Aloe

Aloe is a plant-based therapy that some people use to treat side effects affecting the skin. These are caused by cancer and its treatment. There is not enough reliable evidence to be sure that it works.

Summary

• Aloe is a plant that looks like a cactus.

• The most well-known species is aloe vera.

• In cancer care there are reports of using it as a treatment for sore skin from radiotherapy, this is not backed up by research.

• In cancer care there are reports of using it as a treatment for inflammation of the rectum, and a sore mouth from radiotherapy, which there is not enough evidence for.

• Aloe vera can have side effects if swallowed.

What is aloe?

The aloe plant is from the lily family. It is a common household plant in many countries. The most well-known species of aloe is aloe vera.

It has cactus like fleshy leaves. They contain a thin clear gel that people often use to soothe minor skin problems, such as:

• sunburn
• cuts
• superficial burns

Aloe vera gel has softening properties. Many skin and beauty products such as cleansers, moisturisers and soaps contain aloe vera. The gel can also be made into juice to drink.

An extract taken from inside the outer lining of the leaves is called aloe latex. When dried, it forms brownish granules. These contain a substance that can help to treat constipation.

Why people with cancer use it

There is no scientific evidence to prove that aloe can treat any cancer. Aloe may cause severe side effects when used as a cancer treatment.

Skin conditions

People mainly use aloe vera for skin conditions. There is some evidence to support its use for minor skin problems and burns. Some people with cancer use aloe vera during radiotherapy treatment. They believe it helps to heal and soothe burns caused by their radiotherapy treatment.

A review study in 2017 looked at the use of complementary therapies. This means that a group of experts gather all the evidence about a particular subject. They then go through it to work out whether there is any evidence to support it. The review was in people with breast cancer. It showed that using aloe vera to treat burns from radiotherapy had a small chance of working. The researchers did not recommend it as a treatment.    

Sore mouth

A sore mouth is a side effect of radiotherapy treatment for certain head and neck cancers. Some people believe that aloe vera can be used as a mouth wash to help:

• prevent a sore mouth with treatment
• reduce the soreness and pain

Studies on using aloe vera to treat a sore mouth are small. The evidence is unreliable. A 2020 systemic review and network meta-analysis looked at 9 oral care solutions used to prevent a sore mouth. They ranked aloe vera the lowest out of the 9 solutions. However aloe vera was based on one small study only. 

Inflammation of the rectum

Studies are looking at using aloe vera to help with inflammation of the lining of the rectum. This is a side effect of radiotherapy to the pelvis. This can cause:

• pain and bleeding when passing stools
• diarrhoea
• tummy pain
• feeling like you always need to go to the toilet

A comprehensive review and study have found aloe vera to show signs of helping with this. The study was made up of only 42 people. More research needs to be done for the evidence to be clear.

Diet supplements

In many countries, including the UK, aloe products are available as dietary supplements. Some are sold as a treatment for constipation. Germany's regulatory agency for herbs (Commission E) has approved aloe for treating constipation. In 2002 the Food and Drug Administration (FDA) in America said aloe was not safe to use for constipation.

How you have it

Some people have an aloe vera plant in their home. They squeeze the juice from the plant leaves. They then put it straight onto their skin to help heal minor cuts, scrapes and burns. Aloe vera gel or cream is available in health food shops and chemists.

Aloe products such as aloe latex and aloe juice as a liquid or capsules help treat constipation. They can work well for some people, but you should never take more than the recommended dose. The European Medicines Agency (EMA) evaluates medicines. They suggest that you should not use aloe for constipation for longer than a week.

Let your doctor know about any complementary therapies or supplements that you use.

Side effects

Using aloe vera on the skin to help treat and soothe minor skin problems is generally safe.

Swallowing aloe vera as a liquid or capsules causes side effects for some people. They are usually mild but might be more of a problem for some people. Side effects may include:

• diarrhoea
• feeling and being sick
• a skin rash
• stomach pain

There are reports of severe side effects. These include:

• liver inflammation (hepatitis)
• blood clotting problems
• low blood potassium levels

Aloe products can be powerful laxatives. It may cause a chemical imbalance in the body after severe diarrhoea. These side effects are more likely to occur if you take very high doses.

Aloe vera might interact with other drugs or herbs. Make sure you talk to your doctor before you have it.

The International Agency for Research on Cancer classified aloe vera whole leaf extract as Class 2B. That means it is a possible cancer-causing substance (carcinogenic) for humans.

Research into aloe for cancer

Aloe emodin and cells

Several studies have looked at an aloe extract called aloe emodin. One showed that it could block the growth of some head and neck cancer cells in test tubes. A recent study in 2018 showed that aloe emodin might slow down the growth of glioblastoma cells. Glioblastoma is a type of brain cancer. We need more research.

Aloe and its role in difference types of cancers

A systemic review in 2015 looked at aloe and its role in different types of cancers. This means that a group of experts gather all the evidence about a particular subject. They then go through it to work out whether there is any evidence to support it. The researchers found that aloe has certain promising qualities. But, the information on some of the activities of the chemicals in aloe was lacking. They suggested we need more research.

Aloe and chronic scaring of the mouth

Oral Submucosal Fibrosis (OSMF) is chronic scarring of the mouth. It is usually linked with people who chew tobacco and betel quid. The side effects of this include:

• a burning sensation in the mouth
• limited mouth opening
• ulcers in the mouth

Studies are looking into whether aloe vera can help soothe these symptoms. However, all the studies have very small patient numbers. And the research is very limited.

How much it costs

Many aloe vera products are available to buy in health food shops, chemists and over the internet. Generally, the products aren’t costly, but prices can vary if you buy online.

The amount of aloe vera in each product can vary too. Some may not contain the amount stated on the label.

The cost will depend on:

• where you buy it (health food shops, chemist or online)
• what form you buy it in (cream, gel, liquid)
• the dosage and amount you buy

Don't believe information on the internet that is not backed up by research.

A word of caution

It is understandable that you might want to try anything if you think it might help treat or cure your cancer. Only you can decide whether to use an alternative cancer therapy such as aloe.

You could harm your health if you stop your cancer treatment for an unproven treatment.

Many websites promote aloe. But no reputable scientific cancer organisations support any of these claims.

Check with your doctor before you start using aloe. They have the full picture about your care and treatment.

In Europe it is important to buy registered products under the Traditional Herbal Remedies (THR) scheme. Remedies under the scheme have a THR mark and symbol on the packaging. THR products have been through quality and safety testing.