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PSK, a protein-bound polysaccharide from the turkey tail mushroom, has been an approved adjuvant cancer drug in Japan since 1977. Meta-analyses of Japanese randomised trials in stomach and bowel cancer found a modest survival benefit added to chemotherapy, but these results have never been tested outside Japan.
Polysaccharide-K (PSK, Krestin) is extracted from Trametes versicolor (turkey tail) and approved in Japan as an adjuvant to chemotherapy after gastric and colorectal cancer surgery. A meta-analysis of eight randomised trials with 8,009 patients with curatively resected gastric cancer (Oba et al., 2007) found improved overall survival with PSK added to chemotherapy (hazard ratio 0.88), and a meta-analysis of three trials in colorectal cancer (Sakamoto et al., 2006) reported improved overall and disease-free survival. All trials were Japanese, most are decades old, chemotherapy backbones are outdated, and no Western trial has been done, so regulators outside Japan have not approved it. The NCI PDQ medicinal mushrooms summary describes the evidence as promising but limited to Japan. PSK is well tolerated; over-the-counter 'turkey tail' supplements are not PSK and are unstandardised.
Beta-glucan polysaccharides bind dectin-1 and toll-like receptors on innate immune cells, enhancing dendritic cell and NK activity and shifting cytokine balance toward anti-tumour immunity.
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