss of deep tendon reflexes, diplopia, hair loss, confusion, depression, agitation, hallucinations, fatigue, and dry mouth; in severe cases it can cause death. Therefore this herb must be used under a doctor's guidance, and it cannot be used continuously for long periods. Families with children should also take care when growing Madagascar periwinkle and keep it out of children's reach.
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