Evidence Explorer · MS-N234 · Traditional Persian herbal preparation · Supportive care · Appraised November 4, 2026
A small double-blind trial reported lower anal-burning and diarrhea scores, but the objective RTOG proctitis-grade comparison did not reach statistical significance.
Evidence at a glance
Benefit signal: Subjective symptom signal without confirmed RTOG-grade prevention
Certainty: Very low; single 65-person trial with abstract-level appraisal
Risk context: Mild nausea and abdominal distension; long-term and interaction safety unestablished
What was studied
Sixty-five people receiving prostate radiotherapy were randomized to a 4 g packet of Malva sylvestris and Althaea digitata flower powder or placebo, infused three times daily for five weeks including three weeks of radiotherapy.
RTOG grade distribution did not significantly differ (P=.059). End-of-study visual-analog scores favored the herbal group for anal burning (1.56 ± 1.07 vs 3.82 ± 1.67) and diarrhea (1.06 ± 0.58 vs 1.95 ± 0.79).
What this evidence cannot establish
Only the publisher abstract and a 2026 systematic review were accessible for appraisal; full-text allocation, missing-data and funding details were not verified.
A subjective symptom difference alongside a negative RTOG-grade comparison does not establish prevention of clinically important radiation proctitis.
Practical safety context
The review reports mild nausea and abdominal distension. Mucilage may affect absorption of oral medicines, and product contamination or species substitution is possible.
Rectal bleeding, severe pain, fever, dehydration or persistent diarrhea during radiotherapy requires prompt clinical assessment rather than self-treatment.
Questions for the care team
- Was the exact botanical species and product independently authenticated?
- Could the infusion alter absorption of oral medicines?
- What symptoms require urgent radiation-oncology review?
- How will diarrhea, hydration and objective proctitis severity be monitored?
Funding and conflicts
The paper reported a Tehran University of Medical Sciences grant/thesis relationship and no author conflicts in the publisher abstract. Full-text appraisal was unavailable.
Sources
- Randomized trial publisher record (DOI 10.1016/j.hermed.2018.01.005)
- 2026 systematic review of oral herbal preparations in supportive cancer care (PMID 42930516)
Sources and publication status checked November 4, 2026. Last literature search: November 4, 2026; record appraisal: November 4, 2026.
For education, not personal medical advice. Research regimens are not personal prescriptions. Symptom, laboratory or biomarker changes do not establish tumor response, recurrence prevention or longer survival.
