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In a randomised placebo-controlled trial of 364 people, eight weeks of Wisconsin American ginseng modestly improved cancer-related fatigue, mainly in those still on treatment. The 2024 fatigue guideline says it may be offered during treatment; quality of the product matters.
Panax quinquefolius (American ginseng) was tested in a double-blind randomised trial of 364 patients with cancer-related fatigue (Barton et al., JNCI 2013): 2,000 mg per day of pure ground Wisconsin root for eight weeks improved fatigue scores compared with placebo, with the benefit concentrated in patients receiving active treatment and no excess toxicity. A smaller earlier dose-finding trial pointed the same way. The 2024 SIO-ASCO fatigue guideline says American ginseng may be offered for fatigue during treatment (not after). Commercial products vary widely in ginsenoside content and some contain Asian ginseng (Panax ginseng), which has oestrogenic activity of concern in hormone-sensitive cancers; the trial product was a standardised North American root. Ginseng may interact with warfarin and imatinib.
Ginsenosides are proposed to modulate cortisol regulation and inflammatory cytokines that drive cancer-related fatigue; the mechanism in humans is not established.
The drug that started the targeted therapy era in 2001, turning chronic myeloid leukaemia into a manageable condition with near-normal life expectancy.
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